Postpartum Pelvic Floor Physical Therapy: Why Every Mom Deserves Real Recovery (Not Just "Do Your Kegels")

By Dr. Jessica London, DPT | Your Postpartum PT

The Gap in Maternal Healthcare Nobody Talks About

Picture this: You've just had a baby. Your body has been through one of the most physically demanding events a human being can experience — nine months of carrying another person, followed by hours of labor, pushing, and either a vaginal delivery or major abdominal surgery. You're discharged from the hospital with a newborn in your arms, a pamphlet, and a six-week follow-up appointment.

That's it.

No rehabilitation team. No physical therapist at your bedside. No one walking you through what your pelvic floor and core just went through and what they need to heal properly. Just a new baby, a whole lot of love, and the unspoken expectation that you'll figure out the rest on your own.

This is the reality for the vast majority of mothers in the United States — and it's a reality that Dr. Jessica London, Doctor of Physical Therapy and founder of Your Postpartum PT, experienced firsthand.

"I had my first baby in 2019, a very unexpected and unplanned cesarean birth," she shares. "I was totally ready for some sort of rehab professional to come in, and no one ever did. Mothers were just meant to figure out their own pelvic floor and core rehab on their own."

At the time, Dr. London was working as an orthopedic physical therapist. She knew with absolute certainty that this wasn't how the human body was meant to recover from surgery — or from any major physical event. And yet, for mothers, this was the standard of care.

The more she opened up about her experience, the more other moms came forward with their own stories. A chorus of "me too, me too, me too" that was impossible to ignore. The pain points were real. The gap in care was real. And it was massive.

That's how Your Postpartum PT was born — not from a business plan or a market analysis, but from lived experience, professional expertise, and a deep conviction that mothers deserve better.

What Is Postpartum Pelvic Floor Physical Therapy?

Before we go further, let's make sure we're all on the same page about what postpartum pelvic floor physical therapy actually is — because there's a lot of confusion out there, and far too many women have been given oversimplified or just plain wrong information.

Your pelvic floor is a group of muscles, ligaments, and connective tissues that form the base of your pelvis. Think of it like a hammock or a sling that supports your bladder, bowel, uterus, and, during pregnancy, your growing baby. These structures work together with your deep core, diaphragm, and hip muscles to create what physical therapists call your "inner core unit."

During pregnancy, this entire system is under sustained load for nine or more months. Your growing uterus increases pressure on the pelvic floor. Hormones like relaxin loosen the joints and ligaments of your pelvis to prepare for birth. Your posture shifts. Your breathing mechanics change. Your center of gravity moves forward.

And then comes delivery — vaginal or cesarean — which introduces its own set of physical demands and potential traumas to the pelvic region.

Postpartum pelvic floor physical therapy is specialized rehabilitation that addresses all of these changes. A pelvic health physical therapist is a licensed PT who has completed advanced training in the assessment and treatment of the pelvic floor and its related structures. In a pelvic floor PT evaluation and treatment, you can expect:

A thorough history and intake. Your PT will ask about your pregnancy, delivery, current symptoms, goals, and lifestyle. This isn't small talk — every detail helps build an accurate picture of what's happening in your body.

An external and functional assessment. Before anything else, your therapist will observe how you breathe, how your core activates, how you move, and how your posture and alignment may be contributing to your symptoms. This external assessment alone is incredibly revealing.

An internal assessment (when appropriate and with full consent). For many pelvic floor concerns, an internal assessment of the pelvic floor muscles — conducted vaginally by a gloved, trained practitioner — gives the most accurate information about muscle tone, strength, coordination, and tenderness. This is never required and always conducted with full explanation, consent, and the ability to stop at any time.

A personalized treatment plan. Based on what your PT finds, they'll design a program specific to your body, your symptoms, your goals, and your life. This is not a one-size-fits-all protocol.

Education, manual therapy, and therapeutic exercise. Treatment may include hands-on techniques, guided exercises, breathing work, behavioral strategies, lifestyle modifications, and education about how your body functions and heals.

This is not the same as googling "postpartum exercises" and following a generic workout plan. This is clinical, evidence-based rehabilitation led by a trained specialist who understands the postpartum body in all of its complexity.

Postpartum is Forever: Why It's Never Too Late to Heal

One of the most powerful and important things Dr. London says — and she says it often, because it needs to be said — is this: postpartum is forever.

If you're reading this and your youngest child is two, five, ten, or even twenty years old, this message is still for you.

