Postpartum Pelvic Floor Recovery in Singapore: What’s Normal and When to Seek Help

Pregnancy and childbirth place significant physical demands on the pelvic floor. Hormonal changes, increasing abdominal pressure, altered posture, and changes in breathing mechanics all influence how these muscles function, often more than women realise.

In Singapore, where many women return to work within months of delivery and resume active lifestyles quickly, understanding pelvic floor recovery is especially important. While some postpartum changes are completely normal, ongoing symptoms should not be dismissed as something you simply have to “live with.”

Early awareness, structured pelvic floor therapy, and targeted rehabilitation can make recovery smoother, faster, and far more comfortable.

What Happens to the Pelvic Floor During Pregnancy?

The pelvic floor is a group of muscles and connective tissues that sit at the base of the pelvis. These muscles:

• Support the bladder, uterus, and bowel

• Maintain urinary and bowel continence

• Contribute to sexual function

• Work with the diaphragm and abdominal muscles to stabilise the core

During pregnancy, several changes occur:

1. Increased Load and Pressure

As your baby grows, the pelvic floor supports increasing weight. This sustained load can stretch and fatigue the muscles.

2. Hormonal Influences

Hormones such as relaxin soften connective tissue to prepare the body for birth. While necessary, this also reduces tissue stiffness and support.

3. Postural Changes

The centre of gravity shifts forward, often increasing lower back curvature and altering abdominal engagement.

4. Breathing Pattern Changes

Many pregnant women adopt shallower chest breathing due to pressure on the diaphragm, which can disrupt normal pelvic floor coordination.

These adaptations are natural, but they do affect how the pelvic floor functions postpartum and may influence abdominal separation, commonly known as diastasis recti.

What Is Normal After Birth?

In the early postpartum period (first 6–12 weeks), temporary pelvic floor symptoms are common. These may include:

• Mild urinary leakage

• Reduced muscle endurance

• A feeling of heaviness or pressure

• Reduced core stability

• Temporary discomfort

For many women, these symptoms improve gradually as tissues heal and strength returns. However, persistent symptoms beyond the early recovery phase are not considered “normal,” even if they are common. When urinary leakage continues, professional urinary incontinence treatment can significantly improve outcomes and prevent symptoms from becoming chronic.

When Should You Seek Pelvic Floor Therapy?

You may benefit from pelvic floor therapy in Singapore if you experience:

• Urinary leakage when coughing, sneezing, or exercising

• Urinary urgency or frequent urination

• Pelvic heaviness or a dragging sensation

• Pain in the pelvic region or during intimacy

• Difficulty returning to running, gym, Pilates, or sport

• Ongoing lower back or hip discomfort

• Bowel control issues

Many women delay seeking help because symptoms feel embarrassing or are dismissed as part of motherhood. In reality, early intervention, especially structured urinary incontinence treatment, significantly reduces the risk of long-term dysfunction.

Does Mode of Delivery Matter?

There is a common misconception that cesarean birth “protects” the pelvic floor. While vaginal delivery and cesarean delivery affect the body differently, both can influence pelvic floor function.

Vaginal Birth

May involve stretching or trauma to pelvic floor tissues, particularly with assisted delivery or prolonged pushing.

Cesarean Birth

Although it avoids vaginal stretching, pregnancy itself still loads the pelvic floor. Additionally, abdominal surgery can alter muscle activation patterns and core coordination, indirectly affecting pelvic floor performance.

Both delivery methods may also influence abdominal wall integrity. Separation of the abdominal muscles (diastasis recti) commonly occurs during pregnancy. In some women, this separation persists postpartum and contributes to reduced core strength and pressure management difficulties. Targeted diastasis recti treatment can restore abdominal wall tension and improve pelvic floor coordination.

Research consistently demonstrates that pelvic floor muscle training after childbirth reduces urinary incontinence and improves muscle function when appropriately guided (Hay-Smith et al., 2011).

Regardless of birth method, structured rehabilitation supports recovery.

Why Pelvic Floor Exercises Alone Are Not Enough

Many women are told to “just do Kegels.” While pelvic floor strengthening is important, effective rehabilitation is more comprehensive.

