Taking care of your pelvic floor postpartum

Life with a newborn can be a wonderful, stressful, exciting, and sleepless time! On top of the demands of new parenthood, mothers need to also consider their own health and recovery, especially of the pelvic floor! 

Immediately after delivery (0-6 weeks) 

For a vaginal delivery: 

  • Ice and elevation (laying down) to manage pain and swelling in the perineum 
  • Keeping up fluid and fibre to avoid constipation and straining 
  • Trying to reduce lifting to nothing heavier than your newborn 
  • Start gentle pelvic floor contractions - only if you feel comfortable to do so, and with the guidance of your healthcare team
  • If you have stitches or a perineal tear, your health care team will work with you to care for your stitches and manage pain 
  • Starting gentle abdominal exercises to work on Diastasis Recti

For cesarean-section delivery: 

  • Gentle pelvic floor exercises may be okay to begin earlier if comfortable 
  • Trying to reduce lifting to no heavier than your newborn 
  • Supporting wound and abdominal muscles to avoid pain and straining 
  • Wearing belly band or abdominal supports can help with movement 

Generally, exercise in the first 6 weeks after delivery involves comfortable walking and gentle pelvic floor contractions as feels comfortable.

Returning to gentle exercise: (6-12 weeks)

Once you have been given the “all clear” from your obstetrician or doctor, it's generally safe to begin gentle pelvic floor contractions and core exercises.

Working with a pelvic floor physio is the safest way to commence exercise for your pelvic floor, but some general tips are:

  • Practicing longer pelvic floor contractions
  • Practicing fast on and off pelvic floor contractions
  • Increasing walking distance and intensity 
  • Commencing light abdominal exercises (not crunches) if you have no symptoms 
  • Starting light resistance exercise if you have no symptoms (leaking, heaviness, pain). 
  • Swimming and cycling are great “pelvic floor safe” exercises at this stage 

Returning to sports and high intensity exercise: (12 weeks+)

Remember every body and birth is unique, so these times are general guidelines to follow post-partum. 

Increasing load on the pelvic floor too quickly and without adequate strengthening can increase the risk of pelvic floor dysfunction, so it's best to listen to your body and slowly progress back to high level activity.

  • Running and sport should be gradually introduced in intervals (e.g walk 60 seconds, run 30 seconds, repeat). 
  • Progressing to high level activity is dependent on being symptom free
  • Completing pelvic floor exercises while standing, walking, running etc can increase the strength and endurance of the pelvic floor 

Alongside completing pelvic floor muscle training, a review with a Pelvic Floor Physiotherapist is recommended before returning to sport and exercise, to reduce any potential risk of pelvic floor problems occurring. 

Article written by
Laura Justin
Qualified and Registered Australian Physiotherapist
Women's and Children's Health

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