Postpartum Pelvic Floor Recovery: When "Normal" Doesn't Mean You Have to Live With It
Maybe someone told you that leaking when you sneeze or jump is just what happens after having a baby. That the heavy, bulging feeling is normal. That your pelvic floor has changed and you just need to accept it.
Here's what that advice gets right: yes, your body has changed. Yes, these symptoms are really common after childbirth.
But here's what it misses: just because something is common doesn't mean it's normal. And it definitely doesn't mean you have to live with it.
Postpartum pelvic floor physiotherapy can address many concerns after childbirth - from leaking during exercise to prolapse symptoms to getting back to running or lifting without pain. You deserve to feel strong and comfortable in your body, and there's effective, evidence-based treatment available. (Wondering about pelvic floor physiotherapy during pregnancy? We wrote about that too.)
Postpartum Pelvic Floor Changes: What's Common vs. What's Treatable
Your body just did something incredible. Growing and birthing a human changes your body in significant ways - your pelvic floor stretched, your abdominal muscles separated to make room, your posture shifted, your ligaments loosened. These changes are part of pregnancy and birth.
What's common - as in, a lot of people experience this - but doesn't have to be your "new normal":
Leaking urine when you cough, sneeze, laugh, or jump
A heavy or bulging feeling in your vagina
Separation of your abdominal muscles (diastasis recti)
Painful sex or difficulty with tampons
Lower back or pelvic pain
Difficulty controlling gas or stool
Here's the important part: these symptoms are common, but they're also treatable. Pelvic floor physiotherapy can help with all of these, and the sooner you address them, the better your outcomes tend to be.
(But if it's been six months. Or two years. Or 17 years. If you've been telling yourself "I'll deal with it later" since your baby was born and they're now in 21 - it's still not too late. Good care is good care, whenever you're ready for it.)
Postpartum Urinary Incontinence: Leaking After Childbirth
Urinary incontinence affects up to 1 in 3 people after childbirth. That's a third of postpartum people dealing with some degree of leaking - whether it's a few drops when you sneeze or full leaks running down your leg during running or jumping.
The most common type of incontinence in postpartum is stress urinary incontinence - leaking when pressure increases in your abdomen (coughing, laughing, lifting, exercise). This happens when your pelvic floor muscles aren't able to respond quickly enough to the increased pressure that the activity requires.
Here's what pelvic floor physiotherapy can do:
Your physiotherapist will assess your pelvic floor function - not just strength, but coordination, timing, and endurance. They'll look at your whole body mechanics, your breathing patterns, and how you're moving during the activities that cause leaking.
Here's something important: it's not always about strengthening. Sometimes your pelvic floor is too tight. Sometimes one side is tight while the other side is weak comparatively. Sometimes the front is overworking while the back isn't doing enough.
This is why an internal pelvic exam is so valuable - it allows your physiotherapist to assess exactly what YOUR body needs. They can feel which muscles are tight, which are weak, where there are asymmetries, and how everything is coordinating together. Then they can prescribe the right treatment - whether that's strengthening, relaxation, stretching, or (most often) a combination tailored specifically to your body.
Treatment might include:
Pelvic floor exercises - but the right ones for YOUR specific pattern
Pelvic floor relaxation and lengthening techniques
Core and breathing coordination work
Adjusting your exercise technique
Strategies for managing intra-abdominal pressure
Progressive return to impact activities
Research from the University of Alberta shows that pelvic floor muscle training in the first year postpartum lowers the risk of urinary incontinence by 37% and pelvic organ prolapse by 56%. This research was part of the 2025 Canadian Guideline for Physical Activity throughout the First Year Postpartum.
It works. You don't have to plan your workouts around bathroom access, wear pads every time you exercise, or avoid activities you love because you're worried about leaking.
Pelvic Organ Prolapse After Childbirth: Symptoms and Treatment
Pelvic organ prolapse is when one or more of your pelvic organs (bladder, uterus, rectum) descends into the vaginal canal. It can feel like:
A bulge or something coming out of your vagina
Heaviness or pressure in your pelvis
A feeling like something is "falling out"
Symptoms that get worse as the day goes on or with activity
Prolapse happens when the muscles and tissues supporting your pelvic organs are weakened - often from pregnancy and childbirth, but not exclusively. Studies show that about 14-15% of people experience prolapse beyond the hymen within a year of vaginal delivery though many cases are mild and don't require treatment.
