Key takeaways: Leaking urine, pelvic heaviness, and pain with sex are common after birth but aren’t something you have to live with. Pelvic floor muscle training (Kegels) can help prevent and treat urinary incontinence, according to Cochrane reviews. A pelvic floor physical therapist can teach correct technique and treat symptoms. Talk to your provider at your postpartum visit.
Pregnancy and birth, vaginal or cesarean, put stress on the pelvic floor muscles that support the bladder, uterus, and bowel.
Common Symptoms
- Leaking urine when coughing, sneezing, laughing, or exercising.
- Urgency or frequent urination.
- Leaking gas or stool.
- Pelvic heaviness or bulging (possible pelvic organ prolapse).
- Pain with sex.
- Pelvic or tailbone pain.
These are common but treatable.
Pelvic Floor Muscle Training (Kegels)
A Cochrane review by Woodley and colleagues found that pelvic floor muscle training in pregnancy can help prevent urinary incontinence, and that training may help treat it after birth.
How to do them:
- Find the muscles: imagine stopping the flow of urine or holding in gas. (Don’t regularly practice by stopping urine.)
- Squeeze and lift those muscles, hold for a few seconds, then fully relax.
- Breathe normally; don’t hold your breath or squeeze your belly, buttocks, or thighs.
- Do several repetitions a few times a day, building up gradually.
Relaxing the muscles is just as important as squeezing.
Pelvic Floor Physical Therapy
A pelvic floor physical therapist can:
- Check whether you’re doing exercises correctly.
- Treat tight or painful muscles, not just weak ones.
- Help with prolapse, pain, and returning to exercise.
Many people benefit, especially with ongoing symptoms.
Returning to Exercise
Build up gradually. High-impact exercise like running may need to wait until your pelvic floor is ready. Ask your provider or PT.
When to See Your Provider
- Leaking that doesn’t improve.
- Bulging or heaviness.
- Pain with sex or daily activities.
- Loss of bowel control.
The Bottom Line
Pelvic floor symptoms after birth are common and treatable. Start gentle pelvic floor exercises and ask for a referral to a pelvic floor physical therapist if needed.
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Sources
- Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2020;5(5):CD007471.
- American College of Obstetricians and Gynecologists. Committee Opinion No. 736: Optimizing postpartum care. Obstet Gynecol. 2018;131(5):e140-e150.
- American College of Obstetricians and Gynecologists. Pelvic support problems; urinary incontinence. https://www.acog.org
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
