To Kegel or NOT Kegel for Birth
Why Kegels Aren’t Ideal for Birth Preparation
Kegels have long been touted as a staple exercise in pregnancy & birth preparation, but recent understanding of pelvic floor function challenges this notion, especially when it comes to birth. Mainstream resources, including popular pregnancy guides like What to Expect When You’re Expecting, promote Kegels as a go-to for preparing the pelvic floor. However, while Kegels can improve pelvic floor strength and control, they may actually hinder some women when it comes to the demands of childbirth. As we dig deeper into the biomechanics of labor and birth, it becomes clear that pelvic floor lengthening, relaxation, and breath work are essential elements for an effective birth plan—often more so than the contraction-focused nature of Kegels.
Misleading Information in What to Expect When You’re Expecting
What to Expect When You’re Expecting, though a staple for many expecting mothers, may be distributing advice that can actually lead to increased tension rather than ease during labor. The problem lies in the fact that Kegels are an exercise designed to contract and tighten the pelvic floor. While strengthening may be useful for continence or postural support, birth requires the pelvic floor to release, lengthen, and yield under pressure, not contract or tighten. During childbirth, a shortened, tense pelvic floor can work against the body’s natural processes. It resists rather than opens, potentially creating a narrower passage and increasing the time needed for labor. When the pelvic floor is unable to lengthen, the baby has a harder time descending, which can add hours to the birth process. Moreover, Kegels encourage the pelvic floor to hold tension, which isn’t conducive to the flexibility needed in labor. The high degree of tension they introduce works against the natural rhythm that birth requires.
Kegels and the Sympathetic Nervous System
The effects of Kegels extend beyond the physical strain of shortened muscles. Engaging in these exercises repeatedly tends to activate the sympathetic nervous system—the body’s “fight or flight” response—rather than the parasympathetic, which promotes rest, relaxation, and recovery. Kegels are inherently about exertion and control; they require a degree of focus and effort that can bring a heightened sense of alertness. In labor, however, the opposite state is beneficial. For an effective birth process, we want to cultivate a parasympathetic response: deep breathing, relaxation, and a sense of calm. When the sympathetic nervous system dominates, labor can be prolonged and pain levels can increase due to a reduced ability to relax. This heightened stress can delay labor progress as muscles are not able to soften and release easily. In contrast, activating the parasympathetic nervous system through breath work and relaxation can make a significant difference in labor efficiency and comfort.
Why Lengthening the Pelvic Floor Matters
The focus on Kegels can overshadow the need for true pelvic floor preparation for birth, which involves lengthening these muscles, not tightening them. Birth requires an opening of the pelvic outlet, an ability to surrender and allow the body’s processes to unfold. With Kegels, we’re sending mixed signals to the body: tightening a muscle group that we then need to relax and lengthen on demand. Rather than Kegels, pregnant women benefit from exercises and practices that promote relaxation and elasticity in the pelvic floor, as well as exercises that engage the full range of the pelvis and hips. Hip openers, squats (particularly mid-range squats rather than deep squats), and positions that lengthen the pelvic floor are far more conducive to the birth process. Learning to engage these muscles in lengthening, dynamic ways rather than repetitive contractions allows the body to open, providing the baby more space to descend through the birth canal.
The Role of Breathing and Pushing Techniques in Birth
Breathing exercises also play a crucial role in this preparation. The way we breathe affects the way we carry tension, and in labor, breath work that focuses on deep, diaphragmatic breathing can support pelvic floor relaxation. This type of breathing naturally draws the diaphragm and pelvic floor into a synchronized rhythm, encouraging lengthening on the exhale. Breath training can help expecting mothers feel more connected to the process of letting go rather than holding on, a crucial distinction when preparing to birth. For many, the effort to hold and control (as in Kegels) becomes counterproductive because it draws them away from the yielding, receptive state that birth requires.
Efficient pushing is another area where Kegels may fall short as a preparatory tool. While Kegels strengthen the muscles that help with holding and releasing urine or supporting pelvic organs, they don’t necessarily train the body for effective pushing during birth. Pushing in labor isn’t a controlled, short squeeze like a Kegel but rather a coordinated, whole-body exertion that works with the uterus to guide the baby downward. Effective pushing engages more than the pelvic floor; it uses the full core, including the diaphragm, abdominal muscles, and pelvic floor in a synchronized manner. By focusing on practices that encourage this type of integration—like deep squats, pelvic floor lengthening exercises, and breathing techniques—expecting mothers can prepare more effectively for the demands of labor. These alternatives also reduce the risk of perineal trauma because they promote a natural yielding in the tissues rather than a rigid hold.
Research Shows Relaxing the Pelvic Floor Improves Labor Outcomes
Research supports the idea that a relaxed pelvic floor is more beneficial for labor than a tightened one. Studies have shown that increased pelvic floor muscle tension can lead to prolonged second stages of labor and increase the likelihood of interventions like episiotomies or instrumental deliveries. Lengthening and relaxing these muscles, on the other hand, can create an easier pathway for the baby, potentially decreasing labor time and making the experience less strenuous for the mother. While Kegels have their place in pelvic health—especially for addressing urinary incontinence or mild pelvic organ prolapse—they may not be the best exercise for the unique needs of birthing. By focusing on lengthening, breathing, and efficient movement, expecting mothers can prepare their bodies to work with the natural forces of labor, creating a smoother, less resistant pathway for their baby.
Embracing a New Approach to Birth Preparation
While Kegels are widely recommended as a standard part of pregnancy fitness, they may not serve the needs of birth as effectively as we once thought. Labor and delivery require openness, flexibility, and the ability to let go—qualities that are better supported by pelvic floor lengthening, effective breathing, and learning how to push efficiently. By moving away from a contraction-focused approach and embracing practices that encourage relaxation and release, mothers can prepare more holistically for the demands of childbirth. As we continue to learn more about the body’s needs during labor, we may need to rethink some of the traditional advice, replacing it with methods that truly support the physiological demands of birth.
