Pelvic floor exercises after childbirth

Childbirth is one of the greatest physical stresses the body can go through. The pelvic floor muscles – which have carried your baby for nine months and worked intensely during labor – need targeted rehabilitation to get back to full function.

Most women know that they should do pelvic floor exercises. Fewer know exactly when to start, how to do them right – and what to do if three months of daily exercises still haven’t produced the desired improvement.

This guide will give you the answers.

Advice before starting pelvic floor exercises after childbirth

Start early: You can start with light squats already 1-2 days after giving birth, as soon as you feel ready.
Swelling: It’s normal to be sore and swollen. The knees help reduce swelling and increase blood circulation.
Quality over quantity: It’s better to make a few correct pinches than many incorrect ones.
Relax other muscles: Avoid tensing your stomach, thighs and glutes while squeezing.

Michael Strøm

My name is Michael Strøm and I am the founder of MS Insight. I treat women with pelvic floor problems, incontinence and related disorders at my specialty clinic in Copenhagen S.

What happens to the pelvic floor during childbirth?

During a vaginal birth, the pelvic floor muscles are stretched far beyond their normal capacity – in many cases three to four times their resting length. Combined with the pressure of labor and the urge to push, this can result in muscle fatigue, stretching of nerves and connective tissue, and in some cases tearing or rupture of the perineum.

A caesarean section spares the muscles from the pressure of childbirth, but they have carried the weight of the pregnancy for nine months – and the operation affects the abdominal muscles and surrounding connective tissue that work closely with the pelvic floor.

The result is the same in both cases: the pelvic floor needs active rehabilitation, for example through targeted pelvic floor exercises for women.

When can you start pelvic floor exercises after childbirth

You don’t have to wait for the six-week checkup to start.

The first few days: Focus on relief. Avoid heavy lifting, straining and prolonged standing. Apply cold to the perineum for soreness and swelling (15 minutes at a time). Start with vein pumping exercises – these activate blood circulation and reduce swelling without straining the pelvic floor.
Week 1-2: Begin gentle squats, lying down. The pelvic floor is sore and tired – don’t measure for strength, but for the connection to the muscles.
After week 6 (upon approval): Gradual progression to sitting and standing exercises. Start strenuous activities such as running and jumping after 12 weeks at the earliest – and only if pelvic floor function is stable.
Vein pumping exercises – day 1: Stretch and bend your feet and ankles 10-15 times in a row while lying down. Repeat 3-4 times daily. These exercises reduce swelling and prevent blood clots and can be done already in the first hours after giving birth.

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How to do squats correctly after childbirth

Up to 1 in 3 women pinch wrong on the first try. It’s not your fault. The pelvic floor can be hard to feel because it works invisibly and from the inside.

Find the right muscles

Imagine that you are trying to stop the stream of urine mid-urination or that you are lifting a grape with your vagina. You should feel an inward and upward movement. Only the pelvic floor has to work.

You’re pinching wrong if you:

Tension in the buttocks
Press your thighs against each other
Sucking in the stomach
Holding your breath

The important thing: Let go again.

The relaxation is half of the exercise. Feel the muscles relax completely after each squeeze. An overactive and overly tense pelvic floor can cause pain and discomfort during intercourse. Paradoxically, it can also be a common side effect of improper execution.

Test yourself

Place a finger lightly on the perineum and feel if the area tightens and lifts during the squeeze. You can also place 1-2 fingers in the vagina and squeeze. Here you should feel the fingers squeeze lightly.

Your 12-week program after birth

An effective program builds gradually over three phases.

Phase 1: Weeks 1-4 – rebuilding

Start lying down. Do short squeezes where you squeeze gently for 3-5 seconds and release completely for 5 seconds. Repeat 8-10 times in 2-3 sets. Exercise daily.

Phase 2: Week 5-8 – strength

Move on to seated exercises. Increase the hold time to 8-10 seconds and add quick, powerful squats. Do 10 quick squats followed by full relaxation. Practice 3-5 times a week.

Phase 3: Week 9-12 – function

Move on to standing exercises and squats in motion. Pinch actively when coughing, sneezing, lifting and jumping. Gradually introduce strenuous activity such as fast walking and functional training. Wait to start running until after week 12 at the earliest and only if you have full continence during exercise.

Don’t give up too soon. Many women expect effects after a few weeks, but pelvic floor muscles are like any other muscles: rebuilding takes time.

