Why Pelvic Floor Exercises Are Essential in the Third Trimester
The third trimester of pregnancy brings significant changes to your body as your baby grows rapidly and your due date approaches. Between weeks 28 and 40, the increasing weight of your baby places considerable pressure on your pelvic floor muscles — the group of muscles that stretch like a hammock from your pubic bone to your tailbone. These muscles support your bladder, uterus, and bowel, and they play a critical role during labor and delivery.
Without proper conditioning, the added strain of late pregnancy can lead to urinary leakage, pelvic pressure, lower back pain, and difficulty controlling bowel and bladder functions. Pelvic floor exercises during the third trimester help maintain muscle tone, improve circulation to the perineum, and teach you how to consciously relax these muscles — a skill that becomes invaluable during the pushing stage of labor.
Research shows that women who consistently perform pelvic floor exercises during pregnancy are less likely to experience urinary incontinence in late pregnancy and postpartum. Studies also suggest that prenatal pelvic floor training can shorten the active pushing phase of labor and reduce the risk of severe perineal tearing.
Preparing Your Body for Labor and Delivery
Many women focus exclusively on strengthening their pelvic floor, but in the third trimester, learning to relax and lengthen these muscles is equally important. During delivery, your pelvic floor muscles need to stretch and yield to allow your baby to pass through the birth canal. A pelvic floor that is strong but also flexible gives you the best outcome.
Effective labor preparation through pelvic floor work involves three key components:
- Strength: Maintaining muscle tone supports your growing baby and helps prevent incontinence during the final weeks of pregnancy
- Coordination: Learning to contract and release your pelvic floor on command prepares you for directed pushing during labor
- Relaxation: Practicing deep pelvic floor release teaches your body to let go during contractions and delivery, reducing resistance and the risk of tearing
In the video above, I guide you through exercises that address all three of these components so you feel confident and prepared as your due date approaches.
Safe Exercises for Late Pregnancy
The third trimester requires thoughtful modifications to your exercise routine. Your center of gravity has shifted, your ligaments are more relaxed due to the hormone relaxin, and your growing belly limits certain positions. Here are the key exercises I recommend for this stage of pregnancy:
1. Supported Pelvic Floor Contractions
Performed in a reclined or side-lying position, these gentle contractions help you maintain awareness and strength in your pelvic floor without straining. I teach you multiple muscle cues — imagining you are stopping the flow of urine, lifting a blueberry with your vaginal muscles, or drawing your sit bones together — so your brain can connect with each part of the pelvic floor individually.
2. Pelvic Floor Release and Lengthening
This exercise teaches you to fully relax and gently lengthen your pelvic floor, mimicking the release needed during the pushing stage of labor. Using slow diaphragmatic breathing, you practice letting your pelvic floor soften and open. This is one of the most important exercises for birth preparation, yet it is the one most women overlook entirely.
3. Deep Squats and Hip Openers
Supported deep squats help open the pelvis and stretch the pelvic floor and inner thighs. Using a wall, chair, or your partner for balance, these movements encourage optimal fetal positioning while gently lengthening the muscles that need to stretch during delivery. Hold each squat for 20-30 seconds while focusing on your breath and allowing your pelvic floor to release.
4. Cat-Cow and Pelvic Tilts
These gentle movements on hands and knees relieve lower back pressure, encourage your baby into an optimal position, and help you coordinate your breath with pelvic floor engagement. The hands-and-knees position also takes weight off your pelvic floor, providing temporary relief from the downward pressure that is so common in the final weeks of pregnancy.
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Breathing and Relaxation Techniques
Breath work is the foundation of effective pelvic floor training during the third trimester, and it directly translates to better labor management. Your diaphragm and pelvic floor work as a team — when you inhale deeply, your pelvic floor naturally descends and relaxes; when you exhale, it lifts and engages. Understanding this connection gives you a powerful tool for both exercise and labor.
Here are the breathing techniques I teach in the video:
- Diaphragmatic breathing: Place one hand on your chest and one on your belly. Breathe in slowly through your nose, feeling your belly and ribcage expand outward in all directions. Your pelvic floor should soften and release with each inhale. Exhale gently through pursed lips as your pelvic floor naturally lifts.
