When to see a pelvic floor physiotherapist after birth

Leaking when you sneeze. Pain during sex. A strange heaviness or pressure. These things happen to a lot of people after giving birth. They are also treatable. You do not just have to live with them.

Pelvic floor physiotherapy (also called pelvic floor PT or pelvic health physiotherapy) is specialized physical therapy focused on the muscles, ligaments, and connective tissue of the pelvic floor. After birth, these structures can be weakened, stretched, or overactivated in ways that cause real symptoms. A pelvic floor PT can assess what is actually going on and give you a personalized program to address it.

Signs you should see a pelvic floor PT

Any of these are reasons to book an appointment. None of them are just normal parts of having a baby that you have to accept.

• Leaking urine when you cough, sneeze, laugh, or exercise (stress urinary incontinence).
• Sudden urgent need to urinate that is hard to control (urge incontinence).
• Pain during sex or penetration (whether that is weeks or months postpartum).
• Pelvic pain, pressure, or heaviness, especially when standing or by end of day.
• Tailbone pain (coccydynia) that is not resolving.
• Abdominal separation (diastasis recti) that is affecting your core function.
• Scar tissue pain from a cesarean birth or perineal tear.
• Difficulty with bowel movements or leaking stool.
• You just want to make sure your recovery is going well.

When can you start?

You can often book your first appointment as early as 6 weeks postpartum, sometimes sooner depending on the provider and your situation. You do not have to wait for your 6-week check. If you had a cesarean birth, timing may be slightly different because of abdominal healing, but your PT will guide you.

It is also never too late. People seek pelvic floor PT years or even decades after birth and still see meaningful improvements. If symptoms have been bothering you for a while, that is not a reason to give up. That is a reason to go now.

What to expect at your first appointment

Your first session will usually include a detailed history of your pregnancy, birth, and current symptoms, followed by an external and often internal assessment (with your full consent and control throughout). The internal examination is not like a pap smear. It is a careful assessment of muscle tone, coordination, and tissue health. You can stop or pause at any point.

From there, your PT will explain what they found and create a plan. This might include specific exercises, manual therapy, lifestyle guidance, and strategies for managing symptoms day to day. Most people see meaningful improvement within a few sessions.

Does insurance cover it?

In Canada, pelvic floor physiotherapy is not covered under provincial health plans, but many extended benefit plans cover it under physiotherapy or physiotherapist services. Check your plan details and ask for a referral from your family doctor or OB if required.

In the United States, coverage depends on your insurance plan. Some plans cover it under physical therapy benefits, especially if there is a clear diagnosis like incontinence or pelvic pain. Call your insurer before booking to understand your coverage.

Find a pelvic floor physiotherapist

Search the Cradld directory for pelvic floor physiotherapists near you: