Recovering after birth is more than waiting for the bleeding to stop. Your pelvic floor — the hammock of muscles that supports your bladder, uterus, and bowel — has been stretched, sometimes torn, and is now relearning how to hold up against gravity. This guide explains what’s normal, what isn’t, when to start exercises, and when to see a pelvic health physiotherapist. Written by the pelvic health team at Daisy Hill Physio, Logan QLD.

Why the pelvic floor matters after birth

During pregnancy your pelvic floor carried up to 10–15 kg of additional load and the supporting connective tissue softened under the influence of hormones. During vaginal birth those muscles stretched up to three times their resting length. Whether you had a vaginal birth or a caesarean, the demands of pregnancy alone affect pelvic floor function.

A well-recovered pelvic floor lets you:

• Sneeze, cough, jump, or run without leaking urine
• Empty your bladder and bowels completely and on your own schedule
• Return to running, lifting, and high-impact exercise without pelvic heaviness or prolapse symptoms
• Resume sexual activity comfortably
• Carry your baby and the gear that comes with them all day without back, hip, or pelvic pain

The first 6 weeks — gentle and patient

The early weeks are about healing, not strengthening. Common recommendations:

• Days 1–7: Rest, manage pain, walk short distances, support any perineal tear or caesarean wound. Begin very gentle pelvic floor activations — a brief contraction (less than 1 second) just to wake the muscles up — only if it doesn’t cause pain.
• Weeks 2–4: Gradually increase walking. Continue gentle pelvic floor contractions building toward 5–10 second holds. Don’t lift anything heavier than your baby. Avoid Pilates, running, and sit-ups.
• Weeks 4–6: Start to feel more like yourself. Continue the gentle pelvic floor work. Watch for warning signs: heavy or dragging feeling in the pelvis, leakage with cough or laugh, pain.
• Week 6: Your obstetrician or GP will do the standard 6-week check. This check usually does NOT include a thorough pelvic floor assessment. If you can, book a separate pelvic health physiotherapy assessment — this is the gold-standard for recovery.

Pelvic floor exercises (Kegels) done correctly

Most people doing “Kegels” are doing them wrong. The correct technique:

1. Find the right muscles. Imagine you’re trying to stop the flow of urine and hold back wind from passing — at the same time. You should feel a gentle lift inside your pelvis. The muscles you should NOT be using: your buttocks, inner thighs, or upper abdominals (no breath-holding).
2. Slow holds. Squeeze and lift, hold for as long as you can up to 10 seconds, then fully relax for at least the same duration. The relaxation phase is as important as the contraction.
3. Quick flicks. A series of short, full-strength contractions and releases. These train the muscles to react fast — important for preventing leaks during a sneeze or cough.
4. Build up. Aim for 8–12 slow holds and 8–12 quick flicks, three times daily. It takes 3 months of consistent practice to see meaningful strength gains.

If you can’t feel the contraction, can’t tell if you’re contracting correctly, or have any of the warning signs below, see a pelvic health physiotherapist for hands-on assessment. Doing the exercises wrong is common and can sometimes make symptoms worse.

Warning signs you should not ignore

See a pelvic health physiotherapist promptly (don’t wait for the 6-week check) if you experience:

• Urinary leakage with cough, sneeze, laugh, or exercise — at any point post-birth
• Heaviness or dragging in the vagina, especially worse at the end of the day or when standing
• A bulge or “something coming out” sensation
• Pain with intercourse after you have begun resuming sexual activity
• Difficulty emptying the bladder or bowel completely
• Faecal urgency or incontinence
• Persistent perineal pain beyond 6 weeks
• Diastasis recti (a gap in the abdominal muscles wider than 2 finger-widths)

None of these are “just part of being a mum”. All are treatable.

Returning to running and high-impact exercise

Australian guidelines recommend a minimum of 12 weeks before returning to running, regardless of how the birth went. Even if you feel fine, the structural recovery of pelvic floor and abdominal connective tissue is incomplete before then.

A pelvic health physio can do a return-to-running screening that includes pelvic floor function, single-leg balance, hop tests, and core strength. Passing this screening greatly reduces your risk of incontinence, prolapse, or musculoskeletal injury when you start running again.

What a pelvic health physio appointment looks like

At Daisy Hill Physio your first post-natal pelvic floor appointment is 45–60 minutes:

1. A thorough history including pregnancy, birth, current symptoms, and your activity goals
2. A diastasis recti check on the abdominals
3. An external pelvic floor assessment
4. An internal pelvic floor examination (only with your full informed consent — many women find this is the first time someone has assessed if their muscles are actually working correctly)
5. An individualised exercise program
6. Clear advice on what to do, what to avoid, and when to progress

Booking and access

Daisy Hill Physio offers post-natal pelvic health physiotherapy to mothers across Logan City, south Brisbane, and surrounding suburbs. We see clients privately (claimable on private health extras with HICAPS), under DVA, NDIS, and Medicare CDM plans. Babies are welcome at appointments. See our pelvic health physiotherapy service page for full details.

To book, call 07 3209 2000, email info@daisyhillphysio.com.au, or use the Book Online button.

Frequently asked questions

How soon after birth can I see a pelvic health physio?

For uncomplicated vaginal births and caesareans, around 6 weeks postpartum is ideal. If you have significant pain, leakage, or a bulge sensation earlier, book sooner — we can still help.

Do I need a GP referral?

No. You can book directly. A GP referral is only required for Medicare CDM, DVA, or some NDIS funding arrangements.

What does it cost?

Standard private consultations are A$105 to A$125. Most private health funds rebate a substantial portion via on-the-spot HICAPS claiming. NDIS, DVA, and Medicare CDM are billed at the relevant scheme rate.

Will it hurt?

An external assessment is comfortable. An internal pelvic floor assessment may be uncomfortable if you have ongoing perineal pain, but should not be painful. Tell your physiotherapist immediately if anything is.

Can I bring my baby?

Absolutely. We have private rooms and we’re set up for mums attending with babies in tow.

What if I had a caesarean — do I still need pelvic floor recovery?

Yes. The 9 months of pregnancy alone places significant load on the pelvic floor. Caesarean mothers can have continence and prolapse issues too. The scar tissue from a caesarean also benefits from specific physiotherapy management.

This guide is general information and is not a substitute for individual medical assessment. If you have severe pain, heavy bleeding, or signs of infection, contact your GP or maternity hospital urgently.