Postpartum Care

Postpartum recovery is the physiological process through which the abdominal wall, pelvic floor and connective tissues adapt after the load of pregnancy and the demands of delivery. Pregnancy stretches and lengthens the abdominal and pelvic floor muscles over several months, and delivery — vaginal or by caesarean section — adds further mechanical and, in the case of C-section, surgical change. Postpartum physiotherapy is an evidence-based approach to assessing these tissues and guiding their return to function through progressive, individualized rehabilitation.

Diastasis recti

Diastasis recti is a widening of the linea alba, the connective tissue along the midline, that separates the left and right sides of the rectus abdominis. It is a normal and near-universal change in late pregnancy. For many people it narrows on its own in the early weeks; however, a measurable separation persists in roughly one-third of women at 12 months postpartum. It may present as a visible ridge or midline doming during effort, or as a soft gap that admits the fingers.

Assessment establishes the width and depth of the separation and how the deep core manages intra-abdominal pressure during movement. Physiotherapy for diastasis recti focuses on restoring coordinated control of the deep abdominal muscles and pelvic floor under graded load, rather than on isolated abdominal exercises, which can increase doming when pressure is poorly managed.

Urinary incontinence and pelvic floor dysfunction

Postpartum urinary incontinence — the involuntary loss of urine with coughing, sneezing, laughing or exertion — is common in the first year after birth. It reflects underlying pelvic floor dysfunction, which may involve muscles that are weak, overactive, or poorly coordinated. Related symptoms include urinary urgency, a sensation of heaviness or dragging that can indicate pelvic organ prolapse, and pain with intercourse.

Pelvic floor muscle training, supervised and tailored to the assessment findings, reduces postpartum urinary incontinence and is a recognized first-line treatment. Because leaking can arise from either underactivity or overactivity of the muscles, a generic strengthening routine is not appropriate for everyone; unsupervised effort to strengthen an already overactive pelvic floor can worsen symptoms. Individual assessment determines the correct approach.

The six-week postpartum check

The standard six-week postpartum medical appointment confirms general healing and, where relevant, clearance to resume activity. It is not designed to assess pelvic floor strength, coordination, endurance, or scar mobility in detail. As a result, treatable symptoms such as incontinence, pressure, or persistent abdominal separation can remain unaddressed after a person has been told that recovery is complete. These symptoms can respond to physiotherapy regardless of how much time has passed since delivery.

Recovery after a C-section

A caesarean section is major abdominal surgery. Because the pelvic floor and abdominal wall are affected by pregnancy itself — not only by the mode of delivery — pelvic floor symptoms, core weakness, and scar-related restriction can occur after a C-section as well as after vaginal birth. Once the incision has healed, physiotherapy may include assessment of scar mobility, graded scar management, and core rehabilitation adapted to surgical recovery.

Core rehabilitation