Why Pelvic Floor Physiotherapy Matters During Pregnancy & After Birth

Pregnancy and postpartum periods are times of enormous change. While much of the attention is understandably placed on the growing baby, there is another part of the body quietly working around the clock to support you through it all: the pelvic floor.

Pelvic floor physiotherapy is a specialized form of care that supports your body during pregnancy, birth, and recovery, helping you move more comfortably and feel more confident in your body.

What Is the Pelvic Floor?

Think of your pelvis like a bowl. At the base of that bowl is a group of muscles and connective tissue that form a supportive hammock. These muscles run from the pubic bone at the front to the tailbone at the back and stretch side to side between your sitting bones.

The pelvic floor plays three essential roles in the body. It supports the pelvic organs, including the bladder, uterus, and rectum. It contributes to bladder and bowel control as well as sexual function. It also works with your core, hips, and back muscles to help stabilize your spine and pelvis during everyday movement.

Although we don’t often think about these muscles, they are constantly active — whether you’re walking, lifting, coughing, or simply standing upright.

How Pregnancy Affects the Pelvic Floor

During pregnancy, the body undergoes significant physical and hormonal changes, and your pelvic floor is directly impacted by all of them. As your baby and uterus grow, extra weight and pressure are placed on the pelvic floor muscles, which can lead to fatigue or stretching over time.

Hormones such as relaxin increase joint mobility to prepare your body for birth, but this can sometimes contribute to pelvic girdle pain or lower back discomfort. As your organs shift upward and forward, the bladder becomes more compressed, which often explains the increased urge to urinate during pregnancy.

Pelvic floor physiotherapy during pregnancy helps your body adapt to these changes. Treatment focuses on improving strength, flexibility, coordination, and body awareness, while also teaching you how to move, lift, and breathe in ways that support your pelvic floor and your growing baby.

Why See a Pelvic Floor Physio While Pregnant?

Many people assume pelvic floor physiotherapy is only needed after birth, but pregnancy is an ideal time to start. Some patients seek care because they are experiencing pelvic pain, pressure, low back or hip discomfort, urinary leakage, constipation, or a sensation of heaviness. Others come in simply because they want to prepare their bodies for labour and delivery, learning how to relax the pelvic floor, coordinate breathing, and push effectively.

Even in the absence of symptoms, pelvic floor physiotherapy can be a proactive and preventative part of prenatal care.

Postpartum Recovery: More Than Just “Waiting It Out”

After birth — whether vaginal or via caesarean section — the pelvic floor and core muscles go through a recovery process. This phase is often underestimated, and many people are told that symptoms such as leaking, pain, or weakness are simply part of having a baby; however, these are actually signs that the body may benefit from targeted rehabilitation.

Postpartum pelvic floor physiotherapy commonly addresses concerns such as urinary leakage, pelvic heaviness or prolapse symptoms, scar discomfort from a perineal tear or C-section, pain with intimacy, abdominal weakness, or diastasis recti. It also plays a key role in helping people return to exercise safely and confidently.

A pelvic floor physiotherapist will assess how your muscles are healing, how your breathing and core work together, and how your body moves. From there, a personalized plan is created to rebuild strength, coordination, and confidence.

What to Expect from Pelvic Floor Physiotherapy

Every pelvic floor physiotherapy session looks different, but most include a combination of education, movement-based therapy, and hands-on treatment where appropriate. A large part of care involves helping you understand your anatomy and what is happening in your body. Exercises are tailored to your specific needs and may focus on strengthening, relaxation, or both.

You will also receive practical guidance on daily activities such as lifting, coughing, exercising, and bowel habits, all aimed at reducing unnecessary strain on the pelvic floor.

It’s important to note that pelvic floor therapy is not just about doing kegels. For many people, the issue is not weakness, but tension or poor coordination. In those cases, learning how to relax and breathe effectively is just as important as strengthening.

When Is the Right Time to Book?

There is no “wrong” time to see a pelvic floor physiotherapist. Some people come during pregnancy to prepare for birth or manage discomfort, while others seek care weeks, months, or even years after having a baby to address lingering symptoms or simply check in on how their body has healed.

Ideally, anyone who has been pregnant would have at least one pelvic floor assessment postpartum — like how we routinely care for our teeth or vision.

Your pelvic floor plays a vital role in how you move, feel, and function every day, particularly during and after pregnancy. Pelvic floor physiotherapy is about helping you understand your body, supporting recovery, and giving you the tools to feel strong and capable for the long term.

Whether you’re managing pain, leakage, or simply looking for guidance as you return to activity, pelvic floor physiotherapy can be a valuable part of your care — and it’s never too early or too late to start.

Maddie Allan is a passionate physiotherapist that uses a patient-centered approach to empower people to reach their goals. She holds her Master of Science in Physiotherapy from the University of Toronto and has completed her level 1, level 2, and level 3 pelvic health courses from Pelvic Health Solutions.