Having a baby changes your body. Some of those changes improve naturally as you recover, while others may be signs that your pelvic floor needs a little more attention.
Urinary leakage, frequent bathroom urges, pelvic pressure, bowel control problems, and pain with sex can all happen after childbirth. They’re common, but that doesn’t mean you have to accept them as your new normal.
Pelvic floor physical therapy can help address postpartum symptoms while helping you rebuild strength, coordination, and confidence as you return to exercise, work, caring for your baby, and everything else your day requires.
Reviewed and contributions made by Jennifer Lewis, PT, DPT
Key Takeaways
- Pregnancy itself can affect the pelvic floor, so postpartum symptoms aren’t limited to people who had a vaginal delivery.
- Leaking urine, pelvic heaviness, bowel control problems, and pain with sex are common postpartum concerns, but treatment is available.
- The pelvic floor isn’t just about bladder control. It works with your core, hips, abdomen, and surrounding muscles to support everyday movement.
- Kegels aren’t the answer to every pelvic floor problem. Some people need strengthening, while others need help relaxing or coordinating the pelvic floor muscles.
- You don’t have to wait until symptoms become severe to talk about them with a pelvic health physical therapist or another healthcare provider.
By the Numbers: Postpartum Pelvic Health
Pelvic floor concerns after childbirth are more common than many people realize.
- About 25% of women experience a pelvic floor disorder. Pregnancy and childbirth are among the factors associated with these conditions.
Source: Parents.com - Nearly one-third of women experience urinary incontinence during the postpartum period.
Source: Parents.com - Postpartum adults should work toward at least 150 minutes of moderate-intensity aerobic activity each week, with a gradual return to activity based on individual circumstances.
Source: American College of Obstetricians and Gynecologists
Those numbers tell two sides of the postpartum story. Pelvic floor symptoms are common, but recovery is also about getting back to movement and activity. You shouldn’t have to choose between living with symptoms and giving up the things you want to do.
You don’t have to wait for pelvic floor symptoms to become severe before getting help. If you’re dealing with leakage, pelvic pressure, pain, bowel or bladder changes, or difficulty getting back to the activities you enjoy, a pelvic health physical therapist can help you understand what may be contributing to your symptoms and what you can do about them.
ATI Physical Therapy offers personalized pelvic health care with treatment built around your symptoms, comfort level, and goals.
Your Pelvic Floor Did a Lot Before the Baby Arrived
It’s easy to think of pelvic floor recovery as something that only matters after a difficult vaginal delivery. Pregnancy itself, however, places new demands on the muscles and tissues that support the bladder, bowel, uterus, and pelvis.
As pregnancy progresses, your body also adapts to changes in posture, abdominal pressure, joint stress, and core stability. Then comes childbirth and the physical demands of postpartum life.
And those demands are real.
You’re lifting and carrying a baby. You’re getting up and down from chairs, beds, and the floor. You’re feeding your baby in positions you may hold for long stretches. You’re carrying car seats, folding strollers, and eventually thinking about getting back to exercise.
Your pelvic floor is part of that bigger movement system. That’s why postpartum pelvic health isn’t only about whether you can do a Kegel. It’s about how your pelvic floor, core, hips, abdomen, breathing, and movement work together.
Common Doesn’t Mean You Have to Live with It
One of the biggest challenges with postpartum pelvic health is figuring out what’s simply part of recovery and what deserves more attention.
ATI pelvic health physical therapist Jennifer Lewis, PT, DPT, recently spoke with Parents.com about postpartum pelvic floor symptoms that shouldn’t simply be accepted as part of life after childbirth.
Urinary leakage is one example. Jennifer explained that postpartum leakage may happen when you laugh, sneeze, cough, jump, or lift your baby. But experiencing it after childbirth doesn’t mean you’re destined to leak forever.
As Jennifer told Parents.com: “Pelvic floor symptoms usually don’t fix themselves.”
Read Jennifer’s full comments on Parents.com
That distinction matters. A symptom can be common after having a baby without being something you should simply accept.
What Postpartum Pelvic Floor Symptoms Should You Pay Attention To?
