When Should You Start Pelvic Floor Therapy After Birth?
Having a baby is a major physical experience, and your body goes through significant changes during pregnancy, labor, and the postpartum period. While some discomfort and changes are expected after birth, you do not have to wait until something feels seriously wrong before seeking support.
So, when should you see a pelvic floor therapist after giving birth?
The short answer is: you can seek pelvic floor therapy when you feel ready, and you do not need to wait until you are experiencing severe symptoms.
A postpartum pelvic floor evaluation can help you understand how your body is recovering and provide guidance as you return to exercise, daily activities, intimacy, and the activities you enjoy.
What Does a Pelvic Floor Therapist Help With After Birth?
Your pelvic floor is a group of muscles that supports your bladder, bowel, and reproductive organs. These muscles can become stretched, weakened, tense, or difficult to coordinate during pregnancy and childbirth.
A pelvic floor therapist can help with symptoms such as:
Urinary leakage
Pelvic pressure or heaviness
Pelvic or vaginal pain
Pain with sex
Difficulty emptying your bladder
Constipation or difficulty having bowel movements
Pain with bowel movements
Abdominal separation or diastasis recti
Difficulty returning to exercise
C section or perineal scar discomfort
Pelvic floor muscle weakness or tension
You do not need to have all of these symptoms to benefit from an evaluation.
Do I Need to Wait Until My 6 Week Postpartum Appointment?
Not necessarily.
Your postpartum medical appointment and a pelvic floor physical therapy evaluation serve different purposes.
Your OB/GYN or midwife checks your overall recovery and medical health. A pelvic floor therapist takes a closer look at how your pelvic floor, core, breathing, movement, and musculoskeletal system are functioning.
Depending on your birth and individual circumstances, your healthcare provider may recommend waiting before certain types of physical activity or treatment. Your pelvic floor therapist can also coordinate with your medical care team to determine what is appropriate for you.
If you're unsure when it is appropriate to begin therapy, talk with your healthcare provider.
What Happens After the 6 Week Postpartum Mark?
Once you have reached your 6 week postpartum milestone and have been medically cleared by your healthcare provider, a pelvic floor therapist may be able to perform a more comprehensive evaluation, including an internal pelvic floor examination when appropriate.
An internal exam can give your therapist valuable information about how your pelvic floor muscles are functioning, including whether the muscles are weak, overly tight, painful, or having difficulty relaxing and coordinating.
An internal assessment is not required for everyone. Your therapist will determine whether it could provide useful information based on your symptoms, concerns, and goals.
You will always be informed about what the assessment involves and asked for your consent before proceeding.
If you're experiencing symptoms such as urinary leakage, pelvic pain, pelvic pressure, pain with sex, or difficulty relaxing your pelvic floor, an internal assessment may help your therapist better understand what is contributing to your symptoms and create a more individualized treatment plan.
You don't have to have an internal exam to receive pelvic floor therapy, but when appropriate, it can provide valuable information that may not be possible to assess externally.
Should I See a Pelvic Floor Therapist If I Don't Have Symptoms?
You can.
Many people think pelvic floor therapy is only for postpartum problems like urinary leakage or pelvic pain. However, an evaluation can also help you understand how your body is recovering and how to safely progress toward your goals.
For example, you may want guidance on:
Returning to exercise:
You may be eager to get back to running, strength training, Pilates, or other activities but aren't sure where to start.
Understanding your pelvic floor:
Pregnancy and birth can change how your pelvic floor muscles function, even if you don't notice obvious symptoms.
Returning to intimacy:
A therapist can help you understand what may contribute to discomfort with penetration and how to gradually return to comfortable sexual activity.
Building strength:
Your core and pelvic floor work together. Learning how to coordinate them can be helpful as you return to everyday activities and exercise.
What Are Signs You Should See a Pelvic Floor Therapist?
You should consider scheduling an evaluation if you notice changes that aren't improving or are interfering with your daily life.
You're leaking urine
A little urine leakage when you cough, sneeze, laugh, jump, or exercise is common after pregnancy and childbirth. Common does not necessarily mean you have to live with it.
Pelvic floor therapy can help identify why you're experiencing leakage and develop an individualized treatment plan.
Sex is painful
Pain with penetration after childbirth can have several causes. Changes in the pelvic floor muscles, scar tissue, hormonal changes, dryness, and other factors can contribute.
If sex continues to be painful, you don't have to simply wait for it to go away.
You feel pelvic pressure or heaviness
A sensation of pressure, heaviness, or something feeling different in the vagina or pelvis can be worth discussing with your healthcare provider and pelvic floor therapist.
You have difficulty going to the bathroom
Constipation, straining, difficulty emptying your bladder, or feeling like you cannot completely empty your bowels can sometimes be related to pelvic floor coordination.
You're having difficulty returning to exercise
If you experience leaking, pressure, pain, or discomfort when walking, lifting, running, jumping, or exercising, a pelvic floor therapist can help you understand what your body needs before progressing.
You simply don't feel like yourself
Postpartum recovery isn't only about whether your incision has healed or whether you have been cleared for activity.
If your body doesn't feel the way it did before pregnancy and you're unsure how to move forward, that's a valid reason to seek support.
What Happens During a Postpartum Pelvic Floor Evaluation?
Your first appointment will typically begin with a conversation about your pregnancy, birth, symptoms, goals, and daily activities.
Your therapist may assess things such as:
Breathing patterns
Posture and movement
Core strength and coordination
Hip and pelvic movement
Pelvic floor muscle function
Abdominal wall function
Scar tissue, when applicable
Depending on your symptoms and your comfort level, your therapist may recommend an internal pelvic floor assessment. You should always have the opportunity to ask questions and give consent before an internal examination.
Your treatment should be individualized to your body, your symptoms, and your goals.
What If I Had a C Section?
A C section is still a major abdominal surgery, and pregnancy itself places significant demands on your pelvic floor.
Even if you did not have a vaginal birth, you may benefit from postpartum pelvic floor therapy, particularly if you are experiencing:
Urinary leakage
Pelvic pressure
Abdominal weakness
Diastasis recti
Scar discomfort or sensitivity
Pain with movement
Pain with sex
Difficulty returning to exercise
Your therapist can help you understand how your abdominal wall, core, breathing, and pelvic floor are working together as you recover.
You Don't Have to Wait Until Something Is Wrong
There is a common idea that postpartum symptoms are simply something you have to accept.
They're not.
Urinary leakage, painful sex, pelvic pressure, constipation, and difficulty returning to exercise may be common postpartum experiences, but you deserve support if they are affecting your life.
Whether you're a few weeks postpartum or several years removed from having your baby, it isn't necessarily too late to address pelvic floor concerns.
At Weeks Wellness, our pelvic floor physical therapists work with women throughout pregnancy and postpartum to help them understand their bodies, address symptoms, and confidently return to the activities that matter to them.
Your postpartum recovery doesn't have to be about simply getting back to “normal.”
It's about helping you feel strong, comfortable, and confident in your body again.
