The pelvic floor after birth, in plain language

Your pelvic floor is a sling of muscle across the base of your pelvis, anchored at your pubic bone in front and your tailbone behind, holding your bladder and uterus up from underneath. Pregnancy rests a growing weight on that sling for months, which is why pelvic floor work is raised after a birth of any kind, and the work is repetitive and takes months.

When you personally should start is the one thing on this page we cannot tell you. That is a conversation with your provider.

Finding the muscle without your stomach joining in

You can do this sitting where you are. Without moving your legs and without clenching your buttocks, draw up the muscles you would use to stop yourself passing wind, and lift that feeling inward and up. That is your pelvic floor. If your stomach went hard or you held your breath, something else did the work.

That is the most common mistake with this, and nobody is standing behind you to catch it. Bearing down instead of lifting is the other one, and it is the opposite movement. You cannot see this muscle, and most women cannot tell from the inside which way it went.

Stopping your urine partway is a way to locate the muscle once. It is not a way to train it, and doing that repeatedly while you go is a bad idea.

Why a cesarean does not exempt you

Women who gave birth by cesarean are often told they got off lightly here. They did not.

Two things happen during a pregnancy, before anyone is in a delivery room. A growing uterus presses down on the sling for months, and muscle adapts to what you load it with. Hormones soften connective tissue over the same stretch, so the whole structure tends to sit looser than it did. A scheduled cesarean follows all of that.

A vaginal birth adds stretching, and often stitches, on top of it. If you had a cesarean, this is about you. Raise it at your checkup.

When to start is not our call

We are not going to give you a date. We have not seen how you gave birth or how you are healing, and any shop that hands you a number is guessing.

Ask at your postpartum checkup, and ask again if the answer you get is vague. Bring three questions, because they get separate answers. Am I ready to start pelvic floor exercises at all? Am I ready to add weight to them? How many, how long and how often should I be doing them?

Squeeze, release, most days, for months

You squeeze and let go, most days, for months. Nobody has found a shortcut.

• Lift and hold for a count you can actually hold, then release the whole way down and rest at least as long as you held.
• The release is half the work and it is the half that gets skipped. A muscle that only ever tightens is not a strong muscle. It is a stiff one.
• Add some quick ones. Lift and let go straight away, several in a row.
• The routines clinicians describe usually run to something like ten repetitions in a set and a few short sets a day, but the numbers for you are the third question on that list, because they depend on how you are healing.
• Breathe. If you are holding your breath, your abdomen is doing the work.
• Lying down is easiest. Standing is hardest, and standing is the version that matters when you are carrying a car seat up a flight of stairs.

There is nothing to buy in that list. Plenty of women do the whole thing with no equipment, forever.

A session takes a few minutes and gives you nothing back. Nothing burns, and nothing aches the next morning to prove you did it, which is a common reason women quit. So attach it to something already fixed in your day. The chair you feed the baby in works, and so does brushing your teeth.

A weighted trainer does very little on its own

It sits inside the vagina and your pelvic floor holds it up. The holding is the exercise, and anyone describing it as more than that is describing something else.

What you are buying is feedback. Without weight you are guessing at whether the lift is still there or whether it quietly let go a minute ago. With weight you feel it start to slip. That is worth something. It is worth less than one appointment with somebody qualified to put a hand there and tell you what your body is doing. Weight will not teach you the movement either, and adding it to a contraction you are performing backward only trains the backward version more efficiently.

The one we carry is the Delice Cheri Kegel Trainer from Blush. It is two weighted balls in body-safe silicone, with a retrieval cord that stays outside the body, so getting them back out is not the problem women picture. Our catalog calls it postpartum recovery and everyday strength, and that is the whole of what we claim for it. Use a little water-based lubricant, because dry silicone drags, and Simply Natural Gel is the plain option for that. Rinse the balls afterward and put them away dry.

We cannot ship it to Alabama or Mississippi. State law puts this category out of reach there, so an order from either gets refunded rather than shipped.

Months, and not in a straight line

What shifts first is awareness, which means finding the contraction without hunting around for it and holding it without your breath catching. At the start, three seconds may be all you have.

You will notice nothing day to day. You may notice something looking back across a season. Practicing honestly for months and feeling that not much has shifted happens too, and the answer to that is to go and see someone rather than to buy something heavier.

Take these to a doctor, not to a shop

• Pain of any kind. If squeezing hurts, or sex hurts, stop and say so out loud.
• A feeling of heaviness or dragging low in your pelvis.
• Bleeding that changes or comes back.
• A scar or stitches that still feel wrong to you.
• Not being able to tell if anything is contracting at all.
• Anything you have been quietly waiting to see if it sorts itself out.

Bleeding, or a scar or stitches that feel wrong, go to whoever provided your care. For the rest, ask about pelvic floor physical therapy by name, because it is a real specialty with real training behind it, and one appointment can tell you if you are doing any of this correctly. None of it means you did something wrong.

In much of the world that appointment is routine after a birth. In the United States you usually have to ask for the referral yourself, and plenty of women are never told the option exists. So ask for it by name.