WEPP is for you if you are pregnant or in the postnatal period. Our exercise videos offer a range of classes suited to mixed ability including complete beginners.

WEPP can be used at any stage during pregnancy or in the postnatal period. If you are using our exercise videos please use our Self-Screening for Exercise checklist. If in any doubt please check with a health-care professional. Information videos are suitable for all.

WEPP aims to support you during pregnancy and the postnatal period with evidence-based information and exercise videos which means you can be sure what you are doing is safe for you and your baby. WEPP helps you to commit to regular exercise which can maintain and improve health and fitness and also reduce aches and pains in pregnancy.

This is a specialist type of physiotherapy that focuses on the pelvic area. Conditions commonly treated by pelvic health physiotherapists are bladder and bowel incontinence, urinary frequency and urgency, pelvic organ prolapse, pelvic pain and painful sex. Pelvic health physiotherapists also treat pregnancy related musculoskeletal conditions such as pelvic girdle pain, low back pain, and hip pain.

Leaking when you laugh or sneeze or do high impact activity such as running or jumping is known as stress urinary incontinence. You may see this written as SUI. It is leakage of urine caused by a lack of soft tissue protection and/or weak pelvic floor muscle support around the bladder neck when there is a sudden added pressure or 'stress' on the bladder. This can happen when your abdominal pressure increases; often with the activities previously listed. For some, simply just the impact of walking can cause leakage.

Up to one third of pregnant women and people experience stress urinary incontinence with weight changes as the baby develops, and hormones are also thought to contribute to this increased risk. Although it is common, it shouldn't be seen as normal. It is really important to regularly practice pelvic floor exercises to try and keep these muscles as strong as possible. Our video shows you how to do this.

Pelvic Floor Exercises in Pregnancy

If your symptoms don't go away or are severe, you may also need to see a Pelvic Health Physiotherapist who can assess your individual needs and help you work towards improving your continence.

You can learn more about stress incontinence in pregnancy here.

Absolutely not. During the second, or active, stage of labour your pelvic floor muscles will gradually stretch as the cervix opens and the vaginal entrance widens. This opening needs to stretch to approximately 10cm during vaginal delivery, and a strong area of muscle will not stop this from happening. This is also true if you have been diagnosed with vaginismus, where the pelvic floor muscles have become tight and tense. Having a strong pelvic floor is a great foundation for recovery postnatally, and you should be reassured that if you are able to work your muscles well when pregnant, you will be familiar with restarting pelvic floor strengthening after birth.

High impact exercise such as jumping, running or aerobics (any activity when both feet are off the ground at the same time) may worsen your symptoms especially if your pelvic floor muscles are not strong. Activities using weights may also cause too much downward pressure on your pelvic floor.

Try low impact exercise instead such as modified aerobics, cycling, a cross trainer, fast walking, Pilates ,swimming or low intensity resistance training so you can avoid straining. If your normal exercise routine makes your prolapse symptoms worse ask your healthcare professional for alternatives.

The pelvic floor muscles act like a hammock to support the pelvic organs. Pelvic floor muscle exercises will strengthen the muscles and retrain them to be more effective in supporting the pelvic organs making the symptoms of prolapse less bothersome. To learn more about how to do pelvic floor exercises please watch our Spotlight on Pelvic Floor Exercises in Pregnancy.

Pelvic floor exercises strengthen the pelvic floor muscles. These muscles support your bladder and bowels within the pelvis. They also help you to hold on if it is not a convenient time to use the toilet or if there is no toilet available.

Several pieces of recent positive research have shown that perineal massage reduces the risk of perineal tears or episiotomy during childbirth and can therefore lower the risk of needing perineal stitches especially for first time vaginal births.

• Antenatal perineal massage for reducing perineal trauma | Cochrane

In addition, pregnant women and people who previously birthed vaginally, and practiced perineal massage in the last month of pregnancy, experienced less perineal pain in the immediate postnatal period.

Perineal massage is advised from 35 weeks onwards and is particularly helpful for first time mothers who are more at risk of having a tear or episiotomy. It only needs to take 5 to 10 minutes a day and can also be done by your partner. It may feel strange or slightly uncomfortable to begin with, but after a few weeks of regular perineal massage you will notice some increased elasticity in that area. Further information and a step-by-step guide on how to massage the perineum effectively can be found here.

It is recommended that you aim for 150 minutes of moderate intensity exercise weekly during pregnancy. If you are new to exercise start with 15 minutes 3 x weekly and work up gradually. Examples of moderate intensity exercise include, going for a walk, dancing, cycling, carrying grocery shopping bags, using a treadmill or static bike at the gym, swimming, yoga, gardening and climbing stairs.

In pregnancy, the aim should be to maintain or moderately improve your level of fitness. After your baby is born the aim is to regain your former level of fitness, or to improve on it.

