Recover With Confidence

Supporting your recovery after pregnancy and birth.

Whether you’re preparing for birth, six weeks postnatal, or two years on and still don’t feel right, pelvic health physiotherapy can help you understand what has changed and build a practical pathway back towards the things you want your body to do.

Pregnancy and birth affect much more than one muscle. Your pelvic floor, abdominal wall, breathing, connective tissues and the way your body manages pressure and load all adapt — and recovery isn’t the same for every woman.

Our role is to understand how your body has recovered, identify anything still limiting you, and help you move forward with confidence.

Nobody Really Checked, Did They?

You had your postnatal check. Your midwife signed you off. Everyone’s attention understandably moved towards the baby.

Meanwhile, you might still be leaking when you sneeze, your abdomen doesn’t feel like your own, sitting or sex may be uncomfortable, or perhaps you tried to run and something simply didn’t feel right.

It’s common to wonder:

Is this just what happens after having a baby?

Some changes are part of normal recovery.

Others deserve a closer look.

And many of the things women assume they simply have to live with can improve with appropriate rehabilitation.

It also doesn’t matter if your baby is six weeks, six months or several years old.

If something still doesn’t feel right, it’s worth understanding why.

Understanding What’s Changed

Pregnancy and birth change several systems at once.

Your abdominal wall stretches to accommodate your growing baby.

Your pelvic floor carries increasing load throughout pregnancy and undergoes substantial stretch during vaginal birth.

Your connective tissues adapt under hormonal influence.

Your ribcage and breathing mechanics change, along with the way you generate and manage pressure through your abdomen and pelvis.

If you had a caesarean birth, your pelvic floor still carried the pregnancy and you also have an abdominal wall incision and scar to recover from.

If you had a vaginal birth, your recovery may also involve perineal tearing, an episiotomy, pelvic floor muscle injury or changes in pelvic organ support.

None of this resolves simply because six weeks have passed on the calendar.

Two women who give birth on the same day can have completely different rehabilitation needs.

Assessment helps us understand yours.

Can I Prepare During Pregnancy?

Yes.

Pregnancy can be an excellent time to understand your pelvic floor before birth rather than waiting until something becomes a problem afterwards.

Antenatal pelvic health physiotherapy may include:

Understanding how your pelvic floor is currently functioning

Learning how to contract and, just as importantly, fully relax it

Coordinating your pelvic floor with breathing

Managing pelvic girdle or back discomfort

Maintaining exercise as your body changes

Preparing for the physical demands of birth

Perineal preparation where appropriate

Planning for postnatal recovery and return to activity

This can be particularly useful if you’ve had a difficult previous birth, pelvic floor symptoms during pregnancy or simply want to understand how best to prepare.

We work alongside your midwife, LMC or obstetric team — not instead of them.

Is the Six-Week Check Enough?

Your postnatal check with your GP, midwife or other maternity provider is important.

But it isn’t necessarily a detailed pelvic floor rehabilitation assessment.

At six weeks, tissues are still recovering and your pelvic floor and abdominal wall haven’t necessarily regained the strength, coordination or capacity required for running, heavy lifting or high-impact exercise.

Being medically cleared to return to activity doesn’t automatically mean your body is ready to return immediately to everything it did before pregnancy.

A pelvic health assessment looks more specifically at how your body is functioning now and what may need rebuilding before you increase the demands on it.

What Are We Looking For After Childbirth?

There isn’t one single “postnatal problem”.

Depending on your pregnancy, birth and recovery, we may be looking at several different areas.

Pelvic Floor Function

Can your pelvic floor contract effectively?

Can it relax?

Can it sustain activity?

Does it respond at the right time?

Can it coordinate with your breathing and manage increases in pressure during lifting, coughing and exercise?

For some women, the pelvic floor is genuinely weak.

For others, it may be overactive, painful or poorly coordinated.

The answer isn’t always more strengthening.

Abdominal Separation

Abdominal separation — also called diastasis recti, rectus diastasis or DRAM — is the widening and thinning of the connective tissue running between the abdominal muscles.

It occurs commonly during pregnancy and is a normal adaptation to making room for your growing baby.

For most women, the separation reduces substantially during the early months after birth.

But the width of the gap isn’t the whole story.

We are also interested in how well your abdominal wall generates tension and transfers load, how it coordinates with your breathing and pelvic floor, and how it behaves during the activities you want to return to.

Real-time ultrasound can help us measure the separation and observe how the abdominal wall behaves under load.

Rehabilitation focuses on rebuilding function and capacity, not simply trying to “close a gap”.

Perineal Tears, Episiotomy & OASI

Perineal tearing during vaginal birth varies considerably.

Tears are generally described as:

First degree — involving skin.

Second degree — involving skin and perineal muscle. An episiotomy also involves an incision through these tissues.

Third degree — extending into the anal sphincter.

Fourth degree — extending through the anal sphincter into the lining of the bowel.

Third- and fourth-degree tears are collectively known as obstetric anal sphincter injuries (OASI).

