Pelvic Floor Prep: Should You Do Kegels Before Pregnancy?

You may wonder if preparing your pelvic floor before pregnancy is necessary. This concern is valid—pelvic floor disorders, including urinary incontinence, affect a significant number of people during and after pregnancy, impacting quality of life and daily comfort. Studies show that up to 40% of pregnant individuals experience urinary incontinence, and the risk increases with factors like multiple births, obesity, and heavy lifting.

Strengthening your pelvic floor muscles before and during pregnancy can help prevent or reduce these issues. Kegel exercises, which involve repeated voluntary contractions of the pelvic floor, are safe, effective, and recommended by health professionals to support muscle control during pregnancy and childbirth. Regular pelvic floor training not only helps manage symptoms but also prepares your body for the physical demands of pregnancy and delivery, potentially reducing complications and supporting postpartum recovery.

How does your pelvic floor affect conception and early pregnancy?

A healthy pelvic floor can support your fertility journey. The pelvic floor muscles help maintain the position of your reproductive organs, which may influence the ease of conception. If these muscles are too tight or weak, they can affect blood flow, organ alignment, and even the passage of sperm, potentially making it harder to conceive. While direct evidence linking pelvic floor dysfunction to infertility is limited, assessing and optimizing pelvic floor health before trying to conceive may help address subtle barriers and improve your overall reproductive wellness.

During pregnancy, your pelvic floor undergoes significant changes. Hormonal shifts and the growing uterus cause the pelvic floor to soften and stretch, preparing your body for childbirth. These adaptations can lead to increased mobility of the bladder neck, descent of pelvic organs, and a temporary decrease in muscle strength, which may result in symptoms like urinary incontinence or pelvic discomfort. The extent of these changes varies, but most people experience some recovery of pelvic floor function within a year after delivery, especially with targeted exercises and support. Monitoring and caring for your pelvic floor during pregnancy can help reduce the risk of long-term pelvic floor disorders and support a healthier postpartum recovery.

Balanced strength and flexibility remove these barriers and mesh well with an overall movement plan such as Exercise vs. Fertility: Finding the Sweet Spot.

Do Kegels before pregnancy actually improve fertility outcomes?

Current research does not show that doing Kegel exercises before pregnancy directly improves fertility outcomes or increases your chances of conceiving. Kegels are designed to strengthen the pelvic floor muscles, which support your reproductive organs and overall pelvic health, but there is no strong evidence that they directly impact egg quality, ovulation, or the ability of sperm to reach the egg. However, maintaining a healthy pelvic floor may help address certain subtle barriers to conception, such as improving blood flow and organ alignment, which could indirectly support reproductive wellness.

The primary benefits of Kegels are seen during pregnancy and after delivery, where they help reduce the risk of urinary incontinence, support the pelvic organs, and improve maternal outcomes such as shorter labor, fewer perineal tears, and better postpartum recovery. While Kegels are safe and recommended for most people planning pregnancy, their main value lies in preparing your body for the physical demands of pregnancy and childbirth, rather than directly enhancing fertility. If you have concerns about fertility, it is best to discuss them with your healthcare provider, who can help identify and address any underlying issues.

How can you tell if your pelvic floor needs strengthening, relaxation, or both?

Weak pelvic floor muscles can present with a range of symptoms, including urinary or fecal incontinence, pelvic organ prolapse (a feeling of bulging or heaviness in the vagina), constipation, incomplete emptying of the bladder or bowel, and reduced sexual satisfaction. Women with weak pelvic floors may also experience difficulty holding in urine when coughing, sneezing, or exercising, and may notice a general lack of pelvic support or stability. Clinical assessments, such as vaginal palpation or manometry, can objectively measure weakness; for example, a peak maximal voluntary contraction (MVC) below about 40 cmH₂O on manometry is considered weak. Imaging techniques like MRI can further reveal pelvic floor laxity, organ descent, and poor muscle contraction during straining. Risk factors for weakness include aging, childbirth, obesity, and chronic constipation.

