Kegels During Pregnancy: Do You Really Need to Do Them?

As a pelvic floor physical therapist, I want to chat with you about something that might (and might not) be on your radar yet: Kegels.

If you're in the back wondering, “What the heck is a Kegel?” — a Kegel is a pelvic floor muscle contraction. It involves intentionally contracting and lifting the pelvic floor muscles, which help support your bladder, bowel, and pelvic organs.

You've probably heard that you should be doing them during pregnancy.

Contract. Lift. Hold. Release. Repeat.

In fact, many women come to see me saying, “I need to strengthen my pelvic floor.”

But here's what I want you to know:

Being pregnant doesn't automatically mean you need to strengthen your pelvic floor.

Your Pelvic Floor Doesn't Need to Be Squeezed All Day

Your pelvic floor is made up of muscles, and like every other muscle in your body, they aren't meant to be contracted all day long.

No muscle in your body is meant to function by being squeezed all day long.

Think about your biceps. A healthy, strong biceps isn't one that's constantly flexed. Your jaw isn't healthy because you clench it all day. Your shoulders don't become stronger by staying shrugged toward your ears.

Your pelvic floor is no different.

Strength and tension are not the same thing.

A muscle can have good strength and appropriate resting tone while still being able to fully relax and lengthen. And a muscle that feels tight or tense isn't necessarily a strong muscle. In fact, muscles that are chronically tense can sometimes be quite weak and have difficulty contracting and relaxing efficiently.

So when someone tells you, “You need to strengthen your pelvic floor because you're pregnant,” I want you to pause.

If you're not experiencing pelvic floor symptoms and your pelvic floor is already functioning well, there isn't necessarily a reason to start a strengthening program simply because you're pregnant.

Pregnancy can instead be a wonderful time to become more aware of, connected to, and educated about your pelvic floor.

Can you feel it contract?

Can you feel it relax?

Can you coordinate it with your breath?

Can you notice when you're holding unnecessary tension?

Can you understand how your body responds to different movements and positions?

That awareness is valuable preparation for birth.

Because your pelvic floor doesn't work in isolation. It's part of a larger system that is constantly adapting to your growing baby and the changing demands of pregnancy.

If your pelvic floor is doing its job well, you don't need to fix what isn't broken.

Instead, this can be a season to learn about your body, build awareness and trust, and develop the ability to both engage and let go when your body needs to.

And when it comes to birth, the ability to let go matters.

Does Your Pelvic Floor Actually Need Strengthening?

Pelvic floor strengthening can absolutely be beneficial for some people, but it's usually less about simply doing Kegels for the sake of getting stronger and more about helping the pelvic floor function well again — particularly when there are symptoms or a specific reason to improve pelvic floor strength and function.

But here's where I think the conversation often gets too simple.

We hear:

“Pregnant? Do your Kegels.”

And I think there's a better question to ask:

“What does my pelvic floor actually need?”

For some people, strengthening may be one part of the picture.

For someone else, it may be learning to release tension.

For another person, it may be improving coordination, breathing, mobility, or pressure management.

And often, it's a combination of these things — because the pelvic floor doesn't function in isolation.

The point is that pregnancy alone doesn't tell you what your pelvic floor needs.

What Does Your Pelvic Floor Need for Birth?

Here's where I want to shift the way you think about pelvic floor preparation.

Birth isn't a pelvic floor strength event.

During a vaginal birth, your pelvic floor needs to be able to lengthen, soften, stretch, descend, and make space as your baby moves through the pelvis.

That doesn't mean pelvic floor strength is bad or that there aren't times when strengthening is appropriate.

It means pelvic floor strengthening and preparing your pelvic floor for birth are two different goals.

You don't need to have a highly conditioned pelvic floor to give birth. People birth every day without ever having intentionally strengthened their pelvic floor.

And if you've been taught that preparing your pelvic floor means repeatedly tightening and squeezing it, it's important to understand that this is not the goal during the part of birth when your pelvic floor needs to open and yield.

So instead of automatically asking, “How can I strengthen my pelvic floor?”, I'd encourage you to ask:

“How can I become more aware of, connected to, and prepared for what my pelvic floor will need to do during birth?”

Your pelvic floor needs to be responsive.

It needs to be able to relax and lengthen as your baby moves through. It needs to respond to pressure and coordinate with your breath and body.

That's why I don't want you spending your entire pregnancy thinking:

“I need to do more Kegels or pelvic floor strengthening.”

Instead, I'd love for you to start thinking:

“I want to understand my pelvic floor.”

Pregnancy Is a Time to Get Connected

You don't have to wait until something is wrong to become aware of your pelvic floor.

Pregnancy is actually a wonderful time to learn about this part of your body.

Notice what it feels like when you contract.

Notice what it feels like when you relax.

Notice whether you're holding tension without realizing it.

Pay attention to how your pelvic floor responds to your breath, movement, different positions, and changes in pressure.

Learn what your body is doing now, before you ask it to do something incredibly demanding during birth.

This isn't about adding another thing to your pregnancy to-do list.

It's about connection and education.

The more you understand your body, the more informed you can be about what it may need during pregnancy, birth, and postpartum.

And if you're experiencing symptoms such as leaking, pelvic pressure, pain, heaviness, or other changes that concern you, that's a great reason to seek individualized pelvic floor physical therapy to determine what your body actually needs.

Kegels Aren't Bad. They're Just Not the Whole Story.

I want to be really clear about this.

I'm not anti-Kegel.

Kegels can be an incredibly useful tool when they're appropriate for the person doing them. But Kegels are NOT a full pelvic floor rehab program.

What I am challenging is the idea that "every pregnant person needs to strengthen their pelvic floor simply because they're pregnant."

Your pelvic floor doesn't need to be constantly contracted to be healthy.

And tight doesn't automatically mean strong.

Instead, think about function.

Can your pelvic floor contract?

Can it relax?

Can it lengthen?

Can it respond to pressure?

Can it coordinate with your breath and movement?

Can you feel what's happening?

That's a much bigger picture than simply counting Kegels.

Prepare Your Pelvic Floor for Birth — Inside & Out

If you're ready to stop thinking about your pelvic floor as something you simply need to squeeze more, and instead want to understand how to prepare it for the demands of birth, that's exactly why I created my birth prep program.

Prepare Your Pelvic Floor for Birth — Inside & Out

Release tension, regulate your nervous system & prepare your body to push.

This self-paced digital program helps you prepare your mind, body, and pelvic floor for birth through movement, mindful perineal massage, nervous system regulation, deep pelvic floor release, and pushing preparation.

Because preparing your pelvic floor for birth isn't about making it as strong or as tight as possible.

It's about helping your body become more aware, adaptable, and prepared for what birth asks of it.

→Explore the program & get started here

This program is educational and does not replace individualized evaluation or treatment from a pelvic floor physical therapist or other healthcare provider.

Wishing you a healthy and joyful pregnancy!

Love,Dr. Ashley