below the belt

Pelvic-floor exercises for labor and beyond

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If you had to guess which muscles pregnancy is toughest on, you’d probably start with the abdominals. You’d be half-right, since pregnancy takes an equal toll on the pelvic-floor muscles. But what, you may wonder, do these muscles do? Besides supporting your bladder and the rest of the organs in the pelvis, they keep you from urinating when it’s ... well, inconvenient.

“The abs and the pelvic floor get stretched during pregnancy; there’s no avoiding it,” says Julie Tupler, R.N., who designed the workout featured here. “If you don’t exercise these muscles during pregnancy, it can be difficult to get them back in shape,” adds Tupler, a certified childbirth educator and fitness instructor in New York and founder of Maternal Fitness, an exercise program taught by registered nurses to prepare women for labor.

Strong muscles also are more flexible muscles, which can help you endure the “marathon of labor,” says Tupler. Working your abs and pelvic-floor muscles for even just a few minutes a day with the following workout can help make your labor and delivery easier.

do it right

1A. Elevators (the Tupler Technique) Sit cross-legged on the floor with your back against a wall. Place 1 hand on the center

of your abdomen, over your bellybutton, and the other just under your breasts. Inhale, expanding your belly. Then exhale and pull your bellybutton as close to your spine as possible (imagine your bellybutton pushing out through your spine); squeeze and hold for 1 second. Release slightly, your bellybutton still pulled in, for 1 second. Concentrate on keeping the pelvic-floor muscles relaxed. Aim for doing up to

100 repetitions (1 set). Do 5 sets per day, working up to 10.

After each set, do 1 set of Kegels (see below).

1B. Seated splint variation If you have diastasis recti (see page 112), do this variation instead: Sit cross-legged, wrap a towel around your belly and hold the ends of the towel with opposite hands. Keep your belly pulled in and do Elevator moves in the same manner as described above. Note: Tupler’s research revealed that after a six-week workshop, women’s diastases were unchanged or smaller, as opposed to growing wider. Columbia University graduate students are now researching this.

2. Pelvic tilts Lie on your back with 1 hand resting on your belly and the other near the small of your back (after your fourth month, prop your shoulders with a pillow so your head is higher than your heart). Bend your knees. Inhale to expand your belly; then exhale and draw your bellybutton toward your spine. Without tightening your buttocks, hold this position and press your back toward the floor, continuing to use your abs rather than your legs. Your pelvis may lift slightly off the floor. Hold for 1 second and release. Do 10 reps. Work up to 3 sets of 30 reps. In between each set, do 1 set of Kegels. Note: If you become dizzy, do this exercise from a side-lying position with your back braced against a wall.

3. Side-lying splinted lift Splint your belly as in 1B. Lie on your side with your back against a wall, knees bent [A]. Inhale and expand your belly; then exhale, pulling your bellybutton toward your spine in a “crunch” as you pull the splint inward to support your abs [B]. Imagine your bellybutton pushing out through your spine. Hold for 1 second, release and repeat. Do 10 reps, working up to 3 sets of 30. Do 1 set of Kegels in between sets.

4. Kegels (not shown) Sitting or lying down, put your hands on your belly and relax your abs; keep them relaxed during this exercise. Squeeze and hold the muscles around the vagina (as if stopping the flow of urine). Hold for 10 seconds; slowly release. Squeeze the muscles again when finished to shorten the muscle. Do 20 10-second holds 5 times a day (1 set should be performed in between each set of Elevators, pelvic tilts and side-lying splinted lifts). Note: If holding for 10 seconds is too difficult at first, start with 5-second holds, working up to 8 seconds and then to 10 seconds as you gain muscle strength.

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