Improving The Core and Pelvic Floor of Pregnant Women, New Moms and Female Athletes

By Isa Herrera, MSPT

Training the pelvic floor muscles during pregnancy, in the immediate post-partum period and during sports should involve a multi-system approach.

For over a decade when I rehab the pelvic floor and core muscles I work within the muscular, fascial, respiratory and nervous systems. I also incorporate mind-body visualizations so that the patient/client can have an easier time connecting to and performing the exercises. There are two exercises that I feel are multi-system exercises that not only balance the pelvic floor muscles, but also strengthen the core, the back and provides great stability for the pregnant women.

The transverse abdominal (deep core muscle) muscles make a circuit with the internal oblique abdominal muscle, multifidus (deep back muscle), the diaphragm and the pelvic floor. They all have a synergistic relationship with each other and they work together to produce stability and power.

To connect this ring of muscles and the diaphragm in pregnancy and to enhance sacral stability, pelvic suppleness/flexibility while strengthening the pelvic floor, one must think globally and incorporate them all into exercises.

The “Hug Your Baby Exercise” has two phases and the “Box Plank” has two phases. Each phase will be explained but also look at the video to get a more grounded perspective.

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Phase One of “Hug The Baby” Exercise has 3 Parts:

Part one: A transverse abdominal hold: Imagine you are gently bringing your belly button in towards your spine and lifting your baby up to your towards your heart. You must have both these actions to get the transverse abdominal muscle to kick in properly. It is a gentle activation at about 30% of effort.

Part two: Perineal lift (low-level intensity kegel at about 30% effort.)

Part three: Exhalation breath as you hold the transverse hold and perineal lift.Typically, your client/patient would hold phase one for 3-5 seconds.

Phase Two of Hug The Baby” Exercise has 2 Parts

Part One: After phase one is completed your patient then inhales deeply to release the transverse abdominal hold and expands her belly.

Part Two: As she inhales she imagines that the inhalation is not only expanding her belly and but is also opening the basin of the pelvic floor muscles. This release of the pelvic floor muscle is what I coined as a “reverse kegel” and is the part two of phase two. This deep relaxation of the pelvic floor muscles must be coordinated with the inhalation and physiologic movement of the diaphragm. This insures flexibility and suppleness to the pelvic floor muscles.

Box Plank

For Box Plank Exercise your patient is incorporating part one of “Hug The Baby” exercise as she lifts her knees off the floor. For part two of the “Box Plank” your client /patient is releasing her transverse hold and then goes into Childs pose and inhales as she releases and relaxes her pelvic floor muscles.

Please note: If “Hug The Baby” or The Box Plank are performed with forceful abdominal contractions and with poor coordination of the breath and or breathe holding then there’s is an increased risk for prolapse and pelvic floor tension and poor results.

I see many prenatal programs out there recommending core exercises during pregnancy, much of it not involving the pelvic floor muscles, transverse abdominal muscle, and diaphragm. I find this to be problematic when core exercises that do not incorporate the circuit of muscles I just spoke about create more disconnection and more pelvic floor dysfunction.

If you overlook the couterparts of inhalation and reverse kegel while performing the “Hug The Baby” and “The Box Plank” exercises,  then we risk creating excessive tension, spasms and trigger points within the pelvic floor muscles. Sometimes this excessive tension adversely affects the hips, gluteal and lumbar muscles contributing to pelvic instability and imbalances in the pelvic floor. Layer on, these imbalances can contribute to sexual dysfunction, pelvic instability, organ prolapse, incontinence and sexual pain.

Benefits Of The Hug The Baby and Box Plank Exercises:

  • Helps to enhance lumbar and sacroiliac joint stability.
  • Helps with diastasis recti separation by toning the connective tissue linea alba and tones the abdominal muscles.
  • Creates flexibility in the pelvic floor muscles.
  • Maintains hydration and tone to the pelvic floor muscles.
  • Helps to improve posture.
  • Relieves back pain, sciatica pain and Symphysis Pubic Dysfunction.
  • Strengthening the back muscles.

More Information Like This in My Online Course

Female Pelvic Training For Birth and Wellness Professionals” is opening soon for enrollment.

If would like to learn how to effectively train the core, pelvic floor muscles during pregnancy, in the post-partum period and during sports without having to do internal work, then this class is for you.


Get on the waitlist enrollment opens in April.


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