The changes that pregnancy and childbirth create in the body don't automatically resolve with time. The pelvic floor doesn't just "bounce back" on its own in most cases. In fact, many women who have been living with pelvic floor dysfunction for years — sometimes decades — assume that their symptoms are just a permanent part of their post-baby reality. They've normalized the bladder leakage. They've avoided the trampoline with their kids. They've stopped running because it's just "not comfortable anymore." They wear panty liners every day and don't even think twice about it.

None of that has to be your story.

Your Postpartum PT works with moms at every stage of their postpartum journey. Whether you gave birth three months ago or thirteen years ago, if you still have pelvic floor concerns — leakage, heaviness, pain, pressure, core weakness, pelvic girdle pain, pain with intimacy — there is absolutely still room for healing and improvement.

The research backs this up consistently. Pelvic floor muscle training, when done correctly and guided by a specialist, is effective in reducing and even resolving urinary incontinence, improving pelvic organ support, and restoring function in women across all ages and stages of postpartum life.

It's not too late. It's not too long ago. Your body still wants to heal — it just needs the right guidance to do it.

The Symptoms Moms Are Told to "Just Live With"

Here's a short list of things that are incredibly common after childbirth — and that many women are told (or assume) are just part of life now:

Urinary leakage. Leaking when you sneeze, cough, laugh, jump, run, or lift. Often called "stress incontinence," this is one of the most common postpartum complaints. Research shows it affects anywhere from 30 to nearly 50 percent of women in the first year postpartum. It is also one of the most treatable pelvic floor conditions.

Urinary urgency and frequency. Feeling like you constantly need to rush to the bathroom. Needing to know where every restroom is before you can relax anywhere. Being woken up multiple times at night to urinate.

Pelvic organ prolapse. A feeling of heaviness, pressure, or "something falling out" in the vaginal area. Prolapse occurs when one or more of the pelvic organs descend into or out of the vaginal canal due to weakened support structures. It is more common than most people realize, and mild to moderate prolapse can often be significantly improved with pelvic floor PT.

Pelvic pain. Pain in the pelvic region, low back, hips, or tailbone that persists after childbirth. Pain with sitting, standing, walking, or certain exercises. This can be related to muscle tension, nerve sensitivity, scar tissue (including from a C-section or perineal tear), or joint dysfunction.

Pain with intimacy. Painful intercourse — or the complete inability to have intercourse — after having a baby is extremely common and rarely talked about openly. It can be caused by scar tissue, muscle hypertonicity, hormonal changes, nerve sensitivity, or a combination of factors. It is also highly treatable.

Diastasis recti. A separation of the rectus abdominis (the "six-pack" muscles) at the midline that occurs as the belly expands during pregnancy. Many women have this to some degree postpartum and notice a coning or doming of the abdomen during certain movements. Left unaddressed, it can contribute to core weakness, low back pain, and pelvic floor dysfunction.

Core weakness and instability. Difficulty activating the deep core. Feeling "wobbly" or unsupported. Low back pain that worsens with activity. Struggling to return to exercise because something just doesn't feel right.

Every single one of these symptoms is treatable. Not one of them is something you simply have to accept as the price of motherhood.

If your provider has told you these symptoms are "just normal after having a baby," we encourage you to seek a second opinion — from a pelvic health physical therapist.

Why "Just Do Kegels" Is Terrible Advice

This needs its own section because it is one of the most persistent and problematic pieces of advice given to postpartum women, and it does real harm.

"Just do Kegels" assumes that every pelvic floor problem is caused by weakness, and that the solution is always to squeeze and contract. But the pelvic floor is far more complex than that.

For many postpartum women, the pelvic floor is not too weak — it is too tight. A hypertonic (overly tense) pelvic floor can cause or contribute to:

• Pain with intercourse

• Urinary urgency and frequency

• Incomplete bladder or bowel emptying

• Tailbone pain

• Low back and hip pain

Prescribing Kegel exercises to someone with an already-tight pelvic floor is like telling someone with a muscle spasm to keep contracting that muscle harder. It doesn't help — it makes things worse.

A proper pelvic floor assessment by a trained physical therapist will determine whether your pelvic floor needs strengthening, relaxation, coordination training, or some combination of all three. Treatment is built around what your body actually needs, not around a one-size-fits-all protocol.

This is one of the most important reasons to work with a pelvic health specialist rather than following generic postpartum exercise advice from the internet or social media. Your body is unique. Your birth experience was unique. Your postpartum symptoms are unique. Your treatment should be too.

