Pelvic Floor Physical Therapy Immediately Postpartum
Pelvic Floor Physical Therapy Immediately Postpartum

What are the benefits of Pelvic Floor Physical Therapy Immediately Postpartum?


Before, during, and after delivering a child, whether it be a c-section or vaginal delivery, your pelvic floor takes on a lot of stress! The pelvic floor acts as a sling-like structure to support your internal organs. It is composed of 5 layers of muscles, yes FIVE! There are 14 different muscles that make up the pelvic floor. Due to the stress put on the pelvic floor during pregnancy and through labor and delivery, the muscles can become very weak. The muscles may also become hypertonic or hypotonic – which is just a fancy way of saying the muscles may become overactive or underactive. Because of that, many OB/GYN clinicians may recommend pelvic floor physical therapy immediately postpartum. 


Although most physicians recommend 6 weeks of rest following delivery, there are still low level exercise activities that you can begin immediately postpartum (even while you’re in the hospital!) to improve your pelvic floor function. 


Exercises to Help Immediately Postpartum


Below is a list of a few activities to begin after giving birth that will help to optimize your pelvic floor range of motion, strength, endurance, and function. 


  • Diaphragmatic breathing 
    • Diaphragmatic breathing – also known as belly breathing – can be very beneficial for your pelvic floor range of motion. When you utilize the diaphragm to breathe, this downregulates your entire body due to its connection to the body’s autonomic nervous system. It can help to relax the different muscles in the body, including pelvic floor muscles, to prevent or decrease hypertonicity and pain. 


  • Kegels 
    • Kegels are a simple exercise in which you contract the pelvic floor muscles (think of “stopping the flow of urine”). This will help to strengthen the pelvic floor. You can do quick contractions of the muscles (contract and then relax – repeating this 10-15x) to address the first, outermost layer of pelvic floor muscles. You can also practice holding the contraction for 5-10 seconds. Holding a pelvic floor contraction (Kegel) for 5-10 seconds will improve the endurance of all of the muscles which can improve the support of the pelvic floor. This will be beneficial during activities such as standing, walking, and exercising. 


  • Bulge/bearing down 
    • Bulging or bearing down – which can be used interchangeably – refers to lengthening the pelvic floor muscles. This is the same action that one will do when passing gas. It may feel strange at first, but is very important in preventing hypertonicity of the muscles. This can be performed 10-15x, holding for about 5 seconds each time.


These three activities can be very beneficial in kick-starting the healing process of the pelvic floor immediately postpartum. These activities can be combined as well! For example, if you are practicing diaphragmatic breathing, you can complete the kegels while you are exhaling and the bulge as you inhale. This takes quite a bit more concentration and practice, but is an easy way to group all of these exercises together! It is important to complete each of these, and not just one, as they ALL address important aspects of pelvic floor function – including the strength, length, and endurance of the muscles. 


And, if you are local and want to learn more about our Pelvic Floor Physical Therapy services, feel free to reach out or book an appointment online.


Susannah Azofeifa, PT, DPT was born and raised in Owensboro, Kentucky but now calls North Augusta, SC home. She attended the University of Louisville and graduated with a bachelor’s degree in Kinesiology/Exercise Science in 2017. She then attended Breanu University where she received her doctorate of physical therapy in 2021. Susannah enjoys treating a wide range of orthopedic conditions and also specializes in treating pelvic floor dysfunction, and pre and post partum individuals. She enjoys spending time doing activities such as CrossFit, being outdoors, traveling, being with family, and spending time with her husband, Fabian. She heads up our Pelvic Floor Physical Therapy (PFPT) program here at ProActive.

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Rafi Salazar OT

Rafael E. Salazar II, MHS, OTR/L (Rafi) is the CEO & President of Proactive Rehabilitation & Wellness, as well as the Principal Owner of Rehab U Practice Solutions and the host of The Better Outcomes Show. Rafi’s career trajectory includes 10+ years of experience in healthcare management, clinical operations, programmatic development, marketing & business development. He even spent some time as an Assistant Professor in a Graduate Program of Occupational Therapy and has served on numerous boards and regulatory committees. Today, Rafi helps innovative healthcare companies humanize healthcare through his consulting workHe also leverages his experience as a professor and academic to speak and train on the topics around humanizing the healthcare experience.

Rafi also authored the book Better Outcomes: A Guide to Humanizing Healthcare