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Timeline for recovery of the pelvis and the pelvic floor after childbirth

timeline recovery pelvic floor

1 August 2020

Even if you feel very well after giving birth and if you have no pelvic and pelvic floor complaints at all, you should take recovery time into account. This way, you ensure a good structure and prevent complaints due to overload. The timeline below will give you a good indication for recovery of the pelvic floor after childbirth.

Day 1-10 after delivery (the postpartum)

Your pelvis and pelvic floor are stretched during the delivery. You can see this as a serious sports injury. During this period it is good to give your pelvis and pelvic floor as much rest as possible.

  • Get out of bed only to take care of yourself and your child; try to keep climbing stairs to a minimum.
  • During daily activities such as turning in bed, getting up and walking, make sure you breathe calmly to your stomach; don’t hold your breath.
  • Make sure you sit down on the toilet and do not strain; this puts a lot of pressure on the pelvic floor and can lead to delayed recovery.
  • Keep your stools flexible by drinking enough and eating fibre. If the stool remains hard, discuss this with the midwife or GP.
  • Take the time to urinate, sit upright and pass the urine completely without straining.
  • From the 4th day after delivery, you can start with exercises for the pelvic floor and the transverse abdominal muscles.

In the event of a total rupture, it is wise to contact a pelvic physiotherapist at this stage. He or she can assess whether the scar is recovering properly and whether you may need an adapted exercise program. If you are not sure whether you have a total rupture, check with your midwife, gynecologist or doctor.

10 days to 6 weeks after delivery

The first recovery of the pelvis and pelvic floor has started, and you already have some feeling in these muscles. However, your uterus is still shrinking, and you can still flow a lot. The strength of the connective tissue is only 10-20% of what it’s supposed to be 1 month after delivery. Besides, breastfeeding can demand a lot of energy from you. Your possibility to increase the load is therefore still low.

  • Consciously tighten your pelvic floor just before and during abdominal pressure-increasing moments such as sneezing, coughing, laughing.
  • Tighten your pelvic floor, actively when you lift and carry your child.
  • Try not to lift more than the weight of your child.
  • Consciously tighten your transverse abdominal muscles before changing positions such as getting up, walking and climbing stairs.
  • Increase your overall fitness with walking and cycling.
  • You may experience some muscle pain if you start to exercise more, but this muscle pain should have clearly decreased after 24 hours. Note: does the muscle pain last longer or do you get pain other than muscle pain in the abdomen, pelvic floor or pelvic region after the load? Then the load is too heavy!

6 weeks after delivery

Your uterus has shrunk back to its original size. You no longer have bleeding and in the case of a caesarean section or (sub) total rupture, the scar tissue has recovered to such an extent that you can slowly start to strain it.

  • You can now start with a calm build-up of endurance, strength and coordination of the abdomen and pelvic region.
  • There may only be muscle pain after training.
  • The tensile strength of the connective tissue is still less than 50% of its original strength; your pelvic floor is therefore certainly not able to absorb loads such as jumping and running… even if you feel very faint! By doing this, you risk overload and reduced recovery in the area.
  • Breastfeeding requires a lot of energy. Keep in mind that you, therefore, have less energy left for other loads.
  • Start training under the supervision of a teacher who has experience with women in the period after pregnancy and delivery.
  • Always consult with your teacher before adding more abdominal exercises to your program.

3-4 months after delivery

You have regained the basic load capacity of the pelvis and the pelvic floor and many women are now going back to work; however, the recovery is still in full swing. The tensile strength of the tendons in and around the pelvis and pelvic floor is approximately 75% of the original tensile strength 9 months after delivery. We can say that the body needs at least 9 months to recover from childbirth. In the event of a caesarean section or a (sub) total rupture, this recovery is delayed at least 6 weeks.

  • With strength training; start with low weight and 20-30 repetitions. Increase the weight and do 10 repetitions, but only if the rapid strength of the pelvic floor is sufficiently at the right level (= 3 series of 8-12 fast tensions with a 1-2 minute rest between the series).
  • Exercises such as planks, oblique and straight abdominal exercises and squats increase abdominal pressure; Always tighten the pelvic floor during these exercises.
  • There should only be muscle pain after training.
  • Exercise the pelvic floor, abdominal and back muscles daily.
  • When running: start with gentle dribbling and later jogging, but only if the endurance force of the pelvic floor is sufficiently at the level (= 3 series of 10 times tightening the pelvic floor, 10 counts in and 10 counts out, with 1-minute rest between the series).

6-9 months after giving birth

Your capacity to exercise continues to increase and you can slowly resume the sport you did before you were pregnant. Do not start immediately with competition, but start slowly during the training.

  • If exercises with high abdominal pressure are good, you can try jumping.
  • If jogging goes well, you can expand with faster walking and speed changes.
  • If this goes well, try to add stopping, turning and changing direction in training.
  • even now: after the training, there should only be muscle pain! • ensure a good warm-up and cool down, and drink enough.

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