Virtual Pelvic Floor Therapy: Meeting Moms Where They're At

One of the cornerstones of Dr. London's philosophy — and the mission statement of Your Postpartum PT — is to meet moms where they're at.

That phrase means something concrete.

A new mom with a six-week-old, two older kids, and zero local childcare options cannot easily drive across town to a physical therapy clinic. A mom who works full-time and uses every ounce of her non-working hours for caregiving and basic survival is not going to carve out a ninety-minute round trip to an appointment. A mom in a rural area may not have a single qualified pelvic health physical therapist within an hour's drive.

These logistical barriers are real. And they are one of the primary reasons so many women never access pelvic health care — even when they desperately need it and want it.

Virtual pelvic floor therapy removes those barriers entirely.

Your Postpartum PT is a 100% virtual practice, meaning sessions happen via secure video call from wherever you are. You don't need to arrange childcare, gas up the car, or sit in a waiting room. You can do your session from your living room floor, your bedroom, or even during nap time.

And before you wonder — "Can virtual PT actually be effective?" — the answer is yes. Significantly so. While an internal pelvic floor assessment cannot be completed virtually (and would require an in-person appointment if deemed necessary), the vast majority of pelvic floor evaluation and treatment can be done through virtual sessions. This includes:

• Observing your posture, alignment, and breathing mechanics

• Assessing functional movement patterns (squatting, hinging, lifting, walking)

• Guiding you through specific pelvic floor exercises and teaching you how to feel them correctly

• Providing education about your symptoms, anatomy, and treatment approach

• Prescribing and progressing a custom home exercise program

• Providing ongoing support, accountability, and coaching

Many of the most meaningful components of pelvic floor rehabilitation — the education, the breathing work, the exercise prescription, the guidance on returning to activity — are entirely achievable in a virtual format. And for busy moms who would otherwise go without any support, virtual access isn't a compromise. It's a lifeline.

Your Postpartum PT serves moms anywhere in the world, breaking down geographical barriers and making high-quality pelvic health care accessible to women who would never be able to access it through a traditional in-person clinic model.

What to Expect from Your First Session

If you've never worked with a pelvic health physical therapist before, the unknown can feel intimidating. What happens in the session? What will they ask you? What will they do?

Let's walk through what you can expect when you work with Dr. London and the Your Postpartum PT team.

Before your session: You'll complete an intake process that helps your PT understand your background — your pregnancy and birth history, your current symptoms, your goals, your lifestyle, and what's been impacting you most. This information allows your PT to come into your first session with context and direction.

The initial conversation: Your first session begins with a thorough discussion. Your PT will ask follow-up questions about your symptoms — when they started, what makes them better or worse, how they affect your daily life, your exercise routine, your sleep, your relationships. She'll ask about your delivery, your recovery, and what you've already tried. She'll also ask about your goals. Not just your physical goals ("I want to stop leaking"), but your bigger picture goals ("I want to get back to running," "I want to be able to lift my toddler without back pain," "I want to feel like myself again").

The assessment: Your PT will guide you through a series of movements and breathing exercises that allow her to observe how your body is functioning. She may watch how you squat, how you get up from the floor, how you breathe when you're under load. She's looking at the whole system — not just the pelvic floor in isolation.

Your personalized plan: Based on everything she observes and learns, your PT will explain what she's found and what she recommends. You'll leave your first session with a clear picture of what's happening in your body, why it's happening, and what the path forward looks like. You'll have a home exercise program to begin working on immediately and a scheduled follow-up to assess your progress.

The ongoing relationship: Healing takes time. Pelvic floor rehabilitation is not a one-session fix. Most clients work with their PT over a period of weeks to months, depending on the complexity of their symptoms and their goals. Your PT will progress your program over time, adjust based on how your body responds, and support you through the full arc of your recovery.

At Your Postpartum PT, the client journey is built on exceptional care at every touchpoint. From your very first inquiry call to your final session, the focus is on making sure you feel heard, supported, and confident in the care you're receiving.

How Postpartum PT Supports Your Return to Sport and Exercise

One of the areas Dr. London is most passionate about is supporting moms who want to return to sport and high-intensity exercise after having a baby.

This is a population that is chronically underserved and chronically given bad advice. Women who were runners, weightlifters, CrossFitters, or athletes before and during pregnancy are often told by well-meaning but under-informed providers to "wait six weeks" and then simply resume their previous activity level. The result is predictable: pain, injury, leakage, prolapse symptoms, and the deep frustration of realizing their body isn't responding the way it used to.

