Women's Health

bladder control

Make Your Pelvic Floor Muscles Great Again by Rebecca Urban

During Pregnancy

Practice Kegel Exercises Daily 

While there are lots of things pregnant moms can do during birth to minimize damage to their pelvic floor muscles, one of the most important and often overlooked things that can be done are kegel exercises, and they should be donedaily during pregnancy.

The uterus and pelvic floor are comprised of muscles, and just like other muscle groups, they need to be exercised in order to stay healthy and properly toned. Some pregnant women will have “clues” that their pelvic floor muscles need to be strengthened - such as experiencing urinary incontinence (this first begins when laughing or sneezing, and if unaddressed, can quickly progress to spontaneous leakage).

One of the best things a pregnant mom can do is to practice kegel exercisesdaily.

For most women, the hardest part of doing kegel exercises is

  1. Remembering to do them
  2. Locating their Kegel muscles 
  3. Making sure they’re exercising their Kegel muscles properly

A premium quality Kegel weight system, such as theIntimate Rose Kegel Weight System, is a solution to all three of thesecommon problems. The smooth resistance they provide make it easy for women to locate their Kegel muscles, and the progressive weights make it easy to track progress and maintain motivation.

The Intimate Rose Kegel Weight System is an effective and innovative way for pregnant women to tone and condition their pelvic floor muscles, and I recommend this product to any pregnant woman concerned about preserving her pelvic floor dependability.

How do you make kegel exercises part of your daily routine? How has the Intimate Rose Kegel Exercise System changed your life? What questions can we answer for you?


Choose Your Practitioner Wisely(and please choose one with a low episiotomy rate!)




Many of my childbirth students come to class never having heard of anepisiotomy - a surgical cut between the vagina and the anus made by a doctor or midwife during the pushing stage of labor. They are usually astonished to hear that many doctors and midwives still cut episiotomiesroutinely(meaningnot just in an emergency).

Research has shown that cutting routine episiotomies often causes more harm than good to the perineal tissue. In my childbirth class, I use two pieces of paper to demonstrate this. One of the pieces of paper has a small tear in it, and the other one is intact.

I then ask a student to apply the same amount of pressure to both pieces of paper, tearing in a downward motion. And guess what?  The one with the small tear actually tears farther than the intact one, demonstrating how beginning a cut often leads to more damage once pressure is applied.

Generally my students are very interested in this topic, because the potential damage can be so catastrophic - an episiotomy that results in a third degree tear can require surgery, and even a smaller episiotomy (since the cut is so deep - almost always deeper than a natural tear) can result in permanent nerve damage.

Research also shows us that the greatest indicator of whether or not a practitioner will cut an episiotomy is their individual episiotomy rate. In other words, it isn’t enough for a pregnant mom to write “no episiotomy” on her birth plan.

She must seek out a provider with a low episiotomy rate - a practitioner whom she trusts, who listens to her, and who will be there for herduring the birth.

Pregnant women are often surprised to discover that the practitioner whom they’ve carefully selected and cultivated a relationship with for 9 months will likelynotbe the one present at the birth of their baby!  

What are some ways pregnant moms can gain assurance that their provider will be present at the birth without scheduling an induction or cesarean? How can a pregnant mom know which other doctors or midwives in the practice share her primary provider’s philosophy?

As a seasoned childbirth educator and doula, I have my own ideas on this topic! I’d love to answer your questions and hear your thoughts!


During Labor

Say “No” to Drugs (or choose them wisely!)

The most commonly used drugs by laboring women in the United States, epidural anesthesia and injected narcotics, both increase the risk of pelvic floor and perineal damage.

Injected narcotics can make women less aware and less in tune with the birthing process, causing them to push too hard or ineffectively. Epidural anesthesia numbs and relaxes the uterine muscles, making it harder for them to work efficiently.

Epidural anesthesia can increase the risk of instrumental delivery (the use of forceps or a vacuum), a leading cause of both pelvic floor and perineal damage, and the numbing effect can make it very difficult for a mother to tune into her body and follow her natural pushing urges.

Consider giving birth without drugs, or consider choosing a hospital or birthing center that offers alternatives such as labor tubs, other forms of hydrotherapy, heat therapy, aromatherapy, andnitrous oxide - all of which can be better options for lessening the risk of pelvic floor and perineal damage.

Have you given birth naturally? Did you have an epidural? Did you have nitrous oxide in labor? Did you find the tub helpful? What tips can you share with pregnant moms?


Photo of mother using nitrous oxide during labor courtesy of mommuseum.org

Avoid Instrumental Delivery

Vacuum extraction and the use of forceps are most commonly used on women with epidural anesthesia, and can cause severe damage to the pelvic floor muscles and perineal tissue.

Vacuum extractions also often leave bruises on a baby’s head and are best left for emergency situations.




Give Birth In an Upright Position

Standing, squatting, or giving birth in a semi-upright position have shown to reduce the chance of damage to the pelvic floor muscles and the perineum.

For mothers who choose to have epidural anesthesia, a semi-upright classical position for pushing is usually best.*The classical position involves the back of the hospital bed being tilted upward to support the mother’s back.

During a contraction, the mother bends her knees, grabs her legs (sometimes she may need 2 people holding her legs for her), brings her chin to her chest, sticks her elbows out, and bears down.



A mother pushing in the “classical position” in the hospital with the support of her husband, a labor & delivery nurse, and her doctor. Photo courtesy of InJoy Parenting and Education.


Tune Into Your Body

Moms should follow their body’s lead during the pushing phase. If there is no epidural, then the mother will be able to feel when a contraction is beginning and ending, and she won’t need much verbal coaching through the pushing phase.

Moms who choose epidurals will need more verbal coaching, because they’ll need either a nurse or their main labor support person to look at the Electronic Fetal Monitor to tell them when a contraction is beginning.

At the very end of pushing, when the baby’s head is crowning and the mother will feel a strong burning sensation, the mother should consider panting through that strong sensation and allowing the baby’s head to be born slowly.

When a mom makes a panting noise, she can’t push too hard, and it reduces the chance of damaging the pelvic floor muscles and perineal tissue.*This is general guidance and is not meant to be taken as medical advice.



Practice Kegel Exercises Daily

At your 6 week postpartum visit, your doctor will examine you and ask you how you’re feeling. Now would be a good time to talk to your doctor about resuming kegel exercises.

The Intimate Rose Kegel Weight System is perfect for women who are newly postpartum and will quickly help get the pelvic floor muscles back in shape. Women should do kegel exercises with the weights daily.

For specific directions on how to do kegel exercises, view our guide.

Have you tried the Intimate Rose Kegel Weights postpartum? How have they helped you?