Pelvic floor first

Pregnancy and birth stretch the pelvic floor whatever the mode of delivery. Leaking urine when you cough or laugh is common at this stage and is not something to live with: pelvic floor exercises, ideally guided by a physiotherapist or midwife, resolve it for most women. In several countries this rehabilitation is prescribed and covered.

Moving again

Walking can start as soon as you feel able. The WHO advises building back to 150 minutes of moderate activity a week after birth, gradually. Wait for the postnatal check, and for the pelvic floor to hold, before running or jumping; after a caesarean, give it at least six weeks and your doctor's go-ahead.

Contraception and breastfeeding

Fertility can return before the first period, even while breastfeeding. Exclusive breastfeeding protects only up to six months, with no periods and feeds no more than four hours apart. Progestogen-only methods, the copper or hormonal IUD and condoms are compatible with breastfeeding; combined pills are usually delayed until six weeks, or six months if breastfeeding, per WHO eligibility criteria.

How to do pelvic floor exercises day to day

The principle is simple: squeeze the muscles you would use to hold in wind or stop a flow of urine, without clenching your buttocks or thighs and without holding your breath. The NHS suggests combining slow squeezes, held for a few seconds and then fully released, with quick squeezes in a row. The release matters as much as the squeeze; a pelvic floor that cannot relax causes problems of its own.

Consistency makes the difference, not intensity. Many women attach the exercises to something they already do, such as feeding the baby, brushing their teeth or waiting at traffic lights. Do not, however, stop your urine mid-flow on the toilet to test yourself: that habit interferes with emptying the bladder properly.

If you cannot feel the squeeze, or if you notice heaviness or a bulging sensation at the entrance of the vagina, speak to your midwife or doctor rather than pushing on alone.

What is normal and what deserves an appointment

A few leaks on exertion in the first months are part of recovery, as are a sense of weakness or a more urgent need to pass urine. What should prompt you to seek advice, without waiting for the postnatal check: leaks that do not improve despite the exercises, difficulty holding in wind or stools, pain during sex, or the feeling that something is coming down.

None of these symptoms is shameful or rare, and all of them are easier to treat early. A midwife, doctor or specialist physiotherapist can examine the pelvic floor, check any scar and adapt your programme, and refer you onwards if needed.

If heavy bleeding starts again, or you have a fever, severe pain or a painful, swollen calf, contact a healthcare professional or emergency services straight away: those signs are not a matter for rehabilitation.

Getting back to sport in stages

The WHO notes that doing some activity is better than none, and that people should start small and gradually increase frequency, duration and then intensity. In practice, walking with the pram, an exercise bike or swimming once bleeding has stopped and any wound has healed are good starting points. Then add gentle strengthening, such as adapted core work and bodyweight exercises, before considering high-impact sport.

Watch for three signals during and after a session: leaking, heaviness in the pelvis, or pain that is still there the next day. Any of them means the step is too big for now; go back to the previous level and mention it to your midwife or physiotherapist.

A well-fitted sports bra makes exercise more comfortable while breastfeeding, and drinking before and after a session helps make up for sweat and milk production.

Choosing contraception in practice

The question often comes up at the postnatal check, but nothing stops you raising it earlier with your midwife or doctor. The right time to fit an intrauterine device, start an implant or begin a pill depends on how you gave birth, whether you are breastfeeding and your medical history; that is exactly what the WHO eligibility criteria help the professional assess.

Prepare the conversation with three questions. Do you want a method you do not have to think about every day? Are you hoping for another pregnancy soon, or not at all? Have you had side effects with a method in the past? Your answers guide the choice far better than what friends or family use.

If a method causes unusual bleeding, pain, severe headaches or a marked dip in mood, do not simply stop it without alternative protection: ask for a prompt appointment to switch.

Frequently asked questions

How long does pelvic floor rehabilitation take?

It varies from one woman to another and depends on the starting point. The professional following you assesses the strength and coordination of the pelvic floor and adapts the number of sessions. Home exercises then continue long term: the pelvic floor is maintained like any other muscle, well after supervised care ends.

Can I do pelvic floor rehabilitation after a caesarean?

Yes. Pregnancy itself places strain on the pelvic floor regardless of how you gave birth. Rehabilitation is useful after a caesarean, and the abdominal scar gets particular attention too. Ask your doctor or midwife when to begin, depending on how your wound is healing.

Will urinary leaks go away on their own?

They often improve with time, but pelvic floor exercises speed recovery considerably and resolve the problem for most women. If leaks persist or get worse, talk to your midwife or doctor rather than waiting it out: effective options exist.

When can I start running again after birth?

After the postnatal check, once the pelvic floor holds without leaks or heaviness and brisk walking feels comfortable. Restart with short outings alternating walking and running. After a caesarean, wait for your doctor's go-ahead. If you feel pain or leak, step back to the previous stage.

Does breastfeeding really protect against another pregnancy?

Only under strict conditions: exclusive breastfeeding, no periods and a baby under six months, with frequent feeds day and night. As soon as one of those conditions no longer applies, protection becomes uncertain. Discuss an additional method with your midwife or doctor.

Can I take the pill while breastfeeding?

Progestogen-only pills are compatible with breastfeeding. The combined pill, which contains oestrogen, is usually delayed according to WHO eligibility criteria, particularly if you are breastfeeding. Your doctor or midwife will choose with you based on your personal history.

This article gives general information. It does not replace advice from a healthcare professional.

Sources

Sources checked on 2026-09-06.