Empower Your Pelvis

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When to Start Pelvic Floor Physical Therapy After Childbirth: A Postpartum Guide

Earlier this year, I had a patient who, after delivering her daughter and experiencing a fourth-degree tear, immediately announced in the delivery room, “I need a referral for pelvic floor PT!” She started physical therapy early in her recovery and graduated just a few months later with no symptoms at all. While I was thrilled to hear her story, I don’t expect every new mom to be thinking about their first PT visit right after birth. However, many new moms do ask us, “How soon after delivery should I begin pelvic floor PT?”

The First Few Weeks Postpartum

I usually recommend that new moms take the first couple of weeks to settle in at home. Get as much rest as you can, stay hydrated, and nourish your body with warm, healthy foods. After those initial weeks, some moms feel ready to have their first physical therapy chat. Some may prefer an in-clinic visit, while others might opt for a virtual session. Virtual visits are a fantastic option for new moms—you don’t have to leave home, you can demonstrate how you’re holding and lifting your baby, and you can even feed your baby during the session if needed. If you had a C-section, there’s great benefit in consulting with a pelvic PT within a few weeks postpartum.

The Six-Week Mark

Around six weeks postpartum, you’ll have a follow-up appointment with your OB-GYN, where you’ll typically receive clearance for intercourse, which also means you’re cleared for an internal assessment by a pelvic floor PT. This is an ideal time to schedule your first PT visit. At this six-week OB-GYN visit, you’ll likely be cleared to return to most activities, including exercise and running. However, I strongly encourage you to see a pelvic PT before jumping back into your routine.

During pregnancy and delivery, your body undergoes significant changes. Some muscles may be tight, while others may be weak. Even if you feel ready to return to exercise, only a pelvic PT can accurately assess your muscle function and ensure your body is truly ready. We often hear stories of women who return to activities too soon and end up experiencing urinary or fecal leakage, prolapse, or pelvic pain.

Addressing Scars and Recovery

If you experienced perineal tearing, an episiotomy, or a C-section, pelvic PT can teach you techniques to mobilize and heal this tissue before your six-week follow-up, and even more once the scar has healed. For C-section moms (like me!), it’s important to remember that it’s not just the visible scar—seven different layers were cut to reach your baby. Imagine if you had undergone an orthopedic surgery that major—you’d start physical therapy right away!

Beyond the Pelvic Floor

Pregnancy doesn’t just affect your pelvic floor and abdominal muscles—it can also impact your foot position, balance, ribs, and breathing. Growing a human is an incredible feat, and you deserve to recover with proper guidance. Scheduling a pelvic PT visit between 2 and 6 weeks postpartum can help you reach your recovery goals and avoid injury.

It’s Never Too Late

If you’re reading this and you’re five months (or even five years) postpartum and haven’t started PT yet, don’t worry—it’s never too late to begin. Go ahead and schedule a visit now to start your journey toward recovery and achieving your goals.

By: Dr. Heather Evans, Physical Therapist in Kansas City (Lees Summit Missouri and Overland Park Kansas)

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A video of a woman explaining postpartum rehabilitation.