The six-week clearance is not a return-to-sport clearance. It's a healing check — an assessment of whether your uterus has involuted, your incision (if applicable) is healing, and your bleeding has resolved. It says almost nothing about whether your pelvic floor, deep core, and related structures are ready to handle high-impact, high-load activity.

A safe return to sport after having a baby is a graduated, progressive process that takes the demands of the specific sport into account. Running, for example, requires your pelvic floor and deep core to absorb and manage significant impact forces with every step. Weightlifting requires your inner core unit to generate and transmit force through the trunk under load. High-intensity interval training involves jumping, landing, and rapid changes in direction that place significant demands on the entire system.

Postpartum pelvic floor PT addresses the return to sport systematically:

Restoring the foundation. Before high-load activity, the basics need to be solid — pelvic floor coordination, deep core activation, breathing mechanics, hip strength, and movement patterns. This isn't optional and it isn't boring. This is what protects your body and allows you to perform at your best.

Load management. Your PT will help you understand how much load your system can currently handle and guide you through a progressive return that builds capacity over time without overwhelming the tissues.

Symptom monitoring. Any symptoms during or after exercise — leakage, heaviness, pelvic pressure, pain — are important data points that guide the progression of your return. Your PT will teach you what to pay attention to and how to modify activity based on your body's responses.

Sport-specific training. As you progress, your program will incorporate the specific demands of your sport or exercise of choice, ensuring you're prepared for the real-world physical requirements you're working toward.

Whether you want to run a 5K, deadlift twice your bodyweight, compete in your recreational soccer league, or simply chase your kids around without discomfort — postpartum pelvic floor PT can help you get there, safely and sustainably.

The Mindset Shift Every Postpartum Mom Needs

At some point in this conversation, we have to talk about the harder stuff — the reason so many moms know they have pelvic floor symptoms, know they deserve support, and still don't seek it.

Because it's rarely just about logistics or access.

It's about the deep, conditioned belief that taking care of yourself is somehow optional. That as a mother, your needs go at the bottom of the list. That if you're still functioning — still getting through the day, still caring for your children, still showing up at work or in your business — then your symptoms must not be bad enough to warrant attention.

There's also something else that Dr. London articulates beautifully: integrity with yourself.

When we don't do what we say we're going to do — when we promise ourselves we'll address the leakage, we'll start the exercises, we'll make the appointment — and then we don't follow through, we erode our self-trust. And that self-trust is foundational. Not just for our health, but for our businesses, our relationships, and our lives.

"I had to ask myself, do I have self-trust?" Dr. London reflects. "When we do the thing we say we're going to do, we build self-trust. When we don't — even subconsciously — we lose it. And when we lack self-trust in ourselves, it's really hard to extend trust in others."

The mom who has been living with bladder leakage for seven years. The mom who just "puts up with" pain with intimacy. The mom who stopped running because it "just doesn't work anymore." She has learned to normalize something that doesn't have to be her normal. And in normalizing it, she's also quietly teaching her children — especially her daughters — what women are supposed to tolerate.

As Dr. London puts it: "When women really step into their power in that way of taking back control over their body, they do not pass that belief system or that pattern down to their children. And that's the larger impact. It's generational."

Your healing is not just about you. Your body matters enough to be taken care of — not because you've "earned" it, not because things have gotten bad enough, not because you've finished everything else on your to-do list. It matters because you are a human being who deserves to live in a body that feels good, functions well, and allows you to show up fully in every area of your life.

The work starts with the decision to begin.

Taking the First Step: How to Get Started

If you've read this far, something in these pages resonated with you. Maybe you've been living with symptoms for months or years. Maybe you're newly postpartum and want to start your recovery the right way. Maybe you're a mom who returned to running and something just doesn't feel right. Maybe you've never had anyone explain to you that what you're experiencing isn't something you simply have to accept.

Wherever you are, here's what we want you to know:

It's not that hard to solve. We have a tendency to make our problems feel bigger and more permanent than they are. Pelvic floor dysfunction is incredibly common — and incredibly treatable. The path forward exists, and it starts with showing up for yourself and asking for help.

You don't have to drive across town. Your Postpartum PT is 100% virtual. Sessions happen wherever you are, on your schedule, without arranging childcare or sitting in a waiting room. We built this practice specifically for moms who don't have time for one more appointment — because we knew that was the biggest barrier standing between so many women and the care they needed.

You deserve to be taken care of. You are so used to taking care of everyone else. Your children, your family, your job, your business. Let someone take care of you for once. All you have to do is take that next step.

