Short on time? Then the key things to know are:

• A physio postnatal checkup assesses your pelvic floor, abdominal muscles and movement to help you fully recover from birth
• Your physiotherapist will discuss a tailored exercise programme for you to follow
• This includes guidance on resolving any pelvic floor issues such as incontinence and leakage
• Being able to move and exercise without postnatal pain can also lower depression and anxiety after birth

How do you know if a postnatal physiotherapy check is right for you?

In this article, you’ll find out about common postnatal conditions that, if left untreated, can massively impact quality of life - and how a physio check up can help you to recover.

What is a physio postnatal check up?

Pregnancy is a huge change for our bodies, and whether you’re active or not during your pregnancy, it can take some time to recover. We know that pelvic floor healing alone can take 4-6 months after a vaginal delivery, and a Caesarean scar can take 6-7 months to recover to normal strength.

Physiotherapists look at strength, posture, the way you walk and move. A postnatal check up allows your pelvic health physiotherapist to assess your pelvic floor, abdominal muscles and movement to get you back to fitness and out of pain.

How can postnatal physiotherapy help me?

At least 1 in 3 postpartum women will experience bladder incontinence and 1 in 10 women will have some bowel leakage after giving birth. This means pelvic floor issues after giving birth are common! These issues are often resolved completely with physiotherapy guidance.

We also know 1 in 10 women have depression and anxiety in pregnancy and after birth. And that women who complain of muscle pains in the first year after childbirth are also significantly more likely to describe issues with sexual function.

Quality of life can be much improved if you are able to move and exercise as you wish, or at least have the tools and knowledge to ease your own pain. This is where a physiotherapist can help you bridge the gap between not knowing where to start and having a realistic, individualised exercise programme to follow.

What happens at a postnatal check up?

Your physiotherapist will be a specialist in women’s health and the pelvic floor. This means they are able to:

• Check your pelvic floor strength for you
• Check your abdominal wall muscles
• Check any scars or wounds (perineum and/or Caesarean scar)
• Assess how you’re moving in general after going through 9 months of pregnancy
• Give you a timeline of recovery and support you on your return to exercise

You may be asked about what you enjoyed doing for fitness pre-pregnancy, during pregnancy and how your pregnancy was overall. It’s important to know if you were unwell during your pregnancy, or if it was difficult for you to conceive, as this may affect the length of your recovery.

The weight of your baby and the delivery of your little one will also be covered. Your physio needs to understand the strain that your pelvic floor has gone through to be able to give you a timeline of recovery.

Sometimes, this is the first time that new mums can truly recount their honest feelings, so it’s quite normal for your physiotherapist to listen to your emotional as well as physical issues that have come to the surface. Your physiotherapist may also advise you on positions for feeding your baby to avoid neck and shoulder pain.

Postnatal check up FAQ’s

Do I have to have an internal examination?

No, all internal pelvic floor examinations are optional. It is also possible to opt for an online appointment if you’d prefer, however your physiotherapist may suggest a face-to-face session if you are experiencing symptoms that might need to be checked.

How soon can I return to postnatal exercise after birth?

You can start your pelvic floor exercises and gentle walking right away. After 6 weeks, light exercises such as swimming or postnatal pilates are recommended. After a physiotherapy check, you can be guided on higher impact activities such as HIIT, running or netball. If you are experiencing leaking, or have an abdominal separation, please seek physiotherapy guidance on returning to exercise.

Generally, it is not advised to return to running before 12 weeks postpartum after a vaginal delivery and from 6 to 9 months postpartum for Caesarean deliveries.

Why is avoiding constipation important?

Avoiding constipation is very important through pregnancy and during postnatal recovery. This is because constipation puts undue pressure on your pelvic floor and can also worsen piles (hemmoroids). Stay hydrated and ensure you’re getting adequate fibre in your diet.

What if I’m getting leaking?

Your pelvic physiotherapist can guide you on what you need to work on to help this. It is extremely common and can often be solved with specific pelvic floor exercises.

Get support with postnatal physio

NB: This article contains generalised medical advice and may not be suitable for all pelvic floor symptoms; if in doubt please seek professional guidance.

If you are struggling with your postnatal recovery, then please access reputable healthcare support so you can get the right guidance.

There are lots of treatment options available to you. Speak to one of our women’s health physiotherapists at Naytal for personalised support. Or if you find you are struggling with low mood due to your symptoms, our mental health counsellors can help you.

Other resources for support

Your post-pregnancy body - NHS

Exercise and advice after pregnancy - POGP

References

E. Brockwell et al. (2019) Returning to running postnatal – guidelines for medical, health and fitness professionals managing this population

NICE (2021) Overview | Postnatal care | Guidance | NICE

‌Tenfelde, S. et al. (2019) Musculoskeletal Pelvic Pain and Sexual Function in the First Year After Childbirth. Journal of obstetric, gynecologic, and neonatal nursing