When Should I Start Pelvic Floor Physical Therapy After My Delivery?

When Should I Start Pelvic PT After My Delivery?

By Heather Evans 

            I had a patient earlier this year who, upon being told she had a fourth-degree tear after she delivered her daughter, announced in the delivery room before even being stitched up, “I need a referral for pelvic floor PT!” Spoiler alert – she started physical therapy early in her rehab and graduated a couple months later with no symptoms at all. Now, while I will admit I did get super excited when she told me this delivery room story, I don’t expect all patients to be planning their first visit the minute after a baby is born. That being said, we do get the question a lot … “how early after delivery should I begin pelvic floor PT?”

            I usually tell new mamas to give themselves the first couple weeks to go home and get settled in. Get rest when you can, drink water, and eat warm, nourishing foods. Some moms then feel up to their first PT chat a couple weeks post-partum. Some women will come into the clinic while others choose to do a virtual visit which are a wonderful opportunity for new moms – you don’t have to leave the home, you can demonstrate to your therapist how you are holding and lifting your baby, you can even feed your baby during the session if you need! If you had a c-section especially, there is great benefit to chatting with a pelvic PT within a few weeks post-partum.

            Around six weeks, you will see your OB-GYN and typically receive clearance for intercourse which means you are also cleared for an internal assessment by a pelvic floor PT. This is a vital time to schedule a visit. At this six-week OB-GYN visit, you will also likely be cleared to return to pretty much everything – exercise, running, etc. and I strongly encourage you to see a pelvic PT first. So much happens during pregnancy and delivery. Certain muscles can be tight and many muscles will be weak. You may think you are able to return to exercise however it is only with a pelvic PT visit that you can truly know where your body stands in terms of what your various muscles can withstand. We hear so many stories of people who return to activities too soon and end up with urinary or fecal leakage, prolapse, or pelvic pain.

            Now think if you have perineal tearing, an episiotomy, or a c-section scar. Several techniques can be taught to mobilize this tissue prior to your six-week follow-up and even more can completed once the scar has healed. Remember c-section mamas (that’s me!), it’s not just the scar you can see – seven different layers were cut to reach your baby inside the uterus. Imagine an orthopedic surgery that major – you’d be in physical therapy straight away!

            In addition to the pelvic floor and abdominal muscles, did you know that pregnancy can also affect your foot position? Your balance? Your ribs? Your breathing? You grew a human! That’s an amazing feat – and you completely deserve to recover with proper guidance in order to reach your goals and avoid injury. Schedule a pelvic PT visit between 2 and 6 weeks post-partum to begin this journey.

            One final note – if you are a new mama and you are five months (or five years) post-partum and you read this, don’t feel upset if you haven’t started PT yet. Go ahead and schedule now! It’s never too late to reach your goals.