Pelvic Floor Pain After Birth: Why It Happens & What to Do

Postpartum

pelvic floor pain after birth, physical therapist holding pelvic floor

Experiencing discomfort in your pelvic floor after having a baby? You’re FAR from alone. As a Pelvic Floor Physical Therapist, I regularly talk to moms who deal with pelvic floor pain after birth, such as pain when picking up their baby, leaking, or feeling a constant heaviness in their pelvic region.

Unfortunately, this topic rarely comes up in regular conversation and is often swept under the rug by medical providers. If you’re a new mom (or even if you’ve been a mom for a while!) experiencing these symptoms can feel overwhelming. But you DON’T have to put up with them!

In this blog post, I’ll explain what’s happening in your body and share physical therapy exercises to help you treat postpartum pelvic pain and get back to living a full, active life.

What Is Postpartum Pelvic Pain?

Postpartum pelvic pain develops in the weeks and months after giving birth, affecting the muscles, ligaments, and tissues that support your pelvic organs. These changes occur naturally during pregnancy and childbirth, but sometimes the recovery process needs extra attention and care.

According to the Pelvic Pain Foundation of Australia, 1 in 4 women experience some form of pelvic pain 3 months after delivery. Postpartum pain can develop both after a vaginal delivery and a C-section.

Overall, postpartum pelvic floor issues are VERY common but not talked about enough. According to Brown University Health, 35% of new moms deal with urinary incontinence following childbirth, and 20% face severe pelvic floor muscle injury after a normal pregnancy and delivery.

So, don’t feel like you’re alone if you’re dealing with postpartum pelvic pain or think that something is “wrong” with you! Millions of women struggle with these issues – these conversations just don’t get nearly enough attention.

Physical therapist holding a pelvic floor. Physical therapy can help with pelvic floor pain after birth.

What Does Pelvic Floor Pain Feel Like?

Pelvic floor discomfort can manifest in several ways and locations. Here are the most common symptoms I’ve seen new moms experience:

  • Pressure or heaviness in the pelvic area, especially when standing or walking for a long time
  • Discomfort during everyday activities like lifting your baby or climbing stairs
  • Pain or burning sensation during urination or bowel movements
  • Difficulty controlling your bladder function, especially when coughing, laughing, or exercising
  • Muscle spasms or tension in the pelvic region
  • Pain during sex or when using tampons
  • Sharp or achy tailbone pain that worsens when sitting
  • Discomfort from hemorrhoids, including itching, burning, or pain during bowel movements
  • Constipation or difficulty emptying your bowels completely

You can feel pelvic pain in different places, too. You can experience discomfort inside the vagina, throughout the groin area, or around your tailbone. If you had a C-section or an episiotomy, the pain might concentrate around the surgical scar or healing tissue.

The sensations can range from sharp, shooting pains to deep, persistent aches that worsen with certain movements or positions. All of these symptoms require proper treatment during postpartum recovery.

What Causes Pelvic Floor Pain After Birth?

Your body goes through many changes during pregnancy and childbirth that can lead to pelvic pain afterward. Here are the main reasons why you might be experiencing discomfort:

  • Changes During Pregnancy: Your body goes through a LOT during pregnancy – your posture changes, hormones make your joints looser to prepare for birth, you gain and then lose a lot of weight, muscles can get weaker, you name it. All of this can make your pelvis less stable and cause pain after childbirth. 
  • The Birth Process: When you give birth, your pelvic floor muscles stretch a lot. This stretching, along with things like long labor or tears during delivery, can lead to muscle pain and spasms. With C-section births, there’s still a lot of pressure on your pelvic floor. It’s a VERY common misconception that only vaginal births impact those muscles. 
  • Pelvic Floor Dysfunction/Problems: The muscles in your pelvic floor work hard during pregnancy and birth. When they’re stressed, you might leak pee, have trouble controlling your bowels, feel pain during sex, develop hemorrhoids, or feel like things just aren’t supported properly down there.
  • Pelvic Organ Prolapse: Sometimes pregnancy and birth can weaken the muscles that hold your pelvic organs in place. When this happens, these organs can shift downward (called prolapse), causing a heavy feeling or pressure in your vagina.
  • Complications/Existing Issues: SI joint dysfunction (pain in your lower back where your spine meets your pelvis) and pubic symphysis dysfunction can all contribute to postpartum pelvic floor pain as well.

You may also deal with diastasis recti, a phenomenon that 100% of full-term pregnancies will experience where your abdominal muscles separate. It typically doesn’t cause pain but can contribute to leaking, digestive issues, and core weakness.

Learn how to fix diastasis recti even years later.

Woman doing physical therapy.

How Long Does Pelvic Pain Last After Birth?

