Why do Americans call pelvic floor exercises Kegels?

Pelvic floor exercises are a vital part of postpartum recovery for women, offering benefits ranging from improved bladder control to enhanced sexual health. These exercises are often referred to as “Kegels” in the United States, but many may wonder why this term is used, and whether there are any differences in how pelvic floor exercises are practiced in the US compared to the UK. In this article, we’ll explore the origin of the term “Kegel exercises,” delve into the importance of pelvic floor health, and compare practices in both countries with a focus on antenatal and postpartum recovery.

What Are Pelvic Floor Exercises?

Pelvic floor exercises, also known as pelvic floor muscle training (PFMT), are exercises designed to strengthen the muscles that support the bladder, bowel, uterus, and vagina. These muscles form a “floor” or support system for the pelvic organs, and strengthening them can significantly improve issues such as urinary incontinence, pelvic organ prolapse, and sexual health problems. The exercises primarily involve contracting and relaxing the pelvic floor muscles, which can be done in various positions such as lying down, sitting, or standing. Regular practice can restore muscle strength and function, which is especially important during postpartum recovery after childbirth.

The Origin of the Term ‘Kegel’

In the United States, pelvic floor exercises are often referred to as “Kegels,” named after Dr. Arnold Kegel, an American gynecologist who first developed these exercises in the 1940s. Dr. Kegel introduced the concept as a non-surgical treatment for women suffering from urinary incontinence, which is a common issue after childbirth. He discovered that strengthening the pelvic floor muscles could help restore bladder control and prevent further prolapse of pelvic organs (Kegel, 1948). Dr. Kegel’s exercises became widely popular, and the term “Kegel exercises” became synonymous with pelvic floor strengthening in the United States. Although the exercises themselves are universal in their nature, the terminology has stuck, especially in the US. The exercises gained even more widespread attention when Kegel’s work was popularized in the 1980s by feminist health advocates, further embedding the term in American culture.

Differences in Practice Between the US and the UK

While the term “Kegel” is widely used in the US, in the UK, people are more likely to refer to pelvic floor exercises by their descriptive name rather than using a specific term. In the UK, health professionals typically use the term “pelvic floor exercises” when discussing these vital exercises with patients, regardless of whether they are part of antenatal or postnatal care. However, both countries emphasize the importance of pelvic floor health, especially in postpartum recovery.

Antenatal and Postpartum Care: Why Pelvic Floor Exercises Matter

Pelvic floor exercises are crucial during both pregnancy and postpartum recovery. For expectant mothers, strengthening the pelvic floor muscles through prenatal care and exercise can help improve bladder control, reduce the risk of prolapse, and support the physical demands of childbirth. Furthermore, pelvic floor exercises during pregnancy can help improve recovery post-birth, allowing for smoother healing after delivery. In the postpartum period, pelvic floor exercises are often prescribed to strengthen weakened muscles, especially after vaginal delivery. During childbirth, the pelvic floor muscles undergo significant stretching and pressure, which can weaken their tone and function. Strengthening the pelvic floor can prevent issues like incontinence, prolapse, and improve sexual health post-birth (Royal College of Obstetricians and Gynaecologists, 2018). Postpartum recovery often involves exercises designed to restore normal muscle function and provide support for the pelvic organs. In both the UK and the US, pelvic floor exercises are recommended as part of a comprehensive antenatal care plan, with the goal of preventing long-term pelvic floor dysfunction. According to the NHS (2019), pelvic floor exercises can improve the effectiveness of recovery after childbirth and may prevent the need for surgical interventions for incontinence or prolapse later in life.

Are There Any Differences in How Pelvic Floor Exercises Are Practiced?

Although the underlying principles of pelvic floor exercises are the same across countries, there are some subtle differences in how these exercises are practiced and integrated into care.

1. Health Education and Support In both the UK and the US, pelvic floor exercises are typically introduced during antenatal care. However, the frequency and approach of teaching can vary. In the US, pelvic floor exercises might be discussed in a wider variety of settings, such as through private consultations with gynecologists, women’s health specialists, or physical therapists. In contrast, in the UK, pelvic floor exercises are more commonly introduced by midwives and NHS healthcare providers during antenatal classes, and there may be more reliance on group education during pregnancy.
2. Pelvic Floor Rehabilitation Programs Postpartum rehabilitation programs are another area where there can be variation between countries. In the UK, women are often encouraged to seek physiotherapy through the NHS for pelvic floor rehabilitation if they experience issues such as urinary incontinence. These programs, which may include individual assessments, are tailored to the individual and are typically available for free as part of the national healthcare system. In the US, rehabilitation services tend to be more varied depending on insurance coverage, with women sometimes seeking physical therapy services outside the public system, which can come with additional costs.
3. The Role of Prenatal Yoga and Fitness Prenatal yoga and fitness classes, including antenatal fitness that incorporates pelvic floor training, are becoming increasingly popular in both the UK and the US. However, there are slight differences in how these are practiced. In the UK, antenatal yoga is often part of the broader maternity care system, and women may be referred to these classes as part of a comprehensive antenatal care plan. Many UK-based yoga classes will focus on strengthening pelvic floor muscles, breathing techniques, and relaxation methods in a more holistic way. In the US, while prenatal yoga is also a popular practice, there is a stronger focus on individualised care, with some pregnant women opting for private or small group sessions that are tailored to their specific needs. The exercises may be more focused on strengthening the pelvic floor in a specific manner, with personal trainers or physiotherapists offering instruction on how to correctly perform Kegels and other pelvic exercises (American College of Obstetricians and Gynecologists, 2019).
4. Technological Approaches In recent years, there has been a rise in technological approaches to pelvic floor health. Biofeedback devices, pelvic floor trainers, and apps designed to guide women through pelvic floor exercises have been introduced in both the US and the UK. While both countries use these tools, the US is often ahead in terms of consumer-driven innovation in the field. The UK, however, benefits from its strong NHS system, which sometimes provides more structured guidance, including access to physiotherapy services and NHS-backed tools that assist women with pelvic floor rehabilitation.

Are Kegel Exercises the Best Way to Strengthen the Pelvic Floor?

While Kegel exercises (or pelvic floor exercises) are a proven method to strengthen the pelvic floor, they are not always the only solution. According to recent studies, women can benefit from a range of exercises that involve functional movement and incorporate the entire core system, rather than just focusing on Kegels (Hay-Smith et al., 2018). Additionally, some women may benefit from working with a trained physiotherapist or pelvic health specialist to ensure they are performing exercises correctly and to address specific issues such as pelvic pain, prolapse, or incontinence. Furthermore, a combination of exercises including relaxation, deep breathing, and strengthening can yield better results than Kegels alone. Practices like antenatal yoga, which emphasize full-body awareness, can also help enhance pelvic floor strength in a supportive and holistic manner. Pelvic floor exercises, or Kegels, have become an essential part of both antenatal and postpartum recovery, helping women maintain pelvic health and improve their quality of life. The term “Kegel” has become synonymous with pelvic floor exercises, especially in the US, due to the pioneering work of Dr. Arnold Kegel. While both the UK and the US advocate for these exercises, differences in how they are integrated into care, as well as the tools and technologies available, may shape the experience for women in each country. Regardless of terminology or method, the importance of maintaining pelvic floor health throughout pregnancy and postpartum recovery cannot be overstated. Women are encouraged to seek professional advice to ensure they are performing these exercises correctly and receiving the support they need to maintain optimal health.