The muscle group nobody showed you a diagram of
You have been told to do your pelvic floor exercises since your first midwife appointment. Here is what you are actually being asked to move.
Quick answer
The pelvic floor is a hammock of muscles and connective tissue that spans the base of your pelvis, running from your pubic bone at the front to your tailbone at the back and across between your sitting bones. Its main muscle group is the levator ani, joined by the coccygeus and the ring-shaped sphincter muscles around your urethra and anus. Together they hold up your bladder, bowel and uterus, control when you wee and open your bowels, contribute to sexual sensation, and work with your diaphragm and deep abdominal muscles to manage pressure inside your abdomen. Pregnancy loads this system for nine months and birth can stretch it further, which is why so many mums notice a change afterwards.
women who have had a baby experience some urinary incontinence, according to the Continence Foundation of Australia.
the minimum trial of supervised pelvic floor muscle training NICE recommends as first-line care for stress urinary incontinence (NICE guideline NG123).
of women still had diastasis recti at 12 months postpartum, a reminder that deep core recovery is gradual (Sperstad et al., British Journal of Sports Medicine, 2016).
What the pelvic floor actually is
Picture the bowl of your pelvis. The bones form the sides, and the pelvic floor forms the base, stretched across the opening like a small trampoline. It is not one muscle. It is several layers of muscle, plus the fascia and ligaments that anchor them to bone, with openings for the urethra, the vagina and the anus passing through.
Because it sits at the bottom of your torso, it is under load whenever pressure inside your abdomen rises: when you cough, laugh, sneeze, lift a car seat, or stand up while holding a toddler. A pelvic floor that is doing its job responds to those moments automatically, without you thinking about it.
The muscles and layers involved
Levator ani - the main event
Levator ani is the group most people mean when they say "pelvic floor". It is usually described as three parts working together: pubococcygeus, puborectalis and iliococcygeus. Between them they form the bulk of the muscular support for your pelvic organs, and puborectalis in particular slings around the rectum and helps keep you continent of stool.
Coccygeus
Sitting behind levator ani and running to the tailbone, coccygeus completes the muscular floor at the back and supports the coccyx.
The sphincters
Separate ring-shaped muscles around the urethra and anus give you conscious control over when you empty your bladder and bowel. They are related to but distinct from the levator ani group, which is one reason a program that only trains one kind of squeeze can leave gaps.
Fascia and ligaments
Muscles get the attention, but the connective tissue is doing enormous work. Fascia and ligaments suspend the bladder, uterus and rectum in position. Muscle can be retrained relatively quickly; connective tissue changes more slowly, which is part of why postpartum recovery is measured in months rather than weeks.
It is part of a bigger system
Your pelvic floor works as the base of a canister, with the diaphragm as the lid, the deep abdominal muscles wrapping the front and sides, and the small spinal muscles at the back. Breathe in, the diaphragm descends and the pelvic floor lengthens. Breathe out, both recoil. That is why breathing sits at the start of nearly every credible postpartum program, and why the pelvic floor cannot be trained in isolation from the transverse abdominis or from how you manage pressure inside your abdomen.
What pregnancy and birth change
Three things happen, and they stack.
- Sustained load. A growing uterus rests on the pelvic floor for months. That load exists regardless of how you give birth, which is why a caesarean does not fully protect the pelvic floor.
- Hormonal softening. Pregnancy hormones increase the laxity of connective tissue throughout the body. Helpful for birth, less helpful for support in the short term.
- Birth itself. A vaginal birth stretches the levator ani considerably. Perineal tearing, an assisted birth with forceps or ventouse, or a long second stage can all add strain, and in a minority of births part of the levator ani detaches from the pubic bone.
None of this means damage is permanent, and it is not a reason to panic. It does mean that "just do your kegels" is thin advice for something this layered - a point we unpack in why kegels on their own rarely fix the problem.
60%
45.5%
32.6%
Source: Sperstad et al., British Journal of Sports Medicine, 2016. Figures are for diastasis recti, the abdominal-wall half of the same deep core system, and are shown here to illustrate the pace of recovery.
