K is for Kegel
Pushing your baby through your pelvis and into the world is demanding not only on you, but also on your pelvic muscles — which have to stretch to proportions previously unimaginable. So even if you’ve never thought much about them (or maybe never even realized you had any), you’ll want to pay attention to your pelvic muscles during and after pregnancy. And not only do they play an important role in delivery, but when they work correctly, they hold your uterus, bladder and rectum in place, as well as help to keep your urine from leaking when you cough or laugh (a skill set you’re only likely to notice when it’s gone).
Fortunately, there’s one exercise that experts agree can help prevent problems with your pelvic muscles after birth and may even make your labor go a little smoother: Kegels.
What’s a Kegel?
Named after gynecologist Arnold Kegel, these exercises engage and strengthen your pelvic floor, which is a group of muscles and ligaments that hang like a sling between your hips to support your bladder, uterus and other organs and control the flow of urine and the contraction of the vagina and anal sphincter.
The goal of a Kegel is to contract and then relax the pelvic floor muscles for short periods of time and it's best to aim for several short sets a few times a day (more on just how much below). The exercise is fast and free, and once you know how to do them, you can do them just about anywhere — when you’re stuck at a red light, waiting in line or watching TV.
The Benefits of Kegels
As your baby puts on the pounds inside your uterus during pregnancy, your pelvic floor muscles have to support more and more weight. Sometimes, they’re not fully up to the job. If you notice occasional urine leaking — when you cough, sneeze or try to go on a jog — that’s because your over-burdened pelvic floor muscles aren’t able to fully support your bladder the way they usually do.
When you finally go into labor, these muscles will be stretched out even more to make room for baby to pass through. Around a third of women, researchers have estimated, have some tearing in the pelvic floor muscle tissue during birth. You won’t notice this (it doesn’t bleed or look any different from the outside), but it's one explanation for why up to an estimated third of women have problems with postpartum loss of bladder control. An even smaller number of women — usually those who had severe, third-degree tears or a major episiotomy during birth — experience postpartum fecal incontinence.
But here’s the good news: Study after study has shown that regularly doing Kegels during and after pregnancy can help decrease the odds of incontinence and other pelvic floor issues. What’s more, research has also suggested that women who do pelvic floor exercises may have a slightly shorter active phase of labor than other women. And as if that's not enough, Kegels have even been shown to boost your sexual health and pleasure and help you reach orgasm more easily.
How Do I Find My Pelvic Floor Muscles?
If you’re not sure where to find your pelvic floor muscles, try stopping urination mid-stream. The muscles you’re tightening to do this are the same ones you’ll want to contract when you do a Kegel. But once you find them, don’t repeatedly engage those muscles while you’re urinating — this can actually lead to urinary incontinence, urinary tract infections and other problems.
If you’re still not sure you’ve found the right muscles, put a clean finger in your vagina: If you’re doing a Kegel correctly, the vagina should contract around your finger (try not to hold your breath, and avoid clenching your thighs, stomach or butt muscles at the same time).
Still having trouble? Don’t hesitate to ask your healthcare practitioner to coach you next time you’re having a pelvic exam — that’s what she’s there for!
How Often Should I Do Kegels?
Once you’ve located your pelvic floor muscles, here’s the recommended Kegel routine:
Start out by tightening the muscles for about three to five seconds, then relaxing them for as many seconds (relaxing is as important as contracting). Do it four or five times in a row, a few times a day.
As it becomes easier, start contracting and relaxing the muscles tight for longer — working up to 10 seconds at a time — and doing more repetitions.
Ultimately it’s recommended that you do at least three sets of 10 Kegels every day.
Don’t get frustrated if you’re nowhere close to that goal when you start: Quality is much more important than doing a bunch of Kegels incorrectly. And remember, these are muscles like any other in your body. With time and consistent, mindful work, they can only get stronger.
When Should I Do Kegels?
It’s never too early to start doing Kegels, but the earlier and more regularly you practice them throughout pregnancy, the greater the benefits.
After you’ve delivered, you can restart your Kegel routine immediately. Make it a habit to do them regularly (while, say, you’re feeding your baby) to stimulate circulation, promote healing and improve muscle tone. Don’t worry if you can’t feel yourself doing them initially — the perineum will be numb after birth, but feeling will return gradually over the next few weeks.
In the meantime, the work is being done even if you can’t feel it. If you’re doing your Kegels regularly and correctly, you should expect to see improvement in your bladder control within a few weeks to a few months.
How long should you keep doing Kegels? If you want to keep your pelvic muscles in shape, many healthcare practitioners recommend making them a regular, lifelong habit.
How to Make Kegels Fun
If you’re having trouble remembering to do your daily Kegels (or they just seem like a drag), there’s no better way to mix business with pleasure than performing Kegels during sex — which can double the pleasure for you and your partner. Your partner can also use his or her fingers to check whether you’re tightening the right muscles.
If you’re looking for ways to make Kegels more fun on your own, try a smartphone app. A number of options send you daily reminders, track your exercising and even provide musical routines for your pelvic floor workouts.
There are also devices known as vaginal exercisers that claim to help you isolate the pelvic floor muscles or work them for you. Some are shaped like cones and are held in place in your vagina by your tightened muscles. Others provide electrical stimulation to the muscles. While they might be fun to try, there’s no evidence that they work any better than contracting the muscles on your own (in fact, some studies have found them less effective). What’s more, they could introduce bacteria into the vagina — so skip them if you’re pregnant or recovering from childbirth, and check with your doctor first before trying one for the first time.