What pelvic floor physiotherapy offers: Assessment of your prolapse type and severity, along with a comprehensive treatment plan that might include:
Pelvic floor strengthening and coordination exercises
Strategies for managing symptoms during daily activities
Guidance on safe return to exercise and lifting
Education on what positions and movements help or worsen symptoms
Referrals for pessary fitting if appropriate (we don't fit pessaries, but can connect you with providers who do)
Research shows that people receiving pelvic floor muscle training for prolapse see greater improvement in symptom scores and prolapse stages compared to those who don't do the training PubMed. Surgery isn't always necessary, and when it is, pelvic floor physiotherapy before and after surgery improves outcomes.
Diastasis Recti Recovery: Recovering from Abdominal Separation Postpartum
Diastasis recti is the separation of your rectus abdominis muscles (your "six-pack" muscles). During pregnancy, these muscles separate to accommodate your growing baby. Most natural resolution happens in the first 8 weeks postpartum, but about 36% of people still have diastasis recti at 12 months after birth.
You might notice:
A visible bulge or "doming" down the center of your belly when you do certain movements
A gap you can feel between your ab muscles
Lower back pain
Difficulty with core strength or stability
Diastasis recti isn't just cosmetic (though the appearance can be distressing). It can affect your core function, contribute to back pain, and impact your ability to return to certain activities.
How pelvic floor physiotherapy helps: Your physiotherapist will assess the width and depth of the separation, but more importantly, the tension and function of the connective tissue between the muscles. Not all diastasis needs treatment - it depends on how it's functioning.
Treatment focuses on:
Restoring core coordination and function
Strengthening deep core muscles
Modifying movements that worsen the separation
Progressive loading and return to exercise
Strategies for daily activities (like getting out of bed or lifting your baby)
With proper treatment, most people see significant improvement in function and appearance. The goal is building strength and function in the body you have now.
Return to Exercise After Childbirth: Safe Postpartum Fitness
One of the most common questions postpartum is: when can I get back to running? Lifting? CrossFit? High-intensity workouts?
The traditional answer is "wait six weeks." But here's what that actually means: six weeks is when you're cleared to start rebuilding - it's not a magic number where your body is automatically ready for high-impact exercise.
And here's the thing: you don't have to wait until six weeks to start preparing for that movement you want to do.
Starting before 6 weeks: You can book regular physiotherapy in those early postpartum weeks to start rebuilding your foundation. This might include:
Breathing exercises and core coordination
Pelvic floor awareness (without internal assessment)
Abdominal awareness and gentle isometric work
Movement strategies for daily activities
Building toward that 6-week movement milestone
Starting this foundational work early means when you hit 6 weeks, you're not starting from zero - you have all the basics in place so when you hit 6 weeks, you’re really ready to progress.
After 6 weeks: This is when we can do comprehensive assessment and create your personalized plan for returning to the activities you love. We'll assess whether your body is ready for specific movements, identify any gaps in strength or function, and create a progression plan that works for your goals.
A gradual return to activity looks like:
Building your core and pelvic floor foundation (ideally starting before 6 weeks)
Progressively adding impact and load
Paying attention to symptoms (leaking, heaviness, pain, doming)
Working with a physiotherapist to assess readiness
This doesn't mean you can't be active postpartum. It means being strategic about how you rebuild strength so you can do the things you love without symptoms or injury.
When to Start Postpartum Pelvic Floor Physiotherapy in Coquitlam
You can book pelvic floor physiotherapy anytime after 6 weeks postpartum. If you had a c-section, we recommend waiting until 6 weeks for pelvic floor-specific work, though you can book regular physiotherapy before that for concerns like back pain from feeding and carrying.
Good times to book:
Around 6-8 weeks postpartum for a baseline assessment, even if you don't have symptoms
When you're experiencing leaking, pain, prolapse symptoms, or other concerns
Before returning to high-impact exercise or heavy lifting
If you're having painful sex or difficulty with vaginal penetration
Anytime you feel like something isn't right with your recovery
You don't need to wait a year. You don't need to try to fix it yourself first. Early intervention often means faster, more effective treatment.