What your pelvic floor does all day
| Job | What it means in real life |
|---|---|
| Support | Holds your bladder, bowel and uterus in position against gravity and pressure |
| Continence | Keeps you dry when you cough, sneeze, laugh, run or lift your baby |
| Sexual function | Contributes to sensation and comfort during sex |
| Stability | Works with your breathing and deep abdominals to control pressure and steady your trunk |
| Circulation | The rhythmic movement of the area assists blood and lymph flow through the pelvis |
Signs yours is asking for attention
Any of these is worth mentioning to your GP, midwife or a women's health physiotherapist, whether you are six weeks or six years postpartum:
- Leaking urine or wind when you cough, sneeze, laugh, jump or lift
- A sudden urge to wee that is hard to hold, or going far more often than you used to
- Heaviness, dragging or a bulging sensation in the vagina, often worse by evening
- Pain during sex, or ongoing pain in the perineum, tailbone or pelvis
- Difficulty emptying your bladder or bowel completely
- A sense that you cannot feel anything at all when you try to contract
That last one is more common than mums expect and is not a failure. It usually means the connection needs rebuilding rather than that the muscle is gone. If leaking is your main symptom, this piece on how long postpartum incontinence usually lasts sets expectations honestly, and our explainer on pelvic organ prolapse covers the heaviness symptom in more depth.
How the pelvic floor is retrained
Good rehabilitation is less about squeezing hard and more about coordination. Most plans start by teaching you to breathe so the pelvic floor lengthens on the inhale and recoils on the exhale, then build a contraction you can both switch on and fully release, then add load gradually until the response happens automatically when you sneeze or lift. NICE guideline NG123 recommends judging supervised pelvic floor muscle training over at least three months, and a Cochrane review by Dumoulin and colleagues in 2018 found women doing pelvic floor muscle training were more likely to report improvement in urinary incontinence than women who did not.
If you are weighing up how to get that structure - an app, a physio, a device or a written plan - our honest comparison of postpartum pelvic floor programs for 2026 lays out what each option costs and who it suits. If you would rather just start moving today, the free postpartum pelvic floor exercise guide will get you going.
Rebuild the whole system, not just one muscle
The Complete Postpartum Body Reset bundles Mumma Glow's guides - deep core, pelvic floor, glutes and energy - into one download you buy once and keep, with no subscription and no app. Use code GLOW20 for 20% off.
Frequently asked questions
What is the pelvic floor in simple terms?
It is a hammock of muscles and connective tissue across the base of your pelvis, running from the pubic bone to the tailbone and between the sitting bones. It supports your bladder, bowel and uterus, controls when you wee and open your bowels, and helps manage pressure inside your abdomen.
Which muscles make up the pelvic floor?
The main group is the levator ani, usually described as pubococcygeus, puborectalis and iliococcygeus. The coccygeus completes the floor at the back, and separate sphincter muscles surround the urethra and anus. Fascia and ligaments anchor the whole structure to the pelvis.
Does a caesarean protect your pelvic floor?
Not entirely. Nine months of carrying a growing uterus loads the pelvic floor regardless of how you give birth, and pregnancy hormones soften connective tissue either way. A caesarean avoids the stretch of a vaginal delivery, but many mums who birth by caesarean still notice pelvic floor symptoms.
Why can I not feel my pelvic floor when I try to squeeze?
This is common after birth and usually reflects a lost connection rather than a missing muscle. Starting with breathing rather than squeezing often helps, and a pelvic health physiotherapist can confirm what is happening and give you feedback in real time.
Is the pelvic floor connected to diastasis recti?
Yes. The pelvic floor and the abdominal wall are two sides of the same pressure system, along with the diaphragm and the deep spinal muscles. Changes in one commonly show up in the other, which is why postpartum programs train them together rather than separately.
Sources: National Institute for Health and Care Excellence (NICE) guideline NG123, urinary incontinence and pelvic organ prolapse in women; Dumoulin et al., Cochrane Database of Systematic Reviews, 2018; Sperstad et al., British Journal of Sports Medicine, 2016; Continence Foundation of Australia; NHS, pelvic floor exercises; American College of Obstetricians and Gynecologists, Optimizing Postpartum Care.
This article is general education, not medical advice. Results vary from mum to mum. Please speak to your GP, midwife or a women's health physiotherapist about your own recovery, particularly if you have leaking, heaviness, pain or any concern about your pelvic floor.