It is recommended that women strengthen their perineal, leg, and abdominal muscles during pregnancy.
During pregnancy, your body undergoes many changes that can cause discomfort. Fortunately, certain exercises can help mitigate the aches and pains of pregnancy and childbirth and speed your recovery.
To reduce back pain during pregnancy, assist with childbirth, and accelerate recovery postpartum, it is recommended that you strengthen the muscles in your pelvic floor (Kegel exercises), legs, and abdomen.
How to strengthen your pelvic floor: Kegel exercises
The muscles of the pelvic floor, or the perineum, hold up the organs in the pelvic region. They stretch from the pubic bone to the coccyx, including the urethra, vagina, and anus.
It is important to ensure that your pelvic floor muscles are strong and flexible so that they can work properly. There are several advantages to doing this.
It can help prevent incontinence of urine, gas, or stool.
It reduces the risk of developing a pelvic organ prolapse (urinary bladder, uterus, or rectum).
It can enhance sexual intercourse by both reducing pain and making it easier to reach orgasm.
It stabilizes the pelvis, back, and hips, therefore helping prevent and reduce pain.
Kegels can help strengthen pelvic floor muscles. These exercises consist in pulling up the muscles around the anus, vagina, and urethra as if you were trying to stop yourself from peeing or passing gas. It’s important not to squeeze your buttocks or thighs, suck in your stomach, or hold your breath.
To see if you’re doing the exercises correctly, try stopping the flow of your urine midstream when you are sitting on the toilet. This test is not recommended as a regular exercise.
Try “lifting” your anus and vagina to 60–80 percent of your maximum without holding your breath.
Hold this position as long as you can (up to 10 seconds) while keeping your buttocks and thighs relaxed.
After each contraction, be sure to relax your muscles for twice the amount of time. For example, after a 5second contraction, take a 10second break. It’s important to completely relax the muscles to avoid tension in this area and to maintain flexibility.
If you are able, do up to 10 sets.
After two weeks, try increasing both the length of contractions and the number of sets.
As you get better at them, you’ll be able to do these exercises anytime, anywhere. Start by mastering them lying down, then try doing them while sitting or standing. It’s normal for it to take 4–6 weeks before you can change positions. Eventually, you’ll be able to do Kegels in the car, while waiting in line, or as you watch TV.
Lastly, to teach the pelvic floor muscles to contract at the right time, do them just before you blow your nose, cough, or sneeze. That way, they’ll become just as natural as coughing into your elbow.
Perineal massage consists in manually stretching the vaginal muscles. It helps increase blood circulation in the perineum, thus improving the elasticity of the tissues. According to studies on the subject, massaging the perineum in the weeks prior to your due date may help prevent injuries that require stitches and lower the risk of requiring an episiotomy. However, the benefits appear to be minimal and limited to mothers having their first baby.
You can perform this massage yourself or enlist the help of your partner. Simply put a lubricant on your fingers, then gently insert them into your vagina. Gently massage your vagina by applying downward pressure in a U movement. Try to relax and imagine the pain going away. Concentrate on the stretch rather than trying to resist the pain.
Some experts recommend performing this massage once a day from 34 weeks, while others believe that once or twice in the last week of pregnancy is sufficient.
How to build strength in your legs
During the second stage of labour, good lower body mobility will make it easier for the baby to drop into the pelvis. This area also needs to be strong to support you in the different positions you’ll get into during the pushing stage. Doing exercises that increase strength and flexibility in the lower body is a good way to prepare for labour.
A simple way to stretch the muscles in your inner thighs and butt is sitting with your legs crossed and leaning forward slightly, keeping your back straight.
Another exercise is to sit on a chair with your legs apart and place your hands on your thighs, near your knees. Then lean your body slightly forward, keeping your back tall and straight.
Do these exercises slowly until you feel a stretch, not to the point of pain. Hold the position for 90 seconds (or 3 times 30 seconds) without making any sudden movements.
Squats strengthen the thighs.
With or without a dumbbell in each hand, stand with your feet shoulderwidth apart. Be sure not to arch or round your back—keep it straight.
- Tense your abs by trying to suck in your stomach, as if you were deflating a balloon, and contract your pelvic floor.
- Open your chest and sit back as if you were going to sit in a chair, moving your butt backwards. Keep your back parallel with your shins. Your knees should be in line with your toes and pushing outward.
- Stand back up and repeat.
How to strengthen your abs
During pregnancy, your abdominal muscles stretch. It’s important to prepare them for delivery because you’ll need these muscles to get your baby down into the vagina. Strong abs will also help reduce any back pain caused by your growing belly.
There are certain abstrengthening exercises that you should not do while pregnant, such as sit-ups, leg movements performed while lying on your back (e.g., air cycling or scissor kicks), and oblique exercises. You should only do front planks until your belly starts to pop.
There are some simple exercises that you can do to keep your abs strong throughout your pregnancy. First, check to make sure that you don’t have diastasis recti (a condition that causes the abdominal muscles to separate). If you do, it’s recommended that you avoid working your abs (see box below). What’s more, as of the fourth month, you should avoid any exercises that require being on your back, which can cause discomfort (dizziness, nausea, and difficulty breathing) and lower back pain in some women.
If you start doing these exercises early on in your pregnancy, it will be easier to continue doing them when your belly is larger in the second and third trimesters.
How do I know if I have diastasis?
Diastasis recti occurs when the the ligament that holds the abdominal muscles together separates. It can be a stretch or tear. Diastasis can be caused by the growing uterus or by straining movements. Here’s how to do a self-check for diastasis:
Lie down on your back
Lift your shoulders off the ground without engaging your abs
If your belly bulges or if you can press more than two fingers into the separation between the muscles that run vertically just above and below your belly button, you probably have diastasis recti. Though it’s normal for there to be a 2–3 cm gap during pregnancy, it’s preferable that you try to prevent this, as the gap could remain long after you give birth.
A doctor, midwife, or pelvic floor physical therapist can also help you diagnose this condition by performing a physical examination. However, ultrasound is the best way to determine if you have diastasis.
This exercise consists in strengthening the abdominal muscles while breathing. It can be performed in various positions: sitting, standing with your back against a wall, lying on your back, lying on your side, or on all fours. This exercise should not be done while you are walking.
- Slowly take a deep breath in, then gradually exhale as you contract your abdominals. Imagine that your belly is a balloon that is deflating. Make sure you contract the perineum before engaging your abs.
Once you have completely emptied your lungs, relax your abs.
Complete 2–3 sets of 5–10 reps per day.
Things to keep in mind
Exercising during pregnancy can relieve certain day-to-day discomforts.
Stretching and strengthening exercises help prepare your body for labour and the postnatal period.
Before doing any abdominal strengthening exercises, check with your doctor, midwife, or pelvic floor physical therapist to make sure you don’t have diastasis recti.
Scientific review: Marie-Christine Trahan, M.Sc., pelvic floor physical therapist
Research and copywriting: The Naître et grandir team
Updated: March 2020
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