If your core feels weak or your pelvic floor hasn’t felt right since having your baby, you’ve probably been told to do more ab work or more Kegels. Strength sounds like the fix. For most of the women I see, strength is the second step.
The first step is breath.
I’ve specialized in pelvic health since 2010, and breath is one of the first things I assess in all of my patients. How you breathe shapes how your core and pelvic floor work together all day, every time you lift your toddler, laugh, cough, or carry groceries up the stairs. When your breath pattern is off, strength work has nothing steady to build on.
Your core is a pressure system, like a soda can
Picture an unopened can of soda. It holds its shape because of the pressure inside it. Press on the sides of a full can and it pushes back. Open it and let the pressure out, and it crushes easily.
Your core works the same way. Your diaphragm sits at the top like a dome under your ribs. Your pelvic floor is the bottom. Your deep abdominal and back muscles wrap around the sides.
Together they manage the pressure inside your trunk.
When you inhale, your diaphragm moves down, and your belly, ribs, and pelvic floor soften downward and expand to make room. When you exhale, your diaphragm rises and your pelvic floor gently lifts with it. The top and bottom of the can move together.
Many things can change this system. Pregnancy and birth are one of them. Your baby takes up space, your ribs widen, and the pressure inside your trunk shifts for months. Chronic stress, abdominal pain, and painful periods can change your breath pattern too, whether or not you’ve had a baby. Many women end up breathing high into the chest, holding their belly in, or bracing all day without knowing it.
Bend your knees before you jump
Try to jump without bending your knees first. You barely leave the ground. The bend loads your muscles and gives the jump its power.
Your pelvic floor needs that same bend, and the inhale is the bend. As your pelvic floor lengthens on the inhale, it stores elastic energy. That stored energy lets it respond with a strong, quick lift when you exhale, cough, sneeze, or pick up your child.
A pelvic floor that’s held tight all day has nowhere to load from. It’s like standing with locked knees and trying to jump.
Myth: Kegels fix everything
Kegels have become the go-to answer for almost every pelvic floor symptom, from leaking to heaviness to birth prep.
On evaluation, most women who tell me they’re weak have pelvic floor muscles that are tight and struggle to relax. Adding more squeezing to a muscle that can’t let go usually leads to more leaking, pain, or pressure.
Leaking is common. It is not normal, and it doesn’t always mean you’re weak.
Your diaphragm, deep core, and pelvic floor need to coordinate as a team before strengthening makes sense, and breath is how that team learns to work together. Breath and coordination come first. Strength comes after.
A breath check you can do today
You don’t need equipment or a full workout for this. Give yourself three to five slow breaths in each position.
- Find your easiest Lie on your side with your knees bent and let your top shoulder tip back slightly. Many women take their most relaxed breaths here. Breathe in through your nose and let your belly and ribs widen. Breathe out slowly through your mouth.
- Breathe into your back. Sit and lean forward with your forearms resting on your thighs. Place a hand on your lower back or the side of your As you inhale, feel your back ribs and low back expand into your hand.
- Connect to your pelvic Stay in that forward-leaning position. As you inhale, feel the area between your sit bones gently soften or expand. As you exhale, notice the soft recoil.
Notice what happens. If your shoulders rise, your belly stays tight, or you can’t feel anything happen down below, that’s useful information. It’s a signpost, not a failure.
Tiny breath habits for a full day
You don’t need to carve out 20 minutes a day. Small moments count, especially when you attach them to things you already do.
- On the toilet: lean forward, rest your forearms on your knees, and take three to five slow breaths into your belly or back.
- After you park the car: before you get out, take a few slow breaths to reset between
- At your desk, pause to twist your upper body to one side and take a slow inhale and exhale. Repeat each side 1-2 times every 30-60 minutes.
Pick one and try it today. Add another once the first one feels automatic.
You don’t have to figure this out alone
If these breaths felt awkward, or you couldn’t feel your pelvic floor at all, you aren’t doing anything wrong. Life events such as pregnancy or conditions like chronic pelvic pain or even life stressors can change these patterns, and they can be retrained. A pelvic floor physical therapist can assess how your breath, core, and pelvic floor work together and give you a clear place to start.
Postpartum is a season of healing and restoration before it’s a season of fitness. You’re allowed to start small, and breath is a real place to start.
If you’re pregnant or planning your next birth, take my free Birth Ready Archetype quiz to see whether your birth prep needs more mental or physical focus: Take the Quiz
My book, Birth Ready & Beyond, is a hands-on prenatal companion with prenatal stretches, labor positions, and self-care by trimester: Get the Book
Warmly,
Buffy Stinchfield, PT
The Pelvic Health Coach
