Should I do Kegels in pregnancy? What the research says.
Updated: Oct 14
Short answer? Yes.
Pelvic floor muscle training has been shown to decrease the risk of severe perineal tears (grade III and IV) by about 50% compared to control groups in pregnant people. In the postpartum period, people are also 28% less likely to experience urinary incontinence.
The Part Most People Get Wrong About Kegels
Where people misunderstand pelvic floor muscle training is that they only focus on the contraction phase of the muscle (called concentric). Effective pelvic floor muscle training involves the capacity to both shorten and lengthen the pelvic floor muscles.
How Pelvic Floor Training Should Change Throughout Pregnancy
Often, from weeks ~8-32, a strong emphasis is put on pelvic floor strengthening. Around 32-36 weeks, that emphasis shifts toward pelvic floor lengthening.
That said, there's personalization to consider:
Some people's pelvic floors tend to skew tighter, they need to work more on the lengthening phase.
Some people's pelvic floors tend to skew weaker, they need to focus more on the shortening phase.
Everyone needs to learn to control both, but knowing where your deficits are makes your training far more effective. That's exactly what a session with a pelvic floor physiotherapist is for — an individualized assessment to determine whether you need to train more toward lengthening, strengthening, or both.
A General Pelvic Floor Protocol for Pregnancy
A general protocol includes:
A minimum of 3 rounds of 8-12 near-maximal pelvic floor contractions for 6 months of the pregnancy
Plus 3 minutes of pelvic floor relaxation training
Ideally, contractions are practiced in a variety of positions and at a variety of intensities. Endurance holds, quick contractions, and phasic contractions all play a role.
Why Working With a Pelvic Floor Physiotherapist Makes a Difference
Most of the research to date has patients performing the home protocol above plus attending pelvic floor physiotherapy once per week for directed strengthening. Where people can access pelvic floor physiotherapy easily, this is standard practice.
More often, patients go home with a program for 2-6 weeks before returning to their physiotherapist for a check-in. This is a cadence that balances the real-world barriers to accessing private healthcare with getting optimal outcomes.
If you're pregnant and in East York, the Beaches, or the wider East-End area of Toronto, working with a pelvic floor physiotherapist near you makes it easier to keep that check-in frequency consistent through each trimester.
Ready to Get a Personalized Plan?
Every pregnant body is different, the only way to know which emphasis of training you need most is through a proper assessment. Our team at Thrive Wellness Collective, located near Woodbine subway station in East York, offers pre- and post-natal pelvic floor physiotherapy tailored to exactly where you are in your pregnancy.
We cite our sources, check out the research papers we referenced below:
Influence of pelvic floor muscle training alone or as part of a general physical activity program during pregnancy on urinary incontinence, episiotomy and third‐ or fourth‐degree perineal tear: Systematic review and meta‐analysis of randomized clinical trials
December 2023 Acta Obstet Gynecol Scand. 23;103(6):1015–1027.
DOI: 10.1111/aogs.14744
Evaluation of a birth preparation program on lumbopelvic pain, urinary incontinence, anxiety and exercise: a randomized controlled trial
2013 Jul BMC Pregnancy Childbirth. 229;13:154.
DOI: 10.1186/1471-2393-13-154
Effects of pelvic floor muscle training during pregnancy
August 2007 Clinics 62(4):439-46
DOI:10.1590/S1807-59322007000400011
Single blind, randomised controlled trial of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment in management of genuine stress incontinence in women
February 1999 BMJ
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