Kegel balls, also known as weighted vaginal cones, are devices inserted into the vagina to provide resistance for strengthening the pelvic floor muscles. The user contracts these muscles to hold the device in place against gravity. While pelvic floor training is widely recommended during pregnancy, using weighted devices introduces specific risks that require careful consideration and medical consultation.
Why Pelvic Floor Strength Matters During Pregnancy
The pelvic floor is a hammock of muscles, ligaments, and connective tissue that supports the uterus, bladder, and bowel. During pregnancy, this support system faces immense and progressive strain from the increasing weight of the developing fetus and uterus. Hormonal changes, particularly the release of relaxin, further loosen ligaments, reducing the passive support structure of the pelvis. This combination of increased load and reduced stability means the muscles must work harder to maintain continence and organ support.
A strong, yet flexible, pelvic floor helps to counteract the physical pressure that can lead to common issues like stress urinary incontinence (SUI). SUI, the involuntary loss of urine when coughing, sneezing, or laughing, affects up to 58% of pregnant individuals by the third trimester. Training these muscles also prepares the body for the physical demands of labor, giving the expectant parent better control for the pushing stage and potentially minimizing the risk of perineal trauma. Maintaining muscle health throughout gestation also contributes to a quicker postpartum recovery and the prevention of pelvic organ prolapse later in life.
Safety Guidelines for Using Kegel Balls
The use of Kegel balls should only proceed after receiving specific approval from a healthcare provider, such as an obstetrician or a pelvic floor physical therapist. This guidance is crucial because many individuals struggle with proper technique; nearly half are unable to perform an effective, unweighted Kegel exercise initially. A physical therapist can confirm that the muscles are lifting and tightening the weight, not bearing down and pushing it out, which would be counterproductive and increase downward pressure on the cervix.
If approved, strict hygiene protocols are necessary to mitigate the risk of a vaginal infection, a primary concern with any inserted device during pregnancy. The weighted cones must be thoroughly cleaned with soap and water before and after every use, and any device that is cracked or porous should be immediately replaced. It is prudent to start with the lightest available weight or the largest diameter cone, as a heavier weight increases the risk of muscle strain or poor technique. Sessions should be kept short and focused, typically lasting only a few minutes once or twice a day. If discomfort, pain, or spotting occurs, discontinue use immediately and revert to unweighted exercises until a medical professional assesses the situation.
Medical Conditions That Prohibit Weighted Exercises
Certain medical situations present absolute contraindications, meaning weighted vaginal exercises must be avoided entirely due to the risk of complications. Any active vaginal infection, such as bacterial vaginosis or a yeast infection, prohibits the insertion of Kegel balls, as the device could introduce bacteria higher into the vaginal canal, potentially leading to a more serious infection. Similarly, any unexplained vaginal bleeding or cramping requires the cessation of all pelvic floor exercises until the cause is determined.
Conditions that compromise the integrity of the pregnancy also exclude the use of these devices. Placenta previa, where the placenta covers all or part of the cervix, requires “pelvic rest,” prohibiting insertion and weighted activity due to the risk of hemorrhage. In cases of an incompetent cervix or a history of preterm labor, the increased intra-abdominal pressure generated by straining or improper technique could exacerbate the risk of premature delivery. For individuals with these or other high-risk diagnoses, a pelvic floor physical therapist can prescribe alternative, non-weighted exercises that safely maintain muscle function.