The six-week GP check is not a recovery assessment. It lasts a few minutes, rarely includes any examination of your pelvic floor or abdominal wall, and is designed to screen for problems rather than to plan your rehabilitation. That leaves a great many women signed off as "fine" while still leaking, still feeling heaviness, still unable to run, and quietly assuming this is simply what happens after having a baby.
It is not. Pregnancy and birth place a sustained load on the pelvic floor, abdominal wall and pelvis, and those tissues respond to structured rehabilitation in the same way any other injured muscle group does. Postnatal physiotherapy gives you an actual assessment of what changed, and a graded plan to restore it.
At Zyloh Physio in Woodford Green, postnatal assessments are carried out by a Consultant Pelvic Health Physiotherapist who works in both NHS and private pelvic health — including within the colorectal and pelvic floor team at the Royal London Hospital.
When should you have a postnatal assessment?
The usual recommendation is six to twelve weeks after birth for a routine check. That timing allows the initial tissue healing to settle while still being early enough to correct unhelpful patterns before they become habits.
That said, there is no expiry date on postnatal recovery. A significant proportion of the women seen at the clinic are one, five, or fifteen years postnatal. Pelvic floor muscle training produces measurable improvement in strength and symptoms regardless of how long ago you gave birth — the tissue responds to load, not to the calendar.
Come sooner than six weeks if you have pain that is worsening rather than easing, a wound that feels wrong, sudden onset of incontinence, or a feeling of something bulging or dragging. Those warrant earlier review.
If you have heavy bleeding, fever, a wound that is hot or discharging, calf pain or swelling, or severe headache, contact your midwife, GP or NHS 111 straight away rather than booking physiotherapy.
What postnatal physiotherapy treats
Postnatal recovery is rarely about one thing. Most assessments identify a combination of the following, and treat them as a connected system rather than in isolation.
Urinary incontinence
Leaking when you cough, sneeze, laugh, lift your baby or exercise. Common after birth — but common is not the same as normal, and it is highly treatable. Supervised pelvic floor muscle training is the recommended first-line treatment.
Pelvic organ prolapse
A sensation of heaviness, dragging or a bulge, often worse by the end of the day or after lifting. Physiotherapy is first-line for mild to moderate prolapse. See our prolapse treatment page.
Diastasis recti
Separation of the abdominal muscles that has not closed by itself. What matters clinically is not the width of the gap but how much tension you can generate across it. See diastasis recti treatment.
Caesarean recovery
Scar sensitivity, numbness, tethering, and difficulty reconnecting to the deep abdominal muscles. Scar mobilisation and graded loading make a real difference — including years after surgery.
Perineal tear and episiotomy
Ongoing pain, scar tightness, or pain with intercourse after a tear or episiotomy, including third and fourth degree tears. See perineal tear recovery.
Bowel symptoms
Urgency, difficulty controlling wind, incomplete emptying, or constipation. Frequently under-reported and frequently treatable. See bowel incontinence physiotherapy.
Back and pelvic pain
Pelvic girdle pain that did not resolve after birth, low back pain, or rib and mid-back pain related to feeding postures and carrying.
Return to exercise
Clear, staged criteria for returning to running, lifting and high-impact classes — based on what your pelvic floor and abdominal wall can currently tolerate, not on a fixed number of weeks.
What happens at your postnatal assessment
Your first appointment is a full 60-minute consultation. Babies are welcome — you do not need to arrange childcare.
1. Your history — birth and now
How your pregnancy and birth went, any intervention or tearing, how feeding is going, your bladder and bowel habits, your pain, your sleep, and what you actually want to get back to. That last point shapes the whole plan: returning to marathon running and returning to lifting a toddler without leaking are different targets.
2. Posture, breathing and load transfer
How you breathe, how your ribcage and pelvis sit relative to each other, and how pressure moves through your abdomen when you lift. This is usually where the mechanical cause of persistent symptoms shows up.
3. Abdominal wall assessment
Measurement of any diastasis at several points along the midline, plus — more importantly — an assessment of the tension you can generate across the gap during a controlled contraction.
4. Pelvic floor assessment
An internal vaginal examination is the most accurate way to assess pelvic floor strength, endurance, coordination, prolapse grade and scar tissue. It is always optional and always requires your informed consent. External assessment and real-time biofeedback are available alternatives if you would prefer not to, or are not yet ready.
5. Your plan
You leave with a written, individualised programme — specific exercises, how often, how to progress, what to stop doing for now, and what improvement should look like. Not a generic handout.
Treatment approaches we use
Supervised pelvic floor muscle training
The evidence-based foundation of postnatal recovery. "Supervised" is the operative word — research consistently shows that a substantial proportion of women perform pelvic floor contractions incorrectly when working from written instructions alone, some by bearing down instead of lifting, which makes symptoms worse.
