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Pelvic Floor Therapy 101: A Guide for Women’s Health and Postpartum Recovery

Pregnancy and birth are incredible, but they’re also a full-body workout your muscles never exactly trained for—especially your pelvic floor. Leaking when you laugh, pressure “down there,” pain with intimacy, or feeling like your core is just…gone are extremely common. But “common” doesn’t mean “nothing can be done.”

Pelvic floor physical therapy is a specialized, evidence-based approach that helps women and postpartum patients recover strength, control, and confidence after childbirth. Research shows pelvic floor muscle training can reduce urinary incontinence, improve pelvic organ support, and enhance overall function for postpartum women.

At Cawley Physical Therapy & Rehabilitation, our pelvic health physical therapists work with women across Northeast Pennsylvania (NEPA)—including the greater Scranton and Wilkes-Barre areas—to address these issues in a safe, supportive environment. This guide walks you through what pelvic floor therapy is, who it can help, and what to expect from care during the postpartum journey and beyond.

Note: This article is for educational purposes only and is not a substitute for medical advice, diagnosis, or emergency care. Always talk with your healthcare provider about your specific situation.

Understanding Your Pelvic Floor

The pelvic floor is a group of muscles, ligaments, and connective tissues that form a supportive “hammock” at the base of your pelvis. These structures: 

When these muscles are too weak, too tight, or simply not coordinating well, you may develop symptoms like leaking, heaviness, pain, or difficulty emptying the bladder or bowels.

Pelvic floor dysfunction can happen at any age, but pregnancy and childbirth are major stressors—especially when combined with daily lifting, feeding, carrying, and lack of sleep.

How Pregnancy and Birth Affect the Pelvic Floor

Even before labor, pregnancy alone changes your pelvic floor:

Vaginal birth can stretch the pelvic floor significantly. Tears, episiotomies, forceps, and prolonged pushing may further stress these tissues. Even with a C-section, the pelvic floor supports extra weight for months and your core is affected by abdominal surgery.

Research suggests that stress urinary incontinence (leaking with coughing, sneezing, or exertion) affects about 30–47% of women in the first 12 months postpartum, and a substantial portion experience pelvic organ prolapse symptoms or pelvic pain.

Common postpartum pelvic floor issues include:

These symptoms are common but not “just the price you pay” for having a baby. Pelvic floor therapy is designed to address them.

What Is Pelvic Floor Physical Therapy?

Pelvic floor physical therapy (PFPT) is a specialized branch of physical therapy focused on the muscles, nerves, and connective tissues of the pelvis and core. Using a combination of education, hands-on techniques, and targeted exercises, pelvic health PTs help you:

High-quality evidence shows pelvic floor muscle training is effective in preventing and treating urinary incontinence in postpartum women and improving pelvic floor strength.

Other research supports pelvic floor PT as a first-line treatment for many pelvic floor disorders, including urinary incontinence, pelvic organ prolapse, fecal incontinence, and postpartum pelvic pain conditions.

Common Postpartum Symptoms Pelvic Floor Therapy Can Help

1. Urinary Leakage

Leaking when you cough, sneeze, laugh, jump, or lift (stress incontinence) is one of the most common postpartum complaints. Pregnancy and birth can overstretch or weaken the pelvic floor and urethral support.

Pelvic floor therapy can help by:

Meta-analyses show that pelvic floor muscle training significantly reduces urinary incontinence symptoms in postpartum women. 

2. Pelvic Organ Prolapse Symptoms

Pelvic organ prolapse occurs when the bladder, uterus, or rectum sink downward toward the vaginal opening, often felt as heaviness, pressure, or a “bulge.” Pelvic floor muscle training can reduce symptoms and improve support, particularly in mild-to-moderate prolapse. Therapy may include:

3. Pelvic and Low Back Pain

Pelvic floor muscles can be:

Pelvic floor PT addresses both possibilities through:

4. Pain with Intercourse (Dyspareunia)

Postpartum changes—hormones, scar tissue, birth trauma, and muscle tension—can make intercourse painful or impossible. A pelvic health PT can:

5. Bowel Issues

Straining, constipation, incomplete emptying, or fecal leakage can all be related to pelvic floor dysfunction. Therapy may involve:

6. Core Weakness & Diastasis Recti

Many postpartum women notice doming or coning down the midline of the abdomen, often linked with diastasis recti abdominis (DRA). Research suggests that combining pelvic floor and abdominal exercises can reduce inter-rectus distance and improve function. Your therapist will:

What to Expect at a Pelvic Floor Therapy Visit

If you’ve never seen a pelvic health physical therapist, it’s normal to feel nervous. Our goal at Cawley PT is to make the process comfortable, collaborative, and respectful.

