It’s a topic that is rarely discussed, or only mentioned quietly between two pregnancy confessions. And yet, perineal rehabilitation concerns the vast majority of women after childbirth. Much more than a medical formality or a series of exercises, this key post-partum step sits at the intersection of physical care and self-reconnection. Manual or assisted with a probe, the right choice is the one that respects your body, your sensations, and your pace. Because well-supported pelvic floor muscles also mean greater confidence in your femininity.
TABLE OF CONTENTS :
- The pelvic floor after childbirth: what you need to know
- The two main methods of pelvic floor rehabilitation
- How do you know which method is right for you?
- Frequently asked (and taboo-free) questions about pelvic floor rehab
The pelvic floor after childbirth: what you need to know
Invisible and often misunderstood, the pelvic floor actually plays a central role. Its muscles support the pelvic organs and ensure continence, while also contributing to sexual pleasure… Needless to say, women have every reason to learn about it.
What is the pelvic floor for? A brief anatomical reminder
The pelvic floor, also known as the pelvic diaphragm, is a group of muscles and tissues located between the pubic bone and the coccyx. It supports the lower abdominal organs (bladder, uterus, rectum) and plays a key role in urinary control, pelvic stability, and the quality of sexual intercourse. In fact, when toned, the pelvic floor intensifies sensations during intercourse by naturally tightening contact between both partners. It is therefore essential in everyday life… even if most women only discover it through motherhood.
What can weaken it
During pregnancy, the pelvic floor undergoes a lot of strain: it carries the weight of the baby, amniotic fluid, and placenta… right up until birth, especially with vaginal delivery, which can cause significant stretching, micro-tears, or muscle relaxation. However, throughout life, other, subtler factors can also contribute to weakening it:
- chronic constipation,
- certain high-impact sports (running, trampoline, etc.),
- regularly lifting heavy loads,
- or repeated and prolonged coughing.
When should you consider pelvic floor rehabilitation?
In France, pelvic floor rehabilitation is systematically offered to new mothers, generally 6 to 8 weeks after childbirth, whether the birth was vaginal or by cesarean. It is 100% covered by the national health insurance with a prescription. However, certain signs or sensations should prompt you to consult:
- Urinary leakage with effort, coughing, or laughter,
- a feeling of heaviness in the lower abdomen,
- decreased sexual sensation,
- or an impression of muscle looseness.
💡 Good to know: even without noticeable symptoms, you can ask your midwife or a specialized physical therapist for a check-up.
The two main methods of pelvic floor rehabilitation
If you recognize yourself in the symptoms mentioned or are expecting a baby and want to know what to expect afterward, pelvic floor rehabilitation is a gradual process aimed at both muscle tone and body awareness. Depending on your needs, it is generally offered in two main forms—manual or with a probe—which can also be combined.
Manual rehabilitation
This is often the first method offered. Several sessions led by a midwife or physical therapist teach you which muscles to contract and relax voluntarily.
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The goal? To better feel your muscles, regain control, and restore tone using exercises done lying or sitting, guided by voice or vaginal touch.
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For whom? This approach is ideal if you want to move forward gently and listen to your body. It also supports breathing, posture work, and overall pelvic floor coordination.
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Benefits: no equipment needed, sensory learning, and independent awareness of your body and its sensitivity.
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Drawbacks: requires more personal commitment, and progress can be slower.
Rehabilitation with a probe
Here, a vaginal probe is inserted and connected to a biofeedback device (which detects and displays contractions on a screen) or to an electrostimulation device. At Perifit, rehab sessions are even combined with interactive video games—for extra fun and motivation!
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The goal? To see or receive a physical signal to strengthen your pelvic floor, especially if voluntary contractions are difficult. With biofeedback, you visualize your efforts for more motivation. With electrostimulation, contractions are triggered automatically to “wake up” the muscles.
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For whom? This method is often suggested to women who have difficulty feeling or initiating contractions, or in cases of very weakened pelvic floor, such as after several pregnancies.
