Article by Natalie Garay written for Ellie,



I don’t know how many times I’ve heard this from clients who’ve come in with various ailments, ranging from incontinence to organ prolapse. Many wondered why a friend, family member, or their doctor didn’t bother to say something like, “Heads up, after pregnancy your insides could potentially fall out.”

I kind of get it—nobody wants to scare a pregnant mama. It’s enough just preparing for the arrival of your little one; why add more stress?

But in my opinion, it’s best to know what could happen so that you can prepare for any and all scenarios. Here are a few things that might happen after you deliver your baby.  While some of these sound unpleasant, or even scary, there are effective treatments for each of them and in some cases, preventative measures. There are also some things you should think about as you’re getting back to your life post-birth.


You may have experienced incontinence during pregnancy (a little urine may have leaked when you sneezed or laughed) but you might not have realized that this can happen after the baby arrives, too. The weight of the baby during pregnancy can weaken your pelvic floor; so can pushing during delivery. This is common and treatable; it’s definitely not something you need to live with.

A specialized Pilates instructor or Physical Therapist can also help. You may also want to minimize running or jumping exercises until your pelvic floor has recovered from childbirth. Such exercises may exacerbate a weak pelvic floor. You can strengthen your pelvic floor muscles pre and post-partum but do focusing on kegels and other pelvic focused exercises. But believe it or not—very focused breathing exercises may be the key to getting your pelvic floor to start working again, especially if you suffer from pelvic floor dysfunction.


While rare, this is also a post-birth possibility that many women don’t hear about. Pelvic organ prolapse is an extreme case of a weakened pelvic floor that results in pelvic organs such as the bladder, uterus, or rectum making their way down and out. Yes, they can pass through the pelvic muscles and make their way out of the vaginal opening. While this sounds horrible, it can also be rehabilitated with a specialized women’s health practitioner. If you find yourself straining during bowel movements, either before or after childbirth, work on adding fiber or a stool softener to your diet. By strengthening your deep abdominal muscles, your outer hips, which include your smaller gluteus muscles, gluteus medius and gluteus minimus, and your pelvic floor you can prevent and/or rehabilitate incontinence and organ prolapse.


Diastasis Recti is a separation in your Rectus Abdominus muscle, the top layer of your abdominals. It doesn’t hurt, so you don’t know that it’s happening. This occurs along the linea alba, the center of the abdominal muscle during pregnancy as the muscles stretch. It will show up as a bulge on your abdomen as you sit up or make a crunch-like motion.

If you experience this, you’ll want to avoid forward flexion motions (like crunches) during pregnancy and until you’ve properly rehabilitated your abdominals post childbirth. Otherwise, such movements may exacerbate the condition.  Because your abs also support your back and spine, if you don’t address this issue, it can lead to chronic neck or back pain. Sometimes surgery is recommended, but with proper rehabilitation, the gap in many cases can be significantly reduced or eliminated.


Why mothers giving birth via cesarean section are not regularly prescribed post-op physical therapy or Pilates is beyond me. This is major abdominal surgery and should be rehabilitated as such. Pregnancy stretches and weakens the abdominals; c-section surgery, which cuts through these muscles, only adds to the stress on this part of the body. Once again, proper rehabilitation can help you to avoid back and neck pain that might otherwise arise as a result.


Your body just went through a significant change over the course of 9 months. You do not, I repeat DO NOT, need to bounce back immediately. Take your time and ease back into your pre-pregnancy workout routine. I’ve heard too many stories from mamas who thought they could jump back into their normal running or weightlifting routine and ended up doing more harm than good. The idea here is to strengthen your body so that you can take care of your baby and feel good.

Mothering your little one is challenging enough and trying to mother when you’re feeling weak or in pain is not good for either of you. While you might be focused on nurturing your baby, it’s important to nurture yourself as well.

Pilates can be a very effective post-baby practice. When practiced properly and carefully, you can regain your abdominal strength after your muscles have been stretched beyond recognition. Pilates is known for lengthening and strengthening muscles, giving your body a toned, lean look and feel; it’s also the best way to get into the deep core muscles. Pilates is form-focused, which is great for getting your body back to proper alignment after pregnancy has caused shifts in the pelvis. It’s a gentle yet very effective method for easing back into your movement practice. Try working one on one with a well-trained instructor before moving into a group class setting.

If you can’t get to a private class now, there are many videos online to help you begin practice at home. Here’s my favorite short beginner video for my clients. In it, I show some fundamentals of Pilates including how to activate your deep abdominal muscles. This a great video for postpartum moms who want to reconnect to their abdominals and strengthen their pelvic floor.

As you begin any kind of exercise practice or rehabilitation after your baby’s birth, remember that your body has been through a lot and it will take time to rebuild your foundation. It’s okay to take your time and go at your own pace!