Real-time biofeedback
Visual feedback showing exactly what your muscles are doing while you contract. Particularly useful when you cannot feel the muscle working, which is common after a difficult birth or with scar tissue. See biofeedback therapy.
Scar assessment and mobilisation
For caesarean scars, perineal tears and episiotomy sites. Restores tissue glide and reduces sensitivity, and teaches you how to continue the work at home.
Pressure management retraining
Teaching your system to manage intra-abdominal pressure during real activities — lifting a car seat, pushing a buggy uphill, coughing, getting off the floor — rather than only during exercises.
Graded return-to-exercise programming
A staged progression through load, impact and duration, with objective criteria for moving to the next stage. Includes specific return-to-running screening.
Bladder and bowel retraining
Practical strategies for urgency, frequency, and defaecation mechanics, plus fluid and fibre guidance where relevant.
Returning to running and high-impact exercise
The commonly cited guidance is that return to running should not begin before three months postnatal, and then only once you can manage a set of load and impact tests without symptoms. That is a floor, not a target — for many women the appropriate point is later, and for some it is earlier.
The tests are practical: walking briskly for 30 minutes, single-leg balance and hopping, single-leg squats, jogging on the spot, and repeated bounding — all without leaking, heaviness, dragging or pain. If any of those provoke symptoms, running will provoke them too, and pushing through tends to entrench the problem rather than resolve it.
Where symptoms do appear, that is information, not a verdict. It tells us which specific capacity is missing, and that is what the programme then targets.
Breastfeeding lowers oestrogen, which can leave vaginal tissue drier and less elastic and can make pelvic floor symptoms feel worse. This usually improves as feeding reduces, and it is worth mentioning at your assessment because it changes what we recommend in the short term.
How long does postnatal recovery take?
Most women notice meaningful change within six to twelve weeks of starting a properly supervised programme, with review appointments spaced two to four weeks apart. Pelvic floor muscle strengthening follows the same physiology as any other strength training: it needs consistent load over months, not days.
Full programmes typically run three to six months. Recovery is not linear — sleep deprivation, illness, and returning to work all affect it. The plan is adjusted around your actual life rather than assuming an ideal one.
Frequently Asked Questions
Is postnatal physiotherapy worth it if my six-week check was fine?
The six-week check is a brief screening appointment and does not usually include any assessment of pelvic floor function or abdominal separation. Being cleared at six weeks means no obvious complication was found — it does not mean your pelvic floor and abdominal wall have recovered. If you are leaking, feeling heaviness or a bulge, have a persistent abdominal gap, have pain with intercourse, or cannot return to the activity you want, a dedicated assessment is worthwhile.
How soon after birth can I be seen?
Routine postnatal assessment is usually best at six to twelve weeks after birth. You can be seen earlier if you have specific concerns such as worsening pain, a wound problem, sudden incontinence, or a feeling of bulging — and earlier advice can prevent problems becoming established. There is no upper limit: assessment and treatment remain effective years after birth.
Do I need an internal examination?
No. An internal vaginal examination gives the most accurate assessment of pelvic floor strength, coordination, prolapse grade and scar tissue, and it is offered for that reason. It is entirely optional and always requires your informed consent, which you can withdraw at any point. External assessment and real-time biofeedback are available alternatives, and many women choose to start externally and decide later.
Can I bring my baby to the appointment?
Yes. Babies are welcome at postnatal appointments and you do not need to arrange childcare. If your baby needs feeding or settling during the session, that is expected and the appointment simply works around it.
Is it too late if I gave birth years ago?
No. Pelvic floor muscle training improves strength and reduces symptoms regardless of how long ago you gave birth, because muscle responds to appropriate load at any age. A significant proportion of patients seen at the clinic are several years or more postnatal, including women who are now perimenopausal and finding that old symptoms have returned or worsened.
What is the difference between this and a Mummy MOT?
A "Mummy MOT" is a branded name for a postnatal physiotherapy screening assessment. The assessment described on this page covers the same ground — posture, breathing, abdominal wall, pelvic floor and functional movement — carried out by a Consultant Pelvic Health Physiotherapist with an MSc in Obstetrics and Gynaecology, and followed by an individualised treatment plan rather than a screening report alone.
Will I be able to run again?
For the great majority of women, yes. Current guidance suggests not starting return-to-running before three months postnatal, and then progressing only once you can complete load and impact testing without leaking, heaviness or pain. Where those tests do provoke symptoms, they identify precisely which capacity needs work, and that becomes the focus of your programme.
Clinically reviewed by Jency Sudha, Consultant Pelvic Health Physiotherapist & Biofeedback Specialist — last updated 26 July 2026
The information on this page is for general guidance and does not replace individual clinical assessment. If your symptoms are new, worsening, or accompanied by bleeding, fever or severe pain, contact your GP or NHS 111.
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Whether you are eight weeks or eight years postnatal, a proper assessment tells you what actually changed and what to do about it.
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