How to Prepare Your Pelvic Floor for Birth

When people think about preparing their bodies for birth, strengthening the pelvic floor is often one of the first things that comes to mind. But birth requires something else from these muscles, too: the ability to lengthen, relax, and soften.

Your pelvic floor supports your growing body throughout pregnancy, but during a vaginal birth, these muscles also need to open and make space for your baby to descend through and exit the birth canal.

Preparing for birth isn't about creating the “strongest” pelvic floor possible. It's about helping your pelvic floor work together with your breathing, abdominal muscles, hips, nervous system, and the rest of your body.

Here are several ways to prepare your pelvic floor for birth, and how pelvic PT can support.

1. Learn How to Relax Your Pelvic Floor

We're often taught how to tighten our pelvic floor muscles, but not how to let them go. During birth, the ability to relax and lengthen the pelvic floor is important.

Sometimes it's difficult to understand what's happening in your own pelvic floor muscles, but a pelvic health therapist can help you develop awareness of what contraction and relaxation feel like. If you tend to hold tension in your pelvic floor, manual releases with your therapist, and learning how to intentionally release that tension at home can be particularly helpful.

2. Practice Breathing With Your Pelvic Floor

Your diaphragm and pelvic floor work together. As you inhale, your diaphragm descends and your pelvic floor naturally relaxes and softens. As you exhale, your diaphragm and pelvic floor gently lift together.

Rather than thinking only about “doing Kegels,” or squeezing your pelvic floor muscles, practice taking long slow inhales that create expansion in your lower belly and gently soften or lengthen your pelvic floor muscles. Learning to coordinate your breath with your pelvic floor can help you tremendously through labor contractions and during pushing.

3. Keep Your Hips Moving

Focusing on hip mobility during pregnancy can help you feel more comfortable as baby grows, and may make labor easier. Your hips, back, and pelvic floor work closely and affect each other. Making sure that your hips and trunk have good mobility allows for more space for baby to make his or her way through the pelvis during labor.

Your pelvic floor therapist may work with you on stretching and mobility for the hips, pelvis, spine, and surrounding muscles based on your body's needs.

4. Stay Strong & Active Through Pregnancy

Staying strong and active throughout pregnancy can help you feel better as your belly grows and helps you prepare you for the physical demands of birth and postpartum recovery. Building and maintaining strength can support your growing body, improve mobility, reduce or prevent common aches and pains, and help you continue doing the activities you enjoy.

After birth, that foundation of strength can make everyday demands like getting out of bed, carrying your baby, feeding, lifting, and eventually returning to exercise feel more manageable. As long as you’ve been cleared by your doctor to exercise, staying active and building strength during pregnancy is a meaningful way to support your body through pregnancy, birth, and postpartum recovery. If you're not sure where to start, a skilled fitness professional or pelvic floor PT can help create a program tailored to you and your body.

5. Learn about Birth

Learning about birth ahead of time can help you feel more prepared, informed, and confident going into labor. Explore and practice different labor and pushing positions, learn what options and resources are available at your birthing space, and talk with your care team about your preferences. Consider how your partner or support team can be involved with positioning, comfort measures, breathing, and advocacy. You may also choose to work with a doula for additional education and continuous support throughout labor. Birth doesn’t always go exactly according to plan, but understanding your options can help with overall pelvic health during postpartum recovery, and help you feel more empowered to make decisions as your birth unfolds.

6. Try Perineal Massage

The perineum, or the area between the vaginal and anal opening, needs to expand and stretch tremendously during vaginal birth. Helping the tissue prepare with perineal massage and stretching can reduce the risk of tearing during birth.

To try it at home (with clearance from your healthcare provider), starting around 32 weeks, gently insert your clean, lubricated thumb about 1–2 inches into the vagina and apply slow, steady pressure down and outward near the base of the vaginal opening until you feel a mild stretching or burning sensation. Hold the stretch for 1–2 minutes while breathing deeply, then massage the lower vaginal tissues with gentle sweeping motions. Consider performing perineal massage a few times per week for 5-10 minutes a few times per week to help lengthen the tissue and become comfortable with sensations of stretching and pressure during labor. Pro tip: many find it especially easy to do in the shower!

Your pelvic floor therapist can explain perineal massage in more detail, and at Core Connections, we go over how to perform perineal massage effectively in our Birth Prep Program!

7. Prepare for Postpartum

Prepare for your physical and pelvic floor recovery before your baby arrives. Give your body time to heal, plan for a gradual return to exercise and higher-level activity, and consider scheduling a postpartum pelvic floor therapy appointment ahead of time so it’s already on your calendar. Having a plan can help you address changes in strength, pressure, pain, leakage, or core function and support a confident return to the activities you love.

Do You Need to Do Kegels During Pregnancy?

Most likely not, but not everyone needs the same pelvic floor exercises.

There are times when isolated pelvic floor muscle contractions, or kegels, can be helpful, but if your muscles have difficulty relaxing or are already overactive, focusing only on contractions may not be the best strategy. The ability to relax, lengthen, and soften those muscles is particularly important during birth, and we find that in pelvic PT many need to focus more on relaxing than squeezing. An individualized assessment can help determine what your pelvic floor needs.

When Should You See a Pelvic Health Therapist During Pregnancy?

You don't have to wait until something hurts or you're experiencing leakage to see a pelvic health therapist. At Core Connections, we recommend starting pelvic PT as soon as you feel ready to come in. That allows us time to figure out your baseline and work through or prevent issues during your pregnancy. Pelvic floor therapy during pregnancy can be used proactively to help you understand your changing body, prepare for birth, address symptoms, and develop strategies for postpartum recovery.

Prepare for Birth With Confidence

While we can't predict or control how birth will unfold, what you can do is learn more about your body and develop tools that may help you move, breathe, relax, and adapt during labor.

At Core Connections Pelvic Health, we help expecting parents understand their pelvic floor and prepare their bodies for pregnancy, birth, and postpartum recovery with individualized, compassionate, and evidence-based care.

Want to feel more prepared for birth? Contact us to learn more about our program and schedule care!