A note from Bethany: I am so glad to have Amy from Restore Your Core Physical Therapy sharing her expertise here today. As a Speech-Language Pathologist and Certified Breastfeeding Counselor, I see new mamas every week who are focused entirely on their babies and giving almost nothing to their own bodies. Amy’s work is the other piece of that puzzle, and I could not think of a more important voice to bring to this space. I hope this post gives you permission to take your recovery as seriously as you are taking everything else.
You spend nine months preparing for birth. You read the books, take the class, pack the bag, and assemble the crib. And then the baby arrives, and almost overnight, all of that attention turns toward the little person in your arms.
Here’s what almost no one prepares you for: your body just did something enormous, and it doesn’t simply snap back into place because the pregnancy is over. The weeks and months right after delivery have a name — the fourth trimester — and they deserve every bit as much care, attention, and support as the three trimesters that came before.
In the United States, we don’t talk about that part. We hand you a newborn, schedule a single six-week checkup, and quietly expect you to bounce back and keep moving. But “bouncing back” was never a real plan. It’s a myth — and it’s leaving millions of women to recover on their own, often in silence, often in pain, and often believing that whatever they’re feeling is just their new normal.
It doesn’t have to be.
Your Body Has a Lot Going On Right Now — Even if It Looks Fine on the Outside
Pelvic physical therapists who specialize in pelvic health and whole-body care help new moms navigate far more than most people realize. In the fourth trimester, that can include:
- Pelvic pain and pelvic floor dysfunction
- Urinary leaking, urgency, and frequency
- Pelvic organ prolapse
- Painful sex
- Back pain, SI joint dysfunction, and rib pain
- Neck and shoulder pain (hello, hours of feeding and rocking)
- Foot and ankle pain
- Mastitis
- Lower-extremity swelling
- Diastasis recti (abdominal separation) and a weak core
- Abdominal pain and scar-related pain or pulling, including C-section and tearing scars
That’s a long list — and it’s not even complete. The common thread is that all of it is connected. Your pelvic floor, your core, your breath, your posture, and the way you carry and feed your baby all work as one system. When one part is overloaded, the others compensate, which is exactly why so many of these issues show up together.
Worth noting: neck and shoulder pain from feeding is real, and it often has as much to do with positioning as it does with your body. If breastfeeding is part of what is wearing on your body right now, in-home breastfeeding support can help you find a setup that puts less strain on your neck and shoulders during those long feeding sessions.
“But I Feel Fine.”
This is the part worth sitting with: you should have a postpartum assessment even if you feel good.
Feeling okay is wonderful — but it isn’t the same as a clean bill of health. Many of the issues above are quiet at first. A small diastasis, a pelvic floor that isn’t quite reconnecting, a scar that’s beginning to restrict movement — these don’t always announce themselves with pain. They show up later, sometimes months later, when you return to running, lift your growing toddler, or get pregnant again. An assessment when you feel good is the best possible time to catch what’s developing and prevent it from becoming a problem.
Think of it the way you’d think of a dental cleaning or an annual physical. You don’t wait until something hurts to go. The whole point is to stay ahead of it.
How We Care for New Moms at Restore Your Core Physical Therapy
We built our postpartum care around the reality of new motherhood — the exhaustion, the healing, the not-wanting-to-leave-the-house with a days-old baby.
At about two weeks postpartum, we start with a telehealth visit. This early check-in lets us talk through any pain or concerns you’re having, answer the questions piling up in your head, and — because we’re meeting you in your own home — actually see your surroundings. We can spot the chair that’s wrecking your back during feeds, the way you’re getting in and out of bed, or the setup of your changing station, and suggest simple changes that make recovery easier on your body.
Then, after your six-week OB or midwife follow-up, we see you in the clinic for a full, hands-on assessment. By that point you’ve been medically cleared, and we can do the detailed evaluation — pelvic floor, core, posture, movement, scars — that sets up your recovery plan.
An important note about medical clearance: a very large majority of new moms did not have the pelvic floor assessed by their OB or midwife during that six-week check-up. The OB or midwife checks whether the uterus has returned toward its pre-pregnancy size and asks about postpartum bleeding and discharge, assesses mental health, discusses breastfeeding when appropriate, and discusses contraception and family planning. If you had a vaginal delivery, they’ll often examine the perineum and any tears or episiotomy to confirm healing. After a C-section, they check the incision for proper healing and signs of infection.
