Ms Charlotte Chaliha Gynaecologist with subspecialty expertise in urogynaecology in NW8 St John's Wood London

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Published: 22/09/2026
Edited by: Odette Sotillo on 22/09/2026

Postpartum pelvic floor issues are problems affecting the muscles and tissues that support the bladder, bowel and pelvic organs after pregnancy and childbirth. They can include urinary or bowel incontinence, pelvic organ prolapse, pelvic pain and sexual difficulties.

Pregnancy and childbirth place significant strain on the pelvic floor, and symptoms can occur after both vaginal and caesarean births. Some problems improve as the body recovers, but persistent or troublesome symptoms should be assessed rather than accepted as an unavoidable part of having a baby.

What symptoms can occur after childbirth?

Postpartum pelvic floor symptoms vary considerably, but common problems include:

Urinary leakage, particularly when coughing, sneezing, laughing, exercising or lifting.
Urinary urgency or frequency, including a sudden need to pass urine.
Bowel control problems, such as difficulty controlling wind or leakage of stool.
A vaginal bulge or pressure, which may indicate pelvic organ prolapse.
Pelvic or perineal pain, including discomfort during sexual intercourse.
Difficulty emptying the bladder or bowel or reduced sensation in the pelvic area.

These symptoms can be temporary during the early postnatal period, but ongoing leakage, pain or a feeling of pressure should not be dismissed. Early assessment can help identify the cause and provide appropriate treatment.

Why do pelvic floor problems happen after pregnancy and childbirth?

Pelvic floor problems can develop because pregnancy and childbirth stretch or weaken the muscles, connective tissues and nerves supporting the pelvic organs. Risk can be increased by factors such as an assisted vaginal birth with forceps or vacuum, a baby being in a face-up position during vaginal birth, or injury to the anal sphincter.

The pelvic floor can also be affected by the length and circumstances of labour, the size and position of the baby and previous pelvic floor problems. However, symptoms can occur without a single identifiable cause, so an individual assessment is important.

How are postpartum pelvic floor problems diagnosed?

Diagnosis usually starts with a discussion of symptoms, pregnancy and birth history, followed by an examination of the pelvic floor and surrounding tissues. The assessment may include checking whether the pelvic floor muscles can contract and relax effectively and looking for signs of pelvic organ prolapse.

If urinary incontinence is present, a urine test may be recommended to check for conditions such as a urinary tract infection. Further investigations are considered when symptoms suggest another underlying problem or when the initial assessment does not provide enough information.

How are postpartum pelvic floor problems treated?

Treatment depends on the symptoms, their severity and the underlying cause. Options may include:

Supervised pelvic floor muscle training, particularly for stress or mixed urinary incontinence.
Bladder training for urinary urgency or mixed urinary incontinence.
Pelvic health physiotherapy, which can assess muscle strength, relaxation, coordination and pain.
Lifestyle and bowel management, including appropriate fluid intake and avoiding constipation.
A vaginal pessary for some women with symptomatic pelvic organ prolapse.
Further specialist treatment or surgery when symptoms are severe or do not improve with conservative measures.

NICE recommends supervised pelvic floor muscle training for at least three months as a first-line treatment for stress or mixed urinary incontinence. Training should be tailored to the individual, including the ability to contract and relax the muscles correctly.

What can you do to support pelvic floor recovery after childbirth?

Practical measures that can support recovery include:

Gradually returning to physical activity rather than immediately undertaking high-impact exercise.
Avoiding constipation and straining when opening the bowels.
Following an individualised pelvic floor exercise programme.
Seeking medical advice before returning to strenuous exercise if significant symptoms are present.

When should you seek medical help for postpartum pelvic floor symptoms?

Medical advice should be sought if urinary or bowel leakage persists, a vaginal bulge or pressure develops, pelvic pain continues, or symptoms interfere with daily activities, exercise or sexual intercourse. Women who have experienced an obstetric anal sphincter injury should receive appropriate follow-up, particularly if bowel control is affected.

If symptoms are affecting quality of life or are not improving with recovery and pelvic floor exercises, assessment by a GP, obstetrician and gynaecologist or pelvic health physiotherapist can help determine the most appropriate next steps.

If you are experiencing symptoms or have concerns about your pelvic floor after childbirth, visit Ms Charlotte Chaliha’s Top Doctors profile to book a consultation.