Most people who ask us this have spent months being told to squeeze. Kegels at red lights, Kegels while nursing, Kegels on the toilet. Then they come in with urgency, a bladder that never feels empty, pain with a tampon or sex, or a tailbone that aches by dinner, and the problem turns out to be the opposite of weak. The muscle is on all day and can't come down.
A pelvic floor that won't relax is at least as common after birth as one that won't contract. Often it's both at once: a muscle that holds at a low grip all day gets tired, and a tired muscle tests weak. So squeezing harder makes it worse, and nobody told you that.
The short version: you relax the pelvic floor the same way you relax a jaw. You notice you're clenching, you breathe into the right place, and you give the muscle positions where it's hard to grip. Then you repeat that often enough that it becomes the default again.
At a glance
Belly breathing to let go
- 1
Lie on your back, knees bent, one hand on your belly, one on your ribs. Soften your jaw and shoulders.
- 2
Breathe in through the nose for 4 counts. Belly rises, pelvic floor sinks down like a hammock.
- 3
Breathe out through your mouth for 6 counts. Do not squeeze. Let the pelvic floor stay heavy and loose.
- 4
Repeat for 10 breaths. If you feel a lift on the out breath, slow down and breathe even softer.
- 5
Do this twice a day: in bed before you get up, and after one feed, from the first week on.
How to tell if you're holding
Sit down somewhere ordinary, a kitchen chair is fine, and don't change anything. Then check three things.
Are your glutes on? Press a thumb into the meat of one buttock. If it's hard before you've done anything, that's a clue. The glutes and pelvic floor usually clench together.
Is your tailbone tucked under you? A held pelvic floor tends to pull the tailbone forward, so you end up sitting on it, not on the sit bones. If you can't easily find two bony points under you, you're probably tucked.
Where does your breath go? Put one hand on your chest and one just under your ribs. Breathe normally. If the top hand moves and the bottom one doesn't, your diaphragm isn't doing its job, and the pelvic floor is almost certainly bracing to make up for it.
Other signs we hear about: holding your breath to pick up the car seat, a stream that starts and stops when you pee, needing to "push" a little to start, a feeling of something being in the way during sex, and going to the bathroom "just in case" eight times a day. None of these prove anything on their own. Together they tell a pretty clear story.
Before any of this becomes a program, get the go-ahead from your OB-GYN or midwife, usually at the six-week visit, and if you have leaking, heaviness in the vagina, pain with sex, or a belly gap that isn't closing, ask for a referral to a pelvic floor physical therapist. We can check internally what you can only guess at from the outside.
The drop
This is the piece most people have never been taught. On an inhale, the diaphragm moves down and the pelvic floor is supposed to move down with it. On an exhale, both come back up. If the pelvic floor is locked, it never goes anywhere, so the first job is to get it moving again, and the direction we want first is down.
Lie on your side with a pillow between your knees, or on your back with knees bent and feet flat. Side is better in the first few weeks because you don't have to fight gravity.
Put one hand low on your belly, below the navel. Breathe in through your nose for a count of 4 and send the air down toward that hand, so the belly rises and the lower ribs widen out to the sides. As the air comes in, let the area between your sit bones get wider and lower. Not push. Let. The feeling is closer to the moment you finally sit down on the toilet after holding it too long than to anything you'd call an exercise.
Then exhale through pursed lips for a count of 6 and let everything come back up on its own. Don't add a Kegel at the top. Just let it return.
Do 8 to 10 of these. Twice a day, 5 minutes total, for 2 to 3 weeks before you decide whether it's helping. It takes about that long for a muscle that has been held for months to trust the new instruction.
If you can't feel anything down there at first, that's normal. Two tricks. One: do it on the toilet, feet on a small step or a stack of books so your knees are above your hips, and breathe in while you pee. The stream should get easier, not harder. Two: with clean hands and your doctor's okay, rest a fingertip lightly on the perineum through your underwear during the breath. You should feel it move toward your hand on the inhale, very slightly. If it moves away, you're bearing down, which is a different thing and not what we want.
Positions that help the drop happen on their own:
- Child's pose with knees wide and a pillow under the chest so you aren't folded flat. Breathe into the back of your pelvis.
- Hands and knees, hips back toward your heels, letting the belly hang. Nobody looks good here. Nobody is watching.
- A deep squat holding a doorframe or the crib rail, heels on a folded towel if they lift. Only if your knees are fine with it and you've had clearance.
- Lying on your back with your calves up on the couch cushion, knees bent at 90, for 5 minutes before bed.
Pick one and spend 2 minutes in it while you breathe. That's the whole session.
What you do the rest of the day
The 10 minutes of breathing lose to the 14 hours of gripping if you don't change the gripping.
Exhale when you lift. Picking up the baby, the car seat, the laundry basket. Breathe out as you stand up, the way you'd blow out a candle slowly. Holding your breath and bracing is the fastest way to teach the pelvic floor to lock.
Stop the "just in case" trips. Aim for every 2 to 4 hours while awake. Going constantly teaches the bladder to signal early and the muscle to stay guarded.
Don't hover over public toilets. Sit. A hovering pelvic floor can't let go, and you end up pushing to empty.
Loosen your waistband. Leggings that press low on the belly all day change how you breathe without you noticing. Same for a belt or a tight nursing bra that stops the ribs from widening.
Walk. 10 to 20 minutes, flat ground, arms swinging. Walking moves the pelvis side to side in a way nothing else does.
A note on the words "bulge" and "heaviness," since this post talks about letting things move down. Relaxing is a few millimeters. If you feel a lump at the vaginal opening, if something hurts when you bear down, if you're soaking a pad an hour, running a fever, or have chest or calf pain, that's a same-day call to your provider or 911, not a breathing exercise. The same goes for any thought of harming yourself or your baby. None of that waits for an appointment.
Most people notice the first change in the bathroom, usually the stream getting easier within a week or two. Sex and tailbone pain tend to take longer, closer to the 6-week mark, and often need hands-on work from a therapist to finish the job. We can't tell you a date because every pelvic floor we've examined has a different history, and yours includes whatever happened at your birth.
If you want the daily routine written out in order, our guide "The 10-Minute Mom Pooch Reset" puts this breathing first, before any core work, which is the order we use in clinic.
The 10-Minute Mom Pooch Reset
The 12-week, 10-minute-a-day core and belly plan for exhausted moms: the gap check, breath-to-core, three phases, kitchen-counter and naptime routines, food that helps, and 6 printable trackers.
See the plan →Not sure yet? Take the free 2-minute quiz
Educational content from the Mom Pooch Reset team. Not medical advice for your specific situation. Get clearance from your OB-GYN or midwife before exercising after birth, and see a pelvic floor physical therapist for leaking, pain or a bulge.
