5 Reasons To See A Pelvic Floor Physical Therapist After Have A Baby

by on August 20, 2017

Guest Blog Post by Shannon Pacella

As a pelvic floor physical therapist at the Pelvic Health and Rehabilitation Center, I have seen many women postpartum, who had no idea how I could help them; they only came across pelvic floor physical therapy after their ob/gyn mentioned it, or after doing online research because they were having unwanted symptoms post childbirth. I hope this post gives you a better understanding of how a pelvic floor physical therapist can help you postpartum. Below, I’ve outline 5 reasons to see a pelvic floor physical therapist after having a baby.

#1 – Leakage is not something you need to live with

Urinary and/or fecal leakage at any time is not normal. Having a baby can weaken your pelvic floor muscles, which are used to support the bladder/urethra. Many women postpartum notice stress incontinence and sometimes urge incontinence. Stress incontinence occurs during a stress on the bladder, usually when sneezing, coughing, laughing, jumping, and/or exercising. Urge incontinence is a very strong or sudden need to urinate, making you feel like you may not make it to the bathroom in time, and may result in involuntary urine leakage.

A pelvic floor physical therapist (PT) can assess how well your pelvic floor muscles are working/ how well you can control them. Once evaluated, the pelvic floor PT can teach you bladder and/or bowel retraining exercises to control these muscles and improve your ability to prevent leakages from happening.

#2 – Abdominal separation (diastasis recti) can be reduced

Diastasis recti is the separation of the rectus abdominis (six-pack muscle) that can occur during pregnancy. This can affect how well your abdominal muscles function, and can lead to low back pain and SI joint pain. Don’t fret! This is something that pelvic floor PT can help to treat.

A pelvic floor PT should be able to measure how wide the separation is, teach specific exercises geared toward closing it and strengthening your abdomen/core, teach proper lifting techniques and posture/body mechanics, and educate you on certain things to avoid while you have a diastasis recti. If you’d like to learn more about diastasis recti, check out this blog post.

#3 – Pelvic organ prolapse can be treated

A main job of the pelvic floor muscles is to support the pelvic organs. Pregnancy and delivery can weaken these muscles and allow the pelvic organs to descend into the vagina. Women with pelvic organ prolapse may describe a feeling of heaviness/pressure or fullness in their vagina. A pelvic floor PT should be able to assess whether there is a prolapse, what type of prolapse it is (there are different types of pelvic organ prolapse depending on which organs are affected), and the severity of the prolapse. The pelvic floor PT can then teach specific exercises to strengthen the pelvic floor muscles in order to properly support the organs and prevent the prolapse from worsening.

Depending on the severity of the prolapse, other interventions/treatments (such as a pessary* or surgery) may need to be incorporated along with the pelvic floor physical therapy. *A pessary is a small device that is inserted into the vagina to help support the prolapse. Your PT should refer you to a urogynecologist or other physician to look into these options if needed. To learn more about pelvic organ prolapse, click here.

#4 – C-Section scars (and episiotomy scars) need attention

Most women after having a Cesarean section (C-section) are not given proper instructions on how to care for the resulting scar. A healing incision may form underlying adhesions/scar tissue that can affect the surrounding structures in that area and cause pain. Some changes that may occur include: hypersensitivity of the scar, trigger points in abdominal muscles, postural changes (feeling bent/scrunched forward at waist – which can lead to back pain), and superficial nerve irritation, all which can lead to pain around the scar, abdomen, suprapubic region, and even clitoris/labia. *This also applies to scars from episiotomies/perineal tears after a vaginal delivery; these scars may also result in pain with penetration/intercourse, which can be addressed with pelvic floor physical therapy.

A pelvic floor PT can perform scar tissue mobilization/manipulation in order to prevent these impairments and restrictions from happening, and also treat and reduce the adhesions if they have already occurred. The pelvic floor PT can teach you how to safely and correctly perform some manual techniques on the scar as well. This post has some more great information regarding C-section scars.

#5 – Kegels are not effective if done incorrectly and are not for everyone

Many women are told to “just do kegels” in order to stop their symptoms. And many times, this does not work. Why? Because kegels are more complex than just “squeezing down there”, and most women do not perform kegels correctly, they may compensate by activating their gluteal (buttocks) muscles, or they may not be breathing correctly whilst doing kegels. Another reason why kegels may not be helping is because they can actually making symptoms worse if you have pelvic floor hypertonicity/tension or trigger points in the pelvic floor muscles. *Pelvic floor hypertonicity/trigger points may cause pain with penetration/intercourse, another impairment that pelvic floor physical therapy can treat.

In this case, women need to reduce the pelvic floor trigger points or tension first and then work on strengthening these muscles (if needed). A pelvic floor PT can assess the pelvic floor muscle strength and endurance, as well as, evaluate for trigger points or hypertonicity in the pelvic floor. Depending on what the findings are, the pelvic floor PT will be able to instruct on how to properly perform kegels and set up a home exercise program (if indicated), and/or treat the trigger points/tension. Here’s a great post talking about proper kegel technique.

After having a baby, your focus shifts and there is little time to for yourself. This is even more reason why you should seek out pelvic floor physical therapy, in order to learn ways to make your life easier, so you don’t have to live with leakage, pain, weakness, and many other symptoms that may be hindering you from enjoying your new life with your baby.

If you found this post to be helpful, be sure to check out more of PHRC’s blog posts here.


Shannon Pacella, PT, DPT is a pelvic floor physical therapist at the Pelvic Health and Rehabilitation Center in Lexington, MA, where she treats women and men with pelvic pain, urinary/bowel/sexual dysfunction, and pregnancy/postpartum care. Shannon takes an integrative and mindful approach to treatment, focusing on restoring function and reaching each individual’s goals.

She received both her bachelor’s degree in Exercise Science and her Doctorate of Physical Therapy from Simmons College in Boston, MA. Shannon is a member of the Section on Women’s Health of the American Physical Therapy Association, and a member of the International Pelvic Pain Society.

Shannon was born and raised on Cape Cod, where she regularly goes to visit family and relax at the beach. She is a self-proclaimed ‘foodie’ and loves exploring restaurants all around the Boston area.

To learn more, you can visit the PHRC website, subscribe to their Blog, read Pelvic Pain Explained: What Everyone Needs to Know and follow PHRC on social media on FacebookTwitter  and Instagram.

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