Nobody tells you what actually happens in that room. So here it is.
When to book, what the assessment involves, what you can decline, and how to walk out with a plan you will genuinely use.
Quick answer
A postpartum pelvic floor physiotherapy appointment usually runs 45 to 60 minutes and starts with a conversation, not an examination: your birth, your bladder and bowel habits, any leaking, heaviness or pain, and what you want to get back to. The physio then assesses your posture, breathing, abdominal wall and, with your explicit consent, may offer an internal vaginal examination to feel how your pelvic floor muscles contract and relax. You can decline the internal exam and still get a useful assessment. You leave with a small number of specific exercises and a plan for progressing them. Bring your baby if you need to, most clinics expect it.
of women had diastasis recti at 6 weeks postpartum (Sperstad et al., 2016)
still had it at 6 months postpartum
still had it at 12 months postpartum
Booking a pelvic floor physio appointment is one of the highest-value things a mum can do in the first year after birth, and it is also one of the most quietly intimidating. Most of the nerves come from simply not knowing what happens. So let us walk through it properly, step by step.
Step 1: Work out when to book
The standard timeline is a postnatal check with your GP at around six to eight weeks, which is what the NHS advises, while the American College of Obstetricians and Gynecologists frames postpartum care as an ongoing process rather than a single visit, recommending contact with a provider within the first three weeks and a comprehensive review by twelve weeks. Pelvic floor physiotherapy usually sits alongside that, most commonly from around six weeks once initial healing has happened.
Do not wait for six weeks if something is clearly wrong. Book sooner, or speak to your GP or midwife, if you have heavy or worsening bleeding, signs of infection, severe pain, a feeling of something bulging at the vaginal opening, or you cannot control your bowels. Equally, there is no expiry date on this. Mums come in at ten weeks and at ten years, and both get help.
Step 2: Check how it works where you live
Access varies a lot by country, and it is worth five minutes of checking before you book.
- UK: your GP can refer you to an NHS women health physiotherapy service, though waiting lists vary by area. Self-referral is available in some trusts. Private appointments are also widely available.
- Australia and New Zealand: you can generally book a women health physiotherapist directly without a referral. A GP care plan may allow a Medicare rebate for a limited number of sessions, and private health extras often cover physiotherapy.
- Canada: pelvic floor physiotherapy is usually private, often covered in part by extended health benefits, and typically does not require a referral.
- US: pelvic floor physical therapy may need a physician referral depending on your state and insurer, so check your plan first.
If cost is the barrier, say that out loud when you call. Many clinics offer a single assessment appointment with a home program rather than a course of sessions. We compared the realistic costs of each route in our guide to choosing between a guide, a trainer and a physio.
Step 3: Write down your symptoms before you go
This is the step mums skip, and it is the one that changes the quality of the appointment most. Postnatal brain fog is real, and it is very easy to sit down and say only that you feel weak. Two minutes in your notes app beforehand gives the physio far more to work with.
Jot down: how your birth went, including any tearing, stitches, forceps, ventouse or caesarean; whether you leak, and specifically when it happens, for example coughing, sneezing, laughing, running or on the way to the toilet; any heaviness, dragging or bulging, and whether it worsens through the day; pain with sitting, with intercourse or around a scar; bowel habits, including constipation and straining; and what you actually want to get back to, whether that is lifting your toddler without worry, running, or a class you loved before. If you have already done a home check for a tummy gap, mention what you found. Our at-home diastasis recti self-test walks through it in a minute.
Step 4: Know what the assessment actually involves
Here is the part people are anxious about, described plainly.
The conversation
Roughly the first third of the appointment is talking. Birth history, symptoms, general health, feeding, sleep, and what your days physically demand of you. Nothing is too small or too awkward to mention. Pelvic health physios have heard all of it, many times, today.
The external assessment
You will usually be asked to stand, breathe, and move a little so the physio can look at posture, ribcage position and how you breathe under load. They will often assess your abdominal wall for a diastasis, checking the width and, importantly, the tension of the connective tissue, and watch for any doming when you lift your head. Many will also test hips, glutes and general strength, because the pelvic floor never works alone. If you want the background on why those two things travel together, we covered the link between the pelvic floor and diastasis recti separately.