Moderate exercise intensity is recommended during pregnancy and can be monitored using the Talk Test - you should be able to talk without feeling breathless during exercise, if you are unable to do so you are probably working too hard. Stop, get your breath back and return to exercise at a pace that allows a conversation while exercising.

Aim for at least 150 minutes of moderate exercise weekly throughout pregnancy and two strength training sessions.

No, exercise equipment is not necessary to work out at home although if you have any equipment that is great! Simple body weight exercise is very beneficial in pregnancy and can help strengthen your muscles and protect your joints. If you do feel like you want an extra challenge, you can always substitute a water bottle for weights. You may also choose to invest in good quality resistance bands or a gym ball.

It is not advised that you exercise with placenta previa after your 26th week of pregnancy. You can continue activities of daily living and low intensity activity such as walking, unless advised otherwise. If you do experience any type of vaginal bleeding or contractions, then you must contact triage straight away. Please view our Spotlight On Placenta Previa for more information.

High impact exercise such as jumping, running or aerobics (any activity when both feet are off the ground at the same time) may worsen your symptoms especially if your pelvic floor muscles are not strong. Activities using weights may also cause too much downward pressure on your pelvic floor.

Try low impact exercise instead such as modified aerobics, cycling, a cross trainer, fast walking, Pilates ,swimming or low intensity resistance training so you can avoid straining. If your normal exercise routine makes your prolapse symptoms worse ask your healthcare professional for alternatives.

The pelvic floor muscles act like a hammock to support the pelvic organs. Pelvic floor muscle exercises will strengthen the muscles and retrain them to be more effective in supporting the pelvic organs making the symptoms of prolapse less bothersome. To learn more about how to do pelvic floor exercises please watch our Spotlight on Pelvic Floor Exercises in Pregnancy.

During the first six weeks after having a caesarean birth, you should focus on walking as your main form of exercise. You may also have been given some information immediately postnatally on simple and gentle exercises for your back, tummy muscles and pelvic floor which are available here. In the first few days just moving around the bed and to the toilet and back is enough. Gradually start increasing your walking once you get home, starting with five minutes outside just to get a feel of what it is like. It is best not to be carrying baby when you go for a walk. Remember, you will have good days and bad days and don't expect to keep increasing your walking time daily. In general, aim to be able to walk for approximately 60 minutes non-stop or in line with what you were previously able to do by the end of the six week period.

You should avoid lifting anything heavier than your baby for the first 6 weeks. This is especially important if you have had a caesarean birth, as a lot of healing on the inside continues for up to 12 weeks. Remember that your baby will hopefully be gaining weight, so carrying your little one around is enough in those early weeks. After your postnatal GP check (at 6-8 weeks) you can start resistance training again. As with any sensible weight lifting programme, start with low weights and gradually increase, and be extra careful if you have a hernia, a large diastasis of the tummy muscles or a vaginal prolapse.

We recommend that you wait at least twelve weeks after pregnancy before returning to running. This is regardless of whether you had a vaginal or caesarean birth. To build strength and fitness before this point, you can start doing some gentle resistance training and swimming from week six onwards.

Avoid running if you experience bladder leakage or a sensation of vaginal dragging. If this occurs, please refer to your local pelvic health physiotherapy team.

Many pregnant women and people with Pelvic Girdle Pain worry that their pain will be worse if they have to go through labour. This is not usually the case. Most people with pelvic girdle pain manage to have a normal delivery and a caesarean birth is not normally recommended. It is always a good idea to discuss your birthing options with your midwife or doctor.

Some people may experience pelvic girdle pain again during their next pregnancy. However, this is not always the case. Between pregnancies, continue with any exercises given to you by your physiotherapist; in particular, pelvic floor, tummy and hip exercises. When planning for a future pregnancy, try to be healthy, eat well, aim for a healthy weight for your height and do regular exercise that you enjoy.

No, there is no evidence that breastfeeding will interfere with your recovery from pelvic girdle pain.

It's perfectly safe to have sex during pregnancy unless your doctor or midwife has told you not to. It is, however, normal for your sex drive to change during pregnancy and while sex is safe for most couples in pregnancy, it may not be all that easy. This is an opportunity to explore and try different positions. You may be advised to avoid sex during pregnancy in one of the following circumstances

• Heavy bleeding in pregnancy
• Your waters have broken
• There are problems with the entrance to your womb (cervix)
• You have had early labours before or you are having two or more babies and are in the later stage of your pregnancy

When you are pregnant it is fine to sleep on either your right or left side. After 28 weeks, research suggests that falling asleep on your back can double the risk of stillbirth. This is thought to be linked to the flow of blood and oxygen to the baby. Whilst you should avoid going to sleep on your back don't panic if you wake up in the night on your back - simply turn over and go back to sleep on your side. Using pillows between the knees and ankles and under your bump can also help with finding the most comfortable sleeping position.

