# Pelvic Floor After Birth: Leaking, Kegels and Returning to Exercise

> Why leaking, heaviness and belly separation happen after birth, how to do Kegels, and when to see a pelvic floor therapist.

Stage: family - Topic: For parents - Page: https://www.askcladle.com/guides/parents/pelvic-floor-after-birth

Grounded in: ACOG guidance on postpartum care and "Exercise After Pregnancy", ACOG patient guidance on pelvic floor disorders and urinary incontinence, and widely used UK return-to-running guidance for postnatal women (2019). Summarized in Cradle's own words; none of these sources endorse Cradle. General information, not medical advice.

Reviewed: 2026-11

## TLDR

- Leaking, urgency and heaviness are common after any birth and often improve; a pelvic floor therapist can help.
- Kegels: squeeze and lift as if holding in gas and pee, hold a few seconds building toward 10, then fully relax.
- Many specialists suggest waiting about 12 weeks for running, jumping or heavy lifting; see your provider soon if you can't pee or have new stool leaking.

## What the pelvic floor does

A hammock of muscles from the pubic bone to the tailbone holds up the bladder, uterus and bowel,
helps control pee, poop and gas, and plays a part in sex. Pregnancy stretches it whether you give
birth vaginally or by C-section.

## Common after birth (and often improving)

- **Leaking urine** with coughing, sneezing, laughing or lifting: about 1 in 3 people in the first
  months.
- **Urgency:** a sudden rush to get to the toilet.
- **Heaviness or a bulge** in the vagina, worse at the end of the day: can be prolapse, which is
  common, often mild and very treatable.
- **Leaking gas or stool**, especially after a third- or fourth-degree tear.
- **Pain with sex** or inserting a tampon.
- **Belly separation (diastasis recti):** a gap or doming down the middle of the belly. Most people
  have some at 6 weeks, and many close a lot by 6-12 months.
Common does not mean you have to live with it. All of these can be helped.

## How to do a pelvic floor contraction (Kegel)

1. Lie or sit comfortably. Breathe normally.
2. Squeeze and lift as if you're holding in gas and stopping pee at the same time. Your belly,
   buttocks and thighs should stay fairly relaxed.
3. Hold for a few seconds, building toward 10. Then let go fully for the same time. The letting go
   matters as much as the squeeze.
4. Add some quick squeezes. Aim for about 10 of each, a few times a day.
- Start gently in the first days if it's comfortable. Don't practice by stopping your pee mid-stream.
- If it hurts or you can't feel anything, a pelvic floor physical therapist can check your technique.

## Everyday habits that help

- **Exhale on effort:** breathe out and gently lift your pelvic floor as you lift the car seat,
  stand up or pick up a toddler.
- **Don't strain on the toilet:** feet on a small stool, lean forward, relax. Treat constipation.
- **Don't hover over the toilet** or pee "just in case" often; it can train urgency.

## Getting back to exercise

- Walking, breathing work and gentle core and pelvic floor exercises can usually start early.
- Build up gradually once your provider clears you. Many pelvic floor specialists suggest waiting
  until about 12 weeks for running, jumping or heavy lifting, after you can walk, balance and do
  simple strength moves without leaking, heaviness or pain.
- For diastasis, focus on breathing and deep core work first; a therapist can tell you when crunches
  and planks fit in.

## Pelvic floor physical therapy

- A pelvic floor PT assesses the muscles (often with an internal exam, only with your consent) and
  gives you a plan. In many U.S. states you can book one without a referral; check your insurance.
- Worth seeing for any of the symptoms above, after a severe tear, or before returning to high-impact
  sport.

## When to check in

- Bring up leaking, heaviness, pain with sex or a belly gap at your postpartum visit, and again at
  any later checkup if it hasn't improved by about 3 months.
- See your provider soon if you can't pee, or have new leaking of stool you can't control.