Women's health
Postpartum: the floor comes first
Pelvic floor muscle training is the recommended starting point after birth, and the core work that follows is graded rather than rushed.
What it is
Pregnancy and birth change the abdominal wall and the pelvic floor substantially, and recovery is a process rather than an event. Two things commonly need attention: the pelvic floor, which has been under sustained load and often needs deliberate retraining, and the abdominal wall, where the two halves of the rectus muscle may have separated, a normal change that affects roughly a third of mothers at twelve months. Neither is fixed by going back to previous exercise and hoping.
How it behaves day to day
Common experiences include leaking with coughing, laughing or effort, a feeling of heaviness or pressure, a soft or doming middle, back pain, and fatigue that has as much to do with sleep as with recovery. Symptoms often improve gradually, and the ones that do not are worth taking to a pelvic health physiotherapist rather than waiting out.
What tends to feed it
- Returning to loaded abdominal work before the pelvic floor is contributing
- Breath holding under effort, which spikes pressure downwards
- High impact activity too early
- Long periods of carrying on one hip
What the research recommends
NICE NG210 recommends pelvic floor muscle training for pelvic floor dysfunction, and it is the first thing rather than an addition. Guidance on exercise after pregnancy supports an early return to gentle activity, individualised to the birth and recovery. On the abdominal wall, expert consensus work published by Dufour and colleagues in 2019 describes graded core rehabilitation for diastasis recti, and Sperstad's 2016 work in the British Journal of Sports Medicine established how common the separation remains at twelve months. On impact, the 2019 return to running guidance by Goom, Donnelly and Brockwell is widely used in pelvic health physiotherapy and describes a staged return rather than a date.
Sources
- 1NICE NG210, pelvic floor dysfunction: prevention and non-surgical management (2021)
Pelvic floor muscle training is recommended as the starting point for pelvic floor dysfunction.
- 2Dufour et al., establishing expert-based recommendations for the conservative management of pregnancy-related diastasis rectus abdominis: a Delphi consensus study (Journal of Women's Health Physical Therapy 43(2), 2019)
A three-phase Delphi study with Canadian women's health physiotherapists produced 28 consensus recommendations, treating the impairments related to diastasis as multidimensional rather than a gap to be closed.
- 3Sperstad et al., diastasis recti abdominis during pregnancy and 12 months after childbirth (BJSM 2016)
Abdominal separation is still present in roughly one third of women at twelve months postpartum.
Where Vinys is different
- Vinys starts postpartum work with breath and the pelvic floor rather than with abdominal exercise, which is the order the guidance describes.
- Breath holding under effort is deliberately kept out of postpartum sessions, because that is the mechanism that drives pressure down onto a healing pelvic floor.
- The core work is graded, so it builds rather than starting where you left off before pregnancy.
- Symptoms are asked about, not assumed: leaking, heaviness and pain lead to genuinely different movement selections, because they are different problems.
- The postpartum movement selection was authored by a clinician for this specific recovery, not adapted from a general programme.
A short session to try
- 1
Extended exhale breathing · 3 minutes
Breath is the entry point to reconnecting with the pelvic floor and deep core, which is why it comes first.
- 2
Cat-Cow · 8 slow rounds
Gentle movement through the spine, which is usually welcome after weeks of feeding positions.
- 3
Mini bridge · 8 slow lifts
Rebuilds support behind the hips at a level that does not load the abdominal wall.
- 4
Bird-Dog, small range · 5 each side
Deep core work with the spine held still, which is the graded version of core rehabilitation.
- 5
Scapular wall slide · 8 slow reps
The upper back and shoulders take a beating from carrying and feeding, and this is the antidote.
Breathe out on the effort rather than holding your breath. If you see the middle doming or feel pressure downwards, that movement is too much for now.
Movements often used for this
Breath · 180 to 300 seconds
Extended Exhale Breathing
Longer exhales deeply activate your body's calming response, reducing physiological arousal and pain sensitivity: particularly helpful for highly irritable or sensitive conditions.
Spinal Mobility · 60 to 90 seconds
Cat-Cow: Classic
Gently moves your spine through flexion and extension, promoting fluid movement and reducing stiffness: one of the most versatile spinal mobility exercises in therapeutic yoga.
Stability / Core · 20 to 60 seconds
Bridge: Mini
The most accessible bridge: minimal range makes this gentle enough for almost everyone, introducing posterior chain activation without placing excessive demand on your spine.
Stability / Core · 30 to 60 seconds
Bird-Dog: Small Range
The gentlest version of bird-dog: small limb movements let everyone access this essential spinal stability exercise, building motor control at a comfortable pace.
Stability / Core · 30 to 60 seconds
Scapular Wall Slide
Improves the coordinated upward rotation of your shoulder blade, helping your arm move overhead more smoothly and reducing the strain that contributes to shoulder problems.
Breath · 60 to 75 seconds
Arriving with the Breath
A gentle, guided arrival that simply invites you to notice your breath without changing it: the calmest possible way to begin.
Breath · 180 to 300 seconds
Bhramari: Humming Bee Breath
The gentle vibration of humming during exhale stimulates your vagus nerve, creating a powerful calming effect that reduces stress and soothes your nervous system.
Breath · 180 to 300 seconds
Diaphragmatic Breathing: Dirga Pranayama
Slow belly breathing activates your parasympathetic nervous system, helping to reduce pain sensitivity and calm your body before or after movement.
Hip Mobility · 120 to 180 seconds
Dragonfly: Half
One leg stretches wide while the other supports you, giving your inner thigh and hip a gentle, sustained release: sitting tall works perfectly; folding forward is optional.
Breath · 70 to 90 seconds
Following the Movement of the Breath
A slightly more detailed breath-awareness opening that helps you notice exactly where and how your breath moves: good preparation right before breath-led movement.
Hip Mobility · 240 to 360 seconds
Half Happy Baby
A gentle hip stretch with your back fully supported.
Hip Mobility · 30 to 60 seconds
Parsvottanasana: Wall
A stable, accessible standing hamstring stretch.
Sessions for this lean on the breath, stability / core and hip mobility families in the library. These are the ones most likely to appear, not a prescription: your own session is built from your answers on the day.
Common questions
When can I start?
Guidance supports an early return to gentle activity, individualised to your birth and recovery, which is a conversation to have with your own clinician rather than a fixed date.
Will exercise close a diastasis?
Expert consensus supports graded core rehabilitation, and separation remains present at twelve months for around a third of women. Vinys makes no claim about closing a gap, and works on how the abdominal wall functions.
Can I do abdominal exercises?
Graded core work is part of the plan. The order matters: breath and pelvic floor first, and loaded abdominal work only once the base is contributing.
See a pelvic health physiotherapist if there is leaking, a feeling of heaviness or bulging, pain with intercourse, or ongoing pain, rather than waiting for them to pass. Get your clinician's view before starting if you had a caesarean or a complicated birth.
Also called after birth, post-natal recovery, diastasis recti, pelvic floor recovery. Movements are drawn from the clinically authored Vinys library, and the guidance above is sourced to the publications listed. This page is general movement information, not medical advice, and it is not a diagnosis. How the method works.