Postpartum Pelvic Floor Exercises
- Melissa Hines
- Nov 5
- 6 min read
By Hannah McDuffie, PT, PRPC, OMT
The postpartum period - also referred to as the ‘fourth trimester’ - can certainly be overwhelming! On top of caring for a newborn baby, your body is working very hard to recover from both pregnancy and childbirth. Regardless of whether you had a vaginal delivery or Cesarean delivery, your pelvic floor muscles will need some rehab! Continue reading for more information on taking care of your pelvic floor after birth.
What is the Pelvic Floor?
The pelvic floor is a group of muscles at the base of your pelvis. If you imagine your pelvis as a bowl, the pelvic floor muscles make up the bottom of the bowl. These muscles are important for bladder and bowel control, sexual function, organ support, and postural stability. In fact, the pelvic floor is often an overlooked muscle group when it comes to your ‘core’.
During pregnancy, your pelvic floor is working really hard to support your growing uterus and fetus, as well as to provide additional postural stability as your pregnancy evolves. These muscles will be tired - and potentially weak or tight (or both!) - following your birth. Although we recommend seeking individualized pelvic floor therapy to help recover during the postpartum period, below you will find safe exercises that will help with early healing and re-training.
If you experience any pain with the exercises listed below, do not continue
Postpartum Exercises Weeks 0-1
You may be surprised to learn that you can start with some gentle movement day one postpartum while still in the hospital! The goal in the early days postpartum is to promote blood flow for healing and to reconnect with your body.
These movements are safe for both vaginal and cesarean births. If you had a C-section, be mindful of how your incision feels with movement, and only move through a comfortable range.
Relaxed Breathing:
In a comfortable position, gently inhale through your nose and exhale through your mouth.
Place your hands over your abdomen. As you inhale, think about filling your belly with air, and feel your belly rise underneath your hands. Let the air out through your mouth as you exhale.
Next move your hands to your ribcage. Feel your ribcage widen into your hands as you inhale.
This should feel relaxed. Repeat for 1-2 minutes.
Gentle Stretching:
Reclined Butterfly: Lie on your back with your feet together and knees apart in a butterfly position. Option to place a pillow under each knee for more support.
Happy Baby: Hug your knees towards your chest. If it feels okay, separate your knees and reach for your shins, ankles, or feet to deepen the stretch.
Child’s Pose: Start on your hands and knees, separate your knees, and then move your hips back towards your hips. Allow your chest to rest towards the floor.
In each pose, take 5-10 deep breaths.
Mobility:
Windshield wipers: Lie on your back with your knees bent. Separate your feet towards the edges of the bed or mat and let your knees touch. Slowly move your knees towards the right, allowing your pelvis and lower back to rotate. Move as far as feels comfortable, and then repeat towards the left. Repeat 5-10 times.
Open Books: Lie on your side in a fetal position with your arms extending straight in front of your chest. As you inhale, open your top arm towards the ceiling and rotate through your spine, looking at your hand as you open. Exhale as you stretch further into the rotation. Repeat 5-10 times on each side.
Cat Cow: While on your hands and knees, start to take gentle deep breaths. On an inhale, lift your head and tailbone towards the ceiling and allow your ribcage to move towards the floor creating an arch in your back. On your exhale, tuck your chin and tailbone as you lift your belly button to your spine and allow your back to round. Repeat 5-10 times.
Postpartum Exercises Weeks 1-2
Now that you’ve taken a few days to (hopefully) relax following your birth, it is a great time to reconnect with your abdominal and pelvic floor muscles. Both these muscle groups stretch to accommodate your pregnancy, and so it’s really important to start engaging these muscles early on to build awareness and eventually strength!
Deep Core Activation:
To engage your core you will start with the same relaxed breathing from early on. Inhale through your nose and feel your abdomen and ribcage expand. On your exhale, engage your core by pulling your belly button towards your spine. Inhale again and relax.
Imagine there is a zipper from your pubic bone to belly button, and engaging your core is closing the zipper.
Repeat 10-15 repetitions. This can be done in various positions: lying down, tabletop, sitting, or standing. It’s also beneficial to engage your core with daily activities such as getting out of bed or bending and lifting your baby.
Pelvic Floor Activation:
Continue the same breathing and core engagement, however this time also contract your pelvic floor when you exhale.
To contract your pelvic floor, imagine you are trying to stop the flow of urine. Repeat the deep core and pelvic floor activation for 10 repetitions with your breathing, being sure to relax your pelvic floor after each contraction. (If you find this difficult to coordinate, you may need individualized pelvic floor therapy!)
Next, place a pillow between your knees (sitting or lying down). Add a gentle squeeze of the pillow during your exhale and pelvic floor contraction, and relax everything on your inhale. Repeat 5-10 repetitions.
Walking:
Walking is a great way to ease back into movement in the first few weeks postpartum, as well as get some Vitamin D! Start with 5-10 minute walks the first week, and then add 5-10 minutes each week if your body is feeling okay.
If you experience any pain, vaginal heaviness, or bladder leaks with walking that does not resolve within the first month postpartum, it is recommended to seek out pelvic floor therapy.
Postpartum Exercises Week 3-6
As your mobility improves and soreness reduces, you can start to perform additional bodyweight exercises to continue building core and pelvic floor strength and awareness, as well as lower body strength.
Core and pelvic floor strengthening
Supine marching: Lying on your back with your knees bent and feet flat on the floor, alternate bringing one knee towards your chest as you exhale and engage your core.
Birddog: In a tabletop position, reach one arm forward as you exhale and engage your core, alternating sides. Repeat this with your legs, extending one leg straight behind you on an exhale. To challenge your core and balance, combine extending your opposite arm and leg at the same time.
Wall plank: With your hands against the wall, walk your feet back until you are in a plank position (one straight line from your head to your heels). Engage your core and slightly tuck your tailbone. Hold this position for 10-15 seconds while breathing. To progress your plank, perform this against a counter, table, or couch. The lower the surface, the more challenging.
Lower body strengthening
Glut bridges: Lying on your back with your knees bent and feet flat on the floor, squeeze your gluts and lift your hips off the floor as you exhale. Try to engage your core and pelvic floor at the same time you lift your hips. Repeat 10 times.
Sit to stand: Start seated in a chair or on the couch. Inhale to prepare. As you exhale, gently engage your core and pelvic floor and then stand up tall. Squeeze your gluts at the top. Repeat 10 times.
Squats: Stand in front of a chair with your feet apart. Inhale to prepare. As you exhale, hinge at your hips and bend your knees to touch your hips to the chair. Repeat 10 times.
Option to add light resistance to these movements starting with 5-10 lbs and progressing from there.
Remember that your body has been through a lot in the last year! It will take time, consistency, and a little bit of patience to recover and rebuild your strength and mobility. At Wellest, we believe everyone deserves individualized care following the birthing experience. Contact us today to start your postpartum recovery journey!
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