Before Your Visit

You may be asked to complete intake forms about:

You’re always encouraged to share your goals and any concerns. Interpretation services, chaperones, and trauma-informed care approaches can be provided as needed.

During the Evaluation

Your first session usually includes:

  1. Conversation and history
    • Discuss your symptoms, goals, and daily life demands (caring for a newborn, lifting toddlers, returning to work or exercise).
  2. Movement and posture assessment
    • Observation of breathing patterns, core activation, hips, and spine.
    • Functional movements like sit-to-stand, lifting, or squatting.
  3. Pelvic floor assessment (with your consent)
    • This may include an external and, if appropriate and comfortable for you, internal vaginal exam.
    • The therapist checks strength, endurance, coordination, and tension of the pelvic floor muscles.
    • You can decline any part of the exam at any time; alternative approaches are always available.
  4. Education and initial plan
    • You’ll learn what’s likely contributing to your symptoms and how therapy can help.
    • You’ll leave with a clear first-step home program—often breathing, gentle exercises, and simple lifestyle strategies.

Treatment Techniques Used in Pelvic Floor Therapy

Pelvic floor therapy is much more than “just Kegels.” A typical plan might include:

1. Pelvic Floor Muscle Training

Targeted exercises to improve strength, endurance, and coordination, often called pelvic floor muscle training (PFMT), are a cornerstone of treatment. 

A PT helps you:

2. Relaxation and Down-Training

Sometimes the pelvic floor is too tight, not too weak. In these cases, strengthening alone can worsen symptoms. Therapy may focus on:

3. Core and Hip Strengthening

The pelvic floor is part of your deep core system. Your plan will often include:

4. Manual Therapy

Hands-on techniques may address:

5. Biofeedback and Technology-Assisted Training

Some pelvic health PTs use tools like:

Evidence supports biofeedback and electrostimulation as helpful adjuncts for pelvic floor rehabilitation in some postpartum women. 

6. Lifestyle and Habit Coaching

You’ll also discuss:

When Can You Start Pelvic Floor Therapy Postpartum?

There is no one “perfect” timeline, but research suggests that earlier, appropriate pelvic floor muscle training can help reduce postpartum urinary incontinence and prolapse risk.

A typical progression:

If you’re months or even years postpartum and still dealing with leaking, pain, or heaviness, it’s not “too late.” Pelvic floor therapy can be beneficial long after childbirth.

How Long Does Pelvic Floor Therapy Take?

The length of care varies depending on:

Many postpartum patients notice improvements within a few weeks of regular therapy and home practice, with fuller recovery often taking several months. Evidence suggests that structured programs over several weeks to months are most effective for reducing urinary incontinence and improving pelvic floor strength.

Pelvic Floor Therapy Isn’t “Just” for Postpartum

Although this guide focuses on postpartum recovery, pelvic floor therapy can also help:

Many women benefit from pelvic floor therapy before pregnancy as well, to build awareness and strength ahead of the changes to come.

Direct Access to Pelvic Floor Therapy in Pennsylvania

If you live in Pennsylvania, you may be able to start physical therapy without a doctor’s referral thanks to state “direct access” laws. With a therapist who holds a Direct Access Certification, patients can often begin PT and be treated for a limited time (commonly up to 30 days) before a referral is required for continued care. 

That means you don’t necessarily have to wait for a specialist appointment to begin addressing:

You can reach out directly to a pelvic health physical therapist to discuss whether an evaluation is appropriate for you.

