Postnatal physiotherapy

What else can you do?   

• Follow the advice in the  Fit for the Future leaflet.   
• Start your pelvic floor exercises early.  This will help your recovery. See the videos below for information on how to do this.

• Download the NHS Squeezy App for reminders to do your pelvic floor exercises.   
• Change position regularly, rest when you can. 
• Follow these tips for posture and movement -

• Remember to drink water, little and often and try to eat a mixed diet, including protein to help with muscle recovery.  
• Avoid constipation which will put more strain on your pelvic floor.  Read the NHS Constipation leaflet or watch this video -

• These tips are great for immediate recovery following your delivery.  For information about returning to exercise, look at the postnatal exercise section at the bottom of this page. 

Caesarean Section 

Caesarean section is major surgery to the abdominal wall. It is important to gradually get back to normal activities, allowing time for your body to heal and recover. The videos and leaflets below will give you advice and education on your posture, activities of daily living and how to prepare for your return to work and exercise. They will also show you some gentle exercises to begin to help your back, pelvic floor and tummy muscles recover. 

What can you do? 

• Follow the advice in this Scottish Government video - 

• Watch this NHS Fife video about the importance of following Physiotherapy Advice After Your Caesarean Section -

• Follow the advice and exercises in the  Fit for the Future leaflet 
• Follow these tips about posture and moving - Posture and positioning during pregnancy and following the birth -

• Avoid constipation - Constipation during and after pregnancy -

• For information on returning to driving read:  Driving following a c-section 
• These tips are great for immediate recovery following your delivery.  For information about returning to exercise, look at the postnatal exercise section at the bottom of this page. 

Abdominal Muscle Separation 

Also known Diastasis Recti, Diastasis Rectus Abdominus Muscles, DRA or DRAM. 

During pregnancy and labour it is normal for the abdominal/tummy muscles to stretch and the ligament between the bands of muscle to widen to make space for your growing baby. All women have some degree of separation between the bands of muscle at 35 weeks pregnant and 39% at 6 months postnatal (Mota et al 2014). This is called Diastasis Recti. 

If your tummy ligament has become wider or weaker you may notice your tummy “doming” or a ‘gap’ in your tummy muscles when you do things that require lots of abdominal activity e.g. sitting up from lying, coughing or straining to move your bowels.

You can follow the exercises in the leaflets below, stage 1-3

What can you do? 

1. Follow the advice and exercises in the Fit for the Future leaflet

Follow these tips about posture and moving - Posture and positioning during pregnancy and following the birth -

• Avoid constipation - Constipation during and after pregnancy -

Work your way through the exercise leaflets below. Work on stage one exercises until you can do them easily without any tummy bulging or doming. As they get easier move on to stage two then eventually the advanced exercises in stage three. 

Stage one

Stage two

Stage three

3rd and 4th degree perineal tear 

If you have had a 3rd or 4th degree tear during the delivery of your baby, you will be contacted by one of the specialist urogynaecology nurses at approximately 8-10 weeks following your delivery to check if you still have any symptoms or need any further help.

What can you do? 

• Follow the information in the NHS Fife Third and Fourth Degree Tear Leaflet. 
• Read the RCOG Patient Information Leaflet on 3rd and 4th Degree Tears. 
• Starting pelvic floor exercises early is an important part of your recovery  Pelvic Floor Exercises POGP leaflet. 
• Avoid constipation - Constipation during and after pregnancy -

• Follow the advice in the vaginal delivery section above. If you are having any issues at your review appointment the specialist nurse will refer you to pelvic health physiotherapy for assessment and further treatment. 

Bladder, bowel or vaginal problems after pregnancy 

Incontinence – leakage of urine (pee) or feaces (poo) or vaginal prolapse – the feeling of heaviness or a lump in the vagina after pregnancy are common but NOT normal. It is estimated that up to one third of women will suffer from some degree of incontinence following childbirth.

Bladder and vaginal problems during and after pregnancy - 

Most – around 80% of people can improve or cure these problems by following the advice here.  

What can you do? 

• Follow the information section relevant to the type of delivery you have had. 
• Pelvic floor muscle strengthening is important in the recovery of your pelvic floor and it is important that you do them correctly. For information on correct techniques please read Pelvic Floor Exercises POGP leaflet. 
• It can take 3-6 months of daily pelvic floor strengthening for it to be effective. You might find this challenging with a new baby. The NHS Squeezy App may help you with technique, motivation and consistency. 
• If you are experiencing any problems with incontinence or are concerned about your pelvic floor then please see you midwife or GP for a referral to the pelvic health physiotherapy service. 

Postnatal exercise

Physical recovery after pregancy will take time, but there is a lot you can do to help you recover and regain your fitness which could reduce the risk of physical problems later. 

What can you do? 

• In the beginning, focus on good posture, relaxed breathing into the bottom of your lungs and gradually building up your exercise level with walking or swimming - after any bleeding has stopped.  
• Read the Chief Medical Officers' Guidance on Physical Activity After Childbirth. 
• Try these exercises POGP Pilates Exercises in Womens Health Physiotherapy. 
• Follow the advice in the This Mum moves website 
• Read this blog and look at the infographic about Returning To Running After Having A Baby. 
• If you have had a late miscarriage or still birth, this is a useful leaflet to follow POGP Exercise and Advice after Pregnancy.