When to Start Pelvic Floor Physical Therapy After Childbirth: A Postpartum Guide
By: Heather Evans, PT, DPT, in Kansas City (Overland Park Kansas, and Lees Summit Missouri)
Earlier this year, I had a patient who, after delivering her daughter and hearing she had a fourth-degree tear, immediately announced, “I need a referral for pelvic floor PT!” Spoiler alert—she began therapy early in her recovery and was completely symptom-free within a couple of months. While I was thrilled by her proactive approach, I don’t expect all new moms to be planning their pelvic floor therapy right after giving birth. That said, a common question we hear is: “How soon after delivery should I start pelvic floor PT?”
Take the First Few Weeks to Rest and Recover
I usually recommend that new moms take the first couple of weeks postpartum to rest, hydrate, and nourish themselves with warm, healthy foods. Once you’ve settled in, some moms feel ready for their first physical therapy consultation. Many choose to come into the clinic, while others opt for a virtual visit, which is a fantastic option for new moms. You don’t have to leave the comfort of your home, and you can show your therapist how you’re lifting and holding your baby—plus, you can even feed your baby during the session if needed! If you’ve had a C-section, scheduling a virtual or in-person chat with a pelvic floor PT within the first few weeks can be incredibly beneficial.
Why the Six-Week Mark Is Crucial
Around six weeks postpartum, you’ll have your follow-up appointment with your OB-GYN. You’ll likely be cleared for intercourse and given the green light for an internal pelvic floor assessment with a PT. This is the ideal time to book your first pelvic therapy session. While your doctor might clear you for exercise or running, I strongly recommend seeing a pelvic PT first. So much happens to your body during pregnancy and delivery—some muscles may be tight, and others may be weak. While you might feel ready to return to exercise, a pelvic PT can assess your body to ensure it’s truly ready to handle those activities. We’ve heard too many stories of people returning to activities too soon, only to experience issues like urinary or fecal leakage, prolapse, or pelvic pain.
Healing Scars and Strengthening Muscles
If you’ve experienced perineal tearing, an episiotomy, or a C-section, there are specific techniques we can teach you to mobilize scar tissue before your six-week follow-up. Once your scars have healed, we can do even more to ensure you regain strength and flexibility. For C-section moms (like me!), it’s important to remember that it’s not just the external scar that matters—there are seven layers of tissue that were cut to deliver your baby. If you’d had an orthopedic surgery this major, you’d be in physical therapy immediately!
Recovery Is More Than Just Your Pelvic Floor
Did you know that pregnancy can also affect your foot position, balance, ribs, and even your breathing? Growing a human is an amazing feat, and you deserve to recover with the right guidance to help you reach your goals and avoid injury. Scheduling a pelvic PT visit between 2 and 6 weeks postpartum will help ensure you’re on the right track for a full recovery.
It’s Never Too Late to Start
One final note: If you’re reading this and you’re five months (or even five years) postpartum and haven’t started pelvic floor therapy yet, don’t worry—it’s never too late to begin your recovery journey. Go ahead and schedule a visit today! You’ll be glad you did.