Pelvic Floor Support After Birth (Postpartum)

After birth, the pelvic floor and core have been through major change - even if you had a “straightforward” delivery. Pelvic floor physiotherapy can help with symptoms like leaking, heaviness, prolapse symptoms, pelvic pain, painful sex, and loss of confidence returning to exercise. Online consultations are a safe, effective way to assess symptoms, movement, breathing, and recovery needs -without internal examination.

If this sounds familiar

After birth, you may notice:

• Leaking urine when you cough, sneeze, laugh, run or lift
• A heavy, dragging, or pressure feeling in the vagina
• A bulge sensation or “something falling down” feeling
• Pelvic, hip, tailbone or lower back pain
• Pain during sex, tampon discomfort, or sensitivity
• Difficulty activating your pelvic floor or core
• Abdominal “doming” or reduced core control (including diastasis-related symptoms)
• Feeling unsure what exercise is safe - or scared of making things worse

These symptoms are common - but you deserve support and a clear plan.

Why postpartum affects the pelvic floor and core

Birth changes how your body manages load, pressure and recovery.

Key factors include:

• Stretching and strain through pregnancy and delivery
• Tissue healing after vaginal birth, tears, episiotomy or C-section
• Changes in pelvic floor strength, coordination and endurance
• Postural changes, feeding positions, and carrying a growing baby
• Sleep disruption and fatigue reducing recovery capacity
• Breathing and pressure strategies that overload the pelvic floor
• A return to exercise (or lifting) before the system is ready

Your pelvic floor, core, hips and breathing work as one system. When one area is overloaded or under-supported, symptoms often show up elsewhere.

Common postpartum symptoms pelvic floor physio can help with

Pelvic floor physiotherapy after birth commonly supports:

• Stress urinary incontinence (leaking with movement, coughing, jumping)
• Urgency or bladder control changes
• Pelvic heaviness / prolapse symptoms
• Pelvic pain, hip pain, tailbone pain, or lower back pain
• Pain during sex or discomfort with penetration
• Scar sensitivity (perineal or C-section)
• Pelvic floor weakness or tightness
• Return to exercise guidance (walking, running, strength training)
• Confidence rebuilding after birth

How leaks, heaviness and pain are often connected

Postpartum symptoms are not always caused by “weakness” alone.

They can be driven by:

• Poor timing and coordination of the pelvic floor during pressure (cough/lift)
• Overactive or tight pelvic floor muscles (tight can still leak)
• Scar tissue or healing sensitivity
• Reduced core-to-pelvic floor coordination
• Breathing patterns that increase downward pressure
• Movement strategies that overload the pelvic floor

Pelvic floor physiotherapy helps you understand what’s happening - and what your body actually needs to improve.

Why a C-section doesn’t fully protect your pelvic floor

It’s common to assume a caesarean birth fully prevents pelvic floor problems - but pelvic floor symptoms can still happen after a C-section.

Pregnancy itself loads the pelvic floor.

For nine months, your pelvic floor supports a growing uterus and increased abdominal pressure, while hormones (e.g., relaxin and progesterone) change tissue stiffness and support. This means symptoms like leaking, heaviness/prolapse sensations, urgency, or pelvic pain can occur even when the baby is delivered via C-section. Large population studies show women who deliver by C-section still have higher rates of urinary incontinence than women who have never given birth.

C-section reduces risk, but doesn’t eliminate it.

Research consistently shows C-section is associated with lower rates of some pelvic floor disorders compared with vaginal birth - particularly stress urinary incontinence and pelvic organ prolapse - but the risk is not zero.

Emergency C-sections may not be the same as planned C-sections.

If you laboured (sometimes for many hours) before a C-section, the pelvic floor may have already been under significant strain. Long-term cohort data also suggests mode of birth influences later pelvic floor symptoms, but C-section does not fully remove the possibility of ongoing issues.

Anal incontinence can still occur after C-section.

