When Should I See a Women's Health Physiotherapist After Having a Baby? By Kathryn Melvin Women's Health APA Physiotherapist

Bringing a new life into the world is a monumental experience—but it’s also one of the most physically demanding journeys a woman can go through. Whether you’ve had a vaginal delivery or a caesarean section, your body undergoes profound changes during pregnancy and childbirth. These changes often affect your pelvic floor muscles, abdominal wall, posture, and even breathing mechanics.

Seeking advice from a women’s health physio can provide a safe, empowering space designed to support you—not just back to “normal”—but toward thriving in your new chapter of motherhood.

Childbirth changes the body in profound and unique ways. Whether it’s yourfirst birth or your fourth, every postpartum journey is different. Women's health physiotherapy provides crucial support in recovery, helping to restore function, manage symptoms, and guide new mothers through each phase safely and confidently.

Why Postpartum Physiotherapy Matters:

During pregnancy and childbirth, the pelvic floor, abdominal wall, spine, and surrounding muscles go through immense strain. Many women experience issues such as incontinence, pelvic organ prolapse, back or pelvic pain, and postural changes, which may persist if left unaddressed.

A physiotherapist trained in pelvic health can:

- Assist in the recovery of pelvic floor and abdominal muscles

- Address postnatal pain or dysfunction

- Prevent or treat incontinence and pelvic organ prolapse

- Reduce risk of long-term pelvic organ prolapse and incontinence

- Provide guidance on safe return to exercise

- Offer support for breast-feeding postures and mastitis management

- Address pain or discomfort during sex

- Tailor recovery advice after a vaginal delivery, acaesarean section, episiotomy, or complicated delivery

When to Book Your Appointment:

Ideally, you should book a postpartum physio assessment around 6 weeks after birth, once you’ve had your routine check-up with your GP or obstetrician. But there’s no need to wait if something doesn’t feel right.

Seek support earlier if you experience:

- Leakage of urine, wind or stool

- A feeling of heaviness or bulging in the vaginal area

- Pain in your pelvis, hips, lower back, or perineum

- Difficulty with mobility or function

- Diastasis recti (abdominal separation)Even if you’re not currently experiencing symptoms, a proactive check-in can help set you up

for long-term pelvic health.

What to Expect in Your Session

A comprehensive women’s health physio consultation includes:

- A thorough discussion of your pregnancy, birth and recovery

- Optional internal pelvic floor examination (with consent)

- Postural, abdominal, and musculoskeletal screening

- A tailored rehabilitation plan

Key Time Points for Postpartum Physiotherapy

3–6 Week Check

The early check is usually booked after clearance from your GP or obstetrician. At this stage we assess:

- Pelvic floor muscle engagement

- Abdominal muscle recovery and any diastasis recti

- Perineal healing (including episiotomy or tearing)

- Postural changes

- Bladder and bowel function

- Birth debrief and emotional check-in

We may begin gentle, restorative movements and breathing techniques during this session.

May start Stage 1/ early pelvic floor strengthening exercises.

12 Week Check

Around the three-month mark, rehabilitation moves from foundational recovery into reloading tissues and returning to higher demand activities. This check includes:

- Detailed pelvic floor strength, endurance and coordination testing (often including internal

assessment)

- Abdominal wall reassessment

- Introduction to more dynamic exercises

- Initial impact-readiness screening if returning to sport

- Return to running program.

- Scar tissue assessment for caesarean or perineal scars

At this point, we may introduce Stage 2 pelvic floor training, including functional tasks like coughing, lifting, and low-impact jumping.

6 Month CheckIf your return to exercise is progressing well, this session reassesses load tolerance and

refines your program to support long-term goals. Focus areas include:

- Full pelvic floor capacity testing under load (e.g., running, lifting)

- Advanced core control

- Management of any ongoing symptoms (e.g., leaking during effort, heaviness)

- Exercise and sport-specific progressions

- Advice for future pregnancies if planning more children

This is a great time to check that your recovery has translated into resilience.

Frequently Asked Questions

When can I start running again?

Return to running is typically advised after 12 weeks postpartum. However, readiness is individual. A birth involving significant tearing, pelvic floor dysfunction, or caesarean section may need longer, with proper screening recommended beforehand. Return to running should follow a plan, to be adjusted if symptoms are worsening.

What are the risks of running or lifting too soon?

Starting high-impact or heavy-load activities too early can:

- Delay healing

- Increase intra-abdominal pressure, worsening diastasis or prolapse

- Lead to leaking or pelvic discomfort

- Affect scar integrity from caesarean or perineal tears

What should I expect from my pelvic floor after a caesarean section?

Although the pelvic floor is spared direct birth trauma during a caesarean, pregnancy still places significant load on it. Additionally, scar tissue and abdominal healing affect posture and muscle activation. A tailored pelvic floor and core rehab plan remains essential.

I've had an episiotomy—does that change anything?

Episiotomies and perineal tears can affect pelvic floor function and lead to scar sensitivity. Physiotherapy can help with soft tissue mobilisation, pain management, and progressive rehabilitation to support healing and return to intimacy.

I don’t have symptoms—is physiotherapy still necessary?

Even without obvious symptoms, a check-in can identify underlying weaknesses or imbalances. Early intervention often prevents issues from arising months or even years later.

Can you help with painful sex or prolapse symptoms?

Yes. These are common concerns and are addressed compassionately. Treatment may include education, pelvic floor therapy, positioning advice, and lifestyle strategies.

Final ThoughtsPostpartum recovery is not just about “bouncing back”—it’s about rebuilding wisely. Women’s health physiotherapy provides the roadmap, expertise, and care needed to support healing and long-term wellbeing. Whether you had a straightforward delivery or a more complex birth, early assessment and ongoing support make all the difference.

References:

- Goom, T., Donnelly, G.M. and Brockwell, E., 2019.

*Returning to running postnatal –

guidelines for medical, health and fitness professionals managing this population*

. Available

at:

https://absolute.physio/wp-content/uploads/2019/03/Return-to-running-postnatal-guideline.pd

f

- Bø, K. and Frawley, H.C., 2019. Postpartum pelvic floor muscle training: when, why and

how?*

. International Urogynecology Journal, 30(12), pp.1971–1974.

- National Institute for Health and Care Excellence (NICE), 2021. Postnatal care. [online]

Available at: https://www.nice.org.uk/guidance/ng194

- Hay‐Smith, E.J.C., Herderschee, R., Dumoulin, C., Herbison, G.P., 2011.Comparative

effectiveness of pelvic floor muscle training for urinary incontinence in women. Cochrane

Database of Systematic Reviews, Issue 12.

- Spitznagle, T., Norton, B. and Reale, D., 2021. Assessment and treatment of postpartum

pelvic health concerns. Journal of Women's Health Physical Therapy, 45(1), pp.10–20.