Wondering whether postpartum pelvic floor physical therapy is really necessary? Here is what we see every single week as pelvic physical therapy professionals: your body deserves real rehabilitation, not just a six week clearance.
My name is Heather, and I work in customer service at Ceres Chill. I spend my days talking with moms about pumping, feeding, and everything that comes with it. Pelvic floor therapy made such a huge difference for me, and Carrie Power genuinely changed my life.
After having an emergency c-section with my first, I had hopes of having a less traumatic and redemptive birth with my second. In my second pregnancy I had several friends recommend pelvic floor physical therapy/women’s wellness support with Carrie to me, and I’m so glad I listened! During our PT sessions, Carrie helped me learn proper breathing techniques and taught me various exercises that engaged my pelvic floor to help prepare my body for labor and delivery. She also helped me learn different exercises to help my lower back and sciatica pain. Carrie was always so patient, kind, and knowledgeable during my visits! I’m convinced that she is the reason I was able to have a successful VBAC with my second. I am currently seeing her again and hopeful to have a second successful VBAC with this third pregnancy!
That is why I asked her to write this for us. If you’re one of the moms I talk to every day, I want you to know this exists.
Pregnancy, childbirth, breastfeeding, and early motherhood are incredible transitions. But they also ask a tremendous amount of your body.
Your body is growing a baby, adapting to changing hormones, preparing for birth, recovering from delivery, and then spending countless hours feeding, holding, lifting, and caring for a newborn.
If your OBGYN or nurse midwife didn’t recommend pelvic PT postpartum, you might wonder why. And honestly, as pelvic physical therapy professionals, we do too!
Pelvic Floor Physical Therapy After Vaginal Delivery
It’s important to understand the impact of a vaginal delivery on the pelvic floor. During birth, the pelvic floor muscles can stretch significantly beyond their resting length (up to 200%), while the vaginal and perineal tissues are often torn, resulting in stitches and scar tissue.
We think of this much like any other significant musculoskeletal injury: your body deserves appropriate rehabilitation to restore mobility, coordination, strength, and function.
Pelvic PT can help assess how your pelvic floor and entire body are recovering and guide you through a progressive return to normal activity, exercise, lifting, and everything else you want to get back to doing. ACOG’s postpartum care guidance also emphasizes that recovery is an ongoing process rather than a single six week visit.
What About a C-Section? Pelvic Floor Therapy After Cesarean Birth
We often get asked how the pelvic floor and body are affected after a cesarean section. The answer is: majorly!
Though baby didn’t exit through the pelvic floor, the front half of the core canister being cut through greatly affects how pressure is distributed throughout your core.
Think of Your Core as a Canister
Think of your core as a canister: the pelvic floor is the basement, the diaphragm is the attic, the transverse abdominus is the front, and the deep spinal stabilizers form the back side.
Why C-Section Scar Tissue Matters
Seven layers of the abdomen, ultimately including the uterus, must heal, layer by layer, with scar tissue developing throughout the healing process. The superficial scar can sometimes create a “shelf” appearance, but more importantly, restrictions in the scar tissue can affect how the surrounding fascia and tissues move.
At Currahee Women’s Wellness, we use manual massage, scar mobilization, and functional cupping, when appropriate to help soften scar tissue and restore appropriate gliding of the fascia and tissue for a smooth and strong abdominal recovery.
Breath First. Then Strength.
For both C-section and vaginal deliveries, guided breath work is foundational for restoring the rhythm and coordination between the diaphragm and pelvic floor. The diaphragm and pelvic floor should lengthen together on an inhale and respond together on an exhale. This helps patients learn proper pelvic floor contraction and relaxation while managing intra-abdominal pressure appropriately for bowel, bladder, and sexual function.
Once we have established that coordination, we teach our patients how to breathe 360 degrees into their ribs and brace their core canister appropriately, distributing pressure evenly throughout the system. From there, we can progress into core and full-body strength. The sky is the limit with progressive introduction to higher-level lifting, running, exercise, and whatever goals are important to you.
The Breastfeeding Connection: How Feeding a Newborn Affects Your Body
Breastfeeding itself isn’t a pelvic floor treatment, but the physical demands of feeding and caring for a newborn can have a major impact on your body. New mothers may spend hours each day sitting in one position, leaning forward, holding their baby, pumping, and repeatedly lifting and carrying.
This can contribute to:
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Neck and upper-back pain
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Shoulder tension
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Rib or low-back discomfort
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Postural strain
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Core weakness
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Pelvic pain
Pelvic PT can help address these issues while teaching more comfortable feeding and pumping positions, lifting mechanics, and strategies for changing positions throughout the day. If you are also working through supply or latch questions alongside the physical strain, the CDC’s breastfeeding resources are a solid place to start.
Caring for the Whole Person
Postpartum care for moms is an honor. At Currahee Women’s Wellness, we focus on the whole person: body, mind, and spirit. We discuss mental health, nutrition to support healing and breastfeeding, the hormonal shifts that occur with the loss of estrogen and progesterone postpartum, and how to advocate for your needs with your women’s health providers.
We’ve seen women come alive time after time when they begin to feel confident in their bodies again: through progressive strength training, improved movement, and simply understanding what is happening within their bodies.
Movement truly is medicine, and we love helping women return to moving well!
How to Start Postpartum Pelvic Floor Physical Therapy With Us
If you’re within the state of Georgia, we offer Telehealth PT Sessions. These can be scheduled at cmcpt.janeapp.com with Dr. Katie Jordan, PT, DPT.
If you’re interested in a general wellness and fitness progression consultation, we can provide this across state lines. Book at cmcpt.janeapp.com with Carrie Power, PTA & owner of Currahee Women’s Wellness!
If you live within driving distance, we would love to serve you in person. These sessions can also be scheduled at cmcpt.janeapp.com.
Postpartum Pelvic Floor Physical Therapy FAQ
What is postpartum pelvic floor physical therapy?
It is rehabilitation for the muscles, tissues, and coordination patterns that pregnancy and birth change. We assess your pelvic floor and your whole body, then build a progressive plan to restore mobility, strength, and function.
When should I start pelvic floor PT after giving birth?
Sooner than most moms are told. Gentle breath work and education can begin in the early weeks, and a full assessment is appropriate once you are ready. You do not have to wait for something to feel wrong.
Do I need pelvic floor physical therapy after a C-section?
Yes, and this is the question we get most. Baby didn’t exit through the pelvic floor, but the front of your core canister was cut through, and seven layers of tissue healed with scar tissue. That changes how pressure moves through your whole system.
Can pelvic PT help with neck, shoulder, and back pain from breastfeeding or pumping?
Absolutely. Hours of leaning forward, holding, and lifting add up. We treat the pain and also teach better feeding and pumping positions, lifting mechanics, and position changes throughout the day.
Is it too late to start pelvic floor therapy if I gave birth years ago?
It is not too late. We work with women months and years postpartum, and we see them come alive when they finally understand what is happening in their bodies.
Can I do pelvic floor physical therapy through telehealth?
Yes. If you’re in Georgia, we offer Telehealth PT Sessions. For general wellness and fitness progression consultations, we can work with you across state lines.