You do not have to wait until something is wrong—or until after the baby is born—to learn about your pelvic floor.
Pregnancy asks a lot of your body. Your abdominal wall changes, your center of gravity shifts, your breathing mechanics adapt, and the pelvic floor manages increasing load as your baby grows. Those changes are normal, but that does not mean you simply have to tolerate leaking, heaviness, pelvic pain, pressure, or uncertainty about how to exercise.
One of the biggest misconceptions I hear is that pelvic floor therapy means someone is going to tell you to do Kegels. Sometimes strengthening is appropriate. Sometimes it is not.
The pelvic floor needs to be able to contract, relax, lengthen, coordinate with breathing, and respond to changes in pressure. During pregnancy, physical therapy can help you understand what your body is doing now and give you tools that are specific to you—not a generic exercise sheet.
Care may include managing leaking or pressure, improving hip and pelvic mobility, addressing pain, coordinating the pelvic floor with breathing and movement, modifying exercise, learning strategies for daily lifting and activity, and preparing for postpartum recovery. The plan should change as your body and pregnancy change.
A large 2025 systematic review and meta-analysis included 65 studies and 21,334 postpartum participants from 24 countries. Moderate-certainty evidence showed that postpartum pelvic floor muscle training reduced the odds of urinary incontinence by 37% and pelvic organ prolapse by 56% compared with control groups.
The programs in the review varied widely, and pelvic floor training began anywhere from the third trimester of pregnancy through the postpartum period. That matters: there is not one perfect pelvic floor program for every pregnant or postpartum person. The evidence supports pelvic floor training, but the way it is prescribed should make sense for the person in front of us.
Postpartum recovery deserves more than being told to wait six weeks and then return to everything you were doing before. Recovery is individual. Your pelvic floor, abdominal wall, scar tissue if you had a cesarean birth, strength, symptoms, sleep, activity demands, and goals all matter.
Whether you are pregnant, newly postpartum, or months beyond delivery, it is not too early—or too late—to ask questions about how your body is functioning.
Beamish NF, Davenport MH, Ali MU, et al. Impact of postpartum exercise on pelvic floor disorders and diastasis recti abdominis: a systematic review and meta-analysis. Br J Sports Med. 2025;59(8):562-575. doi:10.1136/bjsports-2024-108619. PubMed article
This post was written with AI assistance and reviewed by the Anchor & Heart Physical Therapy team for accuracy.