So often, we’re told to “do your Kegels,” but real pelvic health is about resilience — strength that can soften, lengthen and coordinate with your breath. Dr. Tia Wallace breaks it down for mothers and families.
“During birth we want the pelvic floor to soften and lengthen. Strength matters — but resilience is the goal.”
Why this conversation
After having three babies in five years, I learned the hard way that pelvic floor health is not optional. Too many of us hear “do your Kegels,” but we’re never taught what our pelvic floor actually does, how it moves with our breath, or how to protect it in pregnancy, birth and postpartum. We invited Dr. Anietie Ukpe-Wallace to share what every mother and family should know about their pelvic floor — and what to start practicing today.
Q&A
Who are you and how do you support families?
Tia: I’m a pelvic floor physical therapist in Oakland. I’ve worked in hospitals and now run a private practice inside a birth collective with midwives, lactation consultants, doulas and mental health therapists. Pelvic PT supports bladder, bowel and sexual function — and plays a big role in pregnancy, birth and recovery.
Are Kegels the answer?
Tia: Kegels aren’t the whole story. We want resilience — a pelvic floor that’s both strong and flexible. During birth those muscles must soften and lengthen so baby can pass. Many folks do Kegels incorrectly, and most aren’t assessed. I train strength and mobility through breath and functional movement, not isolated squeezes alone.
“Pelvic health ≠ Kegels. It’s coordinated strength, mobility, and breath.”
How does breathing affect the pelvic floor?
Tia: Picture your body like a cylinder. The respiratory diaphragm under your ribs is the top, your pelvic floor is the bottom.
Inhale: diaphragm drops, belly expands, pelvic floor lengthens
Exhale: diaphragm rises, pelvic floor lifts
Deep, three-dimensional breathing keeps this system coordinated. Shallow, shoulder-heavy breathing creates tension that shows up in the pelvic floor.
When should someone start caring about their pelvic floor?
Tia: Before pregnancy if possible. Two simple starts:
Three-dimensional breath — expand front, sides and back of the ribcage.
Know your anatomy — look at and gently touch your vulva and perineum. Body literacy helps you notice changes early and advocate for care.
Best way to breathe in labor to protect the pelvic floor?
Tia: Diaphragmatic breathing. Try inhale 6, exhale 6. It lowers heart rate and helps tissues stay supple between contractions. For pushing, short bouts of Valsalva (big inhale, hold, bear down) can help — but not for two hours straight. Use diaphragmatic breath as your baseline, then Valsalva briefly when needed.
“Use 6-in, 6-out to come back to baseline. Push with intention — not for the entire stage.”
Is breathwork just physical, or something more?
Tia: Both. Deep breathing stimulates the vagus nerve, helping you regulate your nervous system. Some connect to the science, others to the energetic — throat, heart, root, sacral. Different languages, same truth: breath creates safety and coordination in the body.
What about access and education?
Tia: Access matters, and so does education. Not everyone can see a PT weekly. Many strategies are teachable in community spaces and doable at home. Birth workers can normalize pelvic floor care, offer simple breath and movement tools, and help families know when to seek assessment.
Quick practice: 3 minutes a day
Sit or lie comfortably.
One hand on ribs, one on low belly.
Inhale 6 through the nose — feel front, sides, and back of ribs widen, pelvic floor soften.
Exhale 6 — ribs narrow, pelvic floor gently lifts.
10–12 cycles. If you lose the rhythm, pause and reset.
Pro tip: Practice daily in pregnancy so it’s automatic in labor. If you’re postpartum, start here before adding load.
Signs to check in with a pelvic floor PT
Leaking with cough, laugh, sneeze, running
Pelvic heaviness or pressure
Pain with intercourse
Constipation or trouble fully emptying
Unresolved back, hip, or SI pain
Birth injury, tearing, or scar tenderness
About our guest
Dr. “Tia” Wallace, PT is a pelvic floor physical therapist based in Oakland. She practices in a collaborative birth collective serving pregnant and postpartum families.
Join the village
If this helped, share it with a friend. Borne is building a community where mothers and families can access education and tools rooted in holistic care and cultural nuance.
Reply with questions for a follow-up Q&A with Dr. Tia
Bay Area birth workers — want to connect with Tia’s collective? Reply “Oakland”
With love,
Lindsey
