What is pregnancy & postpartum rehabilitation?
Pregnancy stretches the abdominal wall, loads the pelvic floor with a growing weight and softens the ligaments that hold the pelvis together. Birth, vaginal or caesarean, is a significant physical event. Yet most women receive no assessment of these muscles at any point. The six-week check confirms that wounds have healed; it does not test whether the pelvic floor can hold a sneeze or whether the abdominal wall has closed.
Prenatal physiotherapy teaches you to find and use your pelvic floor, manage pressure, ease back and pelvic girdle pain, and prepare for pushing and recovery. Postpartum physiotherapy checks what actually happened, then rebuilds strength, coordination and confidence so you return to lifting your baby, exercise and intimacy on solid ground. Leaks, heaviness and pain months after birth are common, but they are not the price of motherhood.
Common signs and symptoms
- Leaking urine with coughing, sneezing, laughing or exercise during or after pregnancy
- Heaviness, pressure or a bulge in the vagina
- A doming or gap down the middle of the abdomen when you sit up (diastasis recti)
- Pain with sex, scar pain or a tender caesarean scar
- Low back, pubic bone, sacroiliac or hip pain
- Constipation, straining or bowel leakage after birth
What causes it?
- The weight of the growing uterus on the pelvic floor and the stretch of the abdominal wall
- Vaginal birth, especially a long second stage, a large baby, tearing or instrument delivery
- Caesarean birth, which cuts through the abdominal wall and leaves scar tissue
- Hormonal softening of ligaments and connective tissue
- Rapid return to impact exercise or heavy lifting before the tissues are ready
- Sleep deprivation, feeding postures and carrying, which load a recovering body all day
How pelvic floor physiotherapy helps
Pre- and postnatal physiotherapy is practical and individual. Before birth, it prepares your body and teaches skills you will use in labour and recovery. After birth, it starts with an honest assessment and builds a program around your delivery, your symptoms and the life you want to get back to.
A treatment plan typically includes:
- Prenatal: pelvic floor awareness and training, pressure management, positions for labour and pushing, and treatment for back or pelvic girdle pain
- A postpartum assessment of pelvic floor strength, prolapse, abdominal separation, scars and posture
- Progressive pelvic floor and deep core retraining after vaginal or caesarean birth
- Scar mobilisation for perineal tears and caesarean scars
- A graded return to walking, running, lifting and sport based on your assessment, not the calendar
- Bladder, bowel and intimacy strategies, and coordination with your midwife, obstetrician or doctor
What the research says
The studies below are peer-reviewed and linked to their permanent records so you can read them yourself.
This Cochrane review of 46 trials found that pelvic floor muscle training started in early pregnancy substantially reduced the risk of urinary incontinence in late pregnancy and in the months after birth, and that it helped treat incontinence when started postnatally.
Woodley SJ, Lawrenson P, Boyle R, et al.. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews, 2020. View study
This systematic review concluded that supervised pelvic floor muscle training during pregnancy and after childbirth can both prevent and treat urinary incontinence.
Mørkved S, Bø K. Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review. British Journal of Sports Medicine, 2014. View study
Exercise programs during pregnancy, including those delivered by physiotherapists, reduced low-back pain and pelvic pain and the disability they cause, according to this Cochrane review.
Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database of Systematic Reviews, 2015. View study
Treatment at Corelife Wellness in Oakville
Corelife Wellness is a dedicated pelvic health clinic at 3075 Hospital Gate, Unit 312, Oakville, next to Oakville Trafalgar Memorial Hospital. Care starts with a free 15-minute consultation by phone, video or in person, followed by a full assessment with our Registered Physiotherapist. Every pelvis is unique, so your plan is built from that exam rather than a template. No referral is needed, and physiotherapy is often eligible under extended health benefits.
How assessment and treatment work, and how to book, are on our main page: Pelvic floor physiotherapy in Oakville. When a weak core or ab separation is part of the picture, Emsculpt in Oakville (Venus Ab Rehab) is available in the same clinic to complement your physiotherapy.
Helpful reading from our team
When to see a doctor first
Pelvic floor physiotherapy is safe and you do not need a referral, but some symptoms need a medical assessment before or alongside treatment:
- Heavy bleeding, fever, or a wound that is red, hot or leaking after birth
- Severe headache, visual changes or swelling in pregnancy (seek urgent care)
- Calf pain or swelling, chest pain or breathlessness
- Being unable to empty your bladder, or sudden loss of bladder or bowel control
- Low mood, anxiety or thoughts of harm: tell your doctor or midwife, or call 911 in an emergency
