I have two kids and had two excellent obstetricians. Neither of them ever mentioned my pelvic floor. I was already a physiotherapist, and I still left my postpartum appointments with nothing more than a vague "do your Kegels" in the back of my mind because that's the only thing I associated with pelvic floor therapy at that point.

My kids are now 9 and 12. A lot has improved since then but the fact remains, women still aren't clear about the importance of pelvic floor therapy and the huge impact it has on how they show up in their own lives.

Many still sneeze in the grocery line or scoop a toddler off the floor, feel that little leak, and shrug it off because someone along the way told them that's just what happens after kids.

Leaking after birth is common. It is also very fixable, and the research behind that has recently become hard to argue with.

Your pelvic floor is a muscle

You would never strain a bicep and decide that's just what you get for having arms. You'd see someone, get a plan and work it back to strength. Your pelvic floor is a group of muscles too, and it spent nine months holding up a growing baby before birth ever entered the picture.

That's also why leaking isn't only a vaginal birth issue. A lot of the load on your pelvic floor happens during pregnancy itself, so women who had C-sections come to see us with the same symptoms and deserve the same care.

What 65 studies found

In 2025, researchers published a large review in the British Journal of Sports Medicine that pulled together 65 studies on exercise after having a baby, covering 21,334 people across 24 countries. When they looked at the seven randomized trials that tested pelvic floor muscle training after birth, the odds of urinary leaking were 37% lower for the people who did the training.

For years "do your Kegels" was handed out like a throwaway line at the end of an appointment. This review is part of why I can now say something more specific: structured pelvic floor training after birth helps with leaking.

What the research can't promise you

Research isn't without its limitations. In this particular review, the studies varied quite a bit in how much training helped, which means results differ from person to person. Training lowers the odds of leaking but for a number of reasons, it won't make leaking disappear for everyone. There were also promising outcomes for pelvic floor prolapse, but they came from a single small trial of 123 people, so further research is needed to support more definitive results.

Why Kegels on your own aren't always enough

Most women who try pelvic floor exercises at home tell us they aren't sure they're doing them right, and they're usually onto something. Very few of us were ever taught properly or with actual feedback, so we squeeze our glutes or hold our breath and bear down instead.

A pelvic floor that's weak also needs a different plan from one that's tight or not coordinating well, and for a tight pelvic floor, piling on more Kegels can make things worse. After decades in practice, I can assure you that I've been surprised by how some clients have presented upon physical exam even after speaking about their symptoms extensively. You can't feel that difference from the outside, which is why an internal exam remains the gold standard when it comes to assessing tone and contractility of pelvic floor muscles.

What happens at your first visit

Pelvic floor exams are vulnerable so having clarity about exactly what is involved is important.

Your physiotherapist will start by talking with you about your birth, your symptoms and what you want to get back to. That might be running again or simply laughing at a dinner party without crossing your legs. We also ask questions about your nutrition, general health, digestion, toileting and stress, all of which can impact your pelvic floor.

The most accurate way to see what your pelvic floor muscles are doing is an internal exam, done vaginally. Your physio will explain everything before they begin and check in with you as they go. It is always your choice, and if you'd rather not have an internal exam that day there's still plenty we can assess externally and start working on.

Either way, you'll leave with a plan built around your body and the week you're living. If you still have questions you feel a bit shy asking, I answered the ones I hear most in 12 "Silly" Questions You Will Want to Know the Answers to Before Your Pelvic Floor Exam.

Canada is behind on this

In France, pelvic floor rehab is a routine part of postpartum care, and new mothers are typically prescribed around ten sessions covered by their public health system. Here in Canada, most women still hear about it from a friend, if they hear about it at all.

I didn't hear about it from my own doctors either, and I'd love for that to change for you. Our team is biased (based on evidence) but we believe firmly that pelvic floor physiotherapists should be a standard member of your perinatal team from pregnancy through to parenthood.

When to book an assessment

I'm of the mind that everyone should have a pelvic exam following birth whether you experience symptoms or not. A postnatal exam provides important information that allows our clients to make educated decisions about how they return to activity, how they heal and help them understand changes to their bodies that contribute to a more positive body acceptance.

If you leak when you cough, sneeze, laugh, lift or exercise, it's worth getting checked, whether your baby is eight weeks old or eight years old. The same goes for heaviness or pressure in your pelvis, or pain that hasn't settled. You don't have to accept leaking as your new normal.

At Body Co in the Junction, our pelvic floor physiotherapy team works with new and not-so-new parents every day. You can see Nicole Newediuk, Tara Campbell or Nikita Gaud, and you can book an assessment online or call us at 416-572-0479 whenever you're ready.

Frequently asked questions about leaking after birth

Is it normal to leak pee after having a baby?

Leaking after birth is common, especially when you cough, sneeze, laugh or lift, and it is also very fixable. A 2025 review of 65 studies in the British Journal of Sports Medicine found that pelvic floor muscle training after birth lowered the odds of urinary leaking by 37%. Common doesn't mean you have to live with it.

How long does postpartum leaking last?

It varies from person to person. For some women it eases in the first few months after birth, and for others it hangs on for years, so waiting it out isn't a reliable plan. If you're still leaking after your six-week postpartum checkup, a pelvic floor physiotherapy assessment can show you why and what will help.

Do Kegels help with leaking after birth?

Structured pelvic floor training helps with leaking, and the research is strong enough to say so. The catch is doing the right exercises for your body. Many women squeeze their glutes or hold their breath without realizing it, and if your pelvic floor is tight rather than weak, more Kegels can make symptoms worse. An assessment tells you which plan fits.

Can you leak after a C-section?

Yes. A lot of the strain on your pelvic floor happens during pregnancy itself, while it carries the growing weight of your baby for months. That means women who deliver by C-section can leak too, and they deserve the same pelvic floor assessment and care as women who deliver vaginally.

When should I see a pelvic floor physiotherapist after giving birth?

Your six-week postpartum checkup is a good time to book, and it's never too late, whether your baby is eight weeks or eight years old. Leaking, heaviness or pressure in your pelvis, and pain that hasn't settled are all good reasons to come in. At Body Co, we recommend a postnatal pelvic floor exam for every new parent, symptoms or not.

Reference

Beamish NF, Davenport MH, Ali MU, Gervais MJ, Sjwed TN, Bains G, Sivak A, Deering RE, Ruchat SM. Impact of postpartum exercise on pelvic floor disorders and diastasis recti abdominis: a systematic review and meta-analysis. Br J Sports Med. 2025;59(8):562-575. doi:10.1136/bjsports-2024-108619. PMID 39694630.

This article is for general education and isn't a substitute for an individual assessment.