Postpartum is forever — and that means it's never too late. Even if you're years postpartum. Even if you've "tried everything." Even if you've been told this is just how things are now. That doesn't have to be true.

Here's how to get started:

You can book a Pelvic Health Audit with Dr. London — an intake call where she'll get to know you, dive into the details of your symptoms and goals, and determine whether one-on-one support with Your Postpartum PT is the right fit for you. There is no pressure and no obligation. Dr. London's commitment is to point you toward the right resource and support for your needs, whether that's with her team or elsewhere.

If you're in the earlier stages of exploring your options and aren't quite ready for one-on-one care, Your Postpartum PT also offers a self-led option designed for moms who want to begin taking steps toward healing on their own timeline.

You can find Dr. London on Instagram at @yourpostpartumpt — where she shares education, tips, and real talk about pelvic health, postpartum recovery, and what moms actually deserve from their healthcare.

Her podcast, What About Mom?, is also back and available wherever you listen to podcasts.

The care you need is available. The specialist is here. The access is easier than it has ever been.

The only thing left is for you to take that first step.

Frequently Asked Questions About Postpartum Pelvic Floor Physical Therapy

Is postpartum pelvic floor PT covered by insurance?

Coverage varies depending on your insurance plan and where you live. Many insurance plans do cover physical therapy with a referral, though pelvic floor PT is still considered a specialty service. Your Postpartum PT is a virtual practice, so it's worth checking with your insurance about telehealth coverage for physical therapy. We always encourage clients to check their benefits and ask about out-of-network reimbursement options if needed.

How soon after birth can I start pelvic floor PT?

You can begin pelvic floor PT earlier than most people realize. Virtual pelvic floor PT that focuses on education, breathing, gentle activation, and posture can begin in the first few weeks after birth, even before your six-week OB clearance. Starting early helps you understand your body, begin gentle recovery, and set the foundation for a progressive return to full activity. More advanced exercise and manual therapy typically begins after your six-week clearance, but starting sooner with the educational and foundational components is absolutely appropriate for most women.

Do I need a referral or prescription to see a pelvic floor PT?

In most states, you can see a physical therapist directly without a referral through what's called "direct access." However, your insurance may require a referral for coverage purposes. It depends on your location and your specific plan. You can contact your insurance directly or reach out to our team, and we can help guide you through the process.

I had a C-section. Do I still need pelvic floor PT?

Yes — absolutely. C-section is major abdominal surgery that has a significant impact on the core, the pelvic floor, the diaphragm, and the fascial system of the entire trunk. C-section scar tissue can adhere to surrounding structures and contribute to a wide range of symptoms, including low back pain, hip pain, bladder dysfunction, pelvic pain, and pain with intimacy. Pelvic floor PT addresses all of these and includes scar tissue mobilization as part of the treatment approach when appropriate. Many women who had C-sections are completely unaware that pelvic floor PT is relevant for them — it is, deeply so.

I'm 5 / 10 / 15 years postpartum. Is it too late for me?

It is never too late. The body is remarkably adaptable, and the pelvic floor responds to rehabilitation at any age and any stage of the postpartum journey. If you've been living with symptoms you assumed were permanent, please reach out. You may be surprised at what is possible.

What if I'm not sure whether my symptoms are a pelvic floor issue?

That's exactly what the Pelvic Health Audit call is for. Book a call with Dr. London, describe what you're experiencing, and she'll help you understand whether pelvic floor PT is appropriate for you and what the path forward looks like. There is no downside to asking the question.

The Bottom Line

The postpartum care gap in the United States is real, significant, and causing unnecessary suffering for millions of mothers. Women are discharged from the hospital with no rehabilitation plan, told that their symptoms are "normal," and left to figure out their recovery on their own.

It doesn't have to be this way.

Your postpartum body deserves the same quality of rehabilitation that any post-surgical or post-injury patient would receive. Your pelvic floor, your core, your whole body went through something significant. And with the right support, it can heal, strengthen, and return to full function — regardless of how long ago you gave birth.

Postpartum is forever. And so is the possibility of healing.

If you're ready to take the next step, we're here — wherever you are.

📱 Instagram: @yourpostpartumpt 🎙️ Podcast: What About Mom? 📅

Dr. Jessica London is a Doctor of Physical Therapy specializing in pelvic health for the pregnant, postpartum, and return-to-sport community. Your Postpartum PT is a 100% virtual practice serving moms anywhere in the world. Because postpartum is forever — and so is your right to heal.