Training the Pre and Postnatal Pelvic Floor

By Erika Bloom

As a specialist in pre and postnatal Pilates, I am often asked questions about what the best exercises are for these important stages in life. This is especially personal to me right now: I just gave birth to my second child, a beautiful baby girl named Anabella. I used Pilates to prepare for both births and to achieve a full recovery—and to get back in shape afterward.

One of the essential issues to address when preparing a pre/postnatal program is, How does one properly train the pelvic floor when it comes to the pre/postnatal woman? Training the pelvic floor is necessary because the condition of those muscles affects a woman’s health in many ways, including: comfort during pregnancy, ease of childbirth and recovery postpartum. Pelvic floor problems can lead to incontinence, back or hip pain, uterine displacement, GI problems and a bulging tummy.

I gained my information on this topic not just from studying pre and postnatal Pilates and anatomy of the pelvic floor, but also from my own experiences with pregnancy, childbirth and recovery and from speaking to obstetricians, midwives, doulas and physical therapists along the way. The result is the conclusion that you must make sure that you and your client are going above and beyond the traditional Kegel exercise. Work the pelvic floor in its full range of motion—to full engagement and to full release—and both eccentrically and concentrically. It’s also essential to work the muscles for both endurance and strength. The goal is to keep the pelvic floor not just strong but also supple and open. The following exercises are designed to do just that, and should be performed several times a week for prenatal and daily for postnatal. The series is also beneficial for anyone and everyone regardless if you are expecting a child or have had children.

#1 Pelvic Floor Stretch

For Prenatal:

Stand on the floor in a wide second position facing the Push-Through Bar at the end of the Cadillac. Hold onto the Push-Through Bar with no springs on. Stand far enough away that your arms are fully straight and then stand back even a step more. Bend your knees deeply, slowly lowering your pelvis down toward the ground until you are in a deep squat. Be sure to keep your knees in safe alignment and to keep your pelvis centered between your feet. Use the Push-Through Bar to help support your weight. Hold the stretch as you breathe deeply, expanding your pelvic floor with each breath. Press into your feet and use your arms to carefully come out of the stretch.

For Postnatal:

Lie on your back with your pelvis resting on a foam roller. Bring your right knee into your chest and extend your left leg long on the floor. Grab your right foot with your right hand to bring your right leg into a “happy baby” position. Hold the stretch, feeling your pelvic floor open. Repeat on the opposite side.

#2 Picking Up a Silk Handkerchief

Sit on a foam block with your spine in neutral. Inhale down into your pelvic floor, allowing it to release and open wide. Then, imagining that you are sitting on a silk handkerchief, exhale and engage your pelvic floor as though you are gathering up the handkerchief from every edge and drawing it up inside your pelvis. Hold the engagement as you inhale. Finish by exhaling and releasing your pelvic floor slowly down and open as though you are lowering the silk handkerchief back to the block and spreading it back out again. Perform 25 reps.

#3 Elevator Rides

In this exercise, use the image of an elevator to gain control and ensure complete engagement of all the fibers of your pelvic floor muscles. The full release point is the basement and the deepest, highest engagement is the 6^th floor.

Start with your pelvic floor fully released (in the basement). Begin by engaging the pelvic floor (closing the elevator doors). Then lift your pelvic floor to the first floor and hold, then to the second floor and hold and so on until you reach the 6^th floor, which should be your maximum engagement, and lift. Now lower in the same manner, 6, 5, 4, stopping on each floor. When you reach the basement, open the elevator doors, finding a full release of the muscles. Repeat 4 more times to complete 5 reps.

#4 Penthouse Pulses

Using the same image as in the Elevator Rides exercise, bring your pelvic floor to the 6^th floor. This is your point of full engagement. Now lift your pelvic floor even higher as though you’re bringing it past the 6^th floor to a newly added penthouse. Continue to breathe as you pulse your pelvic floor engagement from the 6^th floor to the penthouse 25 times.

Feel free to email me with additional pre/postnatal questions or to find out about my Pre/postnatal Pilates Certification at erika@erikabloom.com. To have your questions answered on this blog, email pilatesstyle@erikabloom.com.