Signs of a Weak Pelvic Floor After Childbirth

A Pelvic Floor PT in Charleston, SC Explains

Written by Megan Rome, PT, DPT – Rome Physical Therapy

Your body goes through an incredible transformation during pregnancy and childbirth — and your pelvic floor is at the center of it all.

After delivery, many women are told that symptoms like leaking, heaviness, or discomfort are “normal.” While they may be common, they are not something you have to live with.

At Rome Physical Therapy, with locations in Mount Pleasant, Summerville, and West Ashley, SC, we help women throughout the Charleston area identify and treat pelvic floor dysfunction after childbirth so they can feel strong, supported, and confident again.

What Is the Pelvic Floor?

Your pelvic floor is a group of muscles that sit at the base of your pelvis. These muscles support your:

• Bladder

• Uterus

• Rectum

They also play a major role in:

• Controlling urination and bowel movements

• Supporting your core

• Stabilizing your hips and spine

• Sexual function

During pregnancy, these muscles stretch significantly. During vaginal delivery, they may be further strained, weakened, or injured. Even with a C-section, the pelvic floor is still affected by pregnancy and pressure changes.

Common Signs of a Weak Pelvic Floor After Childbirth

Here are the most common symptoms we see postpartum:

1. Urine Leakage

Leaking when you cough, sneeze, laugh, run, or jump is one of the biggest indicators of pelvic floor dysfunction.

This happens when the pelvic floor and external urethral sphincter cannot generate enough strength or coordination to keep the urethra closed under pressure.

2. Feeling of Heaviness or Pressure

A sensation of heaviness, dragging, or “something falling out” in the vagina can indicate decreased pelvic support.

This may be related to pelvic organ prolapse or general weakness in the pelvic floor support system.

3. Difficulty Controlling Gas or Bowel Movements

If you’re having trouble holding in gas or experiencing bowel urgency or leakage, your pelvic floor muscles may not be providing adequate support and control.

4. Core Weakness or “Mom Pooch”

If your core feels weak, disconnected, or you notice a persistent abdominal bulge, your pelvic floor and deep core system may not be coordinating well.

This often goes hand-in-hand with diastasis recti (abdominal separation).

5. Pain with Intercourse

Pain, discomfort, or a feeling of tightness during intercourse can actually be related to pelvic floor dysfunction.

Sometimes muscles are weak. Other times, they are tight and not functioning properly.

Weak does not always mean loose — it often means dysfunctional.

6. Low Back, Hip, or Pelvic Pain

Your pelvic floor is part of your core system. If it’s not doing its job, other muscles compensate.

This can lead to:

• Low back pain

• Hip pain

• Pelvic girdle discomfort

7. Difficulty Returning to Exercise

If running, jumping, or lifting feels uncomfortable — or causes symptoms like leaking or pressure — your pelvic floor may not yet be ready to handle impact and load.

Why These Symptoms Happen

After childbirth, the pelvic floor may experience:

• Muscle weakness

• Overstretching

• Poor coordination

• Nerve irritation

• Changes in connective tissue support

• Increased intra-abdominal pressure

For proper function, your body needs:

• Strength in the pelvic floor and external urethral sphincter

• Lift and support from the levator ani muscles

• Stability of the pelvic organs and urethra

• Support from the transverse abdominis

• Proper breathing and pressure management

If any part of this system is off, symptoms appear.

The Pelvic Floor Is More Than Just Kegels

One of the biggest misconceptions in postpartum recovery is that the pelvic floor is just one muscle — and that Kegels are the solution.

In reality, the pelvic floor is made up of 16+ muscles that all have different roles, including:

• Supporting organs

• Creating lift

• Providing closure (like the external urethral sphincter)

• Coordinating with your breath and core

If we only focus on repetitive squeezing (Kegels), we are missing the bigger picture.

Some muscles may need strengthening, while others may need to relax. Some need better timing and coordination with your diaphragm and transverse abdominis.

At Rome Physical Therapy, we assess and treat the pelvic floor as a full system — not just a single contraction.

It’s Not Just About Kegels

Many women are told to “just do Kegels” after having a baby.

But Kegels are not a one-size-fits-all solution.

If your pelvic floor is:

• Too tight

• Poorly coordinated

• Not relaxing properly

• Compensating for other weaknesses

…then doing repetitive Kegels can actually make symptoms worse.

This is why a proper pelvic floor evaluation is so important.

How We Treat Pelvic Floor Weakness at Rome PT

At Rome Physical Therapy, we take a full-body, root-cause approach.

Your treatment may include:

• Internal and external pelvic floor assessment

• Strengthening or relaxation exercises (based on your needs)

• Core and transverse abdominis training

• Breathing and pressure management

• Manual therapy and soft tissue work

• Postural and movement retraining

• Return-to-exercise guidance

We don’t just treat symptoms — we help you understand your body and build lasting strength.

When Should You See a Pelvic Floor PT?

You do not need to wait until your 6-week check-up — and you don’t need to wait until symptoms get worse.

You should consider pelvic floor physical therapy if you:

• Are experiencing any of the symptoms listed above

• Want to return to exercise safely

• Had a vaginal delivery, tearing, or C-section

• Simply want to be proactive about your recovery

You Deserve a Strong, Supported Recovery

Postpartum recovery is not just about “getting cleared.”

It’s about actually healing.

If you’re in Mount Pleasant, Summerville, West Ashley, or anywhere in the Charleston, SC area, we are here to help.

At Rome Physical Therapy, we offer:

• One-on-one, full-hour sessions

• Individualized care plans

• A holistic, root-cause approach

• A supportive, education-focused environment

You should not have to live with leaking, pressure, or discomfort after having a baby.

Your body is capable of healing — and with the right guidance, you can feel strong again.