The first few weeks after giving birth can feel overwhelming. Between sleepless nights, feeding schedules, and recovering from childbirth, many new mothers put their own physical health at the bottom of the list. Yet the weeks and months following delivery are crucial for pelvic floor recovery, particularly if you experienced tearing, needed stitches, or delivered via caesarean section.
At our Bloomsbury clinic near Tottenham Court Road, we often see women who wish they had booked a postnatal physiotherapy check earlier. Some wait until symptoms like leaking urine or pelvic discomfort become difficult to ignore. Others are unsure whether what they are experiencing is normal or whether they need professional support at all.
This guide explains what happens during a postnatal pelvic floor assessment, when to consider booking one, and why early intervention can make a significant difference to your recovery. Whether you had a straightforward vaginal birth or a more complicated delivery, understanding your options helps you make informed decisions about your postnatal care.
When Should You See a Pelvic Floor Physio After Birth?
Most women benefit from seeing a pelvic floor physiotherapist around six to eight weeks postpartum, particularly if they experienced perineal tearing, an assisted delivery, or ongoing symptoms such as pain or leaking. However, there is no single “right” time, and some women need earlier or later support depending on their individual recovery.
The traditional six-week postnatal check with your GP focuses mainly on general wellbeing and contraception. It does not usually include a detailed pelvic floor assessment. If you are experiencing urinary incontinence when you cough or sneeze, feel unusual heaviness or bulging in your vaginal area, or have pain during intercourse or bowel movements, waiting for this check may not be ideal.
Some women come to see us earlier than six weeks if they have significant discomfort or concerns. Others wait several months, especially if they delayed returning to exercise or only noticed symptoms when they tried to resume running or lifting weights. Neither approach is wrong, but earlier intervention tends to lead to faster progress.
After a caesarean section, many women assume they do not need pelvic floor support because they did not deliver vaginally. This is a common misconception. Pregnancy itself places considerable strain on the pelvic floor due to the weight of the baby and hormonal changes that soften connective tissue. A C-section may reduce some risks, but it does not eliminate them entirely.
You might also consider booking a postnatal physiotherapy appointment if you have ongoing back or pelvic pain, diastasis recti (abdominal muscle separation), or scar tissue concerns following a caesarean. Our Pre and Postnatal Physiotherapy service addresses all of these issues, not just pelvic floor dysfunction.
Is Pelvic Floor Weakness Normal After Childbirth?
Yes, some degree of pelvic floor weakness is very common after giving birth, particularly in the first few weeks. The muscles and connective tissues have been stretched and stressed during pregnancy and delivery, and they need time to regain strength and coordination.
Weakness does not always mean you will have symptoms. Some women notice leaking when they jump or laugh, while others feel no obvious problems but discover reduced muscle tone during a physiotherapy assessment. Both scenarios are normal, but they require different approaches.
What matters more than the presence of weakness is how it affects your daily life and whether it improves over time. Occasional light leaking in the early weeks postpartum is not unusual, especially if you had a long labour or a large baby. If it continues beyond a few months or worsens, this suggests the muscles are not recovering on their own and would benefit from targeted rehabilitation.
Pelvic floor weakness can also contribute to other issues such as lower back pain, hip discomfort, or difficulty returning to exercise. The pelvic floor works closely with the deep abdominal muscles and diaphragm to stabilise your core. When one part of this system is not functioning well, the rest compensates, sometimes leading to pain or tension elsewhere.
It is worth noting that not all postnatal pelvic floor problems involve weakness. Some women develop overactive or tight pelvic floor muscles, which can cause pain during sex, difficulty emptying the bladder fully, or constipation. A physiotherapy assessment identifies whether your muscles need strengthening, relaxation, or a combination of both.
If you are unsure whether your symptoms are typical or need attention, our Women’s Health Physiotherapy service in Central London offers thorough assessments tailored to your specific recovery.
Do You Need Pelvic Floor Physiotherapy After a C-Section?
Many women who had a caesarean delivery assume pelvic floor physiotherapy is unnecessary because they did not give birth vaginally. The reality is more complex. While a C-section avoids some of the direct trauma associated with vaginal delivery, it does not eliminate pelvic floor strain.
During pregnancy, your pelvic floor supports the growing weight of your baby for nine months. Hormones such as relaxin soften ligaments and connective tissue to prepare for birth, but these changes affect the entire pelvis regardless of delivery method. By the third trimester, your pelvic floor has already adapted significantly, and this can lead to weakness or dysfunction even without a vaginal birth.
Women who had a planned caesarean before labour started may experience fewer pelvic floor issues than those who laboured for hours before having an emergency section. Prolonged pushing or a long second stage of labour increases the likelihood of muscle or nerve strain, even if the baby was ultimately delivered surgically.
Caesarean birth also introduces its own set of concerns. Scar tissue from the incision can cause tightness, pulling sensations, or discomfort, particularly during movement or exercise. Some women develop adhesions where internal tissues stick together, limiting mobility and contributing to pain. Addressing these issues early can prevent them from becoming chronic.
Postnatal physiotherapy after a C-section often focuses on scar tissue management, core strength rebuilding, and gentle pelvic floor retraining. We typically recommend booking an assessment once your six-week check has confirmed that your incision has healed properly. From there, we can guide you through safe progressions back to your normal activities.
You do not need to wait until problems arise. A preventive postnatal check can identify subtle issues before they interfere with your quality of life or your ability to exercise safely.
