Postpartum Care

The six-week postpartum check with an OB or midwife is often the only formal follow-up offered after birth — and for many people, it barely scratches the surface of what their body has been through. Pregnancy and delivery, whether vaginal or cesarean, ask a great deal of the pelvic floor, abdominal wall, and whole musculoskeletal system, and healing continues well beyond that first checkup. At SOMOM, postpartum physiotherapy and massage therapy pick up where that six-week clearance leaves off, offering a dedicated, individualized look at recovery — whatever stage of postpartum you’re in, whether six weeks or six years out.

What’s Happening in the Body After Birth

During pregnancy, the pelvic floor muscles and connective tissue stretch considerably to accommodate a growing baby and, in vaginal delivery, the birth itself; the deep abdominal muscles lengthen and the connective tissue along the midline of the abdomen thins. After birth, these tissues begin to recover, but that process takes real time — often many months — and doesn’t always resolve completely on its own. A cesarean birth involves its own healing process, with a surgical scar that moves through layers of skin, fascia, and abdominal muscle, and can affect core function and sensation even though the pelvic floor itself wasn’t directly involved in the delivery. Hormonal shifts after birth, particularly for those who are breastfeeding, can also temporarily affect tissue elasticity and vaginal comfort.

Common Postpartum Concerns

• Diastasis recti, or separation of the abdominal muscles along the midline, that hasn’t closed as expected
• Leaking urine with coughing, sneezing, exercise, or an urgent need to rush to the bathroom
• A sense of heaviness, bulging, or pressure in the vagina, which can suggest pelvic organ prolapse
• Pain, tightness, or reduced sensation around a cesarean or perineal scar
• Low back, hip, or pelvic girdle pain that hasn’t settled since delivery
• Pain with intercourse
• Uncertainty about when and how to safely return to exercise

These are common experiences, not something to be embarrassed about or simply expected to live with. Many people aren’t told that physiotherapy may help with any of this, or assume enough time has passed that it’s too late to address — it generally isn’t.

Rebuilding the Pelvic Floor and Deep Core

Postpartum physiotherapy typically starts with an assessment of how the abdominal wall, pelvic floor, and breathing are working together, along with a look at posture and movement patterns that may have shifted during pregnancy and the early weeks of parenting. From there, a graded, individualized program helps rebuild strength, coordination, and load tolerance — often starting with fairly gentle breath and core-connection work before progressing toward more demanding strength training, running, or whatever activity you care most about. Scar tissue, whether from a cesarean incision or a perineal tear or episiotomy, can be assessed and treated with massage and mobilization techniques aimed at improving mobility and reducing sensitivity. As always, internal pelvic floor assessment is optional and done only by consent; a great deal of postpartum recovery can be evaluated and treated externally.

A Graded Return to Exercise

A question that comes up again and again postpartum is simply: when can I run, lift, or get back to my previous routine? There isn’t a single timeline that applies to everyone — recovery is guided by how your body is actually doing, not just by the calendar. We help build a progressive return-to-activity plan that respects healing tissue while still moving you meaningfully toward your goals, adjusting the pace based on symptoms like leaking, heaviness, or pain along the way rather than pushing through them.

What Postpartum Care Looks Like

Whether you’re newly postpartum or returning to address something that’s lingered for years, care begins with a thorough conversation and assessment, then unfolds at a pace that matches your recovery and your life with a new baby. Our pelvic health physiotherapy service anchors this care at our High Park clinic, often paired with massage therapy for scar work and general tension relief. Many families we see also bring their baby in for pediatric physiotherapy around the same time, since early development and a parent’s own recovery so often overlap.

Reassurance and When to Seek Assessment

Postpartum symptoms are common, but common is not the same as something you have to permanently live with, and it is never too late — whether you are six weeks or many years past delivery — to have these concerns properly assessed. If you notice leaking, heaviness, persistent pain, or simply don’t feel like yourself physically since giving birth, that’s reason enough to book an assessment. We work alongside your family doctor, OB, or midwife throughout, and will flag anything that needs their input. Book your postpartum assessment whenever you’re ready.