In contrast, strong pelvic floor muscles are associated with good bladder and bowel control, proper support of pelvic organs, and enhanced sexual function. Women with strong pelvic floors typically report fewer issues with incontinence or prolapse and higher scores in sexual desire, arousal, orgasm, and satisfaction. On clinical testing, strong muscles generate higher pressure readings (above 40 cmH₂O on manometry) and can sustain contractions for longer periods. These muscles also respond well to voluntary contraction and relaxation, providing stability and support during physical activities. Regular pelvic floor muscle training can help achieve and maintain this strength, improving quality of life and reducing the risk of pelvic floor disorders.

If you tick boxes in both columns, you’ll likely need a mix of gentle Kegels and relaxation drills. Our Low-Impact Workout Calendar: 30-Day TTC Plan pairs both elements day by day.

What is a safe starter Kegel routine when you’re TTC?

A safe starter Kegel routine when you’re trying to conceive (TTC) involves gentle, regular pelvic floor muscle exercises that focus on proper technique and consistency.

Begin by identifying your pelvic floor muscles, these are the muscles you use to stop the flow of urine. Start with 5–10 slow, controlled contractions: squeeze the muscles for about 3–5 seconds, then relax for the same amount of time. Aim for one to three sets of 10 repetitions per day, gradually increasing the hold time and number of repetitions as your strength improves.

It’s important to breathe normally and avoid tightening your abdomen, thighs, or buttocks during the exercise. Kegels are considered safe before and during pregnancy and can help reduce the risk of urinary incontinence and support pelvic health.

For best results, consistency is key, and you may benefit from guidance by a healthcare provider to ensure you’re using the correct technique and not overexerting the muscles. If you experience pain or discomfort, stop and consult a professional, as some people may need to focus on relaxation or have other pelvic floor needs.

Never practice while urinating—it can lead to UTIs. Match every squeeze with an equal “reverse Kegel” (intentional softening) to keep muscles adaptable.

Can too many or poorly done Kegels backfire on labor or fertility?

Doing too many or poorly performed Kegel exercises can potentially cause problems rather than benefits, especially if the pelvic floor muscles become overly tight or fatigued. Over-exercising or using incorrect technique may lead to pelvic floor muscle tension, pain, or even dysfunction, which could make labor more difficult by reducing the ability of the muscles to relax and stretch during childbirth. While regular, well-performed Kegels are shown to help strengthen the pelvic floor, improve muscle endurance, and reduce the risk of perineal tears and episiotomy during labor, excessive or improper practice could backfire by causing muscle imbalance or discomfort.

There is no evidence that excessive or incorrect Kegels negatively affect fertility directly, but pelvic floor dysfunction, whether from weakness or excessive tightness can contribute to pain, discomfort, or sexual dysfunction, which may indirectly impact conception efforts. The key is moderation and proper technique: Kegels should be done with attention to both contraction and relaxation, and not to the point of muscle fatigue or pain. If you are unsure about your technique or experience any discomfort, it is best to consult a pelvic health specialist for personalized guidance. Properly performed Kegels, in the right amount, are safe and beneficial for most people trying to conceive and preparing for labor.

Which complementary moves prep the pelvic floor and whole body for conception?

To comprehensively prepare the pelvic floor and whole body for conception, a combination of targeted and general exercises is recommended.

Pelvic floor muscle exercises (Kegels) are foundational, as they strengthen the muscles that support the bladder, uterus, and bowel, helping to prevent urinary incontinence and support sexual function. These can be complemented by perineal massage, which may reduce the risk of perineal trauma during childbirth.

Incorporating low- to moderate-intensity aerobic activities, such as walking or prenatal yoga, further supports pelvic health by improving circulation, neuromuscular control, and overall fitness. Yoga for Fertility: Five Poses to Relax and Conceive.

Structured exercise programs that blend high- and low-impact aerobics with pelvic floor muscle training have been shown to enhance neuromuscular activity and relaxation ability of the pelvic floor without negative effects on quality of life. However, evidence suggests that moderate exercise is optimal, as very high-intensity or high-impact activities may reduce pelvic floor muscle strength or increase the risk of pelvic organ prolapse in some women.

Pelvic-abdominal mechanics exercises, which focus on posture and coordinated movement, can also help reduce pregnancy discomfort and improve delivery outcomes. It is important to use proper technique and avoid overexertion, as both excessive and poorly performed exercises can be counterproductive. Consulting a healthcare provider or pelvic health specialist can help tailor a safe and effective routine to individual needs and fitness levels. Wearable Fitness Guide to cement consistency.

