Did you know? Nearly 50% of new mothers experience pelvic floor dysfunction postpartum, with issues like urinary incontinence or prolapse being common. But the good news? Simple exercises can help rebuild strength and prevent long-term complications.

Here’s a quick overview of the 7 key exercises for pelvic floor recovery:

• Pelvic Floor exercises: : Strengthen pelvic muscles by building strength and endurance
• Diaphragmatic  Breathing: Improves co-ordination between the diaphragm and pelvic floor muscles
• Pelvic Tilts: This can help isolate movement between the pelvis and lower back and start to strengthen the abdominal muscles.

• Bridge: Strengthen pelvic floor, deep abdominals and also the gluts  together.

• Squats: Build functional strength in the pelvic floor and legs to allow you to pick up your baby easily

• Side-Lying Leg Lifts: Target pelvic floor and hip muscles, with core control.

• Child’s Pose Stretch: Relax and gently stretch pelvic muscles and the gluts. Consistency is key - start small and gradually increase intensity. For best results, aim for a  20-minute session 2-3 times a week  and consult a pelvic health physiotherapist if you are unsure of your pelvic floor function. Ready to take control of your postpartum recovery? Let’s dive in!

Pelvic Floor Changes After Childbirth

Pelvic Floor Basics

"The pelvic floor muscles form a hammock-like structure that supports your bladder, bowel and uterus"

These muscles play a key role in:

• Controlling urinary and bowel continence
• Supporting and positioning internal organs
• Working with abdominal and back muscles for core stability
• Maintaining sexual function and health

After childbirth, these muscles may be weaker, especially after a vaginal delivery , leading to noticeable changes.

Post-Birth Muscle Changes

Childbirth often causes significant changes to the pelvic floor. During pregnancy, the growing uterus puts continuous pressure on these muscles. Studies reveal that 80% of births result in perineal tears.

"Many women feel their pelvic floor is less supported after a vaginal delivery, with reduced muscle function and increased pressure"

Some common postpartum issues include:

• Urinary Incontinence: Affects 21% of first-time mothers after spontaneous birth, rising to 36% with forceps delivery.
• Anal Incontinence: Occurs in 2–6% of first-time mothers, increasing to 17–62% after severe perineal tears.
• Pelvic Organ Prolapse: Becomes more likely as support structures weaken and can be as high as 50%.

Recovery times differ from person to person.

"What I tell people is that you're pregnant for nine months, so expect recovery to take at least 12-18 months. Once you are post natal, you will always be post natal.”

Understanding these changes is crucial. Specific exercises can help rebuild strength and function. Unfortunately, not every new mum is offered routine post natal pelvic floor   care. This makes self-education and proactive care especially important for new mothers.

Postpartum Pelvic Floor Exercises for Beginners Routine

7 Key Pelvic Floor Exercises

According to Kaiser Permanente's 2024 guidelines, start these exercises gradually and stop if you experience any pain. Begin with the basics to engage your pelvic floor muscles effectively.

1. Basic Pelvic Floor Exercise

This is the starting point for pelvic floor recovery. Here's how to do it:

• Tighten your pelvic floor muscles, as if you're trying to stop wind and then water
• Fully relax for 5–10 seconds.
• Repeat up to 10 times per session.
• Then practice slow endurance holds. Squeeze as above and this time try to hold the contraction, without holding your breath.
• Aim for a hold of 3-5 seconds, and repeat 3- 5 times.
• As you get stronger try and hold longer and do more reps, aiming for a 10 second hold 10 times.

Once you're comfortable doing your pelvic floor exercises, add breath control to your routine.

2. Diaphragmatic Breathing Method

This exercise helps improve coordination between your breathing and pelvic floor muscles:

• Lie on your back with pillows for support. Place one hand on your belly and the other on your chest.
• Slowly inhale through your nose, letting your ribs widen and your upper abdomen soften and expand. .  Both hands should move equally.
• Practice for 3–5 minutes, twice daily.
• Progress to inhale, exhale, and then contracting the pelvic floor as in exercise 1.

After mastering this, focus on strengthening your core.

3. Pelvic Tilts/ Pelvic rocking

This exercise connects your core and pelvic floor:

• Lie on your back with knees bent and feet flat on the floor.
• As you exhale, contract your pelvic floor as above, and allow your pelvis to tilt so that the tail lifts off the bed and the lower back sinks softly into the floor
• Hold for 6 seconds while breathing normally.
• As you inhale, let go and allow the pelvis to come to back to neutral so that there is a small hollow under your lower back and the tail is softly resting on the floor (not pressing into the floor).
• Repeat 8–12 times.

Next, move on to exercises that involve more of your body.

4. Bridge Position

This exercise works your pelvic floor, core and gluts together:

• Lie on your back with knees bent feet flat on the floor.
• Squeeze your pelvic floor go into a pelvic tilt as above, then continue to peel the spine off the floor segment by segment
• Lift your hips until your shoulders, hips, and knees form a straight line, without allowing your ribs to flare too far forwards
• Hold for 6 seconds, without holding your breath
• Slowly lower back down segment by segment, starting with the ribs until your tail gently rests back on the floor.
• repeat 8–12 times.

Finally, add standing exercises to your routine.

5. Squats

Squats are great for strengthening both your pelvic floor and legs:

• Keep your feet shoulder-width apart
• Squat  down as if you are about to sit in a chair.
• Exhale as you come out of the squat
• Repeat 8–12 times.

Recovery Best Practices

To get the most out of the exercises mentioned earlier, follow these recovery tips. Good recovery habits can make a big difference in improving pelvic floor strength.

Regular Practice

Research indicates that doing two 20-minute exercise sessions daily for four weeks can lead to noticeable improvements in pelvic floor strength.

The Squeezy app can act as a gentle reminder throughout the day.

Make sure to rest between sessions to avoid overworking your muscles.

Working with a Specialist

For tailored advice, consulting a specialist can be very helpful. At Lidder Therapies, an initial pelvic health assessment includes a detailed evaluation of muscle function, potential prolapse risks, and personalized exercise guidance.

A pelvic health physiotherapist can help by:

• Assessing how both your muscles, joints and nervous system are recovering
• Measuring pelvic floor strength (via an internal vaginal examination)
• Designing a customised exercise plan
• Tracking your progress and adjusting recommendations as needed

Correct Exercise Form

Using the right technique is crucial for results and to avoid injury. Keep these tips in mind:

• Maintain steady breathing throughout.
• Focus on proper posture and alignment.
• Engage the right muscles (imagine stopping wind and water ).
• Gradually increase the intensity of your exercises.

If you experience any pain, stop immediately and consult your healthcare provider.

Next Steps

Take the exercises outlined and turn them into a routine that naturally fits into your daily life.

Incorporate Pelvic floor exercises  into everyday moments like when you are feeding your baby, or rocking your baby. 

These small windows of time make it easier to stay consistent. Aim for 10 quick squeezes and 10 slow endurance holds 3 times  a day . Pair this with deep breathing exercises for 3–5 minutes twice a day, perhaps during your morning or evening routine.

For a more personalised approach, consider scheduling a pelvic health assessment from 6-8 weeks postpartum.

Once you have started your early core exercises, we can progress your rehab to include advice on returning to fitness and sports that you enjoy.