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.
In this article
- What happens to the pelvic floor during childbirth?
- When can you start pelvic floor exercises after childbirth
- How to do Kegel exercises correctly after childbirth
- Your 12-week program after birth
- Integrate kneeling exercises into everyday life with baby
- Split abdominal muscles - rectus diastasis
- When are knee exercises not enough after giving birth?
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 Kegel exercises, 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.
Pelvic floor exercises after childbirth?
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How to do Kegel exercises 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 Kegel exercises. Do 10 quick Kegel exercises followed by full relaxation. Practice 3-5 times a week.
Phase 3: Week 9-12 - function
Move on to standing exercises and Kegel exercises 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. Squeeze 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 Kegel exercises 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 Kegel exercises. 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
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.