Postpartum Core & Pelvic Floor Recovery: What Every Woman Needs to Know

Why Postpartum Care Deserves More Attention

As conversations around women’s health continue to evolve, one area still remains under-discussed: postpartum recovery. While access to information and care is improving, many women are still left navigating healing after childbirth without the support or guidance they truly need.

After delivery, the body undergoes major hormonal, structural, and physiological changes. Two areas that experience the greatest impact are the abdominal wall and the pelvic floor. These systems don’t function in isolation—they work together to support movement, stability, and organ function. When one is disrupted, the other often follows.

Understanding the Core Connection: It’s More Than Just “Abs”

Your core is not just about aesthetics—it’s a functional system. Think of it as a pressure-regulating “canister” made up of the diaphragm at the top, the pelvic floor at the bottom, and the abdominal and back muscles surrounding it.

During pregnancy, this system is placed under constant pressure as the uterus expands. Without proper postpartum rehabilitation, this pressure system can become unbalanced, leading to symptoms that many women mistakenly believe are just “normal” after having a baby.

What Is Diastasis Recti (DRA)?

Diastasis Recti Abdominis (DRA) refers to the separation of the abdominal muscles along the midline. This is a natural adaptation during pregnancy—but for many, it doesn’t fully resolve on its own postpartum.

Rather than thinking of DRA as just a cosmetic concern, it’s more helpful to view it as a functional core issue.

Why Diastasis Recti Matters

When the abdominal wall loses integrity, everyday movements can become more difficult. Many women notice challenges with getting out of bed, lifting their baby, or returning to exercise. It can also contribute to lower back discomfort, abdominal instability, or visible bulging through the midline.

Research shows that nearly all pregnant individuals develop some degree of DRA, and a significant percentage continue to experience it months after giving birth. This is why guided recovery is so important.

Pelvic Floor Dysfunction: Common, But Not Normal

The pelvic floor muscles play a critical role in bladder control, bowel function, and sexual health. Yet postpartum pelvic floor dysfunction is often minimized or dismissed.

Symptoms can vary widely. Some women experience urinary leakage when they laugh or exercise, while others may notice pelvic heaviness, discomfort during intimacy, or difficulty fully controlling bowel movements.

Although these symptoms are common—affecting up to 30–40% of postpartum individuals—they are not something you simply have to live with. They are signs that the pelvic floor needs support and rehabilitation.

Risk Factors to Be Aware Of

Certain factors can increase the likelihood of developing diastasis recti or pelvic floor dysfunction.

For example, multiple pregnancies, carrying twins, or having a larger baby can place additional strain on the abdominal wall. Similarly, vaginal or assisted deliveries, prolonged labor, or perineal trauma may increase stress on the pelvic floor.

However, it’s important to note that these conditions can happen to anyone—regardless of fitness level or birth experience—which is why proactive care matters.

How These Conditions Are Assessed

Assessment for diastasis recti often includes hands-on palpation, measurement tools, or ultrasound imaging. While the width of separation is sometimes discussed, what matters more is how well the core functions during movement.

A pelvic floor assessment, typically performed by a trained specialist, looks at strength, coordination, and the ability to both contract and relax the muscles. This is key, because dysfunction is not always about weakness—sometimes it’s about tension or poor coordination.

Evidence-Based Postpartum Rehabilitation Strategies

Healing after childbirth isn’t about rushing back into intense workouts—it’s about rebuilding from the inside out.

Pelvic floor muscle training (PFMT) is one of the most well-supported interventions for postpartum recovery. It has been shown to reduce urinary incontinence, improve muscle coordination, and support long-term pelvic health. Importantly, this includes learning how to both engage and relax the pelvic floor.

At the same time, core rehabilitation should focus on deep, functional strength. This means prioritizing activation of the transverse abdominis and gradually progressing movements that mimic real-life activities. High-pressure exercises like crunches, planks, and push-ups are often best avoided in the early stages of healing.

Another foundational piece is breathing and pressure management. Diaphragmatic breathing helps reconnect the core and pelvic floor, allowing pressure to be distributed more effectively and reducing unnecessary strain on healing tissues.

Some women also choose to use abdominal binders for support. While these can provide short-term comfort, they are not a substitute for proper muscle rehabilitation and should be used as a complement—not a solution.

Key Takeaways for Postpartum Recovery

Postpartum healing is not one-size-fits-all. Every body, every birth, and every recovery timeline is different. Comparing your progress to someone else’s can be misleading and discouraging.

Conditions like diastasis recti and pelvic floor dysfunction are incredibly common—but they are also highly treatable with the right approach. Shifting the focus from appearance to function can make a meaningful difference in long-term outcomes.

Perhaps most importantly, personalized care matters. Working with a qualified pelvic floor specialist can significantly improve recovery, helping you return to movement, exercise, and daily life with confidence.

When to Seek Help

If you’re experiencing symptoms such as urinary leakage, pelvic pain or pressure, discomfort during intimacy, or difficulty returning to exercise, it may be time to seek support.

A pelvic floor physical therapist can assess your unique needs and guide you through a personalized postpartum recovery plan—so you’re not left guessing what your body needs to heal.

At IVY Integrative, you can work with our pelvic floor therapist or build your own team of holistic practitioners to reach your optimum health in-person or online. Check out our Get Started page to learn how to work with us!

Author: Dr. Mièka Bryan PT, DPT

References

• Benjamin DR et al. (2019) Systematic Review on DRA

• Sperstad JB et al. (2016) DRA prevalence

• Woodley SJ et al. (2020) Cochrane Review on PFMT

• Lee D & Hodges PW (2016) Linea alba research

• ACOG Practice Bulletin

• Bø K et al. (2017) Pelvic floor training

  
  

Disclaimer: This information is generalized and intended for educational purposes only. Due to potential individual contraindications, please see your primary care provider before implementing any strategies in these posts.