As a physical therapist, I often tell new moms: Postpartum is not just about “bouncing back” — it’s about rebuilding from the inside out. Whether you had a vaginal delivery or a cesarean birth, your body has undergone a tremendous transformation, and healing is a gradual, layered process. Check out our postpartum recovery program here.
Below is a week-by-week guide to what normal postpartum recovery can look like — with a special focus on physical healing, movement, and cesarean-specific care.
Days 1–3: Immediate Postpartum Recovery
Common Changes:
-
Bleeding (Lochia): Heavy bleeding with clots is normal.
-
Perineal discomfort: If you had a vaginal birth, expect swelling and soreness, especially with tearing or episiotomy.
-
Cesarean incision pain: Movement may be difficult. You’ll need help getting in and out of bed.
-
Uterine cramps: Stronger during breastfeeding. These help shrink the uterus.
-
Breast changes: Your milk is likely coming in around Day 3.
Physical Therapist Notes:
-
Start gentle deep breathing and diaphragmatic activation to promote core reconnection and calm the nervous system.
-
For C-section moms, log rolling to get out of bed is key. Support your incision with a pillow when coughing or laughing.
Week 1: Laying the Foundation
Vaginal Birth:
-
Pain and swelling should start decreasing.
-
Short walks around the house are safe and helpful.
Cesarean Recovery:
-
Incision may feel tender or numb.
-
You may notice gas pain or constipation — very common.
-
Avoid lifting anything heavier than your baby.
PT Insight:
-
Begin gentle pelvic floor awareness exercises — not full Kegels, just connection and breath.
-
Practice postural awareness when holding or feeding baby to reduce back and neck strain.
Week 2: Early Healing & Mobility
-
Bleeding: Should begin to slow and change color.
-
Pain: Easier to manage with less medication.
-
Mobility: You may begin short, slow outdoor walks.
C-section Tip:
-
Incision care is critical. Avoid tight waistbands and check for signs of infection.
- You may begin gentle scar desensitization (once the incision is completely closed) by touching around the area with soft cloths.
PT Guidance:
-
Continue breathing work and gentle pelvic tilts in bed or reclined positions.
-
Focus on neutral spine posture during feeding and diaper changes.
Weeks 3–4: Reconnecting With Movement
-
Bleeding: Should be light or spotting.
-
Fatigue: Still very real, but mobility improves.
-
Core stability: You may feel a lack of core support, especially if you had diastasis recti.
PT Milestones:
-
Gentle pelvic floor contractions (if pain-free) can begin.
-
For cesarean recovery, begin scar mobilization techniques (with guidance) to reduce adhesions.
-
Focus on functional mobility: safe lifting, pushing a stroller, and getting on/off the floor with baby.
Weeks 5–6: Medical Clearance & First Check-In
-
Your 6-week postpartum visit should include a check of your uterus, bleeding, healing of any stitches or incision, and (hopefully) clearance for sex and exercise.
-
Bleeding: Usually done, but light spotting can linger.
PT Input:
-
Ask for a pelvic floor physical therapy referral — this is especially important if you notice:
-
Urinary leakage
-
Pelvic pressure or heaviness
-
Pain with sex
-
Core weakness or coning/bulging of your abdomen
but can be useful for anyone postpartum because there may be underlying things that are not bothering you yet, but could pop up later.
-
-
Consider starting a postpartum rehab program (not just generic workouts) to rebuild strength safely.
Weeks 7–8: Rebuilding Strength & Stability
-
You may begin returning to low-impact exercise: walking, light lifting, core rehab.
-
Avoid high-impact (running, jumping) until your pelvic floor is fully evaluated. A pelvic floor physical therapist can help you with this.
For Cesarean Birth:
-
Deep core and scar tissue work becomes important.
-
Numbness around the incision may persist, but should slowly improve.
PT Goals:
-
Work on transverse abdominis activation (deep core muscles).
-
Begin glute, back, and hip strengthening to support pelvic alignment.
-
Continue pelvic floor work — not just strength, but also relaxation.
Weeks 9–10: Restoring Function
-
You may feel more coordinated and confident in daily movements.
-
Some may resume intimacy now; others need more time (especially if pain or dryness is present).
PT Strategies:
-
Integrate functional movement patterns: squats, lunges, lifting with breath coordination.
-
Keep working on posture to prevent tension and support baby care routines.
Weeks 11–12: Returning to Full Activity — Mindfully
-
By now, many women feel “more like themselves,” but full recovery can take 6–12 months.
-
If you’re ready for more exercise, stick to progressive return-to-fitness plans with pelvic floor awareness.
-
Some may see a return of their menstrual cycle, especially if not exclusively breastfeeding.
PT Checklist Before Returning to Impact:
-
Can you walk briskly for 30 minutes without leaking or pressure?
-
Can you hold a plank (modified if needed) for 30 seconds with proper form?
-
Do you feel confident lifting your baby from the floor without discomfort?
If not — you’re not broken, you’re just still healing. A physical therapist can guide you through this phase safely.
When to Seek Help
Call your provider or physical therapist if you experience:
-
Heavy bleeding after Week 2
-
Persistent pelvic, back, or hip pain
-
Pain or numbness at your cesarean incision beyond 8 weeks
-
Bulging at your abdominal midline (diastasis recti)
-
Urinary or fecal incontinence
-
Pain during intercourse
-
Ongoing emotional distress or postpartum depression symptoms
Final Thoughts: Movement is Medicine
From a physical therapist’s perspective, postpartum recovery isn’t just about healing — it’s about reconnecting. With your body, your breath, your strength, and your confidence.
Honor your pace. Rest when you can. Ask for help. And when you’re ready, work with a pelvic health PT to reclaim your body safely and fully.
You created life — now it’s time to rebuild yours, one mindful movement at a time.
Need help?
If you’re struggling with any pregnancy or postpartum concerns and want a personalized evaluation and treatment plan, make an appointment with one of the Pelvic Floor Physical Therapists at The Pelvic Health Center in Madison, NJ. We’re trained to help identify and treat the causes of your incontinence!