Pelvic physical therapy allows for two touchpoints within the first six weeks postpartum — early and thorough care for new moms. That’s a far cry from the single appointment most American new moms are offered. Furthermore, pelvic physical therapists can see a new mom as early as one week postpartum if they are experiencing pain that is limiting her ability to care for her baby.
The postpartum period is full of things that need attention at the same time. If breastfeeding is also something you’re working through, you can read more about what postpartum breastfeeding support in Brownsburg looks like, including in-home visits that fit around a new baby’s schedule.
We Are Genuinely Behind in the US
This isn’t a uniquely hard problem to solve. Other countries have already solved it.
In France, every mom is prescribed roughly 10 sessions of pelvic floor rehabilitation (la rééducation périnéale) after delivery, routinely, regardless of symptoms — and it’s covered by the government. The program has been in place since 1985, specifically to prevent incontinence and prolapse and to restore function and quality of life.
In Belgium, Norway, Finland, Sweden, and Spain, pelvic floor training is woven directly into public health guidelines as a standard step in both prevention and recovery.
Australia, Canada, and the UK, coverage isn’t always universal or mandated, but medical organizations widely recognize pelvic PT as standard postpartum care and increasingly route new moms to it.
In the United States? Pelvic physical therapy is not a routine, automatic appointment after birth. For most women, it only happens if they already have a problem serious enough to get referred — and even then, many have to go looking for it themselves.
The gap isn’t about what the science says. It’s about what we’ve decided to prioritize. And right now, in the U.S., recovering mothers are paying the price for that decision.
A Word About “the Kegel Chair” and Passive Devices
As awareness grows, a few shortcuts are being marketed heavily — and they’re worth understanding clearly.
You may have seen the Emsella chair, which advertises the equivalent of 11,000 Kegels per session: you stay fully clothed, sit down, and let electromagnetic energy contract your pelvic floor for you. VTone, increasingly offered at med spas and functional-medicine offices, makes a similar 11,000-Kegel claim using a vaginally inserted probe that delivers electrical stimulation.
These devices can feel appealing — effortless, fast, no homework. And they may have a role for very specific cases. But here’s the honest limitation: they’re doing passive Kegels. The machine contracts the muscle for you. What it cannot do is teach your body how to coordinate that pelvic floor with your breath, your core, your posture, and the real-life movements of carrying, lifting, and chasing a child.
Your pelvic floor doesn’t work in isolation, and a strong but disconnected muscle doesn’t actually solve most postpartum problems. The research consistently points to the same conclusion: the most effective approach is whole-body physical therapy that helps you reconnect with your inner core — the deep, integrated system of muscles that supports you through everything you do as a new mom. A chair can’t teach that. A skilled pelvic PT can.
You Deserve a Real Recovery
The fourth trimester is not a footnote to your pregnancy. It’s a season of healing that your body moves through whether or not anyone helps you — and you don’t have to move through it alone, guessing.
If you’re pregnant now, you can line this up before the baby arrives. If you’re already postpartum — two weeks, two months, or two years out — it is not too late to be assessed. A pelvic physical therapist can meet you where you are and help you feel strong, connected, and at home in your body again.
You shouldn’t have to live in another country to get the care you deserve. You just have to know it exists — and ask for it.
And while you are building your postpartum support team, do not forget that breastfeeding support is part of your recovery too. You can read the breastfeeding prep checklist or reach out to Bethany directly if feeding is something you want support with before or after baby arrives.
👉 Learn more about Restore Your Core Physical Therapy
👉 Schedule a postpartum assessment with Amy’s team
About the Author
Amy is a pelvic physical therapist at Restore Your Core Physical Therapy, where she specializes in postpartum recovery, pelvic floor rehabilitation, and whole-body care for new moms. She believes every woman deserves more than a single six-week checkup and has built her practice around giving them exactly that.
FROM BETHANY:
If Amy’s post resonated with you and breastfeeding is also something on your mind, I would love to be part of your postpartum support team. I offer in-home visits for families in Brownsburg, Avon, Plainfield, Zionsville, and the westside of Indianapolis.