Pregnancy and childbirth are transformative experiences that place significant demands on a woman's body—particularly the pelvic floor. Pelvic floor physiotherapy is a specialized form of treatment that helps women address common issues that arise during pregnancy and after delivery, including incontinence, pelvic organ prolapse, and pelvic pain.
What is the Pelvic Floor?
The pelvic floor is a group of muscles, ligaments, and connective tissues that form a supportive hammock at the base of your pelvis. These muscles support your bladder, uterus, and bowel, and play a crucial role in bladder and bowel control, sexual function, and core stability.
During pregnancy, the growing baby places increasing pressure on the pelvic floor. Hormonal changes also cause the tissues to become more relaxed in preparation for delivery. Vaginal birth can stretch or injure these muscles, while cesarean delivery can also affect pelvic floor function due to the pregnancy itself and abdominal surgery.
Common Prenatal and Postpartum Pelvic Floor Issues
Urinary Incontinence – Leaking urine when you cough, sneeze, laugh, or exercise is extremely common during and after pregnancy. This is called stress urinary incontinence and occurs when the pelvic floor muscles are weakened or stretched.
Pelvic Organ Prolapse – When the pelvic floor muscles become too weak to support the pelvic organs, one or more organs may descend into the vaginal canal. Symptoms include a feeling of heaviness or pressure in the pelvis, a bulge at the vaginal opening, or difficulty emptying the bladder or bowels.
Pelvic Pain – Pain in the pelvis, lower back, hips, or tailbone can occur during pregnancy due to postural changes and ligament laxity. Postpartum pelvic pain may result from birth trauma, scar tissue, or muscle imbalances.
Diastasis Recti – This is the separation of the abdominal muscles that commonly occurs during pregnancy. While not strictly a pelvic floor issue, it often occurs alongside pelvic floor dysfunction and is addressed in pelvic floor physiotherapy.
How Pelvic Floor Physiotherapy Helps
A pelvic floor physiotherapist is trained to assess and treat these conditions using evidence-based techniques. Treatment may include:
• Internal and external assessment – A thorough evaluation of pelvic floor muscle strength, coordination, and tone to identify areas of weakness or tension.
• Pelvic floor exercises – Customized exercises (often called Kegels) to strengthen weak muscles or release tight muscles. Proper technique is essential—many women perform Kegels incorrectly without guidance.
• Manual therapy – Hands-on techniques to release tight muscles, mobilize scar tissue, and improve tissue mobility.
• Education – Guidance on bladder habits, posture, lifting techniques, and safe return to exercise postpartum.
• Core rehabilitation – Exercises to restore core strength and coordination, including addressing diastasis recti.
When Should You See a Pelvic Floor Physiotherapist?
Ideally, every woman should have a pelvic floor assessment during pregnancy and again at 6-8 weeks postpartum. However, you should seek help sooner if you experience:
• Leaking urine or stool
• A feeling of heaviness or bulging in the vagina
• Pain during intercourse
• Persistent pelvic, hip, or lower back pain
• Difficulty emptying your bladder or bowels
You Don't Have to Live With These Symptoms
Many women believe that incontinence and pelvic discomfort are just a normal part of having children. While these issues are common, they are not something you have to accept. Pelvic floor physiotherapy is highly effective, and most women see significant improvement with proper treatment.
If you're pregnant or postpartum and experiencing any of these symptoms, book an appointment for a comprehensive pelvic floor assessment. Early intervention leads to better outcomes and helps you return to the activities you love with confidence.