If you’ve ever attended a childbirth class, you’ve heard a lot about kegels. But what if most of what your teacher told you was wrong?
You might have had the smartest, nicest, most caring, most conscientious childbirth teacher in the world. But if she was like 99 percent of childbirth teachers out there, she was wrong about kegels — when to do them, how to do them, and why.
What Are Kegels, and What Is the Pelvic Floor?
A “kegel” is not a body part. It’s an exercise. What you might think of as your “kegel muscles” are the muscles of the pelvic floor, a bowl of muscle between your legs at the outlet (the base) of your pelvis.
The pelvic floor supports your pelvic organs, including your great big pregnant uterus, and stabilizes the base of your spine. It’s responsible for when you pee and poo and, more importantly, when you don’t. And the pelvic floor is part of your sexual anatomy. It gives the vagina its structure, includes tiny muscles connected directly to the clitoris, and contracts rhythmically during orgasm. A small gap in the pelvic floor stretches enormously to let your baby out when you give birth, then regains its usual size after your baby is born — especially if you give it a little help by doing kegels correctly.
What Your Childbirth Teacher Said: Is It True?
Most childbirth classes present a mix of facts, myths, and rumors about kegels during pregnancy. Let’s set the record straight!
Your childbirth teacher said…
Doing kegels during pregnancy prevents incontinence.
Is it true?
Yes. Research shows that you are 30% less likely to develop urinary incontinence postpartum if you’ve done an intensive kegel program during your pregnancy. Note: you must be doing kegels intensively and correctly to achieve this effect.
Your childbirth teacher said…
Doing kegels during pregnancy will make your birth faster and easier.
Is it true?
No. But kegels won’t make your birth longer and harder, either. One study found an itsy bitsy positive effect, with the kegels-in-pregnancy group being less likely to push for over an hour when compared with women who didn’t do kegels while pregnant. But in that same study, the second (pushing) stage of labor was, on average, only five minutes shorter for women who did kegels while pregnant. Other studies — including one that tracked over 18,000 women — have shown absolutely no effect, positive or negative, on length of labor, complication rates, or other birth outcomes. Overall, the research says the effect of prenatal kegels on labor and birth is… meh.
Your childbirth teacher said…
Doing kegels during pregnancy helps your postpartum recovery.
Is it true?
Maybe. I can find zero research data about this. I believe it’s probably true, however. Here are my reasons.
• Better circulation. Kegels increase circulation to the pelvic floor, and better circulation generally leads to faster healing. Therapeutic, correctly performed kegels increase muscle mass in the pelvic floor, which increases circulation 24/7, not just while you’re doing kegels. Theoretically, a woman who enters the postpartum period with greater pelvic floor muscle mass and better circulation could heal any (large or small) pelvic floor injury faster.
• Pregnancy may be a better time to learn than postpartum. If you find out how to do kegels correctly while you’re pregnant, you don’t have to learn how when you’re busy recovering from birth and caring for your baby. You’re ready — you can simply do them.
Your childbirth teacher said…
Do 200 kegels a day. Do elevator kegels. When you’re driving, do kegels at every red light.
Is it true?
NO! 200 a day is an outrageously high number that could even be harmful, unless you’re doing short, pulsing kegels, which are basically useless. Current kegel research recommends a completely different approach. Elevator kegels: Somebody simply made that up. It has nothing to do with the kegel techniques shown by research to actually help women. Kegels at a red light? This is the biggest kegel mega-myth out there.
The Kegel Queen’s Kegel Recommendations for Pregnancy
• Do kegels, intensively and correctly as in the Kegel Queen Program, if you want to minimize your chances of having urinary incontinence postpartum.
• You might heal faster postpartum if you do kegels correctly while you’re pregnant.
• Doing kegels postpartum can be tremendously valuable (I’ll plan to cover that in a future post). If you’re going to do kegels after your baby is born, pregnancy might be the best time to find out how and get started with practice, because it may be far more convenient than when you’re busy with a new baby.
• If you’re going to do kegels, the correct technique is essential. Doing kegels wrong is at best a waste of time, and at worst, dangerous. This webinar shows you how to do one perfect kegel, the first step toward doing kegels right.
• Above all, it is vital that your pelvic floor muscles are not overly clenched and tight as you prepare for birth; this is one reason correct kegel technique is so important. Developing your pelvic floor muscle control, so you can effectively relax the pelvic floor, is essential. Also, especially if you’re pregnant with your first baby, perineal massage may be helpful. Ask your midwife, PT, MD, or doula for more information.