You probably left the hospital without anyone mentioning your pelvic floor, not in any real way. You got wound care instructions, maybe something about feeding, a date for your six-week check, and that was mostly it. Whatever showed up after, the leaking when you sneeze, the pressure that’s hard to name, the sex that doesn’t feel right yet, you’ve probably been absorbing it as just how things are now.
Some of that is temporary. Some of it is very treatable. The tricky part is that nobody tends to tell you which is which unless you specifically go looking.
What it is and what it went through
Your pelvic floor is a group of muscles sitting at the base of your pelvis, holding your bladder, uterus, and bowel in place and controlling when things open and close. It carried the weight of a growing baby for nine months, then either stretched significantly during a vaginal delivery or compensated for abdominal surgery during a C-section. Either way, it absorbed something major.
Pelvic floor dysfunction is one of the most common postpartum complications, affecting quality of life in ways that go unaddressed for years in many cases. A systematic review of studies from 2000 to 2024 described it as having substantial public health implications while remaining consistently underreported. In plain terms, lots of women are living with symptoms they’ve stopped mentioning because nobody followed up or seemed particularly interested when they did.
What you might be quietly putting up with
Somewhere between a third and a half of new moms experience urinary leakage after birth. Research published in PMC tracked women who were still leaking at three months postpartum and found 73 percent of them were still reporting it six years later. Waiting to see if it resolves on its own isn’t unreasonable, though that particular piece of data is worth sitting with for a moment.
Pain during sex after birth is also far more common than it gets said out loud. One study found that over 85 percent of women experience pain the first time they attempt intercourse after delivery, whether vaginal or C-section. Around 22 percent were still dealing with it at 18 months postpartum. That’s a long time to manage something quietly, especially when there are people specifically trained to help with exactly this.
Other things worth saying out loud to a healthcare provider rather than absorbing on your own: pelvic heaviness or pressure, difficulty fully emptying your bladder, lower back pain that started around delivery and never quite left, a feeling that something is sitting lower than it used to. You don’t need these to feel extreme before raising them.
Why the six-week check tends to miss it
That appointment wasn’t built to assess pelvic floor function in any real depth. It covers the obvious things: wound healing, contraception, and general mood. By the time you’re seen, the visible parts of recovery are already moving along. The functional stuff that’s quietly affecting your daily life usually doesn’t come up unless you bring it up yourself. Most moms don’t, partly from exhaustion, partly because nobody told them it was worth raising.
Pelvic floor physiotherapy is what fills that gap. A trained physio does an internal and external assessment of your strength, coordination, and function. They also build a rehabilitation plan around what they actually find in your body. Not a general protocol. Yours specifically.
Different research has consistently shown that supervised pelvic floor muscle training reduces urinary incontinence significantly. It can address pain, prolapse symptoms, scar tissue from tears or episiotomies, and discomfort during sex. For context, France offers new mothers ten sessions of pelvic floor rehabilitation as standard postpartum care.
Before your next appointment
You don’t need symptoms that feel severe before asking for a referral. Going early is actually what the research recommends rather than waiting until something becomes undeniable.
C-section moms, this applies to you, too. Pregnancy stresses the pelvic floor regardless of how you delivered. The scar tissue from the surgery creates its own issues worth having assessed.
On Kegels: they’re useful but not always the right move. BMC also found guided pelvic floor training with a physio produces better outcomes than self-directed exercises. This is because many women do them incorrectly. Also, some postpartum pelvic floors are too tight rather than too weak. Kegels can make tight pelvic floors worse. A physio can tell you which situation you’re in.
Next time you see any healthcare provider, try saying this: “I’d like a referral to a pelvic floor physiotherapist.” You don’t need a dramatic reason. You’ve been through pregnancy and birth. That’s the reason.
More on postpartum recovery and getting the care you deserve at firsttimemomsacademy.com.