Postpartum pelvic floor dysfunction doesn’t look the same for everyone.
You may notice urine leaking when you cough, laugh, exercise, or pick up your baby. Or the issue may be urgency, where the need to use the bathroom comes on suddenly and is difficult to control.
Other people notice a feeling of heaviness or pressure in the pelvis, particularly after spending a long time standing or being active. That sensation can sometimes be associated with pelvic organ prolapse, which occurs when the muscles and tissues supporting the pelvic organs aren’t providing enough support.
Bowel symptoms matter, too. Difficulty controlling gas or stool shouldn’t be dismissed simply because you’ve recently given birth.
And then there’s pain. Discomfort during sex can have several contributors after childbirth, including muscle tension, scar tissue, hormonal changes, and pelvic floor dysfunction. The fact that painful sex is common postpartum doesn’t mean you should feel pressured to push through it.
These symptoms can be personal and sometimes difficult to bring up. For a pelvic health physical therapist, they’re part of the job. You aren’t going to surprise us, and you don’t need to wait until a symptom becomes unbearable before talking about it.
Pelvic Floor Recovery Isn’t Just About Kegels
“Kegels” have become almost synonymous with pelvic floor health. They’re useful in the right situation, but they’re not a universal prescription for every postpartum symptom.
Pelvic floor muscles need to do more than contract. They also need to relax, coordinate with your breathing and abdominal muscles, and respond appropriately when you lift, cough, exercise, or move.
Some people need to improve pelvic floor strength. Others have muscles that are too tense and need to learn how to relax them. Still others may have enough strength but struggle with timing or coordination.
In her conversation with Parents.com, Jennifer explained that a pelvic floor therapist can help patients learn to properly engage the pelvic floor or relax tight muscles. Treatment can also go beyond pelvic floor contractions, incorporating breathing techniques and strategies for everyday activities such as lifting.
That’s why simply doing more Kegels isn’t always the answer. Before deciding what an exercise program should look like, it helps to know what your body actually needs.
Read the full Parents.com article
What Happens in Postpartum Pelvic Floor Physical Therapy?
For many patients, the idea of pelvic floor therapy comes with a big question: What actually happens at the appointment?
At ATI, pelvic health physical therapy begins with a one-on-one, consent-based evaluation. Your therapist will talk with you about your symptoms, concerns, daily activities, and goals. The evaluation can look at how your pelvic floor works together with areas such as your core, hips, spine, and nervous system.
An internal examination is not mandatory.
You can ask questions throughout the evaluation, and your therapist will explain what they’re assessing and why. Your comfort and consent remain part of the process.
Treatment looks different depending on what your evaluation finds. Your plan may include pelvic floor muscle training or relaxation, breathing and core exercises, manual therapy, posture and movement training, bladder or bowel education, and progressive strengthening.
The goal isn’t to put every postpartum patient through the same pelvic floor workout. It’s to understand what’s limiting you and build a treatment plan around your needs.
Learn more about Pelvic Health Physical Therapy at ATI
Getting Back to Exercise After Baby
For many people, postpartum recovery eventually comes with another question: When can I get back to working out?
There isn’t one calendar date that works for everyone.
How quickly you return depends on factors such as your pregnancy, type of delivery, complications, symptoms, previous activity level, and the kind of exercise you want to return to. Someone hoping to take daily walks has different demands than someone preparing to run, lift heavy weights, or return to competitive sports.
The American College of Obstetricians and Gynecologists recommends gradually resuming exercise when it’s medically safe and working toward 150 minutes of moderate-intensity aerobic activity each week during the postpartum period. See ACOG’s postpartum exercise guidance
The key word is gradually.
If running brings on leakage, lifting creates pelvic pressure, or exercise causes pain, pay attention to what your body is telling you. Those symptoms may be a sign that you could benefit from additional support before increasing the demands on your body.
The goal isn’t simply to get “cleared” for exercise. It’s to feel ready for the activities you’re returning to.
Postpartum Recovery Is More Than the Pelvic Floor
The pelvic floor deserves attention after childbirth, but it isn’t working alone.