Integrate kneeling exercises into everyday life with baby

The maternity period rarely leaves uninterrupted time for training. The good news: pelvic floor training doesn’t require a separate program – it’s integrated into everyday life.

Pinch while breastfeeding. Squeeze while changing a diaper. Squat while getting up from the couch. Activate the pelvic floor before lifting the baby – and hold the squeeze throughout the lift. Tie it to X’s routine, not your own: when the baby grabs your finger, you squeeze. That’s enough.

Split abdominal muscles – rectus diastasis

Many women discover during the postpartum period that there is a soft zone in the middle of the abdomen – a gap between the abdominal muscles that has not closed again after pregnancy. This is called rectus diastasis (split abdominal muscles) and it’s important information for your rehabilitation.

If you have rectus diastasis, you should avoid classic abdominal exercises such as crunches, sit-ups and leg lifts that increase pressure in the abdominal cavity. Instead, focus on deep stability training and pelvic floor exercises. If in doubt, seek guidance from a physiotherapist specializing in pelvic floor.

When are knee exercises not enough after giving birth?

For most women, regular pelvic floor exercises provide noticeable improvement within 8-12 weeks. But there are situations where self-training is not enough:

You’ve been doing exercises daily for 3+ months with no clear progress.
You’re unsure if you’re activating your muscles correctly – and haven’t been able to find the connection.
You still experience urine leakage when coughing, sneezing or running.
You have had a severe rupture of membranes or complications during childbirth.
You’ve had a caesarean section and are experiencing healing that affects pelvic floor activation.

In these cases, technology-assisted pelvic floor training is a clinically proven supplement – or replacement.

Pelvic chair – neuromuscular pelvic floor training

Pelvic Chair uses HIFEM (High-Intensity Focused Electromagnetic Stimulation) technology to activate the pelvic floor muscles in a way you can’t achieve with squats alone – no matter how correctly you do them.

During a treatment, you sit fully clothed in the chair. The technology triggers supramaximal muscle contractions directly in the pelvic floor muscles. A single session is equivalent to approximately 20,000 squats. It is particularly effective for severe weakness, impaired nerve-muscle connection after childbirth, or inability to activate the muscles voluntarily.

The treatment is non-invasive, painless and takes 30 minutes per session.

Who is Pelvic Chair relevant for after childbirth?

Women with persistent incontinence despite regular knee exercise training
Severe pelvic floor weakness after vaginal birth with complications
Reduced muscle activation – you can’t feel that you are pinching correctly
Women who want faster and more intensive rehabilitation than exercises alone can give

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Frequently asked questions about pelvic floor exercises after childbirth

When can I start doing squats after childbirth?

You can start gentle squats already in the first days after a vaginal birth – lying down, with a short holding time. You can do vein pumping exercises on the same day. Full progression with strenuous exercises is recommended after the 6-week check-up at the earliest and full resumption of normal activity at week 12 at the earliest.

When can I start after a caesarean section?

The pelvic floor has not borne the strain of childbirth, but the abdominal muscles and surrounding connective tissue have been operated on. Start gently with squats, but avoid abdominal exercises and heavy lifting for the first 6-8 weeks. Follow the advice of your midwife and doctor and listen to your body.

How do I know if I'm pinching correctly?

Place a finger lightly on the perineum and feel it tighten and pull upwards during the squeeze. Put 1-2 fingers in the vagina and squeeze – you should feel light compression against your fingers. If your buttocks, thighs or abdomen are tight, you are squeezing incorrectly.

Can you squat too much?

Yes, you can. An overstretched or overactive pelvic floor can cause pain, tension and discomfort during intercourse. If you don’t relax properly after each squeeze, you risk building up tension. Always feel clearly that the muscles fall back to rest between squeezes.

What do I do if the kegels don't work after 3 months?

It’s a sign that your pelvic floor needs more than self-training. It could mean you’re not activating the right muscle fibers, the weakening is too pronounced, or the nerve-muscle connection is affected. A free phone assessment with MS Insight can clarify whether Pelvic Chair HIFEM is right for you.

Get a no-obligation consultation about pelvic floor exercises after childbirth

Are you unsure if your pelvic floor exercises are working – or would you like to know if Pelvic Chair is relevant for you? You are always welcome to contact me by phone: 41 40 08 58 or email: michael@msinsight.dk. Otherwise, you can fill out the contact form with your details and a brief description of your problem. I’ll get back to you quickly with a customized solution proposal so we can find the best way forward together.