Pelvic Floor Physical Therapy: Supporting Women Prenatal and Postpartum

Introduction

Pregnancy and childbirth are among the most profound transformations a woman’s body will ever experience. While these seasons are filled with anticipation and joy, they also bring physical changes that can challenge comfort, confidence, and function. At the center of it all is the pelvic floor: a group of muscles, ligaments, and connective tissues that play a vital role in supporting the bladder, uterus, rectum, and core stability.

Unfortunately, pelvic floor health is often overlooked in traditional prenatal and postpartum care. Many women are told that issues like leakage, pain with intimacy, or heaviness after birth are “just part of motherhood.”

The truth is these symptoms are common but not normal, and they can be addressed.

Whether you’re expecting, recovering from birth, or years into motherhood, Pelvic Floor Therapy can make a remarkable difference in restoring strength, confidence, and overall quality of life.

Understanding the Pelvic Floor During Pregnancy and Postpartum

Prenatal Changes

During pregnancy, the pelvic floor carries a heavier load than ever before:

• Increased weight and pressure: As the baby grows, the pelvic floor must support more abdominal and uterine weight.
  

• Hormonal influences: Relaxin and progesterone loosen ligaments and soften tissues in preparation for delivery, but this can also reduce stability.
  

• Postural adaptations: As the belly expands, posture shifts, increasing strain on the back, hips, and pelvic floor.
  
  

Postpartum Changes

After delivery, whether vaginal or cesarean:

• Tissue stretching or trauma: Vaginal birth can stretch pelvic floor muscles up to 3 times their resting length. Tears, episiotomies, or instrument-assisted deliveries may add further strain.
  

• Nerve sensitivity: The pudendal nerve, which supplies the pelvic floor, may be temporarily stretched or irritated.
  

• Abdominal weakness: The linea alba stretches during pregnancy, and conditions like diastasis recti (abdominal separation) reduce core stability.
  

• C-section recovery: Though not passing through the birth canal, cesarean births involve major abdominal surgery that affects core and pelvic floor function.
  
  

All of these changes set the stage for symptoms such as leakage, heaviness, pain, or weakness.

Common Symptoms Pelvic Floor Therapy Can Address

• Urinary incontinence (leaking with coughing, sneezing, or exercise)

• Fecal incontinence or bowel urgency

• Pelvic organ prolapse (a feeling of heaviness or bulging in the vagina)

• Pain with intercourse (dyspareunia)

• Low back, hip, or pelvic pain

• Abdominal separation (diastasis recti)

• Difficulty returning to exercise safely and confidently
  

Benefits of Pelvic Floor Physical Therapy Prenatally

1. Preparing for Labor and Delivery

Pelvic floor therapists teach strategies to help muscles work with, not against, the the birthing process.

• Breathing and relaxation techniques reduce tension during pushing.

• Exercises to lengthen pelvic floor muscles, decreasing the risk of tearing.

• Education empowers women to feel more in control of their birth experience.
  
  

2. Reducing Pregnancy-Related Discomfort

• Manual Therapy, Dry Needling, and targeted exercises can relieve back, hip, or pubic symphysis pain.

• Gentle strengthening supports posture as the belly grows.
  
  

3. Building Strength for Postpartum Recovery

• Strengthening muscles before delivery builds a foundation for smoother recovery.

• Women who enter postpartum with good pelvic floor awareness often resume normal activities more easily.
  
  

Benefits of Pelvic Floor Physical Therapy Postpartum

1. Restoring Bladder and Bowel Control

Urinary leakage after birth is common, but not something women must “accept.” Pelvic Floor Therapy:

• Retrains muscles for proper contraction and relaxation.

• Restores bladder control and reduces urgency.
  

2. Managing Pelvic Organ Prolapse

Pelvic organ prolapse (when the bladder, uterus, or rectum descend into the vaginal wall) affects nearly 1 in 3 women after childbirth. Pelvic Floor Therapy helps by:

• Strengthening supportive muscles.

• Teaching strategies to minimize downward pressure.

• Guiding safe return to lifting, exercise, and daily life without worsening symptoms.
  
  

3. Supporting Sexual Wellness

Pain with intimacy is a common postpartum concern. Pelvic Floor Therapy addresses:

• Scar tissue mobility (from perineal tears or cesarean incisions).

• Overactive pelvic floor muscles that need relaxation training.

• Vaginal dryness or sensitivity, often worsened by low estrogen while breastfeeding.
  
  

4. Abdominal Separation (Diastasis Recti)

Pelvic Floor Therapy integrates abdominal and pelvic floor exercises to:

• Rebuild core stability.

• Improve posture and reduce back pain.

• Safely progress to higher-intensity activities.
  
  

5. Guiding Safe Return to Fitness

Whether you want to return to CrossFit, running, or yoga, Pelvic Floor Therapy ensures you do so without risking injury. A pelvic floor therapist:

• Assess readiness with strength, coordination, and impact tolerance tests.

• Teaches proper breathing and pressure management during lifting.

• Progresses exercises gradually for confidence and safety.
  
  

What a Pelvic Floor PT Session Looks Like

Many women are nervous about what pelvic floor therapy involves. At Revive Physiotherapy, here’s what you can expect:

1. Conversation First: We start with a detailed discussion of symptoms, goals, pregnancy/birth history, and lifestyle.
   

2. Assessment: Depending on comfort level, this may include external and/or internal evaluation of pelvic floor muscles, abdominal wall, posture, and breathing mechanics.

3. Manual Therapy and/or dry needling to reduce muscle tension, stiffness, and pain
   

4. Personalized Plan: You’ll receive exercises, education, and strategies tailored to your body and goals.
   

5. Progression: Therapy evolves as your body transitions starting with gentle activation and advancing to higher-level functional training.
   
   

The Evidence Behind Pelvic Floor PT

• A Cochrane Review (2017) confirmed that pelvic floor muscle training during pregnancy reduces the risk of urinary incontinence postpartum.

• Postpartum women who participated in structured Pelvic Floor Therapy reported significant improvements in bladder control, prolapse symptoms, and quality of life compared to those without therapy.
  

Takeaway

Pregnancy and postpartum are seasons of immense change, but they don’t have to mean loss of control, pain, or weakness. With the right guidance, women can navigate these transitions with resilience.

Pelvic floor physical therapy offers a pathway to:

• Stronger support

• Better bladder and bowel control

• Improved comfort

• A safe return to activity

• Greater confidence in body and self
  
  

At Revive Physiotherapy, we believe every woman deserves care that addresses the unique challenges of pregnancy and postpartum. Our pelvic health specialist, Dr. Erika Fassler, provides compassionate, evidence-based therapy to help women feel strong, supported, and ready for every stage of motherhood.

📞 Call or text 954-519-4185 today to schedule your prenatal or postpartum pelvic floor assessment
💻 Book online now to start your personalized recovery plan

Motherhood is powerful. Your body should feel that way too!