Postpartum Pelvic Floor Recovery: Regaining Strength and Confidence After Birth
Introduction:
Pregnancy and childbirth can impact the pelvic floor—a group of muscles that support the bladder, uterus, and bowel. New mothers may experience pelvic floor dysfunction, including incontinence, pelvic heaviness, and core weakness. In fact, up to 1 in 3 women experience urinary incontinence postpartum, and many more go undiagnosed. The good news? With guided physiotherapy, most women can regain function, strength, and confidence in their postpartum bodies.
Causes and Risk Factors:
The pelvic floor undergoes intense pressure during pregnancy and delivery. These muscles stretch, weaken, or tear—especially during vaginal delivery. However, even if you have a c-section, you may still be at risk of developing pelvic floor dysfunction.
Common causes and risk factors for postpartum pelvic floor dysfunction include:
Vaginal birth, especially with forceps or vacuum assistance
Perineal tearing or episiotomy
Prolonged second stage of labour (pushing phase)
High birth weight baby
Multiple pregnancies
Chronic constipation or straining
History of pelvic floor weakness or incontinence prior to pregnancy
Symptoms:
Postpartum pelvic floor dysfunction can show up in many ways:
Urinary incontinence, for example with sneezing, laughing, or running
Pelvic heaviness or pressure
Pain during intercourse (dyspareunia)
Low back, hip, or pelvic pain
Difficulty engaging core muscles or a feeling of abdominal "emptiness"
Diastasis recti (abdominal separation), often linked with pelvic floor weakness.
Diagnosis:
Pelvic floor issues are often underreported, but physiotherapists trained in pelvic health, like Maria Gayevski at our clinic can identify and address them through:
A thorough subjective history, including bladder, bowel, and sexual health questions
Physical assessment of posture, breathing, and core activation
Internal pelvic floor exam (with consent), assessing strength, tone, and coordination
Functional movement screening to identify compensations and weakness
Physiotherapy Approach:
At Integrative Physio, we take a holistic and evidence-based approach to postpartum pelvic floor recovery. Our treatment may include:
Pelvic Floor Retraining: Teaching proper coordination, strength, and endurance of the pelvic muscles
Core Reconnection: Safe and progressive activation of the deep core, including the transverse abdominis
Diastasis Recti Rehabilitation: Exercises to close the gap and restore core function
Manual Therapy: For scar tissue, muscle tension, or alignment issues
Education on Bladder and Bowel Health: Including strategies for managing urgency and improving control
Return-to-Exercise Planning: Tailored guidance to safely reintroduce movement and progress it to suit your goals.
Patient Education and Self-Management:
You are not alone—and recovery is possible with the right support.
Here are a few tips:
Begin with gentle core activation and breathing, but focus on quality over quantity.
Avoid holding your breath—coordinate breath with movement, especially during lifting or baby care tasks. Exhale as you lift!
Rest and recover: especially early postpartum - it is a time to rest!
Use good toileting habits (feet elevated, don’t strain) to protect the pelvic floor.
Avoid high-impact activity until cleared by your physiotherapist.
Conclusion:
Postpartum recovery extends far beyond the six-week checkup. Whether you’re a few weeks, months, or even years postpartum, it's never too late to rebuild your pelvic floor and core. Physiotherapy can help you feel strong, supported, and confident in your body again.
Call to Action:
Are you experiencing leaks, pelvic pressure, or core weakness after having a baby? Book a pelvic health assessment with Maria Gayevski at Integrative Physio today. Maria is here to guide you on your recovery journey—both in-person and virtually.
Written By: Maria Gayevski
References:
Bo K, Hilde G. Does it work in the long term?—A systematic review on pelvic floor muscle training for female stress urinary incontinence. Neurourol Urodyn. 2013.
Dumoulin C, Cacciari LP, Hay‐Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018.
Thompson JA, O’Sullivan PB, Briffa NK. Pelvic floor muscle training and education for preventing and treating urinary and fecal incontinence in antenatal and postnatal women. J Wound Ostomy Continence Nurs. 2008.
