Pelvic Floor Exercises After Birth: A Singapore Mum’s Guide

Pelvic floor exercises (Kegels) are the single most useful thing you can do for your bladder, bowel and core after having a baby, whether you delivered vaginally or by C-section. The basic move is a gentle squeeze and lift of the muscles you would use to stop passing wind and urine, held for a few seconds and then fully released. Start softly in the first days if it is comfortable, build up over about three months, and see a women’s health physiotherapist if you still leak, feel heaviness or have pain.

Our postpartum recovery guide covers the first six weeks as a whole. This guide goes deeper on the pelvic floor: how to check you are doing it right, a progressive plan, what changes after a caesarean and where to get help in Singapore.

What your pelvic floor does, and why birth affects it

Your pelvic floor is a hammock of muscles stretching from your pubic bone to your tailbone. It supports your bladder, womb and bowel, helps you hold in urine, wind and stool, and works with your deep tummy muscles to stabilise your back.

Nine months of carrying extra weight, plus pregnancy hormones that soften connective tissue, stretch these muscles whatever way your baby arrives. A vaginal birth adds further stretching, and sometimes tearing or an episiotomy. That is why small leaks when you cough or sneeze are so common early on. Common does not mean you have to live with it.

How to do a Kegel correctly

Many women squeeze the wrong muscles at first, so take a minute to find the right ones.

1. Get comfortable. Lie on your side or back with knees bent, or sit leaning slightly forward. Breathe normally.
2. Imagine stopping wind and urine at the same time. Gently squeeze around your back passage and front passage, then lift upwards and inwards, as if drawing a marble up inside you.
3. Hold, then let go completely. Hold for a few seconds while you keep breathing, then release fully and rest for about the same time before the next squeeze.
4. Add quick squeezes. Squeeze and lift firmly for one second, then relax. These train the fast reflex you need when you cough or sneeze.

Common mistakes to avoid

• Holding your breath. Breathe out gently as you squeeze.
• Squeezing your buttocks, thighs or tummy hard instead of the pelvic floor.
• Not relaxing fully between squeezes. The release matters as much as the lift.
• Practising by stopping your pee midstream as a routine. It can help you identify the muscles once, but doing it regularly may interfere with normal bladder emptying.

A progressive pelvic floor plan after birth

This is a general plan for an uncomplicated recovery. Your doctor or physiotherapist may adjust it, and it is fine to go slower. If anything hurts, stop and ask.

Most women notice improvement over weeks to a few months of regular practice, so keep going.

Pelvic floor exercises after a C-section

A caesarean does not bypass the pelvic floor. Pregnancy itself stretches these muscles, and many mums who had a C-section, especially after a long labour, still have some leaking or weakness.

• Gentle squeezes can usually start soon after birth once your catheter is out and you feel able, but follow your hospital’s advice.
• Breathe into your belly and let your tummy relax between squeezes. Hold a pillow over your wound if coughing or laughing hurts.
• Add gentle tummy work slowly. A light draw-in of your lower belly on an out-breath, together with a pelvic floor squeeze, is often the first step. Avoid sit-ups and crunches in the early weeks.
• Protect your wound. Roll to your side to get out of bed and avoid lifting anything heavier than your baby until your doctor says otherwise.

Our guide to confinement after a C-section covers wound care, food and rest during the first month. For practical supplies such as a peri bottle and cold packs, see our postpartum recovery kit.

Relaxation matters too

Not every pelvic floor problem is weakness. Some women have muscles that are tense and unable to relax, which can cause pain during sex, difficulty emptying the bladder or bowel, or pelvic pain.

If squeezing makes pain worse, focus on the release: breathe slowly into your belly and let your pelvic floor soften and drop on each in-breath. A physiotherapist can assess whether you need strengthening, relaxation or both. Pain during sex after birth is common but worth mentioning at your postnatal check rather than putting up with it. It is also a good moment to talk about contraception options after birth.

Getting back to exercise safely

Walking is ideal from the early weeks, ideally in the cooler morning or evening. Most doctors in Singapore clear you for more structured exercise at the postnatal check around six weeks, but a clearance to exercise is not the same as a pelvic floor that is ready for running or jumping.

UK guidance for postnatal return to running suggests waiting until at least 12 weeks after birth and building up gradually. Before high-impact exercise, you should be able to walk briskly, climb stairs and do basic strength moves without leaking, heaviness or pain. Also check for a gap in your tummy muscles (diastasis recti), which is common after pregnancy and usually improves, but may need guided exercises.

Stop and get advice if you notice leaking, a dragging or bulging feeling in your vagina, or pelvic or back pain during or after exercise.

When to see a women’s health physiotherapist in Singapore

Ask your gynae, GP or polyclinic doctor for a referral, or book privately, if you have:

• Bladder leaks that are not improving by your six-week check, or that stop you from exercising.
• Any leaking of stool, or difficulty controlling wind.
• A heaviness, dragging or bulging feeling in your vagina, which can be a sign of prolapse.
• Pain during sex, or pelvic, perineal or tailbone pain that lingers.
• A third- or fourth-degree tear during birth.
• Uncertainty about whether you are doing the exercises correctly.

Where to go

• KKH: physiotherapists teach pelvic floor exercises after birth and treat bladder and bowel problems. KKH has also offered postnatal physiotherapy education for mums who delivered recently.
• NUH and SGH: both have physiotherapists who treat pelvic floor and bladder problems. SGH’s pelvic health physiotherapy service explains what an assessment involves.
• Polyclinics: a polyclinic referral to a public hospital is usually the most affordable route, with subsidised rates for eligible patients.
• Private clinics: many private physiotherapy practices have women’s health or pelvic health physiotherapists, and some private hospitals offer them too. Fees vary widely, so ask when booking.

A first appointment usually includes questions about your birth and symptoms, and, with your consent, an internal examination to check how your muscles squeeze and relax. You can ask for a female physiotherapist or a chaperone.

Pelvic floor problems can also affect how you feel about yourself. If you are feeling low or anxious as well, read our guide to postnatal depression in Singapore.

Key takeaways

• Every mum benefits from pelvic floor exercises, including after a C-section.
• Squeeze and lift, breathe out, hold, then fully relax. Add quick squeezes.
• Build up over about three months and keep doing a daily set for life.
• Wait until your pelvic floor is ready, often not before 12 weeks, before running or jumping.
• Leaks, heaviness or pain are reasons to see a women’s health physiotherapist, not things to put up with.

Find more on your own recovery in our postpartum section.