Postnatal Physiotherapy: Recovery After Birth

Pregnancy and birth place enormous demands on the body. Postnatal physiotherapy provides an evidence-based approach to recovery — helping new mothers restore pelvic floor function, manage diastasis recti, and return safely to exercise.

Why Postnatal Physiotherapy Matters

The changes of pregnancy and the demands of birth affect virtually every woman to some degree — regardless of whether the birth was vaginal or caesarean, straightforward or complicated. The pelvic floor, abdominal wall, and spinal support system all require rehabilitation to restore their pre-pregnancy capacity.

Without appropriate rehabilitation, issues like incontinence, prolapse, diastasis recti, and pelvic pain can persist or worsen over time — particularly as women return to exercise or have subsequent pregnancies.

Pelvic Floor Assessment and Rehabilitation

The pelvic floor consists of a hammock of muscles, ligaments, and fascia supporting the bladder, uterus, and bowel. It is stretched and sometimes torn during vaginal birth. An internal pelvic floor assessment by a trained physiotherapist provides objective information about:

• Pelvic floor strength and endurance
• The ability to fully relax the pelvic floor (as important as strength)
• Presence of trigger points or scar tissue
• Risk of prolapse

Treatment is tailored to the assessment findings — there is no one-size-fits-all pelvic floor exercise program.

Diastasis Recti Management

Diastasis recti (DR) — separation of the rectus abdominis muscles — is a normal adaptation to accommodate the growing uterus. Some degree of DR is present in virtually all women at full term. The focus of treatment is not “closing the gap” but restoring the load-transfer capacity of the abdominal wall through progressive functional exercises.

Research shows that a functional approach (teaching safe lifting, breathing mechanics, and progressive loading) produces better outcomes than exercises targeting the linea alba directly.

Safe Return to Exercise After Birth

The 2019 returning to running postnatal guidelines recommend waiting until at least 12 weeks before returning to high-impact exercise (running, HIIT, jumping). Before then, walking, swimming, and low-impact exercise are appropriate if symptom-free.

Symptoms that indicate the body is not ready for high-impact exercise: heaviness or bulging at the perineum, urinary or bowel leakage, pelvic pain, lower back pain. A physiotherapy assessment helps determine individual readiness.

Caesarean Section Recovery

C-section scar management begins once the wound is fully healed (typically 6–8 weeks). Scar mobilisation prevents adhesion formation, reduces sensitivity, and can improve the appearance of the scar. Core rehabilitation after C-section follows a gradual progression — the abdominal incision affects layers of tissue that need time to heal before loading.