Pelvic floor physical therapy can help you address bladder, bowel, and pelvic symptoms after childbirth and return to everyday activity with greater comfort. Everyone recovers differently, so your treatment should reflect your symptoms, healing, and goals.
Understanding your pelvic floor
Your pelvic floor is a group of muscles and supporting tissues at the base of your pelvis. It helps support your bladder, bowel, and uterus, and it plays a part in bladder and bowel control. Pregnancy can affect these muscles whether you deliver vaginally or by cesarean.
Symptoms worth discussing
- Urine leakage when coughing, sneezing, lifting, or exercising.
- Urgency or difficulty controlling gas or bowel movements.
- Pelvic heaviness, pressure, or a vaginal bulge.
- Pelvic or perineal pain, or pain with sexual activity.
- Difficulty returning to walking, lifting, or exercise because of pelvic symptoms.
These symptoms can happen after birth. Please tell your OB team about any of these so you can talk about care options together.
What therapy may help with
A pelvic health therapist can teach muscle coordination, strengthening or relaxation, bladder and bowel habits, and a gradual return to activity. Supervised pelvic floor training is a first-line option for stress or mixed urinary leakage. Improvement often takes steady practice over several months, not a single visit. Some problems need additional medical care or care from another clinician.
Learn more
ACOG — Urinary Incontinence
https://www.acog.org/womens-health/faqs/urinary-incontinence
NICE — Pelvic Floor Dysfunction
https://www.nice.org.uk/guidance/ng210/chapter/Recommendations
UCLH — Advice and Exercise Following Childbirth
https://www.uclh.nhs.uk/patients-and-visitors/patient-information-pages/advice-and-exercise-following-childbirth
What to Expect From Therapy
Your first appointment
Your therapist will ask about your pregnancy and birth, symptoms, bladder and bowel habits, pain, and activities you want to return to. Tell them about tears, cesarean surgery, ongoing bleeding, your healing, and any concerns about an examination.
Assessment may include breathing, posture, movement, abdominal function, and pelvic floor muscle function. Your therapist may offer an internal vaginal exam when appropriate, but only with your consent. You can ask questions, decline it, or stop at any time. Ask about a chaperone if you’d like one.
Your plan is personalized
- Exercises to improve strength, endurance, coordination, or relaxation.
- Breathing and movement techniques for everyday tasks.
- Bladder and bowel strategies and guidance to reduce straining.
- Hands-on treatment when appropriate, with your consent.
- A home program and gradual progression toward your activity goals.
More squeezing is not always the answer
Pelvic floor symptoms can involve muscles that are weak, overly tense, or poorly coordinated. Some people need help relaxing before strengthening. If squeezing causes pain or worsens symptoms, stop and ask for an assessment. Avoid a one-size-fits-all Kegel routine.
When can I start?
Ask your OB team about early gentle movement and pelvic floor care. You can bring up symptoms soon after birth. You don’t need to wait for your routine postpartum visit to ask for help. When to start therapy, an internal assessment, or harder exercise depends on your healing, any complications, and your clinician’s advice.
Learn more
Guy’s and St Thomas’ NHS — Pelvic Health Appointments
https://www.guysandstthomas.nhs.uk/our-services/perinatal-pelvic-health/appointments
Mid Yorkshire NHS — Perinatal Pelvic Health
https://www.midyorks.nhs.uk/perinatal-pelvic-health/
ACOG — Exercise After Pregnancy
https://www.acog.org/womens-health/faqs/exercise-after-pregnancy
Recovery Support at Mulberry
Care coordinated with your physical therapist
Mulberry offers a postpartum recovery package, included in Concierge OB care, that brings together physician evaluation and osteopathic care. When pelvic floor physical therapy is part of your plan, we coordinate your care with your pelvic floor physical therapist.
- An osteopathic structural examination with Andrew Nyein, DO.
- Osteopathic manipulative treatment (OMT), when clinically appropriate.
- Coordination with your pelvic floor physical therapist.
OMT and pelvic floor physical therapy are different services. Your physician and therapist will decide which approaches fit your needs. Results vary; treatment does not guarantee resolution of every symptom.
The Postpartum Recovery Care Package is included in Concierge OB care, for Concierge OB patients. Physical therapy is provided and billed separately by your physical therapist. You may choose any physical therapist. If you have questions about your recovery care, contact us.
When symptoms need prompt medical care
Seek immediate medical advice for fever of 100.4°F (38°C) or higher, severe or worsening abdominal or pelvic pain, difficulty urinating, foul-smelling discharge, or worsening wound symptoms. Heavy bleeding that soaks a pad in an hour or less, large clots, severe headache, vision changes, or a painful swollen leg also need urgent assessment. Don’t wait for a physical therapy appointment.
Call 911 for severe breathing difficulty, severe chest pain, collapse, or heavy bleeding with faintness. Call your physician for urgent concerns; do not wait for an email reply.
Contact Us
Mulberry OBGYN
139 Centre St Ph 118, New York NY 10013
646-872-2773 | info@mulberryobgyn.com
Learn more
CDC — Urgent Maternal Warning Signs
https://www.cdc.gov/hearher/maternal-warning-signs/index.html