Dr. Dina Kulik: The Baby Doctor


Do Kegels Actually Work?

Can You Prevent the Dreaded 'Tear’?

I have to admit that when I was pregnant with my first, Dylan, I was terrified of labour, the pain it would likely cause, and, of course, the inevitable tearing I would endure. I was the first of my friends to have a baby and had no one to rely on to find out how bad it really was. So, like many women out there, I assumed I would have the worst birth ever, with awful pain, a long labour and many weeks of excruciating healing. Do other women think like this?

My birth story with Dylan actually turned out very differently than I anticipated. It was fast—almost too fast (about 90 minutes of labour and 2 minutes of pushing)—and ended with no doc in the room, and my husband catching my son. Not expected. Maybe it was my strength, maybe the preparation I did before delivery, or maybe luck, but it certainly wasn’t as I imagined it would be.

What I know now is no delivery is what you expect. Of course, I thought my second baby would come into this world as quickly and easily. Not so. My labour was longer and I ended up being induced, and he ended up spending a night in the NICU. Who would have thought?

At one obstetrics appointment in my third trimester with Dylan, my obstetrician asked me offhand if I was doing Kegel exercises. Embarrassed that I hadn’t even thought of it, I answered no, ashamed. Maybe I was missing out on doing something of paramount importance? She proceeded to tell me that the evidence for them was mixed, but why not? So, I went home and started Googling to find out what those exercises are and how they could help. My type-A personality and science mind makes me a stickler for "evidence-based recommendations." This, coupled with an obsession for exercising, made this an ideal little project for me to undertake.

What I found was a hodge-podge of recommendations and suggestions from doctors, midwives, and doulas around the world. Some experts recommend these exercises and some think they are useless.

Here is some important information about kegels that I think every new and expecting mom should know. Even if you are already a mom, read on—there as are some useful tips for you, as well.

So what are Kegel exercises anyway?


Kegels are exercises you can do to strengthen your pelvic floor muscles. These muscles help support your bladder, uterus, and rectum. A gynecologist created them in the 1940s to prevent urinary incontinent after childbirth. Some believe they will help prevent urinary and anal incontinence during and after pregnancy. Scarily enough, these ailments affect 70% of women! They may also help you heal after delivery and keep hemorrhoids at bay by improving blood circulation to the area. Listen up ladies, the best evidence for Kegel exercises are for . . . you guessed it . . . sex.

The stronger these muscles are, the more enjoyable sex will be for both of you (have you read 50 Shades of Grey?). Have I sold you yet? (Find out more about exercise during pregnancy.)

How do you do a Kegel?


Make sure you pee first, so you don’t have an accident. Now imagine that you are trying to stop yourself from passing gas and peeing at the same time. Visualize "squeezing and lifting" your pelvic muscles upward. A kegel is as simple as that. No need to clench your stomach, butt, or legs—it's all in your vagina (in a matter of speaking, of course).

What did I do?


After my search through the literature, I decided they couldn’t hurt the baby or me, so I might as well give it a go. Around 30 weeks, I started 5 minutes of holding my pelvic muscles for increasing increments. Clench, unclench, clench, unclench, holding for longer periods of time each week. By the time I was due, I was able to hold for a few minutes or longer. It helps that I often go the whole day without peeing when I am running around seeing patients or in a busy emergency room. This is a true "medical practitioner" skill I learned in residency (yes, I know it isn’t a good idea as it predisposes to urinary tract infections).

Some women do them once a day, others several times throughout the day. Whatever you fancy, consider doing Kegels daily and make them part of your routine. Don’t just do it before baby—you can keep up the practice and make it part of your daily routine whether at home, work, or having a mani. No one but you will know you are doing them.

For me, I am lucky and haven’t suffered any of these dreaded incontinence side effects after two deliveries, but am not counting my chickens yet. I have at least one more delivery to go, and I am all too familiar with the decreased bladder control that often comes with age. So, I keep doing Kegels whenever I remember. I haven’t torn badly with either delivery, so maybe they helped?

Will Kegels become part of your routine?

Let me know if they work for you! Your partner may notice a difference too!

There's a new way to track your kegel training with this handy device that will see you on your way to stronger pelvic floor muscles. Would you buy it? 

You think you have a good "I peed my pants" story? You've got nothing on this mom. NOTHING.