When to Start Pelvic Floor Exercises After Birth

Your pelvic floor is a crucial muscle and connective tissue group that supports your uterus, bladder and bowels. During your pregnancy and childbirth, the pelvic floor muscles can weaken, potentially resulting in many common symptoms, including:

• You may leak urine when laughing or coughing
• A heavy feeling in the pelvis
• Early signs of pelvic organ prolapse

Pelvic floor exercises are your best option to avoid these symptoms. The question is, when is the best time to start them after you’ve given birth?

Why pelvic floor exercises are important after birth

Strengthening your pelvic floor muscles is especially important after birth – your pelvic floor experiences a lot of strain during delivery.

In addition to preventing and managing the symptoms we mentioned, these exercises can help support your posture and heal your abdominal muscles if they are stretched.

Additionally, pelvic floor exercises are crucial regardless of the delivery type you have, including a C-section.

When should you start pelvic floor exercises after birth?

There are multiple points after birth when you can start exercising your pelvic floor. However, the duration and level of intensity must change depending on whether you start immediately or wait.

Immediately after the birth

On the first or second day after the birth, you can engage in gentle pelvic floor engagement, mainly breathing-based activation.

You mainly want to focus on inhaling to relax your pelvic floor and slowly exhaling. Doing this reduces swelling and helps you to start healing.

Please avoid straining and forcefully squeezing, which can disrupt healing and worsen tears and stitches.

Within the first six weeks

In this period, you can focus on light exercises (no high-impact exercise), but only if you are completely pain-free. You should avoid it if you feel significant pain, or have stitches, perineal tearing, heavy bleeding or an infection.

If you are pain-free, you can perform some light pelvic floor contractions to aid your recovery.

After your 6-week checkup

The NHS 6-week postnatal check will be the most suitable point to start completing full pelvic floor exercises. The checkup will assess your physical and mental health, and your GP will let you know if you are clear to begin full pelvic floor routines.

Beginning pelvic floor exercises safely

Whether you’ve been cleared for exercise or want to perform a light pelvic floor routine, you need to understand how to begin safely.

The safest approach to strengthen the muscles in your pelvic floor is to:

• Begin with diaphragmatic breathing. Inhale as deeply as you can to let your belly and pelvic floor relax, then exhale softly to lightly lift your pelvic floor muscles.
• Perform some light kegels by gently contracting your pelvic floor, holding for 2-3 seconds, then releasing. You should aim for 5-10 reps of these, ideally once or twice a day.

Remember not to do too many reps or hold your breath during reps. Also, stop the exercise immediately if you feel any pain during a rep.

To start as safely as possible, go through the various positions, including lying down, sitting and standing.

How to maintain consistency for pelvic floor exercises

Reminding yourself to do your pelvic floor exercises every day may not work for you. Here are some alternative methods to stay consistent:

• Link your exercises to your daily routine – for example, feeding your baby
• Create a reminder on your phone or use a pelvic floor training app with timed exercise plans
• You can combine your exercises with your postnatal fitness to save time

When should you delay or modify pelvic floor exercises?

Although there are recommended timeframes for when you should start pelvic floor exercises, everyone is different, and it is better to modify or delay your exercises if you experience the following:

• Tears (third or fourth degree)
• Continuous pelvic pain
• Bulging or sensation (this could be a prolapse)
• Leaking urine

Please see your GP if you are experiencing any of these concerns so they can refer you for support. Leaking urine is common after childbirth, but it is not considered "normal" in the sense that it should be accepted as a permanent condition.

When should you see a pelvic health therapist?

You should also look for the following signs and see a pelvic health physiotherapist if you notice:

• No pelvic improvement after a few weeks
• Pain or discomfort during exercise
• Any difficulty identifying your pelvic floor

A pelvic health therapist can lead to a faster recovery.

Further information on pelvic floor exercises

Most women and birthing people can begin gentle pelvic floor exercises within the first 6 weeks of birth. However, individuals will always differ, so remember to listen to your body and ask your midwife or a pelvic health physiotherapist.

With consistency, your pelvic floor exercises will be essential to your postpartum recovery.

You can learn more about your body after birth by visiting our page here.