The internal examination, and your right to decline it
An internal vaginal examination is the most accurate way to assess how well your pelvic floor muscles contract, relax and hold, and to check for prolapse. It is done with a gloved, lubricated finger, it should not be painful, and it takes only a few minutes. Crucially, it requires your explicit consent, you can ask for a chaperone, you can ask the physio to stop at any point, and you can say no entirely. A no does not waste the appointment. The physio can still assess externally, take a thorough history and give you a sensible starting program. Some clinics also offer real-time ultrasound as an alternative. If you are not ready today, book anyway and decide in the room.
Step 5: Turn the plan into something you will actually do
A good appointment ends with a short, specific plan: usually a handful of exercises, how many, how often, and what to stop doing for now. Before you leave, ask three questions. What am I doing daily? What should I avoid for the next month? And what would tell me this is working, or not working?
Supervised pelvic floor muscle training is recommended in NHS and NICE guidance as a first-line treatment for postnatal urinary incontinence, and the key word is training. It works through consistency over weeks, not effort in a single session. Attaching your exercises to something you already do every day, such as the first feed of the morning, beats scheduling them for a moment of free time that never arrives. If leaking with impact is your main issue, our piece on returning to running and jumping gently pairs well with what your physio gives you.
The short version
Book it. The assessment is mostly a conversation, the internal exam is optional and consent-based, and one appointment often replaces months of guessing. A physiotherapist assesses your body, which is something no online program, ours very much included, can do.
Something to follow between appointments
The Complete Postpartum Body Reset bundle gives you a structured, one-time plan for rebuilding your core and strength at home, designed to sit alongside professional care rather than replace it. Use code GLOW20 for 20% off.
Questions mums ask before their first appointment
Does a pelvic floor physio appointment hurt?
It should not. The external assessment is comfortable, and an internal examination is done gently with a single gloved finger. Tell the physio immediately if anything is painful, as pain itself is useful information and the assessment can be adapted or stopped. If you have scar pain or pain with intercourse, mention it early rather than pushing through.
Can I bring my baby?
Almost always yes, and most pelvic health clinics are set up for it. Bring the pram, a feed and something to occupy an older sibling if you have one. If you would rather have the headspace and someone can watch the baby, that is a lovely option, but do not delay the appointment waiting for perfect childcare.
Do I need a physio if I have no symptoms?
Not necessarily, but a single check-up is still worthwhile, particularly before returning to running or heavy lifting. Some issues, including a mild prolapse or a poorly coordinated pelvic floor, do not announce themselves until you add load. Think of it as a clearance appointment rather than a treatment one.
How many sessions will I need?
That depends entirely on your symptoms and goals, and any clinic promising a fixed number before assessing you is guessing. Many mums have one assessment plus a review, others benefit from a short block of sessions. Ask at the end of your first visit what they expect and why, and it is completely reasonable to start with one and see.
Is it too late if my baby is two, or ten?
No. Pelvic floor muscles and the abdominal wall respond to training at any point postpartum, and physiotherapists routinely treat women years or decades after birth. Recovery may take longer to establish, and results vary from mum to mum, but late is genuinely better than never.
Sources: NHS, Your postnatal check and Pelvic floor exercises; National Institute for Health and Care Excellence (NICE), guidance on pelvic floor dysfunction and urinary incontinence; American College of Obstetricians and Gynecologists (ACOG), Optimizing Postpartum Care; Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), postnatal care information; Cleveland Clinic, Pelvic Floor Physical Therapy; Sperstad JB et al., British Journal of Sports Medicine, 2016.
This article is general education, not medical advice. Every birth and every recovery is different and results vary from mum to mum. Please see your GP, midwife or a qualified women health physiotherapist for an individual assessment, particularly if you have pain, leaking, heaviness in the pelvis or any symptom that is getting worse.