The pelvic floor is the hammock of muscles slung across the base of your pelvis, and during pregnancy it has a demanding job: supporting the growing weight of your baby, your uterus, and everything above it. Under that increasing load, and with the softening effect of pregnancy hormones, these muscles are prone to weakening — which is why leaking when you cough, laugh, or sneeze is so common in pregnancy and beyond. The good news is that the pelvic floor responds beautifully to training, and the earlier you start, the better. This isn’t only about avoiding leaks; it’s about supporting your body through pregnancy, preparing for birth, and recovering more quickly afterwards.
Key takeaway: Start pelvic floor exercises as soon as you know you’re pregnant — there’s no need to wait. Practise both slow holds and quick lifts daily, and learn to fully relax the muscles between reps, not just contract them. Early, consistent training reduces leaking and supports a faster postnatal recovery.
To do pelvic floor exercises in pregnancy, imagine gently stopping the flow of urine and holding back wind, lifting those muscles up and in — without clenching your buttocks, holding your breath, or pushing down. Combine slow holds (lift and hold for several seconds, then fully release) with quick, light lifts. Start as early as the first trimester and practise daily. Sophie Mercer, PMA-certified clinical Pilates instructor, designed a 6-week Pelvic Floor Strengthening protocol of 26 exercises that build both strength and the equally important ability to relax.
When should you start pelvic floor exercises in pregnancy?
Now — whatever stage you’re at. You can begin the moment you know you’re pregnant, and ideally these would already be part of your routine before conceiving. There’s no trimester you need to wait for; pelvic floor exercises are safe throughout an uncomplicated pregnancy. Starting in the first trimester is genuinely worthwhile because it’s easier to build awareness and strength before the later-pregnancy load really ramps up. Women who practise consistently through pregnancy tend to experience less leaking and recover more smoothly afterwards.
How do you do them correctly?
This is where most people go slightly wrong, so it’s worth slowing down. Find the right muscles first: imagine you’re gently stopping the flow of urine and holding back wind at the same time. You should feel a lift up and in around the back and front passages. What you should not feel is your buttocks or thighs clenching, your breath being held, or any downward pushing.
Then train two ways:
- Slow holds: lift the muscles, hold for 5–10 seconds while breathing normally, then fully release. Build up to ten of these.
- Quick lifts: short, sharp lifts and releases — ten in a row — to train the fast response you need when you cough or sneeze.
The release is not an afterthought. A pelvic floor that can’t relax is just as problematic as one that’s weak, and the relaxation phase is what you’ll draw on during birth.
Why relaxing matters as much as squeezing
In pregnancy and birth preparation, the ability to let go of the pelvic floor is genuinely important. During the second stage of labour, these muscles need to release and lengthen to allow your baby to pass. Training that’s purely about clenching harder can, for some women, create an overly tense pelvic floor that doesn’t cooperate when it counts. That’s why a balanced approach — strength and suppleness, contraction and full release — is what I teach. It also tends to help with the pelvic and lower-back discomfort that’s so common as pregnancy progresses.
Fitting it into a busy pregnancy
The beauty of pelvic floor work is that no one can see you doing it. Link it to things you already do — waiting for the kettle, at a red light, feeding times later on — so it becomes automatic. A few focused minutes a day, done consistently, beats a long session you’ll skip. Combining the pelvic floor work with gentle, pregnancy-safe deep-core and breathing exercises makes the whole system stronger together, which is the approach a structured Pilates programme takes.
How the Pelvic Floor Strengthening protocol helps
Sophie’s 6-Week Pelvic Floor Strengthening Program teaches you to find, strengthen, and release these muscles properly — the part most quick guides skip — across 26 progressive exercises. It connects the pelvic floor to your breath and deep core so the whole support system works together through pregnancy and into recovery.
This article is for informational purposes only and does not constitute medical advice. If you have a high-risk pregnancy, pelvic pain, or any complications, please check with your midwife, obstetrician, or a women’s health physiotherapist before starting or continuing exercises.