Pregnancy and childbirth change your body in many ways. But when it comes to pelvic health, many women get dated or incomplete advice.
If you’ve ever had a small leak of urine when sneezing, felt strange pressure in that area or had pain during sex after having a baby, you’ve probably heard people say: "That’s just part of being a mom."
The truth is, it’s not. Changes in pelvic health during pregnancy and after childbirth are common but that doesn’t mean they are normal or something you must accept.
We talked with Olivia Cardenas-Trowers, MD, a urogynecologist and reconstructive pelvic surgeon with Banner - University Medicine, about common misconceptions about pelvic health and share tips to help your recovery.
What is pelvic health, anyway?
Pelvic health refers to how well the muscles, ligaments and tissues in your pelvic area work together.
Your pelvic floor is a group of muscles and connective tissue that forms a hammock at the bottom of your pelvis. It stretches from the pubic bone to the tailbone and supports three important organs: your bladder, uterus and rectum.
Your pelvic floor helps you control your bladder and bowels, supports your growing baby during pregnancy, stabilizes your core and lower back, allows you to enjoy comfortable sex and recover after childbirth.
Most of the time, you don’t think about your pelvic floor when everything works well. But if these muscles don’t work properly, you may feel discomfort or pain.
Misconception #1: Leaking urine and pelvic pain are just part of being a mom
Many women are told to expect discomfort after giving birth. While these symptoms are common, they are not normal.
“Pregnancy and childbirth put pressure on the pelvic floor,” Dr. Cardenas-Trowers said. “The extra weight of your baby, changes in hormones and the delivery itself, whether vaginal or cesarean, can all stretch, weaken or sometimes tighten the pelvic floor."
When these muscles don’t work well, you might notice symptoms like:
- Urine leakage
- Pelvic heaviness or bulging in the vagina
- Lower back or pelvic pain
- Pain with sex or movement
These symptoms can appear days, weeks or even months after delivery. They are signals from your body and not flaws to push through. If something feels off, talk to your health care provider.
Misconception #2: Everyone can benefit from Kegels
Kegel exercises have been the standard advice for years. Pregnant? Do Kegels. Just had a baby? Do Kegels. Leaking urine? Do more Kegels. But new research shows they are not right for everyone.
“Kegels can help but only if you do them correctly and for the right reason,” Dr. Cardenas-Trowers said.
When Kegels can help
- You have a pelvic floor weakness
- You leak urine with movement (stress incontinence)
- You can correctly engage the right muscles
- You’re following a guided program
When Kegels can make things worse
- Your pelvic floor is already too tight
- You’re doing them incorrectly (which is very common)
- You have pelvic pain or pain with sex
- You struggle to relax your muscles
In these cases, doing more Kegels can actually worsen pain and dysfunction. Pelvic health is not one-size-fits-all. What your body needs may be very different from what someone else needs.
Misconception #3: Having a C-section means you don’t have to worry about pelvic floor issues
Many moms who have a C-section think they avoided pelvic floor problems. However, that’s not true. Dr. Cardenas-Trowers said, "A cesarean can lower some risks but it doesn't completely prevent pelvic floor issues."
Here’s why:
- Pregnancy itself puts stress on the pelvic floor
- Hormonal changes affect tissue strength and healing
- The abdominal incision can weaken your core
If you had a C-section, you may still experience:
- Urinary leakage
- Core weakness or abdominal separation (diastasis recti)
- Pelvic pressure or discomfort
- Pain with movement or intimacy
Recovery is about more than healing your incision. It also includes rebuilding your core and pelvic floor strength.
Misconception #4: If I feel fine at first, I’m in the clear
Some women feel okay in the early weeks after birth. Then symptoms show up later, often when they return to activities like running, lifting weights or chasing toddlers.
Here’s what’s happening:
- Early postpartum (after birth) life has lower physical demands
- Activities like running or lifting increase pressure on the pelvic floor
- If your strength or coordination hasn’t fully recovered to pre-pregnancy levels, symptoms appear
This doesn’t mean something suddenly went wrong. It means your body needs more support. If you had your baby five months ago or five years ago, help is still available.
Misconception #5: Painful sex after birth is just how it is
Many women quietly experience pain during sex after having a baby. They often feel embarrassed to talk about it, even with their provider.
You don’t have to suffer in silence. Pain during sex after childbirth is common and can be treated.
The causes include:
- Tight or overactive pelvic floor muscles
- Scar tissue from tears or an episiotomy
- Vaginal dryness, especially while breastfeeding
- Nerve sensitivity or irritation
Treatment depends on the cause. It may include pelvic floor physical therapy to relax muscles, scar tissue massage, vaginal estrogen when appropriate, lubrication and guided strategies to help you return to intimacy.
When should I talk to my health care provider?
You don’t need to wait until your symptoms worsen to seek treatment. Getting help early can make recovery easier.
Reach out if you notice:
- Urine leakage that doesn’t get better
- Pelvic pressure or heaviness
- Ongoing pelvic or back pain
- Pain during sex
- Trouble returning to exercise
How to support your pelvic health
Whether you’re pregnant, newly postpartum or years past delivery, you can take steps to care for your pelvic floor:
- Listen to your body: Pay attention to symptoms like leaking, pain or pressure. These are signs your body needs support. If something feels off, talk to your provider.
- Don’t self-diagnose with Kegel exercises: If exercises don’t help or make things worse, stop and ask for an evaluation.
- Ease back into exercise: Build core and pelvic floor strength before high-impact activities like running.
- Stay hydrated and eat fiber: Constipation strains the pelvic floor.
- Pay attention to posture and breathing: How you sit, stand and breathe affects your pelvic floor.
- Ask about pelvic floor physical therapy: It’s appropriate during pregnancy, after birth and even later.
“Many patients are surprised by how comprehensive and empowering pelvic floor physical therapy can be,” Dr. Cardenas-Trowers said. “It’s not just about doing Kegels. It’s about restoring how your whole system works together.”
Pelvic floor physical therapy treatments may include:
- Exercises to strengthen or relax muscles
- Breathing and coordination training
- Hands-on therapy for tight muscles or scar tissue
- Education on bladder, bowel and sexual health
- Guidance on returning to exercise safely
Frequently asked questions
Is it normal to leak urine after having a baby?
It’s common but not normal. Urine leakage is a sign your pelvic floor needs support and treatments like pelvic floor physical therapy can help.
When should I start pelvic floor therapy after birth?
You can often start as early as a few weeks postpartum, depending on your recovery. Talk to your provider about timing.
Are Kegels enough to fix pelvic floor issues?
Not always. Kegels help in some cases but they can make symptoms worse if done incorrectly or if your muscles are too tight.
Can you have pelvic floor problems after a C-section?
Yes. Pregnancy itself affects the pelvic floor and C-sections do not fully prevent these issues.
Is it too late to get help years after having a baby?
No. It’s never too late. Many women see improvement even years after delivery.
What does pelvic floor physical therapy treat?
It can help with leakage, pelvic pain, pressure, painful sex, core weakness and more.
Bottom line
Becoming a mom changes a lot but chronic leaking, pain and pressure don’t have to be part of the deal. With the right care, your pelvic floor can recover and you can get back to the activities, intimacy and life you love.
If you have pelvic floor concerns during pregnancy or postpartum, talk to your provider or a Banner Health specialist. Schedule an appointment today.
