Pelvic health is an important but often overlooked component of women’s health, particularly before and after childbirth. Pelvic organ prolapse is a common and frequent condition in the population of the United States, roughly affecting half of all women to some degree.  

How does pregnancy and childbirth influence pelvic floor health?

While pelvic organ prolapse is often diagnosed later in life, pregnancy and childbirth can influence pelvic floor health at any age. 

It is significantly more common in women with vaginal births, as the stretching and potential tearing of pelvic muscles and tissues during delivery weaken support structures, especially with larger babies or instrumental delivery, such as forceps or vacuum.

What is pelvic organ prolapse?

Pelvic organ prolapse happens when one or more pelvic organs drop down and push into the vagina. This can include the bladder, uterus (or the top of the vagina after a hysterectomy), or the bowel. Mild prolapse is common and often causes no symptoms, however, it often leads to discomfort and other symptoms, such as a sensation of vaginal pressure or a bulge, urinary urgency, difficulty fully emptying the bladder, leaking small amounts of urine, significant constipation, the need to push on the vagina or perineum with a finger to assist with bowel movements (a maneuver known as “splinting”), and sexual dysfunction such as dyspareunia. 

Symptoms can appear in younger women, particularly during pregnancy or after childbirth. Early intervention is centered around prevention and strengthening the pelvic floor, which can be approached independently or with the guidance of a healthcare professional. This type of preventive work is particularly relevant during the postpartum period, when many women first begin to notice changes in pelvic floor function. Pregnancy and childbirth place significant stress on the pelvic floor, and while many anatomical and functional changes are expected, persistent symptoms should not be dismissed. 

When can postpartum pelvic floor therapy begin?

In general, postpartum pelvic floor therapy can begin around six to twelve weeks after childbirth, which is the amount of time it usually takes for the pelvis to recover from pregnancy and delivery. There are several practical steps women can take during the postpartum period to support pelvic health. These include avoiding excessive straining during bowel movements, managing constipation with adequate hydration and dietary fiber, gradually returning to physical activity rather than rushing into high-impact exercise, and being mindful of heavy lifting during daily activities such as carrying a baby or stroller. Paying attention to posture and breathing during movement, especially when lifting or exercising, can also help reduce unnecessary pressure on the pelvic floor.

Seeking evaluation if symptoms develop—rather than waiting for them to resolve on their own—is an important part of postpartum care. Women with more advanced prolapse should talk to their healthcare providers about procedural or surgical treatment, as there are many non-invasive treatments available. Pessaries are small, flexible plastic devices that you place in your vagina to treat pelvic organ prolapse or urinary incontinence. FEMSelect has launched EnPlace, a minimally invasive, same-day approach to pelvic organ prolapse repair that allows patients to resume normal activities within several days and preserves the uterus.  

Increasing awareness helps women recognize symptoms, understand their bodies, and seek appropriate care. With education, early evaluation, and individualized treatment, many pelvic floor conditions can be effectively managed, supporting comfort, function, and quality of life throughout motherhood and enhancing the quality of life for women worldwide. 

*The information in this article is aligned with current recommendations from the American College of Obstetricians and Gynecologists (ACOG) and the American Urogynecologic Society (AUGS).

ABOUT THE AUTHOR

Dr. Julian Cereghini is a urologist specializing in andrology and women’s pelvic health. He completed fellowships at Northwell Health in New York and currently supports clinical development and physician education for FEMSelect’s EnPlace system. His work focuses on advancing minimally invasive treatments and strengthening collaboration between clinicians and industry partners.

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Cover photo by cottonbro studio