Your pelvic floor after birth: when to start exercising and how to return to sport

After giving birth, many women find their body takes time to recover: leaking a little when they cough, a heavy feeling low down, or difficulty tightening the muscles as before. These changes are common, and exercises and professional support help in many cases. Here is when and how to start.

What happens to the pelvic floor

Pregnancy and birth can weaken the muscles that help you hold in urine (NHS). NICE lists birth-related risk factors: an assisted vaginal birth (forceps or vacuum), a baby lying face up, a second stage of labour lasting more than an hour, and injury to the anal sphincter. Having a baby after 30 also raises the risk (NICE NG210).

Signs to look out for: leaking urine, wind or stools; a frequent or sudden need to go; a heavy or bulging feeling in the vagina; and pain. You do not have to put up with them.

When to start pelvic floor exercises

• After a straightforward birth, the NHS says you can start gentle exercise — including walking, gentle stretches and pelvic floor exercises — as soon as you feel up to it (NHS).
• After a caesarean or a more complicated delivery, recovery takes longer; talk to your midwife or doctor before doing anything strenuous (NHS). Return to everyday activities when they no longer feel uncomfortable, which may take around 6 weeks (NHS).
• NICE recommends encouraging pelvic floor training before discharge and during routine postnatal care, and discussing the pelvic floor at every postnatal contact. A 3-month supervised programme should be considered after an assisted vaginal birth, a face-up baby or an anal sphincter injury (NICE NG210).

If you exercised during pregnancy, that was worthwhile too: for women without incontinence, antenatal training probably slightly lowers the risk of incontinence 3 to 6 months after birth (Woodley et al., 2020).

How to do the exercises

Based on NHS guidance (NHS):

• squeeze as if you were holding in wind and stopping the flow of urine;
• long squeezes: hold for as long as you can, but no longer than 10 seconds, then relax;
• short squeezes: squeeze quickly and let go straight away;
• build up to 10 repetitions of each, at least 3 times a day;
• keep breathing normally and do not pull in your stomach. Doing them straight after using the toilet can be a good reminder.

Your tummy muscles and diastasis

During pregnancy, the growing womb pushes apart the two long muscles down the middle of the stomach, usually by about two finger widths. The gap usually returns to normal by 8 weeks after the birth. To check it, lie on your back with your knees bent, lift your shoulders slightly and use your fingertips to feel how many fingers fit between the muscle edges above and below your belly button. Check now and then that the gap is getting smaller. If it is still obvious 8 weeks after the birth, contact your GP, who can refer you to a physiotherapist. Regular pelvic floor and deep stomach muscle exercises can help reduce the gap. At first, avoid sit-ups, planks and high-impact exercise, as well as straining on the toilet and heavy lifting (NHS).

Returning to sport

• Running, jumping and other high-impact activity too soon after birth may reduce pelvic floor strength and increase the risk of incontinence and prolapse (Pelvic Floor First).
• Until your postnatal check at around 6 weeks, stick to low-impact activity such as walking, and get advice at that check before starting high-impact exercise (NHS).
• Build back up to high-impact exercise gradually, over roughly 3 to 4 months after the birth (Pelvic Floor First).
• Leaking, heaviness or pain during exercise are signs to ease off and talk to a professional.

Staying active after birth has benefits: WHO links physical activity in the postpartum period with a lower risk of postpartum depression, among other things (WHO).

When to see a doctor

• leaking urine, wind or stools;
• a heavy or bulging feeling in the vagina;
• a gap in your tummy muscles that is still obvious 8 weeks after the birth;
• sex is still painful at your postnatal check (NHS).

KegelFit offers a Kegel exercise timer and video workouts for the pelvic floor and the whole body. It helps you keep a routine, but it does not measure muscle strength or check your technique. Free to download, with in-app purchases: Google Play · App Store.

Sources

1. NHS. Your post-pregnancy body (reviewed 20 July 2026). https://www.nhs.uk/baby/support-and-services/your-post-pregnancy-body/
2. NHS. Keeping fit and healthy with a baby (reviewed 20 April 2026). https://www.nhs.uk/baby/support-and-services/keeping-fit-and-healthy-with-a-baby/
3. NHS. Caesarean section: recovery (reviewed 4 January 2023). https://www.nhs.uk/tests-and-treatments/caesarean-section/recovery/
4. NHS. Urinary incontinence (reviewed 15 June 2023). https://www.nhs.uk/conditions/urinary-incontinence/
5. NICE. Pelvic floor dysfunction: prevention and non-surgical management (NG210), 2021. https://www.nice.org.uk/guidance/ng210
6. Woodley SJ, et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2020;5:CD007471. https://doi.org/10.1002/14651858.CD007471.pub4
7. Continence Health Australia. Pelvic Floor First: Returning to sport or exercise after birth. https://www.pelvicfloorfirst.org.au/pages/returning-to-sport-or-exercise-after-birth.html
8. WHO. Physical activity. Fact sheet, 26 June 2024. https://www.who.int/news-room/fact-sheets/detail/physical-activity