How to Improve Your Pelvic Floor In the 4th Trimester

From the Experts at Flyte Therapy

Written by: Shravya Kovela, PT, DPT, OCS & Leah Fulker, PT, DPT
Posted: March 21, 2022
You’ve probably seen articles and ads proclaiming “Get your pre-baby body back”. Most women would love to “bounce back” after pregnancy and delivery. But let’s get real. During the 4th trimester (the first 3 months after baby), you are recovering from the toll of pregnancy and birthing a new human being! As wonderful as pregnancy and childbirth can be, your body has changed. So often, the emphasis is on weight and shape. We’re going to focus on a part of the body that receives less attention but is vital to your health and wellness — especially after giving birth. Let’s talk about the pelvic floor. 

What is the pelvic floor? 

The pelvic floor is a bowl-like network of muscles and tissue that run from your pubic bone to the tail bone, sitting under the bladder, bowel, and uterus supporting them. These muscles help with bladder control, bowel control, and sexual function. 

Pregnancy and childbirth put tremendous pressure on the pelvic floor, which can weaken and traumatize the pelvic floor muscles. And it’s no wonder: these muscles have a big job as your pregnancy progresses. They hold the weight of your growing baby, help stabilize your spine, hips, pelvis, and keep you from leaking urine or poop! And then there’s the birthing process: Consider that the pelvic floor muscles stretch and strain up to 245% of its resting length during a vaginal delivery.1 Your body has been through a lot in the process of nurturing a new life. 

What are some common issues stemming from pregnancy and delivery? 

Pregnancy and postpartum can be glorified, especially in social media. As a result, some women might be surprised, embarrassed, or even ashamed if they experience issues like bladder leakage, fecal leakage, pelvic pain, or sexual difficulties in the 4th trimester. There is no need to be embarrassed. These are common and treatable issues. It’s important to take care of yourself and your own needs while you’re taking care of baby. If you find yourself thinking, I don’t even have time to take a shower, it may be time to take a step back. Gently remind yourself to take care of your needs too. 

What can I do to take care of my pelvic health? 

You don’t just have to live with uncomfortable symptoms, which can worsen over time. Here are some steps to consider: 

• You are not alone! It’s important to never ignore pain or other uncomfortable symptoms. Discuss your concerns with your healthcare provider or a qualified pelvic floor physical therapist. You will have a full examination and evaluation to understand what’s happening and determine treatment options. It could be that you need a pelvic floor strengthening program, or maybe you need a program more focused on relaxation, breathing, and stretching. You may need some manual physical therapy to address scar tissue or other issues, or maybe even a combination of all of the above. A good healthcare team between your birthing provider and a pelvic PT is essential to take good care of yourself during pregnancy and postpartum. 

• Learn more about the pelvic floor. Here are some additional resources: 

Demystifying the pelvic floor, presented by Leah Fulker, PT, DPT
Pelvic health patient education from American Academy of the American Physical Therapy Association
5 Reasons Why Every Postpartum Plan Should Include Kegels

• Consider pelvic floor exercises to improve tone, strengthen weakened pelvic floor muscles, and improve bladder leaks, if that’s a concern for you. Stress urinary incontinence (leaking with coughing, laughing, sneezing, bending, exercise), is common during pregnancy and often persists a year and longer after delivery.2 Pelvic floor exercises, such as Kegels, are recommended by the American College of Physicians as a first-line treatment for women with SUI3 and is a safe and effective way to improve bladder control. Adding a product like Flyte by Pelvital can help you supercharge your Kegels. Flyte is an intravaginal pelvic floor device that has been clinically proven to be 39x more effective than Kegels alone for pelvic floor strengthening. You can learn more about Flyte by Pelvital here, and the article 5 reasons why every post-partum plan should include Kegels.

If you want to get yourself set up for postpartum support like pelvic floor pt, create your free registry at


1. Svabík K, Shek KL, Dietz HP. How much does the levator hiatus have to stretch during childbirth? BJOG. 2009 Nov;116(12):1657-62. doi: 10.1111/j.1471-0528.2009.02321.x. Epub 2009 Sep 1. PMID: 19735376.

2. Gill, B., Moore, C. and Damaser, M., 2010. Postpartum stress urinary incontinence: lessons from animal models. Expert Review of Obstetrics & Gynecology, 5(5), pp.567-580. 

3. Qaseem, A., Dallas, P., Forciea, M., Starkey, M., Denberg, T. and Shekelle, P., 2014. Nonsurgical Management of Urinary Incontinence in Women: A Clinical Practice Guideline From the American College of Physicians. Annals of Internal Medicine, 161(6), p.429. 

About the authors: 

Shravya Kovela, PT, DPT, OCS is a pelvic floor physical therapist and orthopedic clinical specialist. After receiving her Bachelor of Arts at the University of Virginia, she went on to Emory University for her DPT. She completed her orthopedic residency at The Jackson Clinics in northern Virginia and began treating pelvic health shortly afterwards. She is passionate about increasing awareness of pelvic health conditions. At Pelvital, Shravya is the Business Development Manager where she leads clinician outreach. 

Leah Fulker, PT, DPT, has treated a wide variety of pelvic floor conditions including stress urinary incontinence, urge incontinence, overactive bladder (OAB), pelvic pain, and prolapse. Since achieving her Doctorate in Physical Therapy in 2012, she realized the need for pelvic floor physical therapy and began her certifications in 2014. She has aided in the recovery of many of these conditions during her career. At Pelvital, Leah is the Customer Care Manager and leads the Ask a PT program. You can reach her through their website and click on Ask a PT. 

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Category: Postpartum Planning
Tags: pelvic floor , postpartum body , pelvic floor pt , the fourth trimester


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