Most women who ask us this are already doing kegels, and most of them are doing the same two things wrong: holding their breath and pushing down instead of lifting up. So before you add anything, we'd rather you check those two things. If you fix them, the exercise you already know becomes a different exercise.
Also, if you had a baby in the last six weeks, get the go-ahead from your OB-GYN or midwife before you start a routine. The breathing part below is fine from day one. The rest can wait for that visit.
Find it before you train it
Lie on your back, knees bent, feet flat. Put one hand on your lower belly, below the navel. Breathe in through your nose and let the belly rise into your hand. Don't push it out, just let it fill. As you breathe in, the pelvic floor drops a little. You probably won't feel that yet. That's normal.
Now breathe out slowly, as if you're fogging a mirror, and at the same time close around the back passage like you're holding in gas. Then draw that closing forward toward the pubic bone and up into the body. That forward-and-up part is the lift. The hand on your belly should feel the lower abdomen flatten gently, not brace hard.
Then breathe in and let it all go. Completely. The letting go is half the exercise, and it's the half almost everyone skips.
Things that mean you're doing it wrong: your buttocks clench, your thighs squeeze together, your shoulders come up, you stop breathing, or you feel pressure going down toward the vaginal opening or the anus. Pressure down means you're bearing down, which is the opposite of what we want and is a habit worth breaking now.
If you want to confirm the direction, wash your hands and place one finger just inside the vagina while you do the exhale and lift. You should feel a squeeze around the finger and a pull inward. If the finger gets pushed out, you're bearing down. If you feel almost nothing, that's useful information too, and it's one of the reasons to see a pelvic floor physical therapist rather than guess for six months.
Don't practice by stopping your urine stream. It confuses the bladder's signals, and it's a one-time check at most, not a training method.
The lift, and how many
Once you can feel the lift and the release, there are two versions.
Slow holds. Breathe in, breathe out and lift, hold the lift for one more full breath in and out, then release completely and breathe normally for two breaths. Do 8 to 10 of these. If the lift fades before the breath is over, that's your current limit. Stop the hold there and work up over weeks.
Quick lifts. Breathe out and lift, release right away, breathe in. Lift, release. Do 10 in a row at an easy pace. These train the fast response you need for a sneeze or a cough.
One set of each, two or three times a day. More is not better. We see plenty of women who did 100 a day for a month and got sore, tight and no less leaky. Ten good ones with a full release beat fifty gripped ones.
Start lying down because it's easiest to feel. After a week or two, move to sitting on a firm chair, where you can feel the sit bones and the lift between them. Then standing. Then, and this is the part that matters for real life, do a lift right before you pick the baby up out of the crib, before you lift the car seat, before you cough. Exhale, lift, then move. That's the habit we're actually building. The reps on the floor are practice for that moment.
If you want to keep track of what you did and where you're at, our free core tracker is at https://postpartumlibrary.com/tools/core-tracker.
Expect this to take weeks, not days. Coordination usually comes first, within a couple of weeks. Endurance and the ability to hold while standing or walking come after that. Leaking with a sneeze is often one of the last things to change, so don't judge the whole program on that one symptom in the first month.
Letting go, and stretches
Here's the part people don't expect: a lot of pelvic floors after birth are not weak so much as tight and tired. If you have pain with sex, trouble starting your stream, constipation, or a feeling of constant gripping in the pelvis, more kegels will make that worse. Those muscles need to learn to lengthen before they can learn to lift well.
These are the positions we use for that. Hold each for 5 to 8 slow breaths, breathing into the belly and the back of the pelvis, and feeling the floor soften and widen on the inhale.
- Child's pose with knees wide, forehead resting on the floor or a pillow, arms wherever they're comfortable.
- Happy baby, lying on your back, holding behind the knees or the outsides of the feet, knees wider than your trunk. Let the tailbone stay heavy on the floor.
- A supported deep squat, holding a doorframe or the edge of a heavy table, heels down if they'll go, heels on a folded towel if they won't.
- A half-kneeling hip flexor stretch, back knee on a pillow, tucking the tailbone slightly so you feel the front of the hip, not the low back.
Do these before your lifts, or on their own at night. If you take nothing else from this post, take this: you can't strengthen a muscle that never fully relaxes.
A few reasons to stop and get seen rather than keep going on your own. Leaking that isn't improving after a couple of months of consistent practice. A heavy or dragging feeling in the vagina, especially by the end of the day. Pain with sex. A gap between the abdominal muscles wider than two finger-widths that isn't narrowing (how to check it yourself is at https://postpartumlibrary.com/diastasis-recti-check). None of those are things a blog post can sort out, and a pelvic floor physical therapist can, usually in a few visits.
And separately, the things that aren't a wait-and-see: bleeding that soaks a pad in an hour, a fever, chest pain or calf pain, a bulge that hurts, or any thoughts of harming yourself or your baby. Call your provider or 911 for those. We say it once here rather than assume you've heard it.
If you'd like the breathing, the lift and the deep core work put together in a short daily routine you can actually finish, our guide The 10-Minute Mom Pooch Reset lays it out day by day.
The 10-Minute Mom Pooch Reset
The 12-week, 10-minute-a-day core and belly plan for exhausted moms: the gap check, breath-to-core, three phases, kitchen-counter and naptime routines, food that helps, and 6 printable trackers.
See the plan →Not sure yet? Take the free 2-minute quiz
Educational content from the Mom Pooch Reset team. Not medical advice for your specific situation. Get clearance from your OB-GYN or midwife before exercising after birth, and see a pelvic floor physical therapist for leaking, pain or a bulge.