When should you see a pelvic floor physical therapist before pregnancy?

It is advisable to see a pelvic floor physical therapist before pregnancy if you have symptoms such as urinary or fecal incontinence, pelvic pain, painful intercourse, pelvic organ prolapse, or a history of pelvic floor dysfunction, as early intervention can improve quality of life and help prevent complications during pregnancy and postpartum.

Even without symptoms, women planning pregnancy, especially those with risk factors like previous pelvic injuries, chronic constipation, or high-impact athletic activity can benefit from an assessment to learn proper pelvic floor muscle training and preventive strategies. Starting pelvic floor muscle training before pregnancy, when muscles and nerves are intact, is often easier and more effective than waiting until after symptoms develop or after childbirth. A therapist can provide individualized guidance, ensure correct exercise technique, and address any muscle imbalances or tension that could affect pregnancy or delivery.

For recreational athletes or women with specific fitness goals, a tailored preconception program can help minimize musculoskeletal symptoms and support a safe return to activity after childbirth. Additionally, women experiencing pelvic girdle pain or those who want to optimize pelvic health for conception and delivery may find early consultation especially helpful.

Overall, seeing a pelvic floor physical therapist before pregnancy is a proactive step for both prevention and management of pelvic floor issues, and can be considered part of comprehensive preconception care. Post-session, support recovery with tips from Post-Workout Recovery: Tips for TTC Parents.

Should male partners join the pelvic floor prep?

Yes, male partners should consider joining pelvic floor preparation when you are trying to conceive. Pelvic floor muscle training is simple, safe, and noninvasive. It can improve sexual health, support fertility, and enhance overall well-being.

Benefits for male partners include:

• Improve erectile function and help manage erectile dysfunction. Studies show that up to 40% of men with erectile dysfunction regain normal function after pelvic floor muscle training, with another 34% seeing improvement.
• Increase control over ejaculation, reducing symptoms of premature ejaculation. One review found that 82.5% of men improved their ejaculatory control after a 12-week program.
• Reduce urinary incontinence, especially after prostate surgery, and support faster recovery of continence.
• Enhance sexual satisfaction and confidence for you and your partner.
• Noninvasive, safe, and can be done at home without special equipment

A 2022 narrative review in Sexual Medicine Reviews found that pelvic floor muscle training, especially when combined with manual therapy, can significantly improve erectile dysfunction and premature ejaculation in men. The authors recommend a multifaceted approach, noting, “Pelvic floor muscle training is simple, safe, and noninvasive; therefore, it should be a preferred approach in the management of erectile dysfunction and premature ejaculation”.

To get started:

• Identify your pelvic floor muscles by stopping urination midstream (do not do this regularly, just to locate the muscles).
• Contract these muscles (as if stopping gas or urine flow), hold for 3–5 seconds, then relax for 3–5 seconds.
• Practice contracting and relaxing these muscles for 5–10 repetitions, holding each contraction for 3–5 seconds.
• Avoid holding your breath or tightening your abdomen, thighs, or buttocks.
• Repeat 1–3 times daily, ensuring you do not overexert or cause discomfort.
• Consistency is key—practice daily for best results.
• If you have difficulty or symptoms persist, consult a pelvic floor physical therapist for personalized guidance.

According to the National Institutes of Health (NIH), regular moderate exercise, including pelvic floor training, supports male fertility, but excessive or high-intensity exercise may have the opposite effect. If you or your partner have concerns or symptoms, consult a healthcare provider for personalized guidance. Including both partners in pelvic floor prep fosters teamwork and can improve your chances of conception.

Your Top Questions, Answered

How many Kegels a day do I really need?
Aim for 10–15 Kegel contractions per set, 2–3 sets per day. Each contraction should last 3–5 seconds, followed by equal relaxation. Consistency is more important than high volume. Quality matters: focus on correct technique and full relaxation between contractions.

Can weak pelvic muscles cause miscarriage?
No evidence links weak pelvic floor muscles directly to miscarriage. Miscarriage is most often caused by chromosomal abnormalities or medical conditions, not pelvic muscle strength. However, strong pelvic muscles can support your pelvic organs and improve comfort during pregnancy.