Large register-based research indicates anal incontinence diagnoses are lower after C-section than vaginal birth, yet still higher than in women who haven’t given birth.

Bottom line: if you’ve had a C-section and notice leaking, urgency, heaviness, pain, or sexual discomfort, it’s real - and it’s treatable. Postnatal pelvic health guidance in the UK emphasizes early identification and support rather than dismissing symptoms as “normal.”

Can pelvic floor physiotherapy be done online postpartum?

Yes - and it is commonly used.

Online pelvic floor physiotherapy is appropriate postpartum because it focuses on:

• Detailed symptom and birth history assessment
• Breathing and pressure-management strategies
• Posture and movement analysis
• Core and pelvic floor coordination
• Exercise modification and progression
• Education on what is safe, helpful and unnecessary

Online consultations do not include internal examination. If your physiotherapist thinks an in-person assessment would add value, they will guide you clearly.

What happens in an online postpartum pelvic floor consultation?

Your pelvic health physiotherapist will:

• Take a detailed birth, recovery and symptom history
• Discuss feeding, sleep, activity levels and return-to-exercise goals
• Assess breathing, posture and functional movements (e.g., lifting, standing, walking)
• Identify likely contributors to leaking, heaviness, pain or weakness
• Create a personalised plan, which may include:
  • Pelvic floor strengthening or relaxation strategies
  • Core coordination and diastasis-safe rehab guidance
  • Scar-friendly approaches (if relevant)
  • Pressure management for lifting and daily life
  • Exercise guidance and progression (including return to running if appropriate)

You’ll leave feeling clear, supported, and confident about next steps.

When should you book an assessment?

Consider booking an online consultation if:

• Leaking is affecting your confidence or activity choices
• Heaviness or pressure makes you feel nervous to move or exercise
• Pain is limiting daily life, intimacy, or recovery
• You’re unsure what is safe to do postpartum
• You want to rebuild strength gradually and properly
• Symptoms aren’t improving - or feel like they’re getting worse
• You want expert guidance before things escalate

Early, tailored support can make a real difference.

When online care may not be appropriate

You should seek in-person or urgent care if you have:

• Unexplained bleeding
• Signs of infection (fever, unusual discharge, severe pain)
• New neurological symptoms (numbness, weakness, changes in saddle sensation)
• Severe prolapse symptoms outside the vaginal opening
• Sudden, severe pelvic pain or rapid symptom deterioration
• Post-surgical or post-birth complications requiring medical review

Your health comes first - and your physiotherapist will guide you if escalation is needed.

Why Mothercore

• Specialist pelvic health physiotherapists who truly understand what you’re going through
• UK-registered clinicians you can feel confident and safe with
• Evidence-based, personalised care - built around your body, your symptoms, and your life
• Clear, supportive explanations (no shame, no guesswork, no “just live with it”)
• Flexible online appointments that fit around work, recovery and childcare

Frequently Asked Questions

Is leaking urine normal after giving birth?

It’s common, but it’s not something you have to accept. Leaking is often a sign of pelvic floor dysfunction and can improve significantly with the right physiotherapy plan.

I had a C-section - do I still need pelvic floor rehab?

Often, yes. Pregnancy alone places load on the pelvic floor, and C-section recovery can affect core control, posture and pressure management.

How soon after birth can I start pelvic floor physiotherapy?

Many people can start gentle, recovery-focused support early - and benefit from guidance on safe movement and rebuilding strength over time. Your plan should match your symptoms and stage of healing.

Do I need an internal examination to get help postpartum?

No. Online consultations can assess symptoms, breathing, movement and function safely without internal examination. If an in-person exam would be helpful, your physiotherapist will explain why and what to do next.

Book your online pelvic floor consultation

Confidential, one-to-one postpartum support with a specialist physiotherapist.

Useful links:

What you need to know about prolapse

Painful sex

Tight pelvic floor

Weak pelvic floor

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