Pelvic Floor Health: What Every Woman Needs to Know (Before and After Birth)

Pelvic floor health is one of the most important — and most overlooked — aspects of women’s wellbeing.

Many women only begin learning about their pelvic floor during pregnancy, or worse, after symptoms begin. Yet research shows that pelvic floor training is beneficial from adolescence onwards, not just during or after pregnancy.

Understanding how this group of muscles functions — and how to support it properly — can dramatically improve long-term bladder, bowel, sexual and core health.

Let’s break it down clearly and simply.

What Is the Pelvic Floor?

The pelvic floor is a group of muscles and connective tissue that forms a supportive “sling” at the base of the pelvis.

It stretches:

• From the pubic bone at the front

• To the tailbone at the back

• Between the sitting bones side-to-side

The main muscle group, called the levator ani, works alongside a smaller muscle called the coccygeus. Together, they form a muscular diaphragm that closes the bottom of the pelvis.

These muscles support:

• The bladder

• The bowel

• The uterus and vagina

But support is only one part of their function.

The pelvic floor also:

• Controls urine, stool and gas

• Contributes to sexual sensation and function

• Assists with posture and spinal stability

• Helps regulate pressure inside the abdomen

It is not an isolated muscle group — it is part of a coordinated system.

The Pelvic Floor Is Part of Your Core System

Many women are told to “just do your Kegels.” While pelvic floor exercises can be helpful, strength alone is not the goal.

Healthy pelvic floor function depends on coordination.

The pelvic floor works closely with:

• The diaphragm (your breathing muscle)

• Deep abdominal muscles (particularly the transversus abdominis)

• Deep spinal stabilisers

  
  

When you breathe in, the diaphragm moves downward and the pelvic floor lengthens slightly. When you breathe out, the diaphragm rises and the pelvic floor gently recoils.

This natural rhythm helps regulate intra-abdominal pressure — which is essential for lifting, coughing, exercising, and even speaking.

Dysfunction can occur not only when the muscles are weak, but also when they are:

• Overactive or too tight

• Poorly coordinated

• Unable to relax fully

This is why simply “squeezing harder” is not always the solution.

Common Symptoms of Pelvic Floor Dysfunction

Pelvic floor dysfunction is extremely common — particularly after pregnancy and birth — but common does not mean normal.

Symptoms may include:

Bladder Symptoms

• Leaking urine (with coughing, sneezing, exercise)

• Sudden urgency

• Frequent urination

Bowel Symptoms

• Constipation

• Difficulty emptying

• Accidental leakage

Pelvic Organ Prolapse

This occurs when pelvic organs descend into the vaginal space due to reduced support. Symptoms can include:

• A dragging or heavy sensation

• A visible or palpable bulge

• Pelvic pressure

Sexual Symptoms

• Pain during intercourse

• Reduced sensation

• Vaginal dryness

Many women assume these symptoms are simply “part of motherhood.”

They are not something you have to tolerate.

In many cases, symptoms are significantly improvable with the right rehabilitation and support.

Why Breathwork Matters After Birth

Pregnancy changes breathing mechanics.

As the uterus expands, the ribcage often flares and breathing becomes more upper-chest or abdominal dominant. After birth, restoring coordination between the diaphragm, abdominal wall and pelvic floor is one of the most important early recovery steps.

A simple starting exercise:

1. Place your hands around your ribcage.

2. Inhale through your nose and feel the ribs expand in all directions.

3. Exhale slowly through your mouth and feel the ribs soften inward.

4. At the end of the exhale, gently draw the lower abdomen inward and lift the pelvic floor.

5. Fully relax everything on the inhale.

The key principles:

• The lift should be gentle.

• Full relaxation is essential.

• Breathing should remain smooth and natural.

Research shows that pelvic floor contraction is more effective when coordinated with breath — not performed in isolation.

C-Section Recovery: Why Scar Care Matters

After a Caesarean birth, scar mobility is an important but often neglected part of recovery.

The body’s connective tissue (fascia) forms a continuous network. When scar tissue becomes tight or restricted, it can alter movement patterns and affect nearby structures — including the pelvic floor.

Restricted scar tissue may contribute to:

• Core weakness

• Pelvic discomfort

• Altered muscle recruitment

Gentle scar massage (once healed and approved by your clinician) can:

• Improve tissue mobility

• Enhance circulation

• Support neuromuscular re-connection

• Improve abdominal wall engagement

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Breastfeeding, Oestrogen and Bladder Symptoms

Breastfeeding reduces oestrogen levels.

Oestrogen plays a key role in maintaining the health and integrity of vaginal and urethral tissues. Lower levels can lead to:

• Vaginal dryness

• Thinner, more sensitive tissue

• Bladder irritation or urinary infection

• Increased urgency or leakage

For some women, local vaginal oestrogen can significantly improve symptoms. This is safe for many breastfeeding mothers but should be discussed with your family doctor or gynaecologist.

Hormones matter — and symptoms during breastfeeding are not uncommon.

Daily Habits That Impact Pelvic Floor Health

Small daily behaviours can either protect or overload the pelvic floor.

Helpful habits:

• Adequate hydration

• A fibre-rich diet

• Using a small footstool during bowel movements

• Allowing the pelvic floor to fully relax when urinating

Habits to avoid:

• Going “just in case”

• Straining

• Hovering over toilets

• Constantly sucking in your stomach

Chronic abdominal gripping increases intra-abdominal pressure and can overload the pelvic floor over time.

Early Prolapse Symptoms After Birth

If you notice heaviness or prolapse-type symptoms in the first three months postpartum, this does not automatically mean permanent damage.

The early postpartum period involves tissue healing and hormonal fluctuations. With appropriate rehabilitation, symptoms often improve significantly.

You can also have mild prolapse without symptoms — and this does not automatically mean intervention is required. Early support is key.

When to Seek Professional Support

If symptoms persist, a structured rehabilitation programme is recommended.

Pelvic floor physiotherapists can assess whether muscles are:

• Weak

• Overactive

• Poorly coordinated

Further assessment by a gynaecologist may include:

• Detailed history

• External and internal examination (with consent)

• Bladder scan

• Urine testing

• Occasionally specialised bladder function testing

Treatment options range from conservative to minimally invasive:

Conservative

• Pelvic floor rehabilitation

• Vaginal oestrogen

• Bladder medications

• Pessary devices (removable vaginal support devices many women find life-changing)

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Minimally Invasive

• Bladder Botox injections

• Urethral bulking injections

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Surgical (if required)

• Prolapse repair

• Sling procedures

Surgery is usually considered only after conservative measures.

And importantly — there is nothing embarrassing about any of this.

This is about quality of life.

How We Can Support You

We offer:

✨ 1-to-1 tailored pelvic health support Individualised rehabilitation plans designed around your body, your birth history and your goals.

✨ Pregnancy preparation packages Medically led, coaching-informed guidance through pregnancy, including how to optimise pelvic floor function before birth.

✨ Postnatal recovery pathways Breathwork, core restoration, scar support and graded return to exercise.

✨ Small group workshops Supportive, educational sessions covering pregnancy, birth preparation and postpartum recovery.

If you’re unsure where to start, we recommend booking a Discovery Call. This allows us to understand your concerns and guide you towards the most appropriate support pathway.

If you’re ready to feel stronger, more informed and more confident — we are here to help.