The reason I love working with my pregnant patients is that pregnancy is such a great time to build a wellness routine. It is also good to clarify exercise guidelines and to encourage women to check with their obstetricians in case there are special circumstances around their pregnancy that would affect their exercise tolerance.
The American Congress of Obstetricians and Gynecologists publishes recommendations that can be found here:
Exercise During Pregnancy
There is also a lot of misinformation out there regarding pregnancy and exercise, including kegels prenatally and post-partum. While these are important core muscles, it is important to remember that they need to be relaxed and flexible in order to birth a baby.
Many women will begin kegel exercises for the first time during pregnancy. Therefore, I recommend only 2 sets of 10 repetitions of "quick flicks". These are quick kegels that you do not hold...the pace is "tighten, relax...tighten, relax" and so on. Ten repetitions should only take 10 seconds!
Post-partum is a wonderful time to pick up kegels to restore normal pelvic floor muscle tone, increase circulation to the pelvis and to promote healing in the event of episiotomey or tearing. Return to "quick flicks", but increase to 5 sets of 10 repetitions. Then incorporate kegels that you hold for up to a count of 20 seconds-build up to 2 sets of 10 repetitions.
Please note that it is very important not to do a kegel to stop and start the flow of urine as an exercise! It can increase your risk of a urinary tract or kidney infection!
How do I do a kegel, you ask?
First, lying down or sitting in a relaxed position, imagine your pelvic floor muscles. These are the muscles you contract to stop the flow of urine or from passing gas. Trying not to tighten you abdominal or buttock muscles, gently contract your pelvic floor muscles. Imagine lifting up and in with the muscles, feeling them tighten and subsequently relax when you release them. As you do a kegel, begin with tightening gently to avoid using other muscles such as your abdominals. Gradually, work towards holding the kegel longer and contracting more forcefully.
- Nancy Charlebois PT, MT