When should you start pelvic floor therapy after giving birth?
First things first: your body has just done something incredible, and recovery deserves time, attention, and support!
Whether you had a vaginal delivery or C-section, pregnancy and childbirth place significant demands on your pelvic floor, abdominal wall, and surrounding muscles.
While some changes are expected during postpartum recovery, symptoms like leaking, pelvic heaviness, pain, or difficulty returning to exercise don’t have to be your new normal.
A pelvic floor physical therapist can help guide you through recovery and build a plan that supports your individual goals.
Postpartum care can begin with education, breathing, and gentle movement as medically appropriate. A more comprehensive pelvic health assessment is commonly recommended around six weeks postpartum, although timing depends on your healing, symptoms, and medical clearance.
The American College of Obstetricians and Gynecologists (ACOG) recommends postpartum contact with your healthcare provider within the first three weeks and continued individualized care through the first 12 weeks.
What postpartum symptoms can pelvic floor therapy help with?
Pelvic floor physical therapy can address a wide range of postpartum concerns, including:
- Urinary leakage with coughing, sneezing, lifting, or exercise
- Pelvic heaviness, pressure, or symptoms of pelvic organ prolapse
- Diastasis recti and difficulty reconnecting with your core
- Pelvic pain or discomfort with intimacy
- Perineal pain or discomfort following tearing or episiotomy
- C-section scar sensitivity, tightness, or discomfort
- Low back, hip, or pelvic girdle pain
- Difficulty returning to running, lifting, or other physical activities
One thing I love to emphasize is that postpartum rehabilitation is about so much more than getting your body “back.”
It’s about helping you feel strong, supported, and comfortable in your body as you navigate this new chapter.
When is it safe to return to running after having a baby?
This is one of my favorite topics because returning to running is about readiness, not just reaching a certain number of weeks postpartum!
The 2019 Returning to Running Postnatal guideline recommends waiting until at least three months postpartum before returning to running, with a gradual progression typically considered between three and six months when appropriate criteria are met.
Before returning to impact activities, we want to assess how your body manages load, including:
- Walking comfortably for 30 minutes
- Single-leg balance and control
- Hopping and impact tolerance
- Core and pelvic floor coordination
- Absence of concerning symptoms such as leaking, heaviness, or pain during testing
Your pelvic floor physical therapist can help you build strength, assess your readiness, and develop a gradual return-to-running program.
The same principles apply to returning to strength training, HIIT, and other higher-impact activities.
Related pages: Pelvic floor physical therapy · Urinary incontinence · After prostate surgery · Your first visit
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Frequently asked questions
Is postpartum pelvic floor therapy different after a C-section?
Yes and no!
Regardless of how you delivered, your pelvic floor and abdominal wall experienced significant changes throughout pregnancy.
A C-section doesn’t automatically mean your pelvic floor was unaffected. Bladder leakage, core weakness, pelvic pressure, and other symptoms can still occur.
Following a vaginal delivery, treatment may focus on perineal healing, pelvic floor muscle coordination, scar tissue, and restoring strength.
After a C-section, we may also incorporate scar mobility once the incision has healed, abdominal wall rehabilitation, breathing mechanics, and strategies for lifting and carrying your baby comfortably.
Every birth experience is different, and your rehabilitation should reflect that.
What happens during a postpartum pelvic floor therapy session?
Your initial appointment is a full 60-minute evaluation focused on understanding your pregnancy, delivery, recovery, symptoms, and personal goals.
We’ll look at how your body is functioning as a whole, including your breathing, abdominal wall, hips, low back, posture, and pelvic floor coordination.
An internal pelvic floor assessment may be offered, but it is always optional and only performed with your consent. You can decline, postpone, ask questions, request a chaperone, or stop at any time.
Treatment may include manual therapy, scar mobilization when appropriate, breathing and core retraining, pelvic floor strengthening or relaxation, and a personalized home exercise program.
Our pelvic health team includes Dr. Danielle S., DPT, Dr. Analise R., DPT, Abby A., PTA, and Kathryn T., PTA.
How much does postpartum pelvic floor therapy cost?
Cash-pay pelvic floor physical therapy is $249 per 60-minute session.
Insurance may cover part of your treatment, and HSA and FSA cards are accepted.
Please contact our office or visit our pricing page for additional information.
How should I prepare for my postpartum appointment?
Bring your insurance information, medication list, and any relevant delivery or surgical records.
Wear comfortable clothing, and arrive approximately 10 minutes early.
If you’d like to bring your baby to your appointment, please contact our office ahead of time to confirm accommodations.
Rausch Physical Therapy offers pelvic health services in Laguna Niguel, Dana Point, and Mission Viejo.
When should I contact my OB or midwife instead?
Some postpartum symptoms require prompt medical attention rather than physical therapy.
Contact your medical provider right away for heavy bleeding, fever of 100.4°F or higher, foul-smelling discharge, signs of wound infection, or severe abdominal pain.
Chest pain, difficulty breathing, or symptoms concerning for a blood clot require emergency evaluation. Seek immediate help for thoughts of harming yourself or your baby.
Once any urgent medical concerns have been addressed, pelvic floor therapy can be an important part of your ongoing recovery.
