Dr. Margaret Archer, a pelvic floor physical therapist at Mère Health and a mother of two boys, emphasizes the importance of the recovery process during pregnancy and after childbirth. She employs a fitness-oriented, evidence-based approach to her care. Here’s what she wants every mother to know about the healing journey, accessing the right support, and regaining strength following childbirth.
As shared with Motherly, with minor adjustments for clarity and flow.
If you’re currently pregnant or have recently given birth, this may be your first encounter with the concept of pelvic floor health. Welcome—you are definitely not alone.
Many women find they lack adequate knowledge about their bodies, particularly concerning the pelvic floor. You might also be sifting through the vast amount of information available online regarding pregnancy and the postpartum phase: What is considered safe? Am I experiencing something normal, or is it unusual?
If you are facing pelvic floor challenges such as leaking, pain, or are interested in strategies for prevention, you are in the right place! As a mother of two boys and a pelvic floor physical therapist, we will explore all things related to pelvic floor physical therapy.
I hope you recognize that you are not alone in this journey, learn about the support services available to you, and feel empowered to ask for what you require!
What is pelvic floor therapy?
Before delving into the details of pelvic floor physical therapy, let’s talk about how pelvic floor PTs assist women during pregnancy and postpartum.
Pelvic floor physical therapists support women experiencing an array of symptoms during pregnancy and the postpartum period, including pelvic heaviness or prolapse, urinary incontinence, pelvic pain, and core weakness.
A pelvic floor physical therapist can pinpoint the root causes of your symptoms and create a tailored treatment plan for postpartum recovery. They are also an integral part of your wellness and childbirth preparation team, helping to alleviate discomfort during pregnancy and ensuring a smoother postpartum experience, regardless of how you deliver.
How does pregnancy impact a woman’s pelvic floor?
The progression of pregnancy, childbirth, and the postpartum period significantly affects a woman’s body.
Throughout pregnancy, the pelvic floor, hips, and core muscles face increased demands to support the developing baby. Our bodies rely on both passive structures (like ligaments and bones) and active supports (muscles) to maintain posture and facilitate movement throughout the day.
These heightened demands can lead to pelvic floor muscles becoming fatigued, tense, or less coordinated, all of which can impact their effectiveness.
This is why symptoms like incontinence and pelvic pain may surface during pregnancy; it also underscores the need for exercise during this time, as it helps sustain strength in anticipation of the increased demands on your body. Staying active while pregnant may lead to faster recovery postpartum.
While we cannot control many factors of pregnancy or childbirth, we can “stack the deck” in our favor through exercise, education, and establishing care with a pelvic floor physical therapist!
Pelvic floor therapy is essential for ALL women and ALL birth types.
How does a pelvic floor physical therapist assist you?
A pelvic floor physical therapist can meet with you (and your support network, if you wish) prior to childbirth to prepare you for labor and delivery. This could involve education and guidance on exercises that support labor, techniques for relaxing your pelvic floor, teaching pushing methods, and clarifying what to expect regarding the pelvic floor and core.
Some women may believe—or have been informed—that if they are planning for a C-section, pelvic floor therapy is unnecessary. This misconception is far from accurate! I encourage every woman to engage in birth preparation with a pelvic floor physical therapist to understand how to prepare for a scheduled C-section or to know what to expect if an unexpected one occurs.
In the U.S., around 30% of deliveries are C-sections, yet many women receive little essential information about what to expect and how to recover from this major abdominal surgery. A pelvic floor physical therapist could be a vital member of your support system.
After delivery, a pelvic floor physical therapist can assist you with starting the recovery process and can see you within the first few weeks following childbirth. Women may experience various symptoms like pain, incontinence, or weakness. During those early postpartum days, a pelvic floor physical therapist can evaluate your healing.
They can also help alleviate any symptoms you might have and introduce gentle mobility exercises to foster healing and set the foundation for returning to exercise and intimacy. This may involve techniques to mobilize scar tissue, reconnect with your pelvic floor and core, and empower you on your postpartum journey.
When should you commence pelvic floor physical therapy?
This highlights the importance of establishing care with a pelvic floor PT before delivery, ensuring that you have support as early as two weeks postpartum and continuing for as long as necessary.
How long does a pelvic floor PT session last?
Usually, a pelvic floor physical therapy session lasts between 30 minutes to an hour. A pelvic floor PT can assess your needs and connect you with resources and healthcare providers for common postpartum concerns such as depression, anxiety, feeding challenges, or discussions with your OB provider about medical issues.
Why is pelvic floor therapy essential postpartum?
In the U.S., pelvic floor physical therapy is often overlooked, and women frequently receive referrals only after advocating for themselves—or, worse, never at all due to lack of awareness, dismissal of symptoms, or barriers like cost, access, or time.
While childbirth can be a beautiful experience, it also constitutes physical trauma that requires recovery—ideally under the guidance of a professional to ensure optimal healing. For instance, after a knee replacement, patients begin physical therapy immediately in the hospital and continue for weeks or months thereafter.
Childbirth warrants similar attention. A pelvic floor PT is trained specifically to guide you through recovery. That’s why I advocate for early postpartum pelvic floor physical therapy for every woman.
Reflecting on the knee replacement analogy, it would be irresponsible to discharge a patient after six weeks without PT and simply say, “You’re fine! Just listen to your body.”
Yet, this is often the advice given to postpartum women—and it doesn’t make sense.
As a result, many women find themselves feeling lost when trying to resume exercise, face challenges with incontinence, or experience pain during intimacy.
We are currently failing to provide adequate care for healing after childbirth. Women must have access to pelvic floor therapy services that offer education on what to expect, respond to symptoms in a timely manner, and initiate healing.
Image Source: Unsplash
