You spend nine months preparing for the birth. You attend prenatal classes. You pack a hospital bag. You read about labour. But in all of that preparation, nobody sits you down and says: after this baby is born, your pelvic floor is going to need real care and attention, and most of the healthcare system is not going to give it to you unless you ask.
The 2025 Canadian Postpartum Guidelines changed this officially. For the first time, daily pelvic floor muscle training is now a formal recommendation for all postpartum women, associated with a 37% decrease in urinary incontinence and significant improvements in core recovery and overall wellbeing. But guidelines change faster than clinical practice. Most mothers still leave hospital with little to no guidance on pelvic floor recovery.
This article is the conversation you should have had before you were discharged.
"1 in 4 new mothers experiences pelvic floor dysfunction after birth. Most never get told what to do about it. You deserve better than that."
What Is the Pelvic Floor?
Your pelvic floor is a group of muscles, ligaments, and connective tissues that form a hammock-like structure at the base of your pelvis. These muscles support your bladder, bowel, and uterus. They play a role in bladder and bowel control, sexual function, core stability, and the health of your lower back and hips.
During pregnancy, your pelvic floor carries the increasing weight of your growing baby for nine months. During a vaginal birth, those muscles stretch dramatically, sometimes to several times their resting length. Even a C-section does not spare the pelvic floor, as the weight of pregnancy still strains these tissues throughout the third trimester.
What Can Go Wrong: Diastasis Recti and Beyond
Pelvic floor dysfunction after childbirth can take many forms. The most common include urinary incontinence (leaking when you sneeze, cough, or laugh), pelvic organ prolapse (a feeling of heaviness or pressure in the vaginal area), pain during sex, and lower back or hip pain. Diastasis recti, a separation of the abdominal muscles along the midline, affects up to 60% of women postpartum and is closely connected to pelvic floor weakness.
- Leaking urine when you sneeze, cough, jump, or laugh
- A feeling of heaviness, pressure, or something "falling out" in the pelvic area
- Difficulty fully emptying your bladder or bowel
- Pain or discomfort during sex that was not present before pregnancy
- A visible "pooch" or gap along your midline when you sit up
- Lower back pain, hip pain, or instability in the core
These symptoms are common. They are not normal, in the sense that you should simply accept them as the price of motherhood. They are treatable, and in most cases, significant improvement is achievable with the right guidance and consistent work.
What You Can Do: Where to Start
The first and most important step is to breathe. Not metaphorically, literally. Diaphragmatic breathing, breathing that engages your diaphragm and allows your belly to expand, is the foundation of pelvic floor recovery. It re-establishes the pressure management system in your core that pregnancy disrupts.
From there, gentle pelvic floor contractions (Kegels) can be introduced in the first days after birth, even before you leave the hospital. These are not the aggressive contractions you might associate with exercise. They are soft, intentional lifts and releases that begin to re-establish the connection between your brain and your pelvic floor muscles.
Simple starting exercises (days 1 to 14)
- Diaphragmatic breathing: 10 slow breaths, three times per day
- Gentle pelvic floor lifts: hold for 3 seconds, release fully, repeat 10 times
- Ankle pumps and leg circles: support circulation and reduce swelling
- Gentle walking: even short walks from day three or four post-vaginal birth
If you had a C-section, perineal tearing, or an episiotomy, always speak to your midwife or doctor before beginning any exercise, even gentle ones. And regardless of your birth experience, a pelvic floor physiotherapist assessment at six to eight weeks postpartum is one of the best investments you can make in your long-term health.
How A.M.A Supports Your Recovery
At every A.M.A care visit, our specialists provide pelvic floor and core recovery guidance as part of your personalised care plan. We talk through what is normal, what to watch for, and how to progress safely at each stage of your recovery. For our Mama's Dream and Mama's Treasure packages, we also help coordinate referrals to pelvic floor physiotherapists if needed.
African belly binding, a traditional postpartum practice we offer as part of our care packages, also plays a supportive role in early pelvic floor and core recovery by providing gentle external support to the abdomen while the internal structures heal.
Your body did something extraordinary. It deserves the care it takes to recover fully, not just to "get back to normal," but to feel strong, comfortable, and like yourself again.
