Heal Your Core, Restore Your Body: The Importance of Pelvic Floor Therapy Postpartum
Hey!
DID YOU KNOW 1 in 2 women experience pelvic organ prolapse (where organs shift downward due to weakened pelvic floor muscles) later in life and can often results in a hysterectomy?
DID YOU KNOW 40% of postpartum women experience incontinence (leaking urine) by 6 months after birth lasting years or decades?
DID YOU KNOW Diastasis recti (abdominal separation) affects 60% of postpartum moms and can impact a core strength and stability for life?
If you’ve recently given birth—whether vaginally or via C-section—you might assume pelvic floor therapy isn’t for you if you didn’t tear or feel any immediate issues. Maybe you feel “fine” down there, or you’re eager to jump back into your regular routines. But here’s the truth: every postpartum body benefits from pelvic floor therapy.
At 6 weeks postpartum, I started pelvic floor therapy. At my first appointment, my Doctor saw a symptom that could have been a vulvar cancer symptom. Luckily, my biopsy came back negative...but what if? My labia fused from birth, which is a symptom of Lichen Sclerosus. If left untreated, it can turn into vulvar skin cancer. What if I had never noticed my labia fused? Or what if I did notice but had no idea what happened?
It changed my life. Over the next 8 months, pelvic floor therapy became my lifeline. It wasn’t just about exercises—it was about truly understanding and caring for my postpartum body. My therapist taught me how to massage my stitch sites, both externally and internally, to gently break up scar tissue. This process not only eased lingering discomfort but also restored flexibility and function I didn’t know I was missing.
I also learned about splinting, a technique to manage rectocele—a condition where the rectum bulges into the back vaginal wall, causing constant feelings of fullness, difficulty passing bowels, and gas. Using splinting, I learned how to support my body during bowel movements to reduce strain and improve comfort. It was one of the many tools that empowered me to address my postpartum body’s specific needs.
I also discovered how much emotional stress I had been holding in my pelvic floor. Unpacking and releasing that tension felt like reclaiming a piece of myself. Now, sex feels better than it did before giving birth, my core is stronger, and I’ve regained a deep connection to my body that I didn’t even realize I needed.
Pelvic floor therapy wasn’t just about physical recovery—it was about transformation. It gave me the tools to honor my postpartum body, heal emotionally, and rebuild my strength from the inside out. 🌸
Your pelvic floor carried the weight of your baby for nine months. Pregnancy and delivery (of any kind) place immense stress on these muscles, your core, and your entire abdominal system. Ignoring this critical area of recovery can lead to long-term consequences that may not show up for months—or even years.
Let’s dive into why pelvic floor therapy matters, the science behind it, and the foundational first steps to protect your body for lifelong health.
What is the Pelvic Floor and Why Does It Matter?
The pelvic floor is a hammock-like group of muscles, ligaments, and connective tissues located at the base of your pelvis. It supports your organs, helps control bowel and bladder function, stabilizes your core, and even plays a role in sexual function.
Organ Support: It holds and supports your pelvic organs—bladder, uterus, and rectum—keeping them in their correct positions.
Bowel and Bladder Function: These muscles help control urination and bowel movements by contracting and relaxing when needed.
Core Stability: The pelvic floor is part of your "deep core" system, working alongside the transverse abdominis, diaphragm, and multifidus muscles to stabilize your spine, hips, and pelvis.
Sexual Function: A healthy pelvic floor enhances sensation, comfort, and blood flow during intimacy. Weak or overly tight muscles can cause discomfort, pain, or lack of sensation.
Pressure Management: It manages intra-abdominal pressure, which is crucial for movement, exercise, lifting, and even simple tasks like laughing or coughing.
What Happens to the Pelvic Floor During Pregnancy and Birth?
Pregnancy and childbirth—whether vaginal or cesarean—place tremendous strain on the pelvic floor and surrounding structures. Here’s how:
1. During Pregnancy
The weight of the growing baby, placenta, and amniotic fluid increases pressure on the pelvic floor. This constant downward force can cause the muscles to weaken or stretch.
Hormonal changes: The hormone relaxin loosens ligaments, softens tissues, and allows the pelvis to expand for birth. While essential, this can make the pelvic floor less stable and more prone to stress.
The abdominal wall stretches to accommodate the baby, reducing its ability to support the pelvic floor effectively.
Changes in posture and the way you move to carry the weight of pregnancy can lead to imbalances, overuse, or underuse of certain pelvic muscles.
2. During Vaginal Birth
The pelvic floor muscles stretch up to three times their normal length during delivery to allow the baby to pass through the birth canal. Even without tearing, this extreme stretch can weaken or damage the muscles and ligaments.
Pushing during labor places significant pressure on the pelvic floor, and prolonged pushing can result in micro-tears or dysfunction that might not be obvious immediately.
Tearing or episiotomies add further trauma that may cause scar tissue, pain, or muscle dysfunction if not properly rehabilitated.
3. During C-Section Birth - It’s a common misconception that C-sections “save” the pelvic floor. While the pelvic floor may not endure the trauma of pushing or tearing, it is still impacted by pregnancy:
The weight and pressure of the growing baby weaken the pelvic floor over time.
Core stability is disrupted during the surgical procedure, which severs layers of abdominal muscles and fascia. This can affect pelvic floor function since the pelvic floor and core work together to stabilize the body.
Poor core activation post-surgery can increase pressure on the pelvic floor, leading to weakness, incontinence, or discomfort later.
