What this resource is
This printable handout helps a pregnant or postpartum adult record pelvic-floor guidance across changing symptoms, birth plans, tissue recovery, and return to activity. It gives no universal Kegel dose and does not replace maternity, obstetric, midwifery, pelvic-health, or postoperative advice.
Print this page from the browser when a paper copy is useful. Navigation, advertising spaces, and promotional calls to action are hidden in print, while the instructions, blank fields, related context, and sources remain.
Review the on-screen version again if the page shows a newer update date.
How to use the handout
Write the pregnancy week or time since birth, delivery information when relevant, current symptoms, wound or healing considerations, approved movement, and review plan. Use evidence-equivalent inclusive language and adapt the sheet to the person’s anatomy and care context. A maternity or treatment professional’s instruction always overrides general website content.
Read every safety boundary before completing the fields. Keep a completed copy private because bladder, bowel, sexual-health, pregnancy, surgery, or symptom notes can be sensitive. This resource is educational and does not establish a clinician–patient relationship.
During pregnancy
Pelvic-floor training may be discussed for prevention or treatment of leakage, but goals and tolerance change across pregnancy. the Cochrane perinatal PFMT review distinguishes prevention and treatment contexts rather than promising the same effect for everyone. Record pressure, leakage, pain, bowel symptoms, high-risk pregnancy advice, and any instruction to modify general exercise.
After vaginal or caesarean birth
Mode of birth does not by itself reveal pelvic-floor function. Perineal tears, episiotomy, obstetric anal sphincter injury, abdominal surgery, catheter use, bleeding, infection, pain, sleep, feeding, and overall recovery can affect the plan. Early practice should never be forced through pain, wound concerns, dizziness, illness, or inability to release.
Contraction and relaxation
A postpartum plan may need awareness, gentle coordination, strength, endurance, pressure management, scar or pain care, bowel support, or relaxation. Vaginal heaviness, painful sex, urinary urgency, bowel leakage, and persistent clenching deserve specific assessment. More repetitions are not a substitute for identifying which quality is impaired or whether another condition is present.
Returning to movement
WHO postnatal guidance and RCOG patient information place pelvic-floor recovery within broader postnatal care. Progress walking, lifting, impact, and sport according to healing, symptoms, capacity, and professional advice. Leakage or heaviness during impact is information to review, not proof that the answer is simply harder Kegels.
Personal or clinician-supplied fields
Leave any item blank when it has not been assessed or agreed. Blank space means “not supplied”; it is not an invitation to invent a dose, diagnosis, treatment date, or clearance decision.
Pregnancy week or time since birth, birth details, and care team
Current bladder, bowel, pressure, pain, sexual, wound, or scar symptoms
Approved cue, position, dose, relaxation, pressure strategy, and activity stage
Stop rules, urgent-care pathway, referrals, and review date
Safety and review boundaries
Pause an exercise that causes pain or clearly worsens symptoms.
Seek a qualified pelvic-health physiotherapist or other appropriate clinician when technique is uncertain, symptoms are complex, emptying is difficult, a programme is not helping, or treatment and recovery affect exercise choice.
New or severe symptoms may require medical assessment rather than an exercise review.
The page cannot examine tissue healing, muscle activity, sensation, coordination, prolapse, retention, infection, neurological function, or the reason for leakage. A completed form records observations and instructions; it does not convert them into a diagnosis or prove that the exercise was performed correctly.
Review before reusing
Date the printed copy and replace it when professional instructions, symptoms, medicines, pregnancy stage, catheter status, treatment, or functional goals change. Do not keep progressing an old plan because it is convenient.
If the resource is shared by a clinician, that clinician remains responsible for checking that the written variables and safety route fit the individual.
Related guides
Continue with How pelvic-floor training changes across the three trimesters, postpartum pelvic floor return program, and Returning to running, lifting, and impact after childbirth.
Sources
- Woodley SJ et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2020. Official or indexed source.
- World Health Organization. WHO recommendations on maternal and newborn care for a positive postnatal experience. 2022. Recommendation 7. Official or indexed source.
- Royal College of Obstetricians and Gynaecologists. Your pelvic floor. Patient information. Official or indexed source.
- Santos-Rocha R, ed. Exercise and Physical Activity During Pregnancy and Postpartum: Evidence-Based Guidelines. 2nd ed. Springer; 2022. doi:10.1007/978-3-031-06137-0. Official or indexed source.