A proper pelvic floor physiotherapy assessment evaluates:

• Muscle strength

• Endurance

• Timing and coordination

• Ability to fully relax

• Breathing mechanics

• Core engagement

• Presence of diastasis recti

• Posture and movement patterns

• Load management strategies

Without professional guidance, some women:

• Over-brace their abdominal muscles

• Excessively tighten their pelvic floor

• Perform exercises incorrectly

• Focus on strength without coordination

Over time, this can contribute to pelvic pain, voiding difficulty, persistent abdominal separation, and inefficient movement patterns.

Comprehensive pelvic floor therapy addresses both pelvic floor function and abdominal wall recovery. When needed, diastasis recti treatment is incorporated to ensure the deep core system works as an integrated unit.

The goal is not simply stronger muscles, it is balanced, coordinated function.

The Link Between the Pelvic Floor, Diastasis Recti and Core Stability

The pelvic floor works as part of a pressure management system alongside:

• The diaphragm

• Deep abdominal muscles (transversus abdominis)

• Deep back stabilisers

When this system is functioning well:

• Pressure is evenly distributed

• The pelvic floor responds automatically during movement

• Core stability improves

• Risk of urinary leakage decreases

When coordination is disrupted, whether from pregnancy, birth, or unresolved diastasis recti, symptoms can arise.

In Singapore’s active fitness culture, many new mothers return to high-impact exercise too quickly. Running, HIIT classes, and heavy lifting increase intra-abdominal pressure. Without adequate pelvic floor preparation and appropriate diastasis recti treatment, symptoms such as leakage or abdominal doming may worsen. Graded rehabilitation ensures a safe return to activity.

Returning to Exercise After Childbirth in Singapore

Whether your goal is:

• Returning to reformer Pilates

• Resuming CrossFit or strength training

• Running around Marina Bay

• Playing sports

• Simply lifting your baby without discomfort

Pelvic floor readiness matters.

A progressive rehabilitation plan often includes:

1. Restoring breathing coordination

2. Addressing abdominal separation through tailored diastasis recti treatment

3. Rebuilding foundational pelvic floor strength

4. Implementing structured urinary incontinence treatment where required

5. Gradually introducing impact

6. Monitoring symptoms throughout

Returning too quickly may not cause immediate problems, but issues often appear months later when training intensity increases.

Individualised Postpartum Care in Singapore

Every woman’s recovery journey is unique. Factors influencing healing include:

• Birth experience

• Number of pregnancies

• Pre-existing fitness level

• Lifestyle demands

• Work requirements

• Sleep and stress levels

At PhysioMatters Singapore, our Women’s Health Physiotherapists provide personalised, evidence-based care tailored to your goals.

Our approach to pelvic floor therapy integrates:

• Pelvic floor muscle retraining

• Urinary incontinence treatment

• Diastasis recti treatment

• Core rehabilitation

• Postural retraining

• Education on safe exercise progression

Rather than treating symptoms in isolation, we focus on restoring efficient, coordinated function across the entire core and pelvic system.

The Key Takeaway: Postpartum Symptoms Should Not Be Persistent

Pelvic floor changes after pregnancy are common, but ongoing symptoms are not something you have to accept.

Early physiotherapy intervention can:

• Provide effective urinary incontinence treatment

• Improve pelvic floor strength and coordination

• Address abdominal separation with targeted diastasis recti treatment

• Support safe return to exercise

• Enhance overall quality of life

If you are experiencing urinary leakage, urgency, pelvic heaviness, abdominal separation, or are unsure what is normal after childbirth, a professional pelvic floor therapy assessment can provide clarity and reassurance.

Postpartum recovery is not just about healing, it is about rebuilding strength, confidence, and long-term resilience.

If you are looking for expert pelvic floor therapy in Singapore, our Women’s Health Physiotherapists at PhysioMatters are here to support your recovery journey.

Contact us today!

Contact Information

Email: hello@physiomatters.com.sg

Tele: +65 9352 9067

Address: 360 Orchard Road #10-07 International Building, 238869