How Pregnancy and Postnatal Recovery Impact the Pelvic Floor
What Happens, What Helps, and What You Can Do Today
Why This Matters
Here's a stat that might surprise you: nearly 1 in 3 women leak urine in the first year after giving birth, and those symptoms can stick around for decades if the muscles aren't properly rehabilitated. Even more shocking? Only 25 percent of new moms seek pelvic-floor recovery.
This isn't just about inconvenience—pelvic-floor dysfunction affects your mental health, sexual comfort, and ability to get back to the activities you love.
What Actually Happens During Pregnancy
Let's break down what your body is dealing with:
The Growing Load By your third trimester, your pelvic floor is supporting 25-35 pounds of extra weight. That increases your risk of stress incontinence even before delivery.
Hormonal Changes Relaxin and progesterone are doing their job—loosening up collagen to help your body accommodate your growing baby. But this also reduces your baseline pelvic floor tissue strength and stability.
Delivery Impact Here's where things get intense: vaginal birth can stretch the pelvic floor muscle up to 250% of its normal length. Forceps deliveries and prolonged second-stage labor add further risk of pelvic floor dysfunction.
The Postpartum Reality Check
The Symptom Timeline At 12 months postpartum, 74% of women still report at least one pelvic floor dysfunction symptom—whether that's leakage, heaviness, or pain.
The Mental Health Connection A 2024 meta-analysis found something crucial: urinary incontinence doubles your odds of postpartum depression. Your physical and mental health are more connected than you might think.
When Can You Start Recovery? Good news: The American College of Obstetricians and Gynecologists says you can begin light pelvic-floor squeezes within days of uncomplicated deliveries, then progress after your six-week check-up.
What Actually Works (And What's Just Hype)
Structured Pelvic-Floor Training The gold standard: supervised pelvic-floor muscle training that starts in pregnancy and continues for at least 12 weeks postpartum cuts stress-incontinence rates by about 30%.
Audio Guidance Here's something interesting—a 2025 study co-authored by Expect board-certified physical therapist Dr. Nicole Dugan showed that externally focused verbal cues improved both contraction quality and how well women stuck with their programs. That's exactly why Expect’s new Pelvic Floor Rescue program is audio-based.
What May Not Live Up to the Hype Those fancy biofeedback gadgets? Recent Cochrane data suggests they don't add much benefit over well-coached training for most women. And those "quick fix" programs under 4 weeks? Ultrasound shows meaningful muscle growth doesn't happen until around 12 weeks, so ultra-short programs may have little effect.
Your Action Plan
Start Gentle, Focus on Breathing
Re-establish that mind/pelvic floor muscle connection before you worry about strength. Breathe out during each pelvic floor squeeze.
Make It Automatic
Just like you've learned to cover your mouth when you sneeze or cough, train yourself to gently contract your pelvic floor in those same moments. This simple habit can significantly reduce those surprise leaks during sudden increases in pressure.
Get Expert Guidance
Try Expect’s Pelvic Floor Rescue—an audio-only series created by a board-certified pelvic floor physical therapist and approved by a board-certified urogynecologist, designed to fit into the busy, fragmented days of new motherhood.
Know When to Ask for Help
If you're still dealing with leaking, heaviness, or pain after 10-12 weeks, it's time for a pelvic-floor physical therapy referral.
The Bottom Line
Pregnancy and birth put extraordinary demands on your pelvic floor, but dysfunction isn't inevitable. High-quality research confirms that early, well-coached training restores strength, prevents prolapse, and can even lower your risk of postpartum depression.
Every intentional squeeze you do today is an investment in your long-term comfort, control, and confidence. And honestly? You deserve all three.