Ready to talk with a pelvic health expert in NEPA?
 Take the first step toward feeling like yourself again and contact Cawley Physical Therapy today to request an appointment.

Pelvic Floor Therapy at Cawley PT in Northeast Pennsylvania

At Cawley Physical Therapy & Rehabilitation, our pelvic health PTs offer:

Whether you’re six weeks postpartum or several years past your last birth, persistent pelvic symptoms are worth addressing. You deserve care that looks at the whole you—not just one muscle group.

Want to learn how pelvic floor therapy can fit into your recovery plan?
 Reach out through our online form to contact us and schedule your visit.

Resources: Supporting Pelvic Health Articles

For a deeper dive into related topics in our pelvic health series, explore these supporting articles from the Cawley PT 2025 content calendar:

These supporting pieces expand on exercises, specific diagnoses, and the broader role of physical therapy in women’s pelvic health.

Frequently Asked Questions About Pelvic Floor Therapy 101: A Guide for Women’s Health and Postpartum Recovery

1. Is pelvic floor therapy safe right after having a baby?

For most women, pelvic floor therapy is safe once your medical provider confirms you’re healing well and gives the green light—often around 4–6 weeks postpartum after a vaginal delivery or C-section. That said, support can begin earlier in the form of education, breathing strategies, positioning tips for feeding, and gentle circulation exercises. Your therapist will always tailor care to your specific birth, any complications, and your comfort level. Internal exams aren’t required and will only be offered with your consent. If you’re unsure whether you’re ready, a pelvic health PT can still meet with you to review your history and provide gentle, appropriate guidance while you continue to heal.

2. What happens during an internal pelvic floor exam, and do I have to have one?

An internal exam is one way a pelvic health PT can directly assess your pelvic floor muscles—similar to how they would test strength or flexibility in your shoulder or knee. With your consent, the therapist uses a gloved, lubricated finger inside the vagina to evaluate muscle strength, endurance, coordination, and tension. Many women find this exam helpful because it provides specific information that guides treatment. However, it is always optional. You can decline, stop at any time, or choose an external-only assessment and still receive valuable care. Trauma-informed providers will explain each step, check in frequently, and adapt the session based on your boundaries and comfort.

3. Will pelvic floor therapy fix my leaking or prolapse completely?

Many women see significant improvements in leaking, urgency, and prolapse symptoms with a consistent pelvic floor therapy program, but results vary. Research shows pelvic floor muscle training can reduce the odds of postpartum urinary incontinence and pelvic organ prolapse and improve quality of life, especially when started early and followed for several weeks or months. Some women experience complete resolution of symptoms; others notice fewer leaks, less heaviness, or better control rather than a total cure. Your therapist will be honest about what’s realistic for your specific situation, and will help you pair exercise, lifestyle strategies, and medical care when needed to get the best possible outcome.

4. How is pelvic floor therapy different from just doing Kegels on my own?

“Kegels” are one form of pelvic floor exercise, but they’re often done incorrectly or without considering the whole system. Some women actually need to relax an overactive pelvic floor before doing any strengthening. Others need help coordinating the pelvic floor with their breathing, abdominals, and hips. A pelvic health PT evaluates how your muscles are working—too tight, too weak, or poorly timed—and then designs a customized plan with specific reps, positions, and progressions. They also integrate your symptoms into real-life tasks, like lifting your baby, running, or returning to work. In other words, pelvic floor therapy is personalized, supervised, and function-focused, not just a generic “squeeze 10 times” routine.

5. Do I need a referral to start pelvic floor therapy at Cawley PT?

Because Pennsylvania has direct access laws for physical therapy, many patients can begin PT— including pelvic floor therapy—without a physician’s referral, as long as they see a therapist with the appropriate certification. In practice, this means you can often schedule an evaluation directly if you’re experiencing leaking, pelvic pain, or postpartum concerns. Depending on your insurance and how long you need care, a referral may eventually be required, especially for ongoing treatment after the initial direct-access period. Our front desk team can help you navigate your specific benefits and requirements. If you already have a trusted OB/GYN, midwife, or primary care provider, we’re happy to communicate with them and coordinate your care from day one.