Should I keep doing Kegels during the two-week wait?
Yes, Kegels are safe to continue during the two-week wait after ovulation or fertility treatments. They do not interfere with implantation or early pregnancy. If you experience pain or discomfort, consult your healthcare provider. For full-body calm, try the routines in Two-Week Wait Workouts: Gentle Moves to Calm the Mind.

Are biofeedback devices or apps worth it?
Biofeedback devices and apps can help you learn correct technique and track progress, especially if you struggle to identify or engage your pelvic floor muscles. They are not required for most people, but may be helpful if you want extra guidance or have persistent symptoms. Always choose devices cleared by the U.S. Food and Drug Administration (FDA) and discuss with your provider if unsure.

Are Kegels safe during an IVF cycle?
Yes, Kegel exercises are considered safe during in vitro fertilization (IVF) cycles. They do not affect egg retrieval, embryo transfer, or implantation. Continue Kegels unless your fertility specialist advises otherwise. The American College of Obstetricians and Gynecologists (ACOG) supports pelvic floor exercises as a safe, effective way to improve pelvic health during fertility treatments and pregnancy.

Final Thoughts

Pelvic floor preparation before and during pregnancy is a proactive step that can significantly improve your comfort, health, and recovery. Regular pelvic floor muscle training (PFMT) has been shown to reduce the risk of urinary incontinence and severe perineal tears during childbirth, and may also shorten the active pushing phase of labor. Starting PFMT during pregnancy (ideally after the first trimester) allows you to build strength and awareness while your muscles and nerves are still intact, making it easier to learn proper technique and see benefits. Other approaches, such as perineal massage and yoga, can further support pelvic floor health and reduce distress symptoms, with studies showing significant improvements and no adverse effects.

Despite these benefits, many women lack knowledge or do not practice these exercises, highlighting the importance of education and support from healthcare providers. While protocols for frequency and duration vary, consistency and individualized assessment are key to effective preparation. PFMT is safe for most women, but always consult your provider to tailor a program to your needs and address any concerns. Ultimately, investing in pelvic floor health before and during pregnancy can help prevent dysfunction, support a smoother delivery, and enhance your quality of life postpartum.

References

1. Pelvic floor status during pregnancy as a predictor of pelvic dysfunction and birth outcome. Journal of obstetrics and women’s diseases. https://doi.org/10.17816/jowd629250

2. The benefits of Kegel’s exercises during pregnancy. International Egyptian Journal of Nursing Sciences and Research. https://doi.org/10.21608/ejnsr.2021.181227

3. Diagnostic accuracy and cut-off points for vaginal manometry to differentiate between weak and strong pelvic floor muscle contraction in pregnant women… Brazilian journal of physical therapy, 28 5, 101115. https://doi.org/10.1016/j.bjpt.2024.101115

4. Pelvic floor dysfunction in postpartum women: A cross-sectional study. PLOS ONE, 19. https://doi.org/10.1371/journal.pone.0308563

5. Application Of Kegel Gymnastics And Audio Hypnobirthing In Midwife Care During Pregnancy To Reduce Urine Incontinence And Anxiety. Journal of Maternal and Child Health Sciences (JMCHS). https://doi.org/10.36086/maternalandchild.v3i1.1700

6. The effect of pelvic floor muscle exercises applied during pregnancy on genito-pelvic pain level in postpartum period. International Urogynecology Journal, 33, 2791 - 2799. https://doi.org/10.1007/s00192-022-05225-2

7. Expertise and individually tailored interventions are expected by pregnant women with pelvic girdle pain who seek physical therapy: a qualitative study… Brazilian journal of physical therapy, 27 2, 100494. https://doi.org/10.1016/j.bjpt.2023.100494

8. The Effect of Pelvic Floor Rehabilitation on Males with Sexual Dysfunction: A Narrative Review… Sexual medicine reviews. https://doi.org/10.1016/j.sxmr.2021.02.001

9. Male Fertility and Physical Exercise. The World Journal of Men’s Health, 41, 482 - 488. https://doi.org/10.5534/wjmh.220199