- Birth breathing: Practice slow, controlled exhales while consciously releasing your pelvic floor and relaxing your jaw. This technique mimics the breathing pattern that helps you work with contractions rather than against them. A relaxed jaw directly correlates with a relaxed pelvic floor.
- Perineal relaxation visualization: As you breathe in, visualize your pelvic floor opening like a flower blooming. This mental imagery, combined with deep breathing, trains your body to release tension in the muscles that need to stretch during delivery. Practice this daily in the weeks leading up to your due date.
Third Trimester Exercise Tips
- Exercise in short sessions of 10-15 minutes rather than one long session
- Avoid lying flat on your back after 20 weeks — use a side-lying or reclined position instead
- Stay well hydrated before, during, and after exercise
- Practice your pelvic floor releases as often as your contractions — both skills matter for delivery
- Listen to your body and rest whenever you feel fatigued or uncomfortable
When to Modify or Stop Exercises
While pelvic floor exercises are safe for most pregnant women, there are important signs that should prompt you to stop and consult your healthcare provider immediately:
- Vaginal bleeding or fluid leaking
- Regular, painful contractions that do not stop with rest
- Dizziness, chest pain, or shortness of breath
- Severe pelvic or abdominal pain
- Decreased fetal movement
Additionally, if you have been diagnosed with placenta previa, cervical insufficiency, preterm labor risk, or preeclampsia, your provider may recommend modifying or pausing certain exercises. Always keep your healthcare team informed about your exercise routine.
As your pregnancy progresses into the final weeks, you may also need to adjust the intensity and duration of your exercises. In the last month before delivery, focus more on relaxation and release work rather than intense strengthening. Your body is already working incredibly hard — the goal now is to prepare your pelvic floor to open and yield during birth, not to build maximum strength.
Important Note
Every pregnancy is unique. While the exercises in this video are designed to be safe for healthy pregnancies, always consult with your OB-GYN, midwife, or pelvic floor physical therapist before starting or modifying any exercise program during pregnancy. If you experience any unusual symptoms, stop exercising and contact your healthcare provider.
Frequently Asked Questions
Are pelvic floor exercises safe during the third trimester?
Yes, pelvic floor exercises are generally safe and highly recommended during the third trimester. In fact, maintaining pelvic floor strength and flexibility in late pregnancy can help prepare your body for labor and support postpartum recovery. Always consult your healthcare provider before starting any exercise program during pregnancy, especially if you have complications.
How often should I do pelvic floor exercises in the third trimester?
Aim for 3-4 short sessions per week, each lasting about 10-15 minutes. In the third trimester, shorter and more frequent sessions are often better than long workouts. Listen to your body and rest when you need to. Consistency matters more than intensity, especially in late pregnancy when your body is already under significant physical demands.
Can pelvic floor exercises help with labor and delivery?
Yes. Women who practice pelvic floor exercises during pregnancy often experience shorter pushing stages during labor, reduced risk of severe perineal tearing, and faster postpartum recovery. Learning to both contract and fully relax your pelvic floor muscles is key to effective pushing during delivery. The relaxation component is especially important in the third trimester.
Should I focus on strengthening or relaxing my pelvic floor before labor?
Both are equally important. A strong pelvic floor supports your growing baby and helps with bladder control, while the ability to fully relax these muscles is essential for labor and delivery. In the third trimester, we emphasize both contraction exercises and deep relaxation techniques to prepare for birth. Many women are surprised to learn that pelvic floor release is just as important as strengthening.
When should I stop doing pelvic floor exercises during pregnancy?
Stop exercising and contact your healthcare provider if you experience vaginal bleeding, painful contractions, dizziness, shortness of breath, or fluid leaking. If you have been placed on bed rest or have been diagnosed with placenta previa, cervical insufficiency, or preterm labor risk, consult your provider before continuing any exercises. Otherwise, gentle pelvic floor work can typically continue safely right up until labor begins.
Sheree DiBiase
Sheree DiBiase has been a physical therapist for over 40 years, specializing in pelvic floor rehabilitation. She is the founder of Lake City Physical Therapy and the creator of the Pelvic Floor Pro app. Sheree is a board-certified Pelvic Rehabilitation Practitioner (PRPC) and has helped thousands of women regain pelvic floor strength and confidence.