Fourth Trimester

• Your pelvic floor supports your bladder, bowel, and uterus, pregnancy and birth can weaken or tighten these muscles. 
• Start gentle pelvic floor exercises as soon as you feel ready (unless advised otherwise by your healthcare provider). 
• Begin with short squeezes, then gradually build up to longer holds and more repetitions. 
• Good habits like staying hydrated, eating fibre, and avoiding heavy lifting can support recovery. 
• Not all pelvic floors are weak, some can become overactive (too tight), causing pain or bladder/bowel issues. 
• If you still notice leaks, heaviness, or discomfort after 6–12 weeks, ask your GP about referral to a women’s health physiotherapist. 

Pregnancy and birth put a lot of strain on your pelvic floor, the sling of muscles that support your bladder, bowel, and uterus. It’s common to notice changes during pregnancy (like leaks, constipation, or a heavy feeling) and after your baby arrives, such as less control when you cough, sneeze, or exercise. 

The positive news is your body is designed to heal. By starting small and staying consistent with gentle exercises, you can support recovery, rebuild strength, and boost confidence. You don’t need fancy equipment, little and often really does make a big difference. 

How can I care for my pelvic floor during pregnancy?  

Your pelvic floor is working hard throughout pregnancy, carrying the extra weight of your growing baby as well as adapting to hormonal changes. Looking after these muscles during pregnancy can help ease discomfort now and support a smoother recovery after birth. 

Why it matters: 

• Strengthening helps prepare your body for labour and delivery. 
• Relaxation is just as important as squeezing, some people develop an overactive pelvic floor, where the muscles stay too tight and struggle to let go. 
• Good pelvic floor habits can reduce common pregnancy issues like leaks, constipation, or pelvic pain. 

Tips for pregnancy pelvic floor care: 

• Practise gentle squeezes and releases: Work on both contracting and fully relaxing the muscles. 
• Focus on breathing: Deep belly breathing helps the pelvic floor move naturally with your breath. 
• Avoid straining: Stay hydrated, eat plenty of fibre, and lean forward slightly when on the loo to help your bowels empty more easily. 
• Check in with a professional: If you notice pain, difficulty going to the toilet, or a heavy dragging feeling, ask your healthcare team for specialised support. 

Caring for your pelvic floor during pregnancy is one of the best ways to support your body and lay strong foundations for your postpartum recovery. 

Why looking after your pelvic floor matters 

Your pelvic floor muscles are like a hidden sling, stretching across the base of your pelvis to support vital organs and keep everything working smoothly. During pregnancy, these muscles carry extra weight, and labour and birth can stretch or weaken them even further. 

When your pelvic floor is under strain, you might notice symptoms such as: 

• Leaking wee when you cough, sneeze, or exercise 
• A heavy or dragging feeling in your vagina 
• Less control when you need the toilet 

These changes are common, but they’re not something you just have to live with. Strengthening your pelvic floor helps restore function, improves comfort, and can prevent longer-term issues like prolapse. It also supports your core strength, which can make everyday activities, from lifting your baby to going for a walk, feel easier and more comfortable. 

Simple steps to strengthen your pelvic floor 

Start with gentle squeezes 

To find the right muscles, imagine you’re trying to stop yourself passing wind or urine. You should feel a lift and squeeze inside. Begin with short squeezes, gently contract for a second or two, then fully relax. Aim for 5–10 squeezes at a time, a few times a day. Gradually you should feel more control when you laugh, sneeze, or exercise. You may also notice you can hold squeezes longer. 

Build up gradually 

Over time, try holding the squeeze for longer (up to 10 seconds) and repeating 10 times in a row. Mix in both short squeezes and longer holds. Once you feel comfortable, practise in different positions such as sitting, standing, or even while walking. 

Pair with daily routines 

It can be easy to forget, so tie your exercises to everyday habits, for example, do a set while brushing your teeth, waiting for the kettle to boil, or feeding your baby. 

Posture and breathing 

Keep your breathing relaxed. Try not to hold your breath or strain when you contract the muscles. Good posture also helps your pelvic floor work more effectively. Think tall spine, relaxed shoulders, and gentle alignment when sitting or standing. 

Everyday lifestyle habits to support recovery 

1. Stay hydrated and eat fibre: This helps prevent constipation, which can put unnecessary pressure on your pelvic floor. 
2. Avoid heavy lifting early on: Let others take the strain when possible. If you do need to lift, bend your knees, keep your back straight, and exhale as you lift. 
3. Gentle movement: Walking, stretching, and light activity can all aid recovery, as long as you build up gradually and avoid high-impact exercise until you feel stronger. 

What if your pelvic floor feels too tight? 

Not everyone experiences a weak pelvic floor after birth, some people find their muscles are actually too tight, which is called an overactive pelvic floor. This means the muscles struggle to relax fully, which can be just as uncomfortable as weakness. 

Pregnancy puts extra weight and pressure on the pelvic floor muscles, and in some cases, this can cause the muscles to become too tense or overactive. Instead of relaxing and supporting the pelvic organs, the muscles stay tight 

Signs of an overactive pelvic floor can include: 

• Pain or discomfort in your pelvic area, hips, or lower back 
• Difficulty starting the flow of urine or feeling like you can’t fully empty your bladder 
• Constipation or straining to open your bowels 
• Pain during intercourse 

What can help: 

• Focus on relaxed, deep breathing, letting your tummy rise and fall gently 
• Try gentle stretches, warm baths, or yoga-style relaxation 
• Avoid clenching or “holding in” your pelvic floor outside of exercise 
• Balance strengthening with relaxation, your muscles need to contract and release 

If these symptoms continue or affect your daily life, ask your GP for a referral to a women’s health physiotherapist. They can assess what’s going on and give you tailored guidance to help release tension and restore balance. 

When to get extra help 

If you’re still leaking, experiencing heaviness, or finding symptoms affect your quality of life 6–12 weeks after birth, ask your GP about a referral to a pelvic health physiotherapist. In Australia, you can also search for a women’s health physio via the Australian Physiotherapy Association. 

Got other questions? We’ve got you. Read our postpartum and parenting guides here.   

Sources

• Pelvic Exercises - Pelvic Floor Safe Exercises for Women 

• Pelvic Floor First