It varies from mama to mama. It’s normal to have some mild discomfort in the first few weeks after delivery, but persistent pelvic pain beyond 6-8 weeks postpartum deserves your attention. Without proper pelvic floor therapy, you may continue to experience symptoms for months or even years after giving birth.

Many new moms think they should wait it out and see if things improve on their own. But as a Pelvic Floor Therapist, I always tell my mama clients that the longer you wait to address pelvic floor issues, the more likely your body is to develop compensatory patterns that can make recovery more difficult.

Pelvic floor dysfunction postpartum is absolutely fixable with the right approach, so take proactive steps, such as physical therapy! 

FREE Download for postpartum recovery, including minimizing pelvic floor pain after birth.

Is It Normal to Have Pelvic Floor Pain Postpartum?

NO! Persistent pelvic floor pain postpartum isn’t normal, and you don’t have to accept it as just part of your everyday life. 

In my practice, I’ve seen many moms who suffered silently for months or years because they thought their symptoms were just part of motherhood. It doesn’t have to be this way. The #1 thing I hear from the moms I work with is, “I wish I would have done this earlier!”. 

Your body went through significant changes during pregnancy and childbirth, but that doesn’t mean you have to live with ongoing pain or discomfort. Physical therapy can help you recover and strengthen your pelvic floor muscles.

Physical Therapy for Pelvic Pain Postpartum

Physical therapy exercises help you reconnect your core and pelvic floor muscles, minimize uncomfortable symptoms, heal faster, and feel stronger postpartum. It can make a HUGE difference if you’re experiencing pelvic floor pain after birth.

Try my program Strong Healing Mama if you recently gave birth (starting at 2 weeks postpartum), or Strong Core Mama if you’re any time after 6-8 weeks postpartum! 💪

Strong Healing Mama is a physical therapy program that can help you reduce pelvic floor pain after birth.

Pelvic Floor Physical Therapy Exercises

Here are 3 pelvic floor physical therapy exercises to help you get rid of pain after birth! 

These exercises may look “boring” at first, but this isn’t your traditional workout, it’s a physical therapy REHAB routine to reconnect your breath with your deep abdominal muscles and pelvic floor.

This is how you build a solid base for future decades of healthy movement for your pelvic floor, core, and entire body!

Exercise #1: Supported Child’s Pose

What You’ll Need: A couple of comfortable pillows

  1. Gather a few pillows and kneel on the floor with your knees together
  2. Place the pillows on top of your knees
  3. Lower yourself forward over the pillows into Child’s Pose
  4. Inhale through your nose, focusing on breathing into your rib cage and mid + lower back, especially the tailbone region
  5. Exhale slowly through your mouth
  6. Keep your shoulders down and relaxed (not up by your ears)
  7. Repeat for 5-10 breaths

Exercise 2: Sidelying Transversus Abdominis

What You’ll Need: A small ball (like a pilates ball) and a pillow for your knees

  1. Lie on your side with a pillow between your knees
  2. Hold a small ball against the floor in front of your chest 
  3. Relax your neck and head into your arm or a pillow
  4. Inhale deeply through your nose
  5. As you exhale through your mouth, push the ball into the floor and pull your hip bones together to contract your deep core muscles
  6. Repeat 5 times

Exercise 3: Legs Up the Wall

What You’ll Need: Wall and yoga block or pillows

  1. Lie on your back with your bottom close to the wall
  2. Extend your legs straight up the wall
  3. Lift your tailbone slightly off the floor
  4. Inhale deeply through your nose, focusing on your side ribs and back
  5. Exhale slowly through your mouth, allowing your body to relax
  6. Repeat for 5-10 breaths

You can also try this postpartum ab workout to get your core back!

More Pelvic Floor Pain After Birth Issues

Hemorrhoids Postpartum

Hemorrhoids are swollen blood vessels in or around your anus that can develop during pregnancy or from pushing during delivery. They might cause pain, itching, or bleeding when you go to the bathroom. 

Many moms don’t realize this, but hemorrhoids postpartum ARE a pelvic floor issue! So, physical therapy can help a lot with them. Learning how to lift your children/stroller properly and relax pelvic floor tension is key. 

Staying hydrated, eating fiber-rich foods, and avoiding straining during bowel movements can help with healing as well. 

Pain with Sex Postpartum

Discomfort during sex after having a baby is common but it doesn’t mean that you should ignore it. 

This pain often develops because of pelvic floor muscle tension or tearing, so physical therapy can help address the underlying causes and significantly improve symptoms. Pain with sex postpartum often develops after C-section births.  

PT can help you learn how to relax the pelvic floor through exercise and also through stretches and manual techniques you can do at home. 

