For years, “kegeling” has been widely promoted in the birthing world as a highly effective and crucial prenatal exercise.  Less focus is placed on abdominal and back strength because, seemingly, the abdominal and back muscles are not used to birth the baby.  However, this is rather far from the truth.  Having poor abdominal tone throughout pregnancy will cause many more physical discomforts for mom throughout pregnancy, and can more directly affect baby’s position and rotation through the pelvis.  Equally, it is possible to “Kegel” (that is, strengthen the pubococcygeous muscles) incorrectly, or too much, and create increased and unnecessary tension, when what mom really needs is to learn the ability to relax the muscles of the birth canal, not contract.  This can result in a longer and more difficult birthing stage, just the opposite of what the "Kegel" exercise is promoting.

First of all, our bodies are just as strong as they need to be to do the job they were designed to do.  Yes, it is true that most of us sit and are inactive much more than what our ancestors were, resulting in varied body shapes, so low-impact daily physical activity is an optimal addition to your daily routine.  Do you need to bench press or run marathons?  Absolutely not.  Our bodies were designed to work in fields, hunt and gather food, tend to household chores, and birth babies.  The tone necessary to birth our babies was created from our regular daily chores and tasks.  Do we know of more beneficial practices now than what people did hundreds of years ago?  Of course – but lets put our modern practical knowledge to use where it is necessary and understand our body’s design before promoting the necessity of something.  Contrary to many's beliefs, our bodies really haven't evolved over the past hundreds of years, and are still designed (brain and all) to do what they were meant to do from the beginning.

One of the important things to understand is that our pre-pregnancy health directly affects our prenatal and postpartum health.  This goes from nutrition, to emotional well-being, and physical health.  Someone who is in less than optimal health in the conception phases will likely have a more difficult time obtaining pregnancy, and more discomforts throughout pregnancy.  The 3rd trimester is clearly not the time to start getting healthy - before you get pregnant is, although if you didn't start prior to pregnancy, you can alleviate some discomforts by starting at any time. 

Before pregnancy, you want to start the habit of eating healthy and incorporating low-impact physical exercise into your daily routine.  These are not small steps to take once in your life, these are life changes that will benefit you forever.  The nutrition you put into your body affects how your body utilizes each part of the food - so choose wisely.  Additionally, as we grow older, and sit in front of our computers and TVs, our posture slumps, our pelvis tilts incorrectly, and our muscle tone diminishes.  All of this causing some of the most widely-known discomforts of pregnancy - back pain.

Back pain, like many other pregnancy conditions, is not a symptom of pregnancy.  It is avoidable, treatable, and likely indicates that mom needs to focus on the physical strength of her abdominal and back areas.  Having poor posture results in the back bowing, the buttocks overly protruding, and the belly hanging low which pulls on the anterior part of the body and causes increased strain on the back.  The shoulders likely slump forward, and an extensive curve results in the body.  Over time, this poor posture actually results in difficulties standing upright correctly because the wrong muscles have been toned, and your body is being pulled in the wrong directions.  You try to stand up straight and tuck in your butt, and you feel like you're working out rather than just naturally standing tall.  Once you're in the 3rd trimester, all of this can be difficult to fix and you've already hit the point of unnecessary physical discomfort.  The sooner you start correcting your posture, the easier things become.  Fix this before pregnancy, and you'll likely experience little physical discomfort.

When this poor posture results, your pelvis tilts incorrectly which causes the baby to fall in a variety of unfavorable positions, and more importantly may be unable to tuck his chin for an easier birth.  When the baby tucks his chin to his chest, the narrowest part of his head presents through the birth canal creating an optimal setting for rotating through the inlet and outlet of the pelvis, and molding through the birth canal.  If the chin does not tuck, the baby may have difficulties rotating or present brow or face-first resulting in a less than optimal birth.  For instance, a longer labor, a longer birthing (pushing) stage, and more risks for tearing.  If you're not under the care of a loving, supportive, and patient provider - then you're adding more difficulties to the situation as you may not be given optimal settings to birth a baby presenting in this manner.

Postpartum posture correction can be even more difficult to correct.  If you've went throughout pregnancy with poor posture, you're likely to take longer getting back into a pre-pregnancy physical shape and also cause more discomfort during breastfeeding (and even simply holding your baby).  Healthy abdominal tone prior to pregnancy and throughout will allow you to feel less discomfort during postpartum as your organs are moving back to their original locations.  This abdominal tone helps you to avoid that feeling as if your insides are going to fall out after the baby has been born.  Likewise, a healthy posture will allow cesarean recovery to be easier.  During breastfeeding, a mother who has developed the habit of slouching forward may experience increased back pain as she leans towards her baby to breastfeed.  Additionally, latching the baby on to the breast may become difficult as it is more effective to bring the baby towards your breast, rather than reaching towards your baby.  Sitting upright and having the proper muscle tone to support your back (and likely enlarged breasts) will be valuable to an extended breastfeeding experience.

Kegeling does little to help all of these factors during the perinatal stages.  Does kegeling tone the pubococcygeus muscles?  Possibly, but often in a way that tightens the muscles rather than making them efficient.  When kegeling, you're not only contracting the PC muscles, but you're also contracting the muscles of the birth canal as well.  This can result in tissue that is tight rather than flexible and able to be relaxed.  Your uterus involuntarily contracts during labor, and needs no assistance to birth the baby.  Only an overwhelming urge may assist your uterus during the birthing stage, but this is an instinctual reaction and one that doesn't need a tight birth canal.  In fact, just the opposite is true; learning to relax the PC muscles results in an easier birthing stage.  Contracting the muscles causes them to squeeze, which makes the birth canal smaller.  We want to achieve a relaxed muscle state so the baby can easily move through the canal and vaginal and perineal tears are reduced.  Ultimately, if you're not experiencing incontinence, your PC muscles are toned just fine.  And posture exercises actually do more for avoiding incontinence than do kegel exercises which you can read about here in this great post on why kegeling is not an optimal exercise.

A very simple way of toning your abdomen, back, and butt, is to simply remember to "walk proud."  If you can remember that when sitting or standing, you need to sit up straight, tuck your buttocks, and keep your chin up then you not only tone the muscles in the correct manner, but you also feel better about yourself.  Getting into the 3rd trimester, you can remember that waddling is also not a symptom of pregnancy.  If you're waddling, you're likely not walking tall and concentrating on those necessary muscles to tuck your butt and hold in your abdomen.  So, the sooner you start, the easier your pregnancy and birth will become.  There is never a better time to start getting in shape and preparing for your birth.