Inhale or Exhale? Breathing Through Pelvic Floor Exercises

How do you breathe when you do kegels?  Do you inhale as you lift or exhale as you lift?  The good news is that there is no wrong answer.

There are many reasons why we invest time and energy into our pelvic floors during and after pregnancy.  How you breathe, depends on your purpose.

If you purpose is to strengthen your pelvic floor in order to avoid back pain, reduce incontinence, reduce your chances of tearing/having an episiotomy and avoid prolapsed organs, then you want to exhale as you engage.

Why? Three Reasons. 

Reason #1: Think about strength training in general.  You inhale to prepare and you exhale as you perform the hard part.  Well, your pelvic floor is a sling of muscles too.  Using your breath in this way will give you more power to lift, hold and therefore strengthen your pelvic floor muscles.  Remember, toned pelvic floor muscles are more elastic so are better able to stretch out of the way as baby is born.  All things being equal, toned pelvic floor muscles = less chance of tearing or need for an episiotomy. 

Reason #2: If you are currently 3+ months pregnant, let me ask you this… Do you have extra space in your abdomen right now?  I’m guessing the answer is ‘no’.  As your uterus grows is displaces all of your other organs and puts excess stress on your pelvic floor, blood vessels, nerves and more.  When you inhale your lungs fill with oxygen and your diaphragm pushes downwards. Trying to effectively lift your pelvic floor while you have significantly less space and your respiratory system is sending pressure downwards is counter productive.   

Reason #3: It promotes healthy breathing.  Our bodies naturally expand as we inhale and contracts as we exhale.  Watch a baby breathe.  Having healthy breathing patterns is integral to your health and is a fantastic tool for dealing with the sensations of labour as well as the stress of being a new parent.

If your purpose is to learn how to/practice relaxing your pelvic floor and perineum for the pushing stage of labour, then you want to add to your core training routine.  Let’s explore inhaling as you engage and exhaling as you relax.

Why? Two Reasons.

Reason #1: Have you ever been to a yoga class and they ask you to tense one muscle group and then release it.  Try it.  Tense your glutes for 5-10 second and then release.  What do you notice about your breath.  You probably inhaled briskly then held you breathe as you tensed and then exhaled thankfully as you relaxed.  Just as releasing tensions allows us to breathe, breathing allows us to release tension.  This can be a fantastic labour preparation tool.   

Reasons #2: Women with backgrounds in dance, gymnastics, horse back riding, waitressing, piano etc have often spent their whole lives with their pelvic floor and transverse abdominis muscles on all the time.  Some of these women find it easier to relax their pelvic floor if they are exhaling as they relax. 

My 2 Cents

During your 1^st and 2^nd trimesters, focus on engaging on the exhale.  This might take some time to learn but will serve your body well.  As you progress into your third trimester, continue with engaging on the exhale but giving more attention to the relaxation phase.  Honour the release as much as the lift.  Begin adding (not replacing) some pelvic floor work where you engage on the inhale and relax on the exhale.  Again, focus more on the relaxation stage.  Notice what works best for you when it comes to releasing your pelvic floor and softening your perineum.  Let this body awareness empower you during your childbirth experience.

Finding it difficult to stay disciplined with your pelvic floor exercises on your own? Feeling like you need more instruction and cues? You're in luck...there's an app for that! Download the mom-approved Pelvic Floor Trainer App and enjoy both visual and audio routines at your fingertips. 




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