Don’t you hate it when you’re laughing at a dinner party or jumping on the trampoline with your kids and a little pee leaks out? Total party pooper, right? But have no fear! Kegels are here! Sure, if you are doing them correctly, Kegels can help strengthen your pelvic floor to prevent the oh-so-embarrassing postpartum incontinence (that for some of us never goes away…ever.) But is it really a good idea to be doing Kegel Boot Camp before you deliver that watermelon through your lemon? Do you really want that lemon to be more like the size of a lime on labor day? I say we rethink this advice for a minute.
Maybe it’s not such a good idea to be doing Kegels during pregnancy. Hmmmm…
Have I lost you? Ok…let me back up a bit. According to Merriam-Webster.com, the definition of kegel exercises (a.k.a Kegels) is “repetitive contractions of the pelvic muscles that control the flow [of] urination in order to strengthen these muscles especially to control or prevent incontinence or to enhance sexual responsiveness during intercourse.” And if you didn’t know already, Dr. Kegel is the man who claims to have “discovered” the pelvic floor muscles and their role in female urinary incontinence and sexual pleasure. (But let’s not digress…we’re talking about delivering large-headed babies and peeing your pants.)
Physical therapists–hands down–have the most expertise when it comes to the pelvic floor. Early in my career, before becoming a pediatric physical therapist, I specialized in “Women’s Health,” which is a nice way of saying “treating women who have problems with peeing their pants and have pain during sex.” As a pediatric therapist, I also specialize in pelvic floor dysfunction in kids, which is known in the industry as PVD–pediatric voiding dysfunction. That means I’ve been treating pelvic floor disorders for over 10 years!
Soon after I started treating women with pelvic floor issues, I realized a couple of things. One, very few people actually do Kegels correctly; and two, it doesn’t make sense to me that women are doing Kegels during pregnancy. Isn’t the goal of Kegels to tighten and strengthen your pelvic floor? Why would you want to push your baby out through a ring of tighter, stronger pelvic floor muscles? Owww!
Out there in the big bad world of internet information, I see articles about “how to avoid an episiotomy” or “how to avoid an epidural” as much as I see stuff about Kegels nowadays. Doesn’t it make more sense to be working on relaxing and stretching our pelvic floors during pregnancy, and then work on strengthening once the baby is out?
If I had to choose between the lesser of two evils, I would much rather have a natural childbirth with no tearing, then worry about a few leaks here and there down the road. Like I said, most people aren’t even doing the Kegels correctly.
A win-win, in my humble (expert) opinion, would be to focus on relaxing and stretching the pelvic floor during your pregnancy, then if you have issues with incontinence later on, you can go see a physical therapist for 4 visits to learn to strengthen and tighten the pelvic floor.
In physical therapy treatments, we use biofeedback displayed on a computer screen, so you can visually understand and retrain what your muscles are doing in terms of contracting or relaxing. For women and children alike, relaxing the pelvic floor is usually more important than strengthening it. Once the pelvic floor knows how to relax, it becomes easier to strengthen if incontinence is still an issue.
“Well then, what do you think we should do, EB?”
I think we should focus more on teaching the pelvic floor to relax better during the pushing phases of labor. Wouldn’t it be cool if you could watch and control what your pelvic floor muscles are doing while you push the baby out?
Ponder this, my dear readers, and tell me what you think! Do you want to know more? Just ask! (Check out Let’s Talk!)