Pelvic Floor Physiotherapy in Pregnancy

Pelvic floor physiotherapy in pregnancy is a personalized approach that assesses not only the strength of your pelvic floor muscles but also their ability to relax when needed and to work in harmony with movement. Your physiotherapist looks at your symptoms, such as urinary leakage, pelvic pressure or pain, together with your breathing and daily movements. The assessment focuses on whether you can contract and relax your pelvic floor muscles correctly and how well they coordinate with your breathing. That's why the approach is not always just about giving you “Kegel exercises.” Depending on your needs, pelvic floor awareness, muscle coordination and exercises for everyday movement during pregnancy are planned. Even if you have no symptoms but want to start exercising, you can check whether it suits your pregnancy with your doctor and a physiotherapist who specializes in this area.

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Why Is Pelvic Floor Physiotherapy Important in Pregnancy?

The Role of the Pelvic Floor in Pregnancy

The pelvic floor muscles provide bladder and bowel control and support the pelvic organs (bladder, bowel and uterus). Their ability to relax is just as important as their ability to contract when needed.

Pelvic Floor Physiotherapy Assessment

The assessment covers symptoms such as urinary or fecal leakage, pelvic pain or a feeling of pressure in the pelvis, as well as your daily life. How your pelvic floor muscles contract, relax and coordinate with your breathing is examined according to your needs.

Physiotherapy and Exercise Plan in Pregnancy

Your physiotherapy plan includes exercise, breathing and relaxation work based on your assessment findings. Pelvic floor muscle training is planned according to your symptoms and personal needs; the same exercise program isn't right for everyone.

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Common and Treatable

A meta-analysis of 30 studies including 6,691 participants reported that pelvic floor muscle training during pregnancy reduced the risk of urinary incontinence by 28% compared with control groups.

"I'm not sure I'm contracting and relaxing my pelvic floor muscles correctly."

"I feel pain and pressure in my pelvic area during pregnancy."

"I struggle during bowel movements and can't relax my pelvic floor."

Zhang D, Bo K, Montejo R, ve ark. 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. Acta Obstetricia et Gynecologica Scandinavica. 2024;103(6):1015–1027.

Pelvic Floor Physiotherapy in Pregnancy FAQ

Who is pelvic floor physiotherapy in pregnancy for?

If you have urinary or fecal leakage, pelvic pain, a feeling of vaginal pressure, or difficulty contracting and relaxing your muscles, you can come in for an assessment. But even if you have no symptoms, you can get pelvic floor physiotherapy guidance to prepare your muscles for birth.

What happens during a pelvic floor physiotherapy assessment in pregnancy?

Your physiotherapist first listens to your health and pregnancy history, symptoms and expectations. Your pelvic floor muscle function is then assessed together with your breathing, abdominal muscles and movement habits. Your muscle function is checked with an EMG biofeedback device.

Do I need to do Kegel exercises during pregnancy?

Kegel exercises focus on contracting the pelvic floor muscles, but relaxing these muscles is just as important. If you feel pain or excessive tension during exercise, or you're not sure whether you're working your muscles correctly, get support from a physiotherapist.

Is pelvic floor physiotherapy just Kegel exercises?

No. The assessment considers not only muscle strength but also the ability to relax, endurance and coordination with breathing. Depending on your needs, contraction and relaxation exercises, breathing work, EMG biofeedback, movement adjustments or manual therapy are used; not everyone gets the same exercises.

Do I need pelvic floor physiotherapy in pregnancy if I don't leak urine?

Not every pregnant woman without symptoms needs a physiotherapy assessment. However, if you find it hard to identify or relax your pelvic floor muscles, have had pelvic floor symptoms before, or would like personalized exercise advice for pregnancy, an assessment can be planned around your needs.

Can manual therapy be used during pregnancy?

Depending on the assessment, manual techniques for the tissues of the abdomen, hips or pelvic region are added to your physiotherapy plan. The type of technique and your position are chosen based on your week of pregnancy, your symptoms and your comfort.

How many sessions of pelvic floor physiotherapy will I need in pregnancy?

There is no fixed number of sessions that applies to everyone. How often you come is decided together, based on your symptoms, the assessment findings, any difficulties you have doing the exercises and your progress.