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Benefits: helpful in cases of significant muscle weakness, and sometimes more rapid improvement in muscle tone.
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Drawbacks: less focused on sensation and requires equipment some women may be uncomfortable using.
🩷 In addition to rehabilitation with your doctor, you can perform sets of pelvic floor contractions at home while sitting at the table or your desk, stretching, hypopressive abdominal exercises (focused on creating a vacuum effect), try certain yoga postures (Supta Baddha Konasana, Balasana, or Setu Bandhasana), or explore Pilates. Don’t hesitate to ask your doctor to discuss these alternative approaches with you in more detail.
Choosing a midwife or physical therapist: the importance of good support
Both midwives and physical therapists can support your pelvic floor recovery, provided they have the right training. Do you need more holistic or emotional support, or are you postpartum? A midwife offers a care environment more centered on motherhood. Looking instead for a technical approach or support for other musculoskeletal issues (lower back pain, instability, etc.)? A specialized PT might be an excellent option.
In any case, trust your gut feeling. Successful rehabilitation always starts with a relationship built on trust.
Learning to know your body to take care of it
Beyond your chosen method, pelvic floor education is fundamentally important beforehand. Understanding how your body works, knowing when and how to contract the right muscles, learning conscious breathing and good posture… All these elements enhance the effectiveness of rehabilitation and help prevent recurrences.
How do you know which method is right for you?
When choosing, your healthcare provider’s opinion is your best guide, as they can assess the health of your pelvic floor and your needs based on your personal history.
But beyond the protocol and best medical approach for your body, your own feelings also matter. Whether you’re hands-on with your rehab or 100% guided, the best method is the one that causes you no stress and matches your pace. It’s absolutely possible to alternate or even combine both techniques.
Finally, as with all healthcare, the trust you share with your practitioner is vital; because you’re dealing with an intimate area, and because you’ve been through so much during pregnancy. You should feel free to ask questions, express doubts, and refuse any exercises that make you uncomfortable.
Frequently asked (and taboo-free) questions about pelvic floor rehab
🩺 Does the probe hurt?
No, the probe is usually well tolerated. It is thin, flexible, and used gently under professional guidance. If any discomfort occurs, it can be adjusted or replaced by another method.
🙈 Is pelvic floor rehab awkward or embarrassing?
It’s an intimate area, but healthcare professionals are trained to guide you respectfully. Any embarrassment generally fades after the first few minutes, especially if you feel at ease.
🍼 If I’m not breastfeeding, does it make a difference?
No. Rehab is recommended for all women after childbirth, regardless of whether you breastfeed. It works on the muscles, independently of your baby’s feeding routine.
👶 Is it only for vaginal births?
No. Even after a cesarean, your pelvic floor may have been strained during pregnancy and deserves to be assessed.
💧 Is it really necessary if I don’t have leaks?
Yes! Having no leakage does not mean everything is perfect. Rehabilitation helps prevent potential issues and restores proper muscle tone overall.
🧘 What is a pelvic floor rehab session like?
It lasts about 30 minutes. Depending on the method chosen, it may include manual exercises, guided contractions, or use of a probe. Everything is explained and adapted to your comfort.
🚫 Are there any contraindications?
Pelvic floor rehabilitation is generally gentle and well tolerated. However, in case of infection, unexplained pelvic pain, or a specific neurological condition, a medical opinion is crucial before starting. The primary goal remains a personalized approach tailored to your health as a whole.
What if we changed how we look at pelvic floor rehab?
Too often seen as a medical formality or a chore, caring for the pelvic floor can also be approached as a moment of reconnection to oneself. An opportunity to re-inhabit your body after pregnancy and enjoy deep self-care, without pressure.
Your body deserves time, attention, and respect. So whatever the method, the most important thing is to be supported with kindness.
And what about later? Pelvic floor rehab at menopause
While it’s most often discussed after childbirth, pelvic floor rehab can also be beneficial later in life, particularly at menopause. Due to the drop in hormones, the pelvic floor can become weaker. Targeted sessions can bring back muscle tone and comfort at any age.
