Pelvic floor and tummy muscles after birth

Finding the right muscles

The pelvic floor is a sling of muscle under your bladder, womb and bowel. Pregnancy and birth stretch it, which is why leaks and a feeling of heaviness are so common in the months after. The NHS describes the squeeze in two parts:

1. Squeeze and draw in your back passage as if you are holding in wind.
2. At the same time, squeeze around your vagina and bladder as if you are stopping the flow of urine.

The NHS routine

Tie the routine to something you already do several times a day: each feed, each nappy change, brushing your teeth.

What the research shows

The Cochrane review of 46 trials and 10,832 women (Woodley et al., 2020) is the most complete summary:

• women without leaks who did structured pelvic floor training in pregnancy were probably less likely to report leaks in late pregnancy (62% fewer) and slightly less likely 3 to 6 months after birth (29% fewer);
• for training started only after delivery, the effect on leaks in the later postnatal period was uncertain;
• no trial except one small study reported side effects.

In plain words: training helps most when it starts early and is done properly. If you are still pregnant, start now. If you have already given birth and still leak, specialist pelvic health physiotherapy is the next step rather than simply doing more squeezes on your own.

The tummy gap (diastasis recti)

It is common for the two long muscles down the middle of your stomach to separate during pregnancy, usually by about two finger widths, says the NHS. The gap usually closes by the time your baby is 8 weeks old.

The self-check

1. Lie on your back, knees bent, feet flat.
2. Lift your shoulders slightly off the floor and look at your tummy.
3. With your fingertips, feel between the muscle edges above and below your belly button and count how many fingers fit in the gap.
4. Repeat every week or two to see whether it is narrowing.

The NHS stomach exercise: breathe in gently, then as you breathe out draw in the lower part of your stomach like a corset while squeezing your pelvic floor. Hold for a count of 10, breathing normally, then release. Repeat up to 10 times.

What helps day to day, from Leeds Teaching Hospitals NHS Trust: avoid sit-ups and exercises that make the tummy bulge, and roll onto your side to get in and out of bed. The trust notes that up to one third of women still have a separation 12 months after birth.

What the evidence says: a 2023 review of 16 trials found that abdominal exercise led to a small reduction in the gap (about 0.4 cm) compared with usual care, not enough to call clinically significant, though exercise may bring other physical and emotional benefits (Benjamin et al., Physiotherapy 2023). Support bands are discussed in our postpartum belly band guide.

Is this normal? When to call

When to ask for a referral

• A gap still obvious 8 weeks after birth, or a bulge when you sit up.
• Leaking urine or poo that is not improving.
• A heavy feeling between your vagina and anus, or a bulge in the vagina, which can be a sign of pelvic organ prolapse.

Your GP, midwife or health visitor can refer you to a pelvic health physiotherapist. Bring these questions to your postpartum check.

Questions parents ask

Sources

1. NHS, Your post-pregnancy body (pelvic floor and stomach exercises, separated stomach muscles) checked October 13, 2026
2. Leeds Teaching Hospitals NHS Trust, Diastasis of recti (separation of stomach muscles) checked October 13, 2026
3. NHS, Pelvic organ prolapse checked October 13, 2026
4. ACOG, Exercise after pregnancy (Kegel exercises) checked October 13, 2026
5. Woodley SJ et al., Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women, Cochrane 2020 (PMID 32378735) checked October 13, 2026
6. Benjamin DR et al., Conservative interventions may have little effect on reducing diastasis of the rectus abdominis in postnatal women, Physiotherapy 2023 (PMID 36934466) checked October 13, 2026

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