Although these injuries are repaired after birth, they can have longer-term effects on pelvic floor function, bowel urgency, control of wind and, for some women, bowel leakage.

Perineal or episiotomy scars can also remain tender, tight or restricted after the tissues have healed, contributing to discomfort with sitting, movement or intimacy.

These are all things we can assess and incorporate into your rehabilitation.

What Is a Levator Ani Avulsion?

The levator ani forms a major part of the pelvic floor.

During vaginal birth, part of this muscle can sometimes separate from its attachment to the pubic bone. This is called a levator ani avulsion and can occur on one side or both.

For some women, this may contribute to persistent pelvic floor weakness, heaviness or prolapse symptoms, or help explain why the pelvic floor hasn’t responded to rehabilitation as expected.

An avulsion isn’t something exercise can simply reattach.

But knowing that an injury is present can change the rehabilitation strategy.

The focus becomes making the most of the muscle function that remains, improving coordination and load management, and building a realistic pathway around the activities that matter to you.

Understanding the injury prevents us from asking your body to solve the wrong problem.

Why Am I Still Leaking Months or Years Later?

Bladder leakage after childbirth is common.

That doesn’t mean it should automatically be accepted as your new normal.

Persistent leakage may involve:

Reduced pelvic floor strength or endurance

Poor timing or coordination

An overactive pelvic floor that isn’t relaxing effectively

Changes in pelvic organ support

Birth-related injury

Breathing and pressure-management strategies

The demands of running, jumping, lifting or other activity exceeding your current capacity

These factors can be assessed.

If bladder leakage is one of your main concerns, you can also read our dedicated Bladder Control page.

What About Pain or Sex After Childbirth?

Sexual discomfort after birth can have several contributors.

Healing tissues, perineal or caesarean scars, pelvic floor overactivity, reduced tissue lubrication — particularly while breastfeeding — fear of pain and changes in pelvic floor function can all play a role.

Persistent pain deserves assessment rather than simply being tolerated.

The aim isn’t just to make an examination comfortable.

It’s to help you return to intimacy with greater comfort, confidence and trust in your body.

If this is your primary concern, you can also read our Comfortable, Confident Intimacy page.

When Can I Start Running Again?

There isn’t one date that applies to every woman.

Returning to running is less about reaching a particular week on the calendar and more about whether your body is ready to repeatedly manage impact without leakage, heaviness, pain or loss of control.

Before progressing to running, we may look at things such as your ability to:

Walk briskly without symptoms

Perform repeated calf raises

Control single-leg movements

Squat and load effectively

Hop and jog on the spot

Manage impact without leakage, heaviness or pain

If something provokes symptoms, that isn’t failure.

It’s useful information about what still needs rebuilding.

We identify what’s missing, build capacity progressively, and work towards the running, sport or exercise you want to return to.

The goal is not to keep you away from exercise.

It’s to prepare your body for it.

How We Assess Your Recovery

We don’t begin by assuming what childbirth has done to your body.

We assess it.

Understanding Your Birth & Recovery

We’ll talk through your pregnancy and birth, including anything relevant such as:

Vaginal or caesarean birth

Perineal tears or episiotomy

Forceps or ventouse

Your healing

Bladder and bowel function

Abdominal symptoms

Pelvic heaviness or prolapse symptoms

Pain or sexual discomfort

Exercise and activity

What you’re trying to get back to

If your birth was difficult, you can tell us as much or as little as you feel comfortable discussing.

Objective, Non-Invasive Assessment

Whenever appropriate, we can begin with objective, non-invasive assessment.

Real-time ultrasound can help us observe pelvic floor movement, contraction, relaxation and coordination.

It can also be used to assess abdominal separation and observe how the abdominal wall behaves during breathing, movement and loading.

Biofeedback may provide additional objective information about pelvic floor recruitment and control.

We also look at how your pelvic floor, diaphragm and abdominal system work together during movement and how you manage pressure during the activities relevant to your symptoms and goals.

Will I Need an Internal Examination?

Not necessarily.

There is a great deal we can learn through your history, movement assessment, real-time ultrasound and biofeedback without an internal examination.

In some situations, an internal vaginal assessment can provide additional information about pelvic floor muscle function, pain, scar tissue, pelvic organ support or birth-related muscle injury.

If we think it would provide information likely to change your rehabilitation, we’ll explain why.

It remains your choice.

You can consent, decline or defer it.

Nothing happens without your understanding and consent.

Your Personalised Recovery Pathway

Once we understand what’s changed, we can build rehabilitation around what your body actually needs.

Your pathway may include:

Pelvic Floor Rehabilitation

Improving strength, relaxation, endurance, timing and coordination according to your assessment.

Abdominal Wall Rehabilitation

Rebuilding abdominal function, breathing, pressure management and capacity following pregnancy or caesarean birth.

Scar & Tissue Rehabilitation

Helping improve comfort, mobility and sensitivity around perineal, episiotomy or caesarean scars where needed.

Breathing, Pressure & Movement

Improving how your pelvic floor, diaphragm and abdominal wall work together during lifting, exercise and everyday activity.

