Pelvic Floor Therapy During Pregnancy

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pregnant patient lays on bed with therapist standing over her talking

Pregnancy changes our bodies in extraordinary ways. But pain and discomfort during pregnancy aren’t inevitable! Pelvic floor physical therapy during pregnancy is one way we can proactively take care of our body. And the earlier we can start, the better.

The Benefits of Pelvic Floor Therapy During Pregnancy

If you’re new to the idea of pelvic floor physical therapy, you might be thinking, “Aren’t they just going to prescribe Kegels and send me on my way?”

Short answer? Nope!

Most people actually don’t need Kegels at all, or they need a combination of Kegels (and other exercises) for strengthening and stretching for relaxation. A pelvic floor PT can help determine what’s right for you and give you a wide range of exercises, stretches, and other strategies to keep your down there in tip-top shape. 

Specifically, pelvic floor PTs can help pregnant people with:

  • Prevention of pelvic floor problems
  • Physical exercise and pregnancy modifications
  • Pain relief
  • Preparation for birth and postpartum recovery


Pelvic floor physical therapy isn’t just about treating problems that already exist. It’s also about preventing problems in the future! 

Pelvic floor therapy during pregnancy can help you prevent future dysfunction by guiding you through strategies to:

  • Strengthen your pelvic floor and core
  • Improve posture throughout different pregnancy stages
  • Adapt daily activities to prevent pain or strain on these muscle groups
  • Minimize the risk of diastasis recti, a separation of the abdominal muscles

Physical Exercise

Contrary to popular belief, being active throughout pregnancy is not only safe, but also it’s really healthy for mom and baby!

By staying active throughout pregnancy–including exercising your pelvic floor and core–you’re in a better position to maintain strength and flexibility, manage weight gain, optimize cardiovascular health and alleviate pain. 

In that regard, pelvic floor PTs are like pregnancy experts in your back pocket. They can help you determine pregnancy-safe exercises, practice proper breathing, change your posture to support your pelvic floor and core, and support you in preparing for the birthing process itself.


Aches and pains seem to be par for the course in pregnancy, especially in the later weeks. Pelvic floor PTs can help you assess and treat lower back, hip, pelvic, and postural pain and can guide you to: 

  • Relieve muscle tension causing sciatica, low back pain and tailbone pain. 
  • Modify your sleeping and standing posture to decrease strain on joints.
  • Strengthen weakened muscles causing pubic symphysis (SPD) or sacroiliac joint (SIJ) pain.
  • Optimize your posture to decrease muscle and ligament strain.


Some people think pregnancy, labor, and delivery are going to do a number on our body, no matter what. But the truth is, there’s plenty we can do to prepare ourselves, our pelvic floor, and our core for birth.

Pelvic floor PTs can advise on:

  • Pelvic floor coordination (how well you can tense, relax, and bear down your pelvic floor muscles)
  • A range of birthing positions
  • Breathing and relaxation strategies to use in the toughest moments
  • Perineal stretching to prepare in advance
  • Cesarean birth planning and recovery
  • Postpartum care

If you’re experiencing any of the following symptoms, a pelvic floor PT might be extra helpful for you:

What to Expect from Your Pelvic Floor Evaluation

Step 1: Verbal Assessment

The first thing any good PT should do before a physical exam is talk to you about your concerns. We want to get to know you! Taking a thorough verbal history and learning about your present concerns can also inform a physical exam and tell us exactly what we should be looking for and what your goals are.

Step 2: Pelvic Floor 101

Your PT should then give you the rundown on your pelvic floor, everything in it, and everything it does. Often many pelvic floor issues are connected, and the more you know, the better the two of you can address your symptoms.

Step 3: Physical Exam

Your pelvic floor PT will do an internal and external exam to assess for tension, weakness, and incoordination throughout your pelvic muscles. The external exam will look at your spine, hip and abdominal wall muscles and the joints that connect to your pelvis. 

If you’re uncomfortable about the thought of an internal exam, it may help to know this: Nothing is ever required. You have complete control and can consent to decline an internal exam! Second, pelvic floor PT is often less invasive or uncomfortable than a gynecological pelvic exam. We don’t use speculums, and we go much slower and talk you through the entire process. We can stop at any moment you would like. 

Pelvic floor examinations of your muscles are safe during pregnancy but absolutely feel free to check in with your medical provider for any precautions or conditions your therapist should be aware of. 

Step 4: Homework

Pelvic floor PTs are natural teachers. We have a passion for passing along vital information to help you feel more prepared to address your concerns at home. If you receive pelvic floor therapy during pregnancy, your provider might start assigning homework from the get-go: 

  • Diaphragmatic breathing
  • Relaxation stretches
  • Strengthening exercises
  • Perineal massage 

Pelvic Floor Therapy and C-Sections

Most people think that C-Section mamas don’t use their pelvic floor and core during labor and birth, therefore do not need to see a Pelvic floor PT. 

But that’s just not true!

While the birthing process is certainly different, pelvic floor dysfunction in C-Section deliveries is all too common, and there are so many benefits to working with a pelvic floor PT during pregnancy and after birth.

For example, take the C-Section scar itself. Restriction in this area can prevent scar mobility and contribute to  pain, numbness, sensitivity and a C-section scar “shelf.”  Pelvic PT can teach you techniques to mobilize your scar to improve mobility and increase abdominal wall and core strength. 

Overall, pelvic floor PT can guide you on strengthening and lengthening exercises before birth and afterwards, to give you the best postpartum experience possible—regardless of the type of birth you have. 

Get started today. 

Always get approval from your provider before starting a new exercise routine. After that, check out the V-Hive Membership!

The V-Hive offers online, on-demand, pregnancy-safe workouts for your pelvic floor and core: 

  • The Pregnancy Series: Strengthen your pelvic floor and core and decrease discomfort with this week-by-week suite of workouts and pelvic floor tips designed especially for pregnant bodies.
  • The Childbirth Prep Series: Prepare your pelvic floor and core for birth and build confidence as your due date approaches. (If you’re in your third trimester, your body will love you for this!)
  • The Childbirth Recovery Series: Gentle stretching and strengthening routines for your first six weeks of recovery. (Great for vaginal or C-section deliveries.)
  • The Postpartum Series: Regain pelvic floor and core strength strength after giving birth and return to your favorite fitness routines without leakage or pain (no matter how long ago it was!).

Your first week in the V-Hive is on me!

Join The V-Hive

Online pelvic floor fitness programs from a board-certified Women’s Health Physical Therapist. Your first week is free.

Free Pelvic Floor Guides

Download these free guides for some simple, do-able, totally-not-weird tips to take better care of your down there.

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