The Role of Physiotherapy in Pre and Post Natal Women

They are multiple physical changes to a women’s body as related to pregnancy. The center of gravity changes, there is more pressure on the organs, and there is increased weight to be carried. All of these in a relatively short period often leads to back pain, pelvic pain, and urinary incontinence.

During pregnancy even before the bump starts showing, the body goes through major changes. The posture and the way the body moves change, the weight going through the joints increases, and the muscles, ligaments, and soft tissues get more flexible and elastic to allow the pelvis to stretch to accommodate the baby. All of these changes happen due to hormonal changes and they are very important. They need to occur for the body to be prepared to create a beautiful human being and to allow the baby to grow in the tummy during roughly the nine months that follow.

Over two-thirds of pregnant women experience back pain, one-fifth experience pelvic pain, and over 40% experience urinary incontinence in their first pregnancy – with half remaining incontinent at 8 weeks post-partum, and one third experiencing a new onset of incontinence after childbirth.

Evidence shows that group training programs designed and delivered by physiotherapists can relieve lower back pain, pelvic pain, and urinary incontinence in pregnant women. Some women feel well during pregnancy with almost no symptoms. However, approximately 20% of pregnant women suffer from pelvic girdle pain and lower back pain during pregnancy, and approximately 7% of women continue to struggle with pain even after giving birth.

It is also known that 30 to 50% of women will experience urinary incontinence during pregnancy and even though these symptoms seem common, they are not normal and can be treated and prevented. If they are left untreated they can become worse over time.


Not every woman will experience these symptoms during pregnancy so if you are pregnant or are thinking about becoming pregnant, you don’t need to worry.

We know that there are risk factors that can make women more predisposed to these problems. Women that have a previous history of lower back pain, pelvic girdle pain, or pelvic floor dysfunction and have a high workload are more predisposed to struggle with pelvic girdle pain and lower back pain during pregnancy and after giving birth.

As for urinary incontinence, being overweight, the pregnancy itself and childbirth (vaginal delivery or c-section) seem to be the risk factors associated with developing it. The risks of developing pelvic organ prolapse in women are related to increasing age and number of deliveries, a family history of prolapse, pelvic floor muscle weakness, obesity, repetitive heavy lifting, and repetitive constipation and straining.


Let’s compare pregnancy and postpartum to a marathon or a sports competition of some sort, where the pregnant woman is a competing athlete.

As with any other athlete, we would ideally prepare ourselves before the competition to make sure we were fit and able to give the best performance without sustaining or being affected by injury.

Preparing the muscles of the lower back, abdominal area, and pelvic floor before and during pregnancy is essential for prevention and a good postpartum recovery.


It is within the scope of practice of a physiotherapist to properly assess, treat and educate pregnant women in effective and safe exercises that have been shown to decrease back pain, pelvic pain, and urinary incontinence – throughout their pregnancy and post-partum.

The goal of such a program would be to offer women improved prenatal fitness – that would lead to a healthier and easier pregnancy and delivery. A good program would also offer an integrated approach to health care – and share detailed assessment findings with the participant’s primary health care providers.

Seeing a physiotherapist who specialises in pregnancy and postpartum for the right treatment and guidance to prevent and treat all of these issues is key.

During pregnancy your physiotherapist will help you by:

  • Prescribing safe exercises and advice for you to stay fit and healthy
  • Teaching you about posture and strategies that may help you to reduce the risk of strain and discomfort on your lower back and pelvic joints during pregnancy
  • Treating and preventing low back pain or pelvic girdle pain.
  • Teaching you about the pelvic floor muscles and how to do pelvic floor exercises.
  • Giving you advice on how to rest comfortably as well as on how to overcome some other pregnancy-related minor problems.
  • Preparing your pelvic floor for labour and teaching you about perineal massage and other strategies.
  • Giving you advice on posture and active strategies for pain management during labour.

After childbirth, you can see a physiotherapist to have an abdominal and pelvic floor muscle assessment. This can be done from 6 weeks postpartum onwards.

The six-week postpartum check is recommended for the rehabilitation of the pelvic floor muscles and abdominal area postpartum. This is especially important not only for the women who have symptoms but also for the women who want to return to exercise safely.

In this postpartum check your physiotherapist will be able to help you by:

  • Giving you advice on how to recover after childbirth (whether you had a vaginal delivery or a C-section)
  • Assessing your posture, breathing, abdominal muscles gap (diastasis rectus abdominis), and pelvic floor muscle function.
  • Creating an exercise plan to rehabilitate your pelvic floor muscles and your abdominal muscles
  • Giving you advice on how to exercise safely in the postpartum
  • Treating any symptoms of pelvic floor dysfunction that may have arisen from childbirth
  • Teaching you about bladder, bowel, and sexual health and improve your pelvic health.

For most women receiving advice alone is not enough. Evidence shows that a big percentage of women fail to perform pelvic floor exercises correctly without being formally trained and without supervision.

The goal of physiotherapy is to support women as well as possible by helping to prepare their bodies for pregnancy, childbirth, and postpartum.

Physiotherapist assists women with a wide spectrum of conditions such as:

Urinary incontinence

  • Stress Urinary Incontinence
  • Urge Urinary Incontinence
  • Overactive Bladder
  • Male Incontinence
  • Childhood Incontinence

Pregnancy & Postnatal

  • Guidelines on safe exercise during pregnancy
  • Provision of Antenatal Classes·        
  • Treatment and management of Pelvic Girdle Pain including symphysis pubis dysfunction·      
  • Low back pain
  • Rib pain/Thoracic Pain
  • Carpal tunnel syndrome
  • Postnatal rehabilitation of pelvic floor and abdominals (including Diastasis Rectus Abdominis)

Pelvic Floor Dysfunction·

  • Prolapse
  • Sexual Dysfunction (Dyspareunia)
  • Chronic Pelvic Pain
  • Bowel Conditions
  • Constipation
  • Faecal Incontinence  


Your first session with a physiotherapist will include a detailed assessment of your condition, beginning with questions about your symptoms and general medical history. You can rest assured that everything you tell the physiotherapist will remain completely confidential.

The assessment will be followed by a physical examination. The type of examination carried out will depend on the condition you are attending to and may include an assessment of posture and function, muscle tone, flexibility, and strength.


Based on the results of the assessment, your physiotherapist will recommend a treatment program that has been specifically developed for you, so there is no standard treatment in this area.

Treatment For Pelvic Floor/Bladder & Bowel Conditions May Include:

  • Exercises to strengthen or release the pelvic floor muscles
  • Manual therapy
  • Advice about healthy bladder and bowel habits
  • Discussion surrounding possible lifestyle changes that will help manage the problem

Treatment For Musculoskeletal Conditions May Include:

  • Manual therapy
  • Exercises to strengthen weak muscles
  • Stretches to reduce tension in tight muscles
  • Kinisio-taping therapy
  • Advice regarding activities
  • Discussion surrounding possible lifestyle changes that will help manage the problem
  • Provision of supports/braces

In line with the ICF model approach, our experts will devise your treatment program. They will use a combination of pelvic floor exercises, pilates and/or electrical stimulation, advice on sleeping postures, toileting and positional modifications, relaxation techniques for treating your condition.

Do you want help preparing your body for pregnancy? Kindly contact us to discuss your options with our physiotherapists.