Return to Activity After Giving Birth

Return to Activity After Giving Birth: Guidelines from a Pelvic Floor Physiotherapist

Prepared by Julia McDaniels, Physiotherapist

Having a baby can be a wonderful and life-changing event. It can also be hard on your body, especially when it comes to getting back to your normal activities. As a pelvic health physiotherapist, I want to share some guidelines to help you return to activity safely and effectively after giving birth.

Understanding Your Body After Birth: Post-Natal Pelvic Health Conditions

Your body goes through many changes during pregnancy and childbirth. It’s important to give yourself time to heal.

To help you understand your body, here is some basic pelvic floor anatomy, and a list of pelvic health conditions commonly experienced after giving birth.

The Pelvic Floor - Basic Anatomy

The pelvic floor muscles are a group of muscles that attach to the front, back, and sides of the pelvic bone and sacrum. These muscles wrap around your urethra, rectum, and vagina, and act like a hammock to support these organs. They contract to maintain continence and relax for urination, bowel movements, and penetration.

The pelvic floor stabilizes the pelvis, supports organs, aids in orgasm, pumps blood flow, and controls the openings of the urethra, vagina, and rectum.

Pelvic Floor Dysfunction

Pelvic floor dysfunction refers to any changes in your pelvic floor that you perceive as negative. These changes can be due to pregnancy, a C-section, or vaginal delivery. Symptoms include pelvic pain, sexual dysfunction, pelvic organ prolapse, and bowel and bladder changes. Causes include increased muscle tension, muscle weakness, and sensitivity changes – areas may become more sensitive or less sensitive.

Diastasis Recti

Diastasis Recti (DR/DRA) is the separation of your abdominal muscles.  Specifically, the right and left rectus abdominis muscles separate due to the stretching and thinning of the linea alba, which is one of the tissues that holds them together.  DR is a natural adaptation during pregnancy.

For some women, the gap between the abdominals closes quickly after birth, while for others, it remains.  If the DR remains after birth, this can affect how those abdominal muscles function. 

I am frequently asked about DR by clients – they want to know how long it will last, what it means for their activity, and if there’s anything they can do to address it. 

Painful Scars

Scars from a C-section or perineal tear/episiotomy can cause pain, sensitivity, and tension.


Dyspareunia is pain with intercourse or other forms of vaginal insertion/penetration.

Pelvic Organ Prolapse

Pelvic organ prolapse is when the pelvic organs – such as your bladder or uterus - descend lower than they were before.  It may also include slackening of the back vaginal wall.

Pelvic Organ Prolapse is a functional problem, not a disease. Symptoms like heaviness, pressure, or bulging from the vagina may affect how you feel and function, day-to-day.

Stress Incontinence

This is the involuntary loss of urinary control with physical motions such as coughing, sneezing, bending, jumping, or running. Stress incontinence is very common after giving birth, but is not normal and can be treated.

Post-Natal Return to Activity Guide

Everyone’s body and experience after birth will be unique, and I strongly recommend working with a pelvic health physiotherapist to customize your return-to-activity program to you.  However, here are some general guidelines that apply to most people after giving birth.

Symptoms to Monitor

If you experience any of the following symptoms, seek help from a medical professional:

  • Pain Pressure/heaviness or bulging 
  • Leaking (urine, stool, or gas) 
  • Any changes in urinary or bowel function 
  • Sexual dysfunction

Physical Activities Progression: What You Can Do When

Here is a general schedule for how you can likely progress your movements and activities after giving birth:

Week 0-2

  • Basic pelvic floor and core exercises
  • Gentle walking

Week 2-4

  • Progress core/pelvic floor exercises and walking
  • Add low-impact bodyweight exercises like squats, bridges, and lunges

Week 4-6

  • Add low-impact exercises like cycling, elliptical, and gentle dance

Week 6-8

  • Scar mobilization and soft tissue work
  • Power walking and increased intensity in other cardiovascular exercises
  • Resistance training (weight training)

Week 8-12

  • Continue to increase the intensity of previous exercises
  • Can add swimming or spinning 

Week 12+

  • Gradual introduction of impactful exercises like running, jumping, or sport-specific activities
  • This stage can take several months or even years

Pelvic Floor Awareness Exercise

Physiotherapist Julia McDaniels teaches this pelvic floor awareness exercise.

The set of pelvic floor exercises that will be right for you will depend on what symptoms you experience after birth – everyone is a bit different.  However, everyone can benefit from this exercise to increase your awareness of your pelvic floor.  Good pelvic floor awareness will make it easier for you to learn other pelvic floor exercises later on.

Perform this exercise smoothly and gently, focusing more on coordination and awareness than strength.


  • Allow expansion through the lower ribs, belly, and pelvic floor
  • Perineum lowers
  • Sit bones widen
  • Pubic bone and tailbone move further apart
  • Allow urine to flow faster
  • Allow gas to pass
  • Imagine a ping pong ball dropping from the vagina


  • Contract the pelvic floor (squeeze and lift) and draw in the belly button
  • Perineum rises
  • Sit bones narrow
  • Pubic bone and sit bone move closer together
  • Stop the flow of urine
  • Hold in gas
  • Imagine drawing a ping pong ball up and into the vagina

Remember: Inhale to lengthen and exhale to contract.


By following the above guidelines and being mindful of your body's signals, you increase your chance of returning to your favorite activities, safely and effectively.

To ensure your pelvic health program is customized to your body and your symptoms, book an appointment with a pelvic health physiotherapist.  In fact, a check-up with a pelvic health physiotherapist is medically recommended for everyone post-partum, to address or prevent common symptoms.