You don't need a referral to see a physiotherapist in BC, though you might need one for insurance coverage.
What to Expect at Your Postpartum Physiotherapy Appointments
Your first appointment (60 minutes) includes a detailed conversation about your delivery, your recovery so far, and what symptoms or concerns you're experiencing. Your physiotherapist will ask about your bladder and bowel function, any pain, your activity level, and your goals.
They'll assess your posture, movement patterns, breathing, and core function. If it's appropriate and you're comfortable, they may offer an internal vaginal exam to assess your pelvic floor muscles.
About internal exams: Are they necessary? Honestly, kind of yes. Pelvic floor conditions can be complex, and without an internal assessment, treatment often takes significantly longer because we're working with less information. Internal exams allow us to properly assess muscle tone, strength, coordination, and identify the specific issue - which means fewer sessions and more cost-effective treatment for you.
That said - you're always in control. Internal exams require your permission and you can decline, ask questions first, or request it at a future appointment once you feel more comfortable.
If you're on your period: Come anyway. We're pelvic health specialists - bodies and bodily functions are literally what we do. We use absorbent under pads and provide wipes, and we have external treatment options available if needed.
Follow-up sessions are typically 45 minutes and focused on your personalized treatment plan. To ensure you're getting good care, we always schedule your first three sessions within one week of each other. If you end up needing less than that, it's easier to cancel than to find room in the schedule later.
What Our Physiotherapist Treats (And What She Doesn't)
Conditions we treat:
Incontinence (both urinary and fecal)
Prolapse support
Overactive bladder
Tailbone pain
Painful sex
Vulvodynia and vestibulodynia
Vaginismus
C-section recovery and scar management (after 6 weeks)
Diastasis recti
Back pain from carrying and feeding (book as regular physio)
Return to fitness after childbirth (book as regular physio)
Conditions we refer out:
Hysterectomy recovery
Endometriosis
Gender affirmation surgery
Pessary fitting
Prostatectomy recovery
If you're not sure if your concern fits, just ask - we're happy to point you in the right direction.
Frequently Asked Questions About Postpartum Pelvic Floor Physiotherapy
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You can book anytime after 6 weeks postpartum. If you had a c-section, we recommend waiting until 6 weeks for pelvic floor work specifically. Earlier than that, you can book regular physiotherapy for back pain or other concerns
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A: No referral is needed to see a physiotherapist in BC, though some insurance plans require one for coverage. Check with your benefits provider.
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A: It varies based on your specific concerns and goals. Some people see improvement in a few sessions, while others need ongoing treatment over several months. We recommend booking your first three sessions within one week of each other for the most effective treatment.
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A: Absolutely. It's never too late to address postpartum symptoms. Whether you gave birth 6 months ago or 6 years ago, pelvic floor physiotherapy can help.
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A: Sometimes symptoms improve naturally in the first year postpartum. But waiting and hoping isn't always the best strategy - early treatment often leads to better outcomes. If something's bothering you, it's worth addressing.
Postpartum Pelvic Floor Physiotherapy Coquitlam: Book Your Appointment
At Capria Care Collective, our physiotherapist takes an evidence-based, body-neutral approach to postpartum recovery. We see clients from Coquitlam, Port Coquitlam, Port Moody, Burke Mountain, Coquitlam Centre, Austin Heights, and throughout the Tri-Cities area. Our clinic is conveniently located in Coquitlam, easily accessible from the Expo line and Millennium Line and Highway 1.
The goal is to help you feel strong, comfortable, and confident in your body - whether that means getting back to running, lifting your kids without pain, or just getting through the day without leaking. No judgment about your body, your birth experience, or how long it's been since you gave birth.
Ready to Feel Like You Again?
You don't have to accept leaking, pain, or feeling weak as "just part of parenthood." These symptoms are common, but they're also treatable.
Whether you're 6 weeks postpartum or 6 years out, dealing with specific symptoms or just want to feel stronger - pelvic floor physiotherapy can help.
Book your postpartum physiotherapy appointment at Capria Care Collective in Coquitlam.
or call us at 604-764-9839