Postnatal Pelvic Floor
Postnatal pelvic floor physiotherapy is the gold standard for assessing and treating leakage, prolapse, abdominal separation and return-to-exercise after birth.
Common symptoms
- Leakage with cough, sneeze, run or lift
- Heaviness or bulge in the vagina (prolapse)
- Abdominal separation (DRA) you can feel or see
- Pain with intercourse
Common causes
- Vaginal birth (forceps, vacuum, large baby)
- Caesarean birth recovery
- Hormonal changes around pregnancy and breastfeeding
- Returning to high-impact exercise too early
When to seek help
Pretty much every new mother has been told their pelvic floor will "bounce back." Some do. Many don’t — and they spend years assuming the leakage, the heaviness, or the gap in the abdominals are just what life looks like now. They aren’t. Most of these things are very treatable.
Book a women’s health physio assessment if:
- you leak when you cough, sneeze, jump or run
- you feel heaviness or a bulge in the vagina, particularly later in the day
- you can feel or see a gap in the front of your abdominals
- sex is painful
- you want to return to running, lifting or impact exercise after birth
- you’ve been recommended a pelvic floor check by a midwife, GP or obstetrician
You don’t have to be in pain to come in. The standard six-week postnatal check with your GP doesn’t usually include a thorough pelvic floor assessment, and most of the things we treat are easier to fix sooner.
How we treat postnatal pelvic floor
A women’s health physio assessment usually includes a conversation about birth, recovery and current symptoms, an external assessment of breathing, posture and abdominal separation, and — with your consent — an internal vaginal examination to assess pelvic floor strength, coordination and any sign of prolapse. Real-time ultrasound is often a good alternative or addition to internal assessment.
From there, treatment is mostly about specific exercises, breathing patterns and graded return to load. We don’t lean on Kegels alone — pelvic floor work is rarely as simple as "squeeze more."
Returning to running after birth
A lot of women try to run too soon and then assume they "can’t" run anymore. The current best-practice guidelines suggest most women shouldn’t return to running until at least three months postpartum, and only when specific pelvic floor and lower-limb strength criteria are met.
The criteria are practical: can you do a single-leg balance for ten seconds, single-leg squat to 60 degrees, jog on the spot, and hop on one leg without leaking or pain? Most physios can take you through the screen in one appointment.
Abdominal separation (DRA)
Diastasis of the rectus abdominis is the gap between the abdominal muscles that nearly all pregnant women develop, and most resolve substantially in the first months postpartum. The ones that don’t aren’t a cosmetic problem alone — the abdominal wall isn’t generating force well, which affects back stability, lifting and core function.
Modern DRA treatment is much more about how the deep abdominal system coordinates than about closing the gap. We use real-time ultrasound to show what’s happening when you breathe, brace and move, and build progressive exercise from there.
When prolapse needs the right conversation
Some degree of pelvic organ prolapse is common after birth, particularly after vaginal delivery. Mild prolapse often improves with pelvic floor strengthening and load management. More significant prolapse sometimes needs a pessary (a supportive device fitted by a physio or gynaecologist) or, occasionally, surgery. We’ll be honest about which category yours falls into and refer on if needed.
Caesarean recovery — not the easier option
A lot of women have a caesarean and assume the pelvic floor escaped the work. Pregnancy itself loads the pelvic floor regardless of how the baby was born, and many post-caesarean women have the same leakage, heaviness or core-control issues as women who birthed vaginally. The recovery looks a bit different — there’s a scar to consider and the abdominal wall has been through surgery — but the pelvic floor still needs assessment.
Common questions about postnatal pelvic floor
Is it too late if my baby is two?
No. Pelvic floor recovery is responsive to treatment well beyond the first year. We see women whose youngest is in primary school, and they still benefit substantially from targeted physio.
Do I have to have an internal exam?
No. Internal assessment is the gold standard but it’s always optional. Real-time ultrasound is a good alternative and we can do a useful assessment externally if that’s your preference.
Are Kegels enough?
Sometimes. For many women, the issue isn’t weakness alone — it’s coordination, breathing patterns, or how the pelvic floor responds to load. A few minutes of Kegels a day won’t fix coordination problems. Assessment first, exercise second.
Can I see you under Medicare?
Yes — under a GP-prepared Chronic Disease Management plan you may be eligible for Medicare-rebated visits. We process the claim at the appointment.
Begin your journey to a healthier you.
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