Pregnancy and delivery can also affect abdominal strength, posture, hip and back comfort, mobility, and the way you manage pressure through your core. Add hours of feeding, carrying, rocking, bending, lifting, and interrupted sleep, and it’s easy to understand why the postpartum body may need time and support.
Pregnancy and postpartum physical therapy can address these areas together, helping you rebuild strength, mobility, coordination, and confidence after childbirth.
That broader view matters because postpartum rehabilitation isn’t about making one muscle group stronger. It’s about helping your body meet the demands of your life now.
When Should You Ask for Help?
You don’t need to wait for a specific postpartum milestone to decide that something isn’t feeling right.
Talk with your healthcare provider or a pelvic health physical therapist if you’re dealing with ongoing leakage, urinary urgency, bowel control problems, pelvic heaviness or bulging, pain with sex, pelvic pain, or symptoms that make exercise and everyday activities difficult.
Postpartum care should include attention to bladder and bowel function, and a physical therapy referral may be appropriate when problems are identified.
And if you’re not sure whether what you’re experiencing warrants an appointment, you don’t have to diagnose yourself first. Talking with a healthcare professional can help you determine the right next step.
Your Postpartum Body Deserves More Than “Just Deal with It”
There’s no single timeline for recovering after childbirth. Your experience doesn’t have to look like someone else’s, and being six weeks, six months, or even longer postpartum doesn’t mean you’ve missed your opportunity to address a problem.
If something doesn’t feel right, keeps getting in your way, or is stopping you from doing things you want to do, it’s worth a conversation.
Pelvic health physical therapy can help you better understand what your body needs, address symptoms that may have become part of your routine, and build strength and confidence for what comes next.
At ATI Physical Therapy, our pelvic health specialists provide personalized care for pregnancy, postpartum recovery, and pelvic floor concerns. We’ll meet you where you are and build a plan around where you want to go.
Learn more about pregnancy and postpartum physical therapy at ATI
Ready to Talk About Your Symptoms?
You don’t have to wait for pelvic floor symptoms to become severe before getting help. If you’re dealing with leakage, pelvic pressure, pain, bowel or bladder changes, or difficulty getting back to the activities you enjoy, a pelvic health physical therapist can help you understand what may be contributing to your symptoms and what you can do about them.
ATI Physical Therapy offers personalized pelvic health care with treatment built around your symptoms, comfort level, and goals.
Ready to take the next step?
Book an Evaluation Today
Frequently Asked Questions
Is urinary leakage normal after having a baby?
Urinary leakage is common after pregnancy and childbirth, but common doesn’t mean you have to live with it. If you’re leaking when you cough, sneeze, laugh, exercise, or lift, a pelvic health evaluation can help determine what may be contributing to the problem and what treatment could help.
Do I need pelvic floor physical therapy after a C-section?
A cesarean delivery doesn’t automatically mean you need pelvic floor PT, but having a C-section doesn’t make pelvic floor concerns irrelevant either. Pregnancy itself changes the demands on your pelvic floor, core, posture, and surrounding muscles. If you’re experiencing pain, weakness, leakage, pressure, or difficulty returning to activity, an evaluation may be helpful.
Are Kegels good for everyone after childbirth?
No. Kegels can be useful when strengthening is needed, but some pelvic floor problems involve muscles that are tight or aren’t coordinating properly. In those cases, simply doing more contractions may not address the problem. A pelvic health physical therapist can help determine whether you need strengthening, relaxation, coordination training, or a combination.
When can I start exercising after having a baby?
It depends on your delivery, recovery, complications, symptoms, and previous activity level. Returning to exercise should be gradual and medically appropriate. If exercise causes pain, leakage, pelvic pressure, or other symptoms, talk with your healthcare provider or a pelvic health physical therapist before progressing.
What should I expect at my first pelvic floor PT appointment?
Your first visit starts with a conversation about your symptoms, health history, activities, and goals. Your therapist may assess your posture, movement, strength, breathing, core, hips, and pelvic floor function. At ATI, pelvic health evaluations are consent-based, and internal examinations aren’t mandatory.