Tailbone Pain Postpartum

The pressure of pregnancy and the birthing process can affect your tailbone (coccyx). If this happens, you might feel pain when sitting, standing up, walking, or running

The discomfort might be more noticeable if you had a long labor or if your baby was in a certain position during delivery.

This is another issue where physical therapy can be incredibly helpful in relaxing pelvic floor tension! There are both exercises and manual techniques you can do at home. 

The Importance of Not Doing Too Much Too Soon

One of the most important aspects of postpartum recovery is pacing yourself! I regularly see moms who pushed themselves too hard and too fast after giving birth. Some come to me 5, 10, or even 20 years later, needing extensive rehab work that could have been avoided with proper postpartum care.

Pushing yourself too hard postpartum can look like: 

  • Standing, walking, or babywearing for too long in the early weeks
  • Trying to “bounce back” and get right back into being active
  • Not taking a break from chores 

If you notice increased bleeding, heaviness, or leaking with any of these activities, you should take that as a warning sign and NOT push through! 

The right foundation built in these early months will serve you for years and DECADES to come. Take the time to heal properly and follow an evidence-based program instead of just jumping back into regular activity and hoping for the best!

You can find support in my programs Strong Healing Mama (starting as early as 2 weeks postpartum) and Strong Core Mama (6-8+ weeks postpartum).

Strong Core Mama is an online program that helps you reduce postpartum pelvic floor pain.

FAQs

How do you know if you have a weak pelvic floor after birth?

You might have a weak pelvic floor if you leak urine when you cough, laugh, or exercise, feel pressure in your vagina, or have trouble controlling gas or bowel movements. Contrary to popular belief, issues like pain with sex, tampons feeling loose or falling out, and the feeling that something is bulging or falling down your vagina AREN’T necessarily a weakness issue. It’s more of a “poor coordination” issue. 

Physical therapy can help with all of these issues. 

How do I know if I have prolapse after birth?

Prolapse often feels like heaviness or pressure in your vagina, like something is falling down or out. You might feel a bulge inside your vagina or notice something at the opening. Some women describe it as feeling like they’re sitting on a ball or notice this sensation more at the end of the day or after being on their feet for a long time. It can feel similar to a tampon falling out as well. 

What postpartum symptoms should not be ignored?

Many moms accept certain symptoms as “just part of motherhood,” but they shouldn’t. Leaking when you sneeze, laugh, or exercise isn’t normal! Neither is pain during sex, having a hard time holding in gas, or feeling like your core is weak or unstable. These are all signs that your pelvic floor needs attention, and physical therapy can help resolve them.

If you feel heaviness or pressure in your vagina or like something is falling out, it could be a sign of vaginal prolapse. It’s a serious condition that often requires medical attention, but physical therapy can still be incredibly helpful. 

While these symptoms are common, they’re NOT something you have to live with – they’re treatable conditions that deserve proper care.

How long until pelvic floor returns to normal after birth?

Some mild discomfort is normal in the first few weeks after birth, but you shouldn’t just wait and hope that pelvic floor problems will resolve on their own. Issues like leaking urine, pain during sex, feeling pressure in your vagina, or having pain in your pelvis or tailbone aren’t things that automatically get better with time. These symptoms need proper treatment through pelvic floor physical therapy!

How to get rid of pelvic pain after delivery?

Pelvic floor physical therapy is one of the BEST ways to treat postpartum pelvic pain! A physical therapist can teach you things like proper breathing, gentle mobilizations, strengthening exercises, and ways to modify daily activities while you heal. If you can’t see a physical therapist locally and are looking for another alternative, try my online programs Strong Healing Mama and Strong Core Mama!

Why does my bottom hurt after giving birth?

Pain in your bottom after birth can come from several sources: healing from tears or episiotomy, hemorrhoids, stretched muscles, or pressure on your tailbone during delivery. The area got quite a workout during childbirth and needs time to heal. Physical therapy can help you heal faster!

How do you relieve pelvic girdle pain after pregnancy?

If you had postpartum girdle pain during pregnancy, it can sometimes continue on into postpartum, but there are MANY things you can do to make it better. Physical therapy exercises that focus on stability and building strength throughout the pelvis and the surrounding muscles are the most effective ways to get rid of postpartum girdle pain. 

Woman doing physical therapy online with baby by her side.

Get Support with Pelvic Floor Pain After Birth in Strong Healing Mama

Whether you’ve just given birth or have been dealing with symptoms for years, it’s NEVER too late to start healing! If you’re early postpartum, building a healthy foundation now will help prevent common “mom injuries” such as back/hip pain, prolapse, or incontinence. 

Get more education & exercises in my programs Strong Healing Mama (for 2-8 weeks postpartum) and Strong Core Mama (6+ weeks postpartum)! As you work through the physical therapy exercises, you can ask me questions to get back to movement with confidence.