The Hidden Impact of an Unaddressed Pelvic Floor
Your pelvic floor isn’t just important immediately after birth; it’s foundational for your lifelong health. Even if you feel “fine” after birth, subtle dysfunction may linger and worsen over time. Left untreated, pelvic floor issues can lead to:
Urinary or fecal incontinence: Leaking urine during exercise, laughing, sneezing, or even walking.
Pelvic organ prolapse: Weak muscles allow the bladder, uterus, or rectum to descend and create a feeling of pressure or bulging.
Chronic low back or hip pain: A weak pelvic floor destabilizes the core, leading to compensatory patterns that stress other areas of the body.
Pain during sex: Scar tissue, weak muscles, or tight muscles can create discomfort and reduce pleasure.
Diastasis recti: The abdominal separation caused by pregnancy can worsen without proper pelvic floor and core rehabilitation.
Caring for your pelvic floor postpartum is a lifelong investment in your well-being, ensuring you feel strong, supported, and comfortable for decades to come.
Why Pelvic Floor Therapy is Important for Everyone
Vaginal Birth: Even if you didn’t tear, the act of pushing places immense pressure on your pelvic floor muscles. Micro-traumas can occur that you don’t immediately notice but impact stability and strength over time.
C-Section Birth: Many assume a C-section means the pelvic floor wasn’t affected. However, pregnancy itself strains the pelvic floor, and surgical trauma to your abdominal muscles can weaken your core and disrupt pelvic support.
“Feeling Fine” Isn’t Always Reliable: Pelvic floor dysfunction can be silent for months or years. Symptoms like leaking urine during exercise, a feeling of heaviness, or low back pain may arise later. Addressing it early prevents these issues.
The Foundation: Diaphragmatic Breathing and Transverse Abdominis Activation
The first thing you’ll focus on postpartum is gentle breathwork and reactivating your transverse abdominal muscles (TVA). These are the foundational steps to building long-term core and pelvic floor strength.
Diaphragmatic Breathing - Diaphragmatic breathing reconnects your breath, pelvic floor, and core. This deep, intentional breathing calms the nervous system, stimulates healing, and gently activates the pelvic floor without straining it.
How to Practice Diaphragmatic Breathing:
Lie on your back with your knees bent and feet flat.
Place one hand on your chest and the other on your belly.
Inhale deeply through your nose, letting your belly rise (not your chest). Feel your breath expand downward toward your pelvic floor.
Exhale slowly, imagining your pelvic floor lifting gently like a hammock.
Repeat this for 5-10 minutes daily. It’s simple, but incredibly powerful.
2. Transverse Abdominis (TVA) Activation - The transverse abdominis is the deepest core muscle, acting like a corset that supports your spine, pelvic floor, and organs. Pregnancy stretches and weakens this muscle, so reconnecting to it is key for long-term strength and stability.
How to Activate Your TVA Postpartum:
Lie on your back with your knees bent.
Take a deep breath in, allowing your belly to expand.
As you exhale, gently draw your belly button toward your spine (imagine “zipping up” your core).
Hold for 5-10 seconds, then release.
This simple engagement sets the stage for proper core and pelvic floor recovery. Work with a pelvic floor therapist to ensure you’re activating this muscle correctly.
Long-Term Benefits of Pelvic Floor Therapy
Prevention of Incontinence: Leaking urine isn’t “just part of being a mom.” Therapy strengthens the muscles that control your bladder and prevent leaks.
Improved Core Strength: Your pelvic floor and core are deeply connected. Proper rehabilitation restores strength and stability, preventing back and hip pain.
Reduced Risk of Prolapse: Strengthening your pelvic floor prevents organs from descending, which can lead to pressure, discomfort, and surgical intervention later.
Enhanced Sexual Health: Pelvic floor therapy restores tone and function to improve sensation, comfort, and pleasure during intimacy.
Full-Body Support: A well-functioning pelvic floor supports posture, movement, and overall physical health.
When Should You Start Pelvic Floor Therapy?
Most moms can begin pelvic floor therapy 4-6 weeks postpartum, once cleared by their healthcare provider. But don’t wait for symptoms to appear—therapy is about prevention and proactive care.
If you experience any of these, seek pelvic floor therapy sooner:
Urine leakage when sneezing, coughing, or exercising
A feeling of heaviness or pressure in your pelvis
Pain during sex
Abdominal separation (diastasis recti)
Lower back, hip, or pelvic pain
The Bottom Line: Whether you had a vaginal birth, a C-section, or feel “fine” postpartum, pelvic floor therapy should be a non-negotiable part of your recovery. These muscles have done monumental work, and honoring them with proper care sets you up for long-term success. Start with diaphragmatic breathing and transverse abdominis activation, and seek guidance from a pelvic floor therapist to help your body heal, strengthen, and thrive.
A Gentle Reminder: Healing Takes Time
Postpartum recovery is a gradual, loving process—not a race to “bounce back.” By prioritizing pelvic floor therapy, diaphragmatic breathing, and core restoration, you give your body the foundation it needs for lifelong health.
Invest in yourself now, so you can move, play, and thrive for years to come. Your pelvic floor is your support system—honor it.
Want to Learn More?
Schedule a consultation with a pelvic floor therapist in your area or explore resources like:
APTA Pelvic Health: pelvichealth.org
Pelvic Guru: Find local specialists and educational tools.
The Vagina Whisperer: Online exercises and programs for pelvic health.
Your pelvic floor matters. Your core strength matters. You matter.
With love and care,
Dru Erin Houchen
