Pelvic Floor Exercises During Pregnancy: A Trimester by Trimester Guide

Pregnancy changes your body in ways you can see, and in ways you cannot. One of the biggest changes happens somewhere most people rarely think about until something feels different: the pelvic floor. Understanding how these muscles work, and learning how to look after them at each stage of pregnancy, can make a real difference to your comfort now and your recovery later.

At Active Women’s Health, our physiotherapists see women at every stage of pregnancy and beyond. This guide brings together trusted, Australian health guidance to help you understand your pelvic floor and how to care for it through each trimester.

What is the Pelvic Floor and Why Does it Matter in Pregnancy

Your pelvic floor is a group of muscles that stretches like a hammock from your pubic bone at the front to your tailbone at the back. It supports your bladder, bowel and uterus, and it plays a part in bladder and bowel control, core stability and sexual function.

During pregnancy, this hammock of muscle takes on extra work. It carries the growing weight of your baby, and it needs to be strong enough to support your pelvic organs while also being able to soften and stretch when the time comes for birth. A pelvic floor that is working well can reduce your risk of bladder and bowel leakage, support faster recovery after delivery, and help your body cope with the physical demands of pregnancy and early motherhood.

How Pregnancy Changes Your Pelvic Floor

Pregnancy hormones soften the tissues and ligaments throughout your body, including those that support your pelvic floor. This is a normal and necessary part of preparing your body for birth. At the same time, the growing weight of your uterus places increasing pressure on these muscles from above.

Together, these changes mean your pelvic floor has to work harder as your pregnancy progresses. It is very common to notice some bladder or bowel changes during pregnancy, and around one in three women experience some form of urine leakage either during pregnancy or after birth. These changes are common, but they are not something you simply have to live with. With the right guidance, most women see real improvement.

How to Find and Feel Your Pelvic Floor Muscles

Before you can strengthen your pelvic floor, it helps to know what you are actually squeezing. Many women find this tricky at first, and that is completely normal.

Start in a comfortable position, either sitting tall with your feet flat on the floor or lying down with your knees bent. Relax your thighs, buttocks and tummy. Gently lift the muscles around your front passage, as though you are trying to stop the flow of urine, then let go. Next, do the same around your vagina, drawing it gently upward and inward, then release. Then try lifting around your back passage, as though holding in wind, and release again.

Once you can feel each part working on its own, try lifting all three areas together in one smooth squeeze and lift. You should feel a gentle drawing up sensation, followed by a clear feeling of letting go when you relax. Keep your breathing normal throughout, and try not to clench your buttocks, thighs or tummy while you do this.

If you find it hard to feel these muscles working, or you cannot tell whether you are lifting or bearing down, this is a good reason to see a pelvic health physiotherapist for a proper assessment rather than guessing.

Pelvic Floor Exercises in the First Trimester

The first trimester is a good time to build the habit of pelvic floor exercises, even before symptoms appear. Your body has not yet taken on the full weight of pregnancy, which can make it easier to learn the correct technique.

Focus on getting the basics right during these early weeks. Practise finding and lifting your pelvic floor muscles in different positions, such as sitting, lying and standing. Once you feel confident locating the right muscles, begin holding each lift for a few seconds before fully relaxing. Many women find it helpful to link this practice to something they already do each day, such as waiting for the kettle to boil or sitting at the traffic lights, so the habit becomes part of daily life rather than another task on the list.

Early pregnancy is also a sensible time to talk with your doctor, midwife or a pelvic health physiotherapist about your general exercise plans for pregnancy, particularly if you already have any bladder, bowel or pelvic symptoms.

Pelvic Floor Exercises in the Second Trimester

As your pregnancy moves into the second trimester, your uterus grows noticeably and the pressure on your pelvic floor increases. This is often when women first notice small leaks of urine when they cough, sneeze, laugh or exercise.

Keep up your pelvic floor exercises through this stage, building on the foundation from earlier in pregnancy. Aim to hold each lift a little longer before relaxing fully, resting for a similar amount of time between each squeeze. From around sixteen weeks, it is generally recommended to avoid exercising flat on your back, so practise your pelvic floor lifts side lying, sitting or standing instead.

This is also a good time to start using what is sometimes called the knack. This simply means gently lifting and bracing your pelvic floor just before you cough, sneeze, laugh or lift something, then relaxing again afterward. This small habit can help protect your pelvic floor from the sudden increases in pressure that happen many times a day.

Pelvic Floor Exercises in the Third Trimester

In the final trimester, the weight of your baby is at its greatest, and your pelvic floor is working hard to support everything above it. Continue your pelvic floor exercises through this stage, adjusting your position for comfort as needed.

It is worth remembering that a strong pelvic floor is not just about squeezing. Your pelvic floor muscles also need to be able to relax and lengthen fully, since this is what allows your baby to move through the birth canal during a vaginal delivery. Practising the full lift and release, rather than only focusing on the squeeze, can help you feel more prepared for labour.

Third trimester is also a sensible time to speak with your doctor, midwife or physiotherapist about what to expect for your pelvic floor during labour and in the days after birth, and to check that your technique is still correct as your body continues to change.

Common Signs Your Pelvic Floor Needs Extra Support

Some pelvic floor changes during pregnancy are common, but that does not mean they should be ignored. It is worth mentioning any of the following to your doctor, midwife or a pelvic health physiotherapist. Leaking urine when you cough, sneeze, laugh, lift or exercise. A sudden or strong need to rush to the toilet. Finding it hard to control wind or bowel motions. A feeling of heaviness, dragging or bulging in your vagina. Ongoing constipation or straining on the toilet. Pain in your pelvis, back or during sex.

Noticing these symptoms early and getting the right support can help prevent them from becoming bigger issues later in pregnancy or after birth.

When to See a Pelvic Health Physiotherapist

You do not need to wait until something feels wrong before seeing a pelvic health physiotherapist. Many women benefit from an assessment during pregnancy simply to check their technique and build confidence, even without symptoms.

That said, it is particularly worth booking an appointment if you cannot feel your pelvic floor muscles working, if you notice no improvement in bladder or bowel control after a few weeks of regular exercises, if you have back or pelvic pain, or if you notice a bulge or ache in your vagina. A physiotherapy check after birth is also considered a routine part of postnatal care, usually scheduled around six to eight weeks after delivery, and is worthwhile even if you feel well.

Preparing Your Pelvic Floor for Birth and Recovery

Looking after your pelvic floor during pregnancy is really about preparing your body for two things: the physical work of labour and birth, and the recovery that follows. Alongside your pelvic floor exercises, a few everyday habits can help. Eating a diet with plenty of fibre and drinking water throughout the day supports regular, comfortable bowel movements, which reduces straining and the pressure this places on your pelvic floor. Good toilet habits matter too, such as only going when you feel the urge rather than just in case, and sitting in a relaxed position with your feet supported and your elbows resting on your knees.

Gentle, pregnancy safe movement also plays a role in supporting your pelvic floor and overall wellbeing, though any new or existing exercise routine should be discussed with your doctor, midwife or physiotherapist, particularly if you have any pregnancy complications.

After birth, your pelvic floor needs time to recover, and this is completely normal regardless of whether you had a vaginal birth or a caesarean. A women’s health physiotherapist can guide you through safely restarting pelvic floor exercises, assess any ongoing symptoms and help you plan a safe return to exercise and daily activities at your own pace.