Several pieces of recent positive research have shown that perineal massage reduces the risk of perineal tears or episiotomy during childbirth and can therefore lower the risk of needing perineal stitches especially for first time vaginal births.

• Antenatal perineal massage for reducing perineal trauma | Cochrane

In addition, pregnant women and people who previously birthed vaginally, and practiced perineal massage in the last month of pregnancy, experienced less perineal pain in the immediate postnatal period.

Perineal massage is advised from 35 weeks onwards and is particularly helpful for first time mothers who are more at risk of having a tear or episiotomy. It only needs to take 5 to 10 minutes a day and can also be done by your partner. It may feel strange or slightly uncomfortable to begin with, but after a few weeks of regular perineal massage you will notice some increased elasticity in that area. Further information and a step-by-step guide on how to massage the perineum effectively can be found here.

Placenta previa is a condition where your placenta is covering your cervix. It is called a 'low lying placenta' if the placenta is less than 2cm from the cervix and 'placenta previa' if the placenta is completely covering the cervix. You will be advised of these conditions during your 20 week ultrasound scan and rechecked at around 32 weeks pregnant. In 9 out of 10 cases the placenta will have naturally moved higher up away from the cervix. You can watch a Spotlight on video on this here.

A hernia is when an internal part of the body pushes through a weakened area in the surrounding muscle or tissue wall. Often it will cause few, if any symptoms or you may notice swelling or a lump in the affected area. Coughing, straining or lifting may make the lump appear. You may be able to push it back and it often disappears when you lie down. Common hernia sites include your groin and tummy area.

A hernia can develop in pregnancy due to stretching and strain on the abdominal muscles from the growing baby. This may lead to an umbilical hernia which is a lump/bulge or swelling poking through your belly button area.

Often a hernia will not require any surgical treatment but you should make an appointment to see your GP if you think you have a hernia so you can discuss management with them. If you have sudden pain, sickness, difficultly doing a poo or passing wind or if the hernia becomes hard or cannot be pushed back you should seek immediate help.

Ehlers-Danlos Syndrome (EDS) is a condition that makes the body’s connective tissues — like skin, joints, and ligaments — more stretchy than they would usually be. Because these tissues help support your muscles and organs, EDS can weaken the pelvic floor (the group of muscles that hold up your bladder, womb, and bowel). During pregnancy or birth, this may increase the risk of prolapse (when one of more of the pelvic organs drops lower). EDS can also result in slower recovery after a perineal tear or an episiotomy because the skin and tissues can take longer to heal. If you have EDS, let your maternity team know so they can give you extra support for birth and recovery.

Lichen sclerosus is a long-term skin condition that makes the skin around the vulva (the outside of the vagina) thin, pale, and sometimes itchy or sore. During pregnancy and birth, this delicate skin can tear more easily, and any cuts or grazes may take longer to heal. Good care, like using prescribed creams and keeping the area moisturized, can help protect the skin. If you have lichen sclerosus, tell your maternity team so they can watch for changes, support you during birth, and guide you on how to care for the area as it heals.

Vulval varicosities are swollen veins that can appear around the vulva (the outside of the vagina). They are more common during pregnancy because of increased blood flow and pressure into the pelvic area. They may feel heavy, achy, or look like soft blue lumps. Although they can be uncomfortable, they usually do not prevent you from having a vaginal birth. Sometimes they can bleed a little if they are injured during birth, but serious problems are rare. Lying on your side, using a cool compress, or wearing support garments can help ease discomfort. Tell your maternity team if you notice these veins so they can take care of you during birth and give advice for recovery. Most people find that vulval varicosities resolve after birth.

At your booking appointment, your midwife will refer you to the Smoke Free Pregnancy Team. A tobacco advisor will then be in touch with you. Our advisors are non-judgemental and specially trained to support you, helping to address any fears you may have about giving up smoking and empowering you to take this important step for both you and your baby.

Support is also available for partners, as we know that having a smoke free household is not only vital for your baby’s health, but also for any children in your home, and it can greatly help you to remain smoke free.

Your tobacco advisor will also discuss nicotine replacement options with you, such as patches, gum, and vaping. In addition, there is a new financial incentive scheme, where you could earn up to £400 (current in 2025) if you remain smoke free throughout your pregnancy.

Everyone who is pregnant will have a breath test at their first antenatal appointment to measure carbon monoxide (CO) levels. This helps us understand whether your baby may be receiving less oxygen than is optimal.

If your CO levels indicate that you smoke or if your CO levels are elevated, your midwife will refer you to the Tobacco Dependency Team, who will provide ongoing support for you throughout your pregnancy to help you stay smoke free in order to protect you and your baby.

