Pelvic Floor Health After Birth

woman doing pelvic floor strengthening exercise

When I first met postpartum fitness trainer and doula Madison Cleckler, it was like we were speaking the same language. We practically finished each other’s sentences, which is really impressive when you consider that one of those sentences started with “I explain the pelvic floor as…” and ended with “both engaging and releasing it are equally important”.

Madison is an amazing resource when it comes to post-partum health, or really, pelvic floor and core muscle health overall. She is a fresh breath of mindful, self-loving wellness in the midst of an industry that prides itself on unrealistic mommy bounce-back bodies. I am so grateful for her wisdom, perspective, and encouraging attitude. I asked Madison to share some insight into demystifying the pelvic floor and helping us all to more easily understand its importance to our post-partum and long-term well-being.

Annie: What’s the easiest way to understand how our pelvic floor is constructed and its basic function?

Madison: The pelvic floor is actually a group of muscles that form a basket at the bottom of your pelvis, from pubis symphysis to tailbone, and hip to hip. It is quite literally the bottom of your bottom.  It is comprised of many different muscles that have fibers which run different ways, meaning each muscle serves its own purpose. These muscles help support your pelvic organs, aid in waste elimination and play a big part in pleasure. So many things in life affect the tone and function of these muscles and, because no one comments on how toned your pelvic floor muscles are at the beach, they are often overlooked.

A: Many women may not hear anything about their pelvic floor until they become pregnant, or after they have a baby. How do pregnancy and childbirth affect the pelvic floor?

M: During pregnancy and childbirth the weight of the growing baby places downward pressure on the pelvic floor, while hormones soften the connective tissues to prepare the body for childbirth. This causes the muscle fibers to elongate and become weaker.

A: What else affects its health?

M: The pelvic floor is also susceptible to weakening as we age due to improper posture, activity, and just life in general.

A: What are the top three things we should understand about our post-partum pelvic floor?


1. Recovery takes time. Your body may not fully recover from labor and delivery for a year or more. During this time the pelvic floor connective tissues may still be weak and the muscles may not be operating at their pre-baby strength quite yet.

2. Pelvic floor muscles are impacted even if you give birth via C-section. Think of it this way; if I place a giant rock on a trampoline (because the pelvic floor muscles operate much like a trampoline) and leave it there for 9 or 10 months, when I remove the rock,  the fibers of the trampoline aren’t going to be as strong as they were before the rock, right? Same applies for your pelvic floor after a C-section.

3. Ease back into exercise. The “all clear” for exercise at 6 weeks doesn’t mean that your pelvic floor is ready for all types of exercise. Running, jumping, and heavy loading postpartum can cause excess downward pressure on the pelvic floor and increase your chances of experiencing issues like incontinence and prolapse. It is best to find someone knowledgeable in the postpartum body that is able to program a safe return to more intense exercise and/or have an assessment done by a women’s health physical therapist to make sure your muscles are recovering well.

A: Show us a couple of exercises we can do with a few spare minutes to our workout, while dinner is cooking, or while watching television?


Side-Lying Clamshells:

Lie on your side with your head supported, knees bent at a 45-degree angle to the hips and feet stacked. Keeping the heels together, squeeze your top glute and lift the top knee. You want to make sure your hips don’t rock, so make sure you don’t lift the knee too high. Inhale while lifting the leg and exhale while lowering. You should feel a nice burn in the booty.  This will strengthen the outer glutes as well as (some of) the adductors and abductors. Do 12-15 of these each side.


Heel Slide:

Lie on your back with your knees bent and feet flat on the floor. Place your hands on your hip bones and inhale deep into your belly. Exhale and draw the bottom of the ribcage down to the floor. You want to make sure that the pelvis isn’t rolling through and the shoulders aren’t rounding forward, so you aren’t pulling the pelvis up to the ceiling or the shoulders down to the ribs. This is deceptively hard! Maintain that abdominal brace, exhale, and extend one leg- hovering it above the floor. Exhale and return the leg to starting position. Repeat on the opposite side, making sure the hips are not rocking and the belly stays engaged. Repeat 10 times on each leg.


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