How Long Does Postnatal Pelvic Floor Recovery Take?
Recovery timelines vary widely depending on the type of delivery, any complications, your fitness level before pregnancy, and how consistently you engage with rehabilitation exercises. Some women regain full pelvic floor function within three to six months, while others need a year or more of targeted work.
If you had an uncomplicated vaginal birth with minimal tearing, you might notice significant improvement in the first few months, especially if you practise pelvic floor exercises regularly. Women who experienced severe tearing, forceps delivery, or other trauma typically need longer and more structured rehabilitation.
Consistency matters more than intensity. Doing pelvic floor exercises correctly for a few minutes each day is far more effective than sporadic, intense sessions. Many women find they perform the exercises incorrectly at first, either by bearing down instead of lifting or by overusing their abdominal or thigh muscles. A physiotherapist can check your technique and make sure you are targeting the right muscles.
Returning to high-impact exercise too quickly can slow recovery or even worsen symptoms. Running, jumping, and heavy lifting all place significant strain on the pelvic floor. We usually recommend waiting until you can perform basic pelvic floor contractions with good control and have no symptoms during daily activities before progressing to higher-impact movements.
Some women feel frustrated when recovery takes longer than expected. It helps to remember that the pelvic floor is not a single muscle but a complex group of muscles, ligaments, and connective tissues that need time to heal and adapt. Nerve function can also be affected during childbirth, and nerve recovery is slower than muscle recovery.
If you have been doing exercises at home for several weeks without improvement, or if symptoms are interfering with your ability to care for your baby or return to work, professional guidance can make a substantial difference. Our team has extensive experience helping women navigate the postnatal recovery period, including those with more complex presentations.
What Happens During a Postnatal Pelvic Floor Assessment?
Your first postnatal physiotherapy appointment at our Central London clinic typically lasts around 60 minutes. We begin with a detailed discussion about your pregnancy, birth experience, and any symptoms or concerns you have noticed since delivery. This includes questions about bladder and bowel function, pain, sexual health, and your goals for returning to exercise or other activities.
We then move on to a physical assessment, which may include examining your posture, breathing patterns, and core muscle activation. Understanding how your whole body is functioning helps us identify compensations or imbalances that might be contributing to pelvic floor issues.
The internal pelvic floor examination is optional but provides the most accurate information about muscle tone, strength, coordination, and any areas of tension or pain. You remain in control throughout and can stop at any time if you feel uncomfortable. We explain each step clearly and only proceed with your consent.
During the internal assessment, we check whether you can contract and relax the pelvic floor muscles on command, how strong those contractions are, and whether you are using the correct technique. We also assess for prolapse, scar tissue, or any other structural issues that might need attention.
Some women find the examination reassuring because it gives them concrete information about what is happening internally. Others feel anxious beforehand but report that the actual experience is much less daunting than they expected. Our physiotherapists are specialists in women’s health and pelvic physiotherapy, and they approach these assessments with sensitivity and professionalism.
After the assessment, we create a tailored rehabilitation plan. This might include specific pelvic floor exercises, breathing techniques, postural adjustments, or manual therapy to address scar tissue or muscle tension. We also discuss realistic timelines and what to expect as you progress.
Follow-up appointments allow us to monitor your progress, adjust your programme as needed, and introduce new exercises when you are ready. Most women attend between three and six sessions, although this varies depending on individual needs.
Choosing the Right Support for Your Postnatal Recovery
Finding a physiotherapist who specialises in postnatal and pelvic health makes a significant difference to your experience and outcomes. General physiotherapy training does not always include detailed pelvic floor work, so it is worth seeking out a clinician with specific expertise in this area.
At PhysioReform in Bloomsbury, our physiotherapists have advanced training in women’s health and pelvic physiotherapy. We understand the physical and emotional challenges of the postnatal period, and we tailor our approach to suit your individual circumstances.
Location also matters when you are managing a new baby. Our clinic is easily accessible near Tottenham Court Road, making it straightforward to fit appointments into your routine without lengthy travel across London. Some women prefer to bring their baby to appointments, and we welcome this. Others arrange childcare so they can focus fully on their assessment and treatment.
According to the NHS, pelvic floor exercises can help with bladder control and should be started as soon as possible after birth. However, knowing how to perform them correctly is equally important. Professional guidance ensures you are doing the exercises effectively and not inadvertently making things worse.
If you have concerns about urinary incontinence, pelvic organ prolapse, or pelvic pain following childbirth, these issues are best addressed early. Leaving them untreated can lead to worsening symptoms and greater difficulty achieving full recovery later.
Postnatal physiotherapy is not just about fixing problems. It is also about helping you feel confident in your body again, supporting your return to exercise and normal activities, and giving you the tools to maintain pelvic floor health as you age.
Booking Your Postnatal Physiotherapy Appointment
You do not need a GP referral to book a postnatal physiotherapy appointment at our clinic. You can contact us directly through our Contact Us page or book online at your convenience.
If you are still in the early postnatal period and unsure whether you need an appointment yet, feel free to get in touch with any questions. Our team can help you decide on the best timing based on your individual situation.
Recovery from childbirth is not a race, but getting the right support at the right time can make the process smoother and more effective. Whether you had a vaginal birth or caesarean section, whether you have obvious symptoms or simply want to check that everything is healing as it should, postnatal physiotherapy offers valuable reassurance and practical help.
Book your postnatal physiotherapy appointment at our Central London clinic and take the first step towards a stronger, more comfortable recovery.