Your pelvic floor is one of the most important, and most under-discussed, parts of your body during and after pregnancy. This group of muscles supports your bladder, bowel, and uterus, and it plays a crucial role in posture, continence, sexual health, and core strength.
During birth, these muscles stretch significantly. In the weeks and months after delivery, it’s essential to give them the care and recovery time they deserve.
Whether you’ve had a vaginal birth or a caesarean, this guide will help you understand how to look after your pelvic floor after birth, plus what’s normal, how to strengthen it safely, and when to seek extra support.
What Is the Pelvic Floor and Why Does It Matter Postpartum?
The pelvic floor is a sling of muscles that runs from your pubic bone at the front to your tailbone at the back. It holds your pelvic organs in place, including:
- Bladder
- Bowel
- Uterus
These muscles work together to:
- Control when you wee or poo
- Support your core and spine
- Play a role in sexual function
- Keep your pelvic organs where they belong
During pregnancy, the weight of your baby puts pressure on your pelvic floor. Then during birth, especially a vaginal delivery, those muscles are stretched even more.
Even after a C-section, pregnancy itself weakens the pelvic floor.
Common Signs Your Pelvic Floor Needs Support
It’s completely normal to experience changes after birth, especially in the first 6–8 weeks. But if these symptoms continue beyond that, it’s time to take action:
- Leaking urine when sneezing, coughing, or exercising
- Pelvic or vaginal heaviness or pressure (feeling like something’s "falling down")
- Pain during sex or when using tampons
- Difficulty controlling wind or bowel movements
- Low back pain linked to core weakness
These are signs of a weakened or overly tense pelvic floor, and they can be treatable.
How Soon Can You Start Pelvic Floor Exercises After Giving Birth?
You can begin pelvic floor exercises (Kegels) as soon as it feels comfortable, even within days after birth. Start gently, and build up slowly.
If you’ve had stitches or a caesarean, wait until the initial soreness or swelling has settled before starting contractions.
Pelvic floor recovery is about little and often - it’s consistency that makes the biggest difference.
How to Do Pelvic Floor Exercises (Kegels)
Step-by-step:
- Get comfortable, lie down or sit with good posture.
- Imagine stopping yourself from weeing and holding in wind.
- Squeeze and lift the muscles around your vagina, anus, and urethra.
- Hold for 5–10 seconds, then slowly release.
- Rest for a few seconds and repeat up to 10 times.
Do this 3–4 times per day. You can also add quick squeezes (holding for 1–2 seconds) to build endurance.
Tips to Make It a Habit
- Link it to a routine: do a set when brushing your teeth or feeding the baby.
- Set reminders on your phone or use a pelvic floor app.
- Focus on quality, not quantity - it’s better to do fewer controlled squeezes than lots of rushed ones.
- Don’t hold your breath - breathe naturally.
- Don’t tighten your glutes or thighs - focus just on the pelvic muscles.
What About Overactive Pelvic Floor Muscles?
Not all pelvic floor issues come from weakness. Some people have overactive pelvic floor muscles that are too tight to function properly.
Signs include:
- Painful sex or vaginal exams
- Difficulty starting a wee
- Pelvic pain or tension
- Trouble doing pelvic floor exercises correctly
If that’s the case, avoid intense strengthening and seek help from a pelvic health physiotherapist.
Can I Strengthen My Core and Pelvic Floor Together?
Yes, but go slowly. Your pelvic floor and deep core muscles work together. Once you’ve built a pelvic floor habit, you can add gentle core exercises like:
- Deep breathing with core engagement
- Heel slides
- Pelvic tilts
- Glute bridges with pelvic floor activation
- Postnatal Pilates or yoga (with guidance)
Avoid sit-ups, planks, or high-impact moves until your pelvic floor is strong and symptoms have resolved.
When to See a Specialist
If you’re still experiencing issues 6–12 weeks after birth, or symptoms are impacting your quality of life, ask your GP for a referral to a women’s health physiotherapist.
They can assess for:
- Pelvic organ prolapse
- Diastasis recti (abdominal separation)
- Muscle tone imbalances
- Tailored pelvic floor rehab plans
You deserve proper postpartum care - not just a tick-box 6-week check-up.
Midwife’s Top Tips
- Start pelvic floor exercises as early as you're comfortable.
- Focus on quality squeezes and relax fully between reps.
- Don’t ignore symptoms like leaking or pressure; they’re common but not normal.
- Try not to rush back into intense workouts without pelvic floor support.
- If in doubt, see a pelvic health physio - they’re specialists in postnatal recovery.
Your pelvic floor has been through a lot and like the rest of your body, it deserves time, care, and consistent support.
By learning how to gently strengthen and protect these muscles, you’re not only supporting postpartum recovery, but laying the foundation for lifelong pelvic health, core strength, and confidence.