You may already know that smoking can increase the risk of a number of health conditions, including cancers, respiratory diseases, gum disease, and tooth loss.

Even though your baby is protected in your womb, they share the same oxygen and nutrients as you through the placenta. The toxins and harmful gases in cigarette smoke, such as carbon monoxide, can cross the placenta and reduce the amount of oxygen your baby receives. This can increase the risk of complications such as miscarriage, stillbirth, premature birth, low birth weight, and cleft lip or palate.

Smoking can also affect your baby’s health after birth and as they grow. This includes a higher risk of problems such as asthma, chest infections and behavioural conditions.

Within a few hours of stopping smoking your baby starts to receive the correct amounts of oxygen through the placenta. We know that stopping smoking before 15 weeks will give your baby the best start in life. However, it’s never too late to stop smoking. Remember, for every cigarette you smoke thousands of toxic chemicals enter the bloodstream and it takes up to 24 hours to exhale the carbon monoxide (CO) from your breath.

Pregnancy is also a time when some people may choose to switch to vaping. A vape contains five main ingredients: water vapour, nicotine, flavouring, preservative, and glycerol. In the short and medium term, vaping poses significantly less risk than smoking.
Your maternity Smoke Free Team may offer a ‘Swap to Stop’ scheme, which allows you and your partner to receive a free vape along with free top-up liquids to support you in moving away from smoking.

Smoking can affect the strength and functioning of your pelvic floor muscles so going smokefree can also help you to reduce the risk of urinary incontinence both during pregnancy and beyond. Smoking can affect your Pelvic Floor Muscles in the following way:

• Carbon monoxide generated from smoking affects oxygen supply to the bodily tissues and can lead to weakening of the pelvic floor muscle's function.
• Chronic cough associated with smoking leads to an increase in intra-abdominal pressure and puts extra pressure on the pelvic floor muscles, increasing the risk of leakage.
• Nicotine can stimulate the detrusor muscle of the bladder and cause bladder overactivity, making you want to go to the toilet more frequently and possibly with more urgency.

If you are enrolled in the financial incentive scheme, you will continue to receive support for up to three months after your baby is born. After this, you will be signposted to your local Stop Smoking Service if further support is needed.

You will also benefit from the involvement of your Health Visitor, who can provide additional guidance and support to help you stay smoke free.

Try to drink around 2 litres of fluid a day. Water and sugar free drinks are best. Yoghurt, milk and soups can also count towards your fluid intake. You may need to drink more in hot weather, if you are sweating, if you exercise a lot or if you are unwell.

There is no safe level of alcohol in pregnancy. Drinking alcohol during pregnancy can affect the way your baby develops in the womb. It can also affect your child's health at birth and in the long term. If you are worried about your alcohol intake, please speak to your midwife - support is available.

Regularly having more than 200mg or caffeine per day can increase the risk of pregnancy complications including low birthweight and miscarriage. There is:

• 100mg in a mug of instant coffee
• 140mg in a mug of filter coffee
• 75mg in a mug of black or green tea
• 40mg in a can of cola
• 80mg in a 250ml can of energy drink
• Caffeine in herbal teas varies so check the labels.

There is also a small amount of caffeine in chocolate.

Look at your urine! If you are drinking enough your urine should be pale yellow (light straw coloured). If it is darker you need to drink more. Being dehydrated increases your risk of urinary tract infections, constipation, fatigue and headaches. Sip drinks throughout the day if you cannot manage a whole cup in one go.

Some foods are not safe in pregnancy such as raw or undercooked meats and fish and certain unpasteurised dairy products. The NHS website tells you what these are - Foods to avoid in pregnancy - NHS (www.nhs.uk)

'Eating for two' is a myth and you should aim to eat normally in pregnancy, even if you are expecting more than one baby. Choose an eating pattern that helps you to feel full and comfortable. This might be three meals a day, or smaller meals and snacks. Including plenty of nutritious foods like wholegrain cereals, fruits and vegetables, nuts and dairy products (like yoghurt), will make sure you and baby have all the nutrients you need.

It is very rare that someone would be advised to lose weight in pregnancy. Even if someone is overweight when they book in for pregnancy, they would normally gain around 4-9kg across 40 weeks. This is made up of the weight of baby, the placenta and other pregnancy related changes. If you are losing weight or are worried about your weight, please speak to your antenatal team.

Hormonal and physical changes in pregnancy can increase the risk of constipation. Stay hydrated - water is best. Eat wholegrains, fruit, vegetables, beans, pulses and nuts as these contain fibre. Some people find prune juice, ripe pears, plums and kiwi fruits (two a day if you are constipated) helpful. Try to stay active; moving around can help your bowels to move too. If you are still constipated despite trying these tips, speak to your GP or pharmacist.