Biofeedback & Rehabilitation Technology

Real-time ultrasound, biofeedback, MAPLe or PelviPower may be incorporated where they provide useful information or help progress rehabilitation.

Bladder & Bowel Rehabilitation

Addressing leakage, urgency, emptying, constipation or bowel-control concerns where these are part of your recovery.

Return to Exercise

Progressively rebuilding the strength, load tolerance and impact capacity required for running, gym training, sport or whatever you want to return to.

A Practical Home Programme

Rehabilitation designed around real life — including the reality that sleep, time and routine can be unpredictable with a baby in the house.

Where appropriate, we work alongside your midwife, LMC, GP, obstetrician, gynaecologist or other healthcare providers.

You don’t need to know which approach is right for you before booking. That’s our job.

What Improvement Can I Expect?

The goal isn’t to make your body exactly as it was before pregnancy.

It’s to help you feel strong, capable and confident in the body you have now.

That may mean:

Exercising without leaking

Running again

Lifting your baby or toddler confidently

Feeling stronger through your abdomen

Reducing heaviness or pelvic pressure

Improving bowel control

Sitting comfortably

Returning to intimacy without pain

Trusting your body again

How much improvement you can expect depends on what happened during pregnancy and birth and what has changed since.

Many women recover very well with appropriate rehabilitation.

Some have injuries or structural changes that can’t be completely reversed, but even then there may be a great deal we can do to improve function, confidence and capacity.

After your assessment, we’ll explain what we think is realistic for you.

ACC Support After a Maternal Birth Injury

Some physical injuries sustained during labour or birth on or after 1 October 2022 may qualify for ACC support.

If your injury is eligible, ACC contributes towards the cost of your pelvic health physiotherapy rather than covering the full CoreGood appointment fee.

At CoreGood, an accepted ACC claim currently reduces your investment in each treatment session by $30.

You don’t need a GP referral to discuss this with us. If your presentation appears consistent with an eligible maternal birth injury, we can explain the ACC pathway and whether a claim may be appropriate.

If ACC doesn’t apply, you can still access exactly the same assessment and rehabilitation privately.

Which Maternal Birth Injuries May Be Covered?

ACC eligibility depends on the circumstances of the injury and current ACC criteria.

Pregnancy-related pelvic girdle pain, back pain and abdominal separation (DRAM) on their own are not generally included within the maternal birth injury scheme.

If you’re unsure whether your situation may qualify, you don’t need to work it out before contacting us.

Frequently Asked Questions

How soon after birth should I have an assessment?

Around six weeks is a common time for a fuller postnatal pelvic health assessment.

If you’re experiencing significant pain, problems with wound healing, difficulty emptying your bladder or bowels, significant heaviness or something simply doesn’t feel right, contact us earlier so we can advise you on the appropriate next step.

And if your baby is already two, five or fifteen, it isn’t too late.

I Had a Caesarean. Do I Still Need Pelvic Floor Rehabilitation?

Possibly.

Your pelvic floor carried increasing load throughout pregnancy regardless of how your baby was delivered, and a caesarean also involves abdominal surgery and a scar.

Assessment tells us whether anything actually needs rehabilitation rather than assuming that it does.

Will My Abdominal Gap Close?

For most women, abdominal separation reduces substantially during the months following birth.

But the width of the gap isn’t the only thing that matters.

We’re also interested in how well the abdominal wall generates tension, manages load and coordinates with your breathing and pelvic floor.

The goal of rehabilitation is a functional abdominal wall, not simply the smallest possible gap.

When Can I Go Back to Running?

There isn’t one date that applies to every woman.

Rather than relying only on the calendar, we look at whether you can manage the strength, single-leg control and impact demands required for running without leakage, heaviness or pain.

Then we build your return progressively.

Can I Bring My Baby?

Yes. Babies are welcome.

Feeding, settling and nappy changes are part of life with a baby and don’t need to stop you attending your appointment.

Will I Need an Internal Examination?

Not necessarily.

We can learn a great deal using your history, movement assessment, real-time ultrasound and biofeedback.

If an internal assessment would provide additional information likely to change your rehabilitation, we’ll explain why and ask for your consent.

It remains your choice.

Does ACC Cover My Postnatal Physiotherapy?

ACC may contribute towards treatment when your symptoms relate to an eligible maternal birth injury sustained during labour or birth on or after 1 October 2022.

ACC does not cover the full CoreGood treatment fee.

For an accepted claim, the ACC contribution currently reduces your investment in each treatment session by $30.

If you’re unsure whether your birth injury qualifies, ask us. We can discuss whether an ACC claim may be appropriate.

If ACC doesn’t apply, you can still access the same assessment and rehabilitation privately.

Ready to Take the First Step?

You don’t need to know exactly what changed during pregnancy or birth before asking for help.

Your first appointment is about understanding how your pelvic floor, abdominal wall and body have recovered, identifying anything that’s still limiting you, and building a practical pathway towards the things you want to get back to.

You’ll leave with a clearer understanding of what’s happening, practical things you can start working on and a plan for what comes next.