Most pregnancy books spend hundreds of pages on what to expect during those nine months, then dedicate maybe a chapter to postpartum recovery. Hospital discharge happens within days, armed with instructions about baby care and a follow-up appointment scheduled for six weeks out. That’s basically it for official guidance on how a woman’s body is supposed to recover from one of the most physically demanding experiences it will ever go through.
The problem is, a lot happens in those six weeks that nobody prepared anyone for. And plenty of issues persist well beyond that arbitrary checkpoint when doctors declare everything “back to normal.”
The Pelvic Floor Reality
Here’s what typically happens: during pregnancy, the pelvic floor muscles stretch and weaken under the weight of a growing baby. During vaginal delivery, they stretch even further. Sometimes they tear. Sometimes there’s significant trauma. Then women get sent home and told to do some Kegels.
But pelvic floor dysfunction goes way beyond what basic exercises can fix. Stress incontinence—leaking when coughing, sneezing, or jumping—affects most new mothers to some degree. Many assume it’s just part of life after kids now. The truth is it shouldn’t be permanent, and a pregnancy physiotherapist can assess exactly what’s going on and create a proper treatment plan rather than leaving women to figure out Kegels from a pamphlet.
Pelvic organ prolapse is even less discussed, despite being fairly common. This is when pelvic organs drop from their normal position due to weakened support structures. It can cause a feeling of heaviness, bulging, or pressure. Some women notice it immediately after birth. Others don’t realize what’s happening until months later. Either way, it rarely comes up in standard postpartum checkups unless the patient specifically mentions it, and many don’t know it’s even a thing to mention.
Abdominal Separation That Doesn’t Close
Diastasis recti—the separation of abdominal muscles—happens to most pregnant women. The growing uterus literally pushes the rectus abdominis muscles apart. For many, the gap closes naturally in the months after birth. For others, it doesn’t.
A persistent separation can cause that postpartum belly pooch that won’t go away no matter how much core work someone does. More importantly, it can lead to back pain, poor posture, and core weakness that affects everyday activities. The standard advice is usually “give it time” or “do some planks,” but a significant gap needs specific rehabilitation techniques. Regular ab exercises can actually make it worse if done incorrectly.
Women often don’t realize they have diastasis recti because nobody checks for it. The six-week postpartum appointment focuses on whether the uterus has shrunk back down and if bleeding has stopped. Abdominal muscle assessment isn’t standard protocol.
The Back Pain That Lingers
Pregnancy changes posture dramatically. The curve of the lower back increases to balance the forward weight of the belly. Hips widen. The whole body compensates. After birth, these changes don’t immediately reverse. The body has to relearn its old patterns, and sometimes it doesn’t do that efficiently on its own.
Lower back pain during pregnancy is almost expected. What surprises many women is when it continues or even worsens after giving birth. Carrying a baby (the outside kind now), bending over cribs and changing tables, awkward breastfeeding positions—all of this puts strain on a body that’s still recovering and rebalancing itself.
Pelvic girdle pain is another one that can persist postpartum. During pregnancy, hormones loosen the ligaments around the pelvis to prepare for birth. This instability can continue for months afterward, causing pain in the hips, pelvis, and lower back. It can make walking painful. Getting in and out of the car becomes difficult. Rolling over in bed hurts.
C-Section Recovery Gets Shortchanged
Caesarean sections are major abdominal surgery, yet recovery expectations are often unrealistic. Yes, women are up and moving within a day or two because they have to be—there’s a newborn to care for. But the body needs proper time to heal from having multiple layers of tissue cut through and stitched back together.
Scar tissue can cause problems long after the incision heals. It can feel tight, numb, or painful. It can restrict movement. Some women develop adhesions where internal scar tissue sticks to nearby organs or tissues, causing pain or digestive issues. These complications can emerge months or even years after the surgery.
Core strength takes a significant hit after a C-section. The abdominal muscles are cut during the procedure, and they need specific rehabilitation to function properly again. Without proper recovery work, women can experience persistent weakness, pain, and movement dysfunction.
The Six-Week Myth
That standard six-week postpartum checkup creates an expectation that recovery should be complete by then. For some women, it is. For many, it’s not even close. But when a doctor says everything looks fine, it’s hard not to internalize the message that any ongoing problems must be personal failings rather than legitimate issues needing treatment.
The appointment itself is usually brief. A quick physical exam, maybe some questions about mood and bleeding. If there’s no obvious medical emergency, women get cleared to resume normal activities, including exercise and sex. But “cleared” doesn’t mean the body is actually ready—it just means there are no red flags requiring immediate medical intervention.
Real recovery from pregnancy and birth takes months, sometimes a year or more. Muscles need to regain strength. Connective tissue needs to heal. Hormones need to rebalance. None of this happens in six weeks, regardless of what the calendar says.
What Actual Support Looks Like
Proper postpartum care should include assessment of pelvic floor function, abdominal muscle integrity, and overall movement patterns. It should address pain, weakness, and dysfunction rather than dismissing them as normal. It should provide treatment plans specific to individual needs rather than generic advice.
Most women don’t get this level of care because it’s not part of standard medical protocol. They’re left to navigate recovery on their own, often not knowing that the problems they’re experiencing have names, causes, and solutions. The postpartum period deserves the same attention and resources as pregnancy itself, but the current system treats birth as the finish line rather than the beginning of a long recovery process.