As a women's health physiotherapist with more than 20 years' experience and four children of her own, Amy Cooke from Ramsay Health Plus knows a thing or two about the pelvic floor.

"Pelvic health is something that when it works well, you don't think about it, but when it's a problem, it can really affect your quality of life," she explained.

"There's so much research showing just how interconnected our strength, fitness, bone health and cardiovascular wellbeing are." It's this kind of whole-body approach that Ramsay Health Plus offers, with programs designed to support women through pregnancy, postnatal recovery, midlife changes and beyond.

Keeping the big-picture focus in mind, Amy shared her take on how women might support their pelvic floor and core, before, during and after bub — all aimed at long-term wellbeing.

The power of prevention.

The best time to think about pelvic floor health? Before problems even begin. "Every woman is different — factors like connective tissue, genetic history and how many babies you've had can all play a role," said Amy.

While some women sail through pregnancy and birth with minimal issues, others, particularly those with larger babies, multiple births, forceps deliveries or pre-existing conditions (like endometriosis), may experience additional challenges. "On average, it can take seven years for women to be diagnosed with pelvic pain," said Amy. "That's why paying attention to your pelvic floor can be so helpful — listening to your body is an important part of staying aware."

Moving through pregnancy the right way.

"The most important thing throughout pregnancy is to remember that it's a healthy, normal life stage, so staying active is key," explained Amy. "Many women find personalised guidance from a women's health physiotherapist helpful, whether it's for a pelvic floor assessment or tailored exercise advice."

Amy pointed out that women who try pelvic floor exercises without professional input may not always be doing them correctly. "Sometimes people think they're relaxing when they're actually lifting, and vice versa — and that awareness can make a big difference," she said. "I find a lot of women who come in for birth prep around 20 weeks already have pelvic girdle pain and need support with lumbopelvic stability because they're tense or overactive."

While certain exercises should be avoided after 20 weeks, there are many safe ways to stay active. "Gentle core work or other forms of movement can help maintain strength," Amy added. "There are so many women's health physiotherapists and clinical pilates classes now — the options are endless."

For those planning a vaginal delivery, Amy emphasised that being familiar with techniques like breathwork can be valuable. "Many women choose to explore breathwork and gentle pelvic floor down-training and activity as part of their birth preparation, depending on their needs," she said.

Recovery and maintenance.

If you've experienced a challenging birth or surgery that may have affected your pelvic floor, a women's health physio can provide guidance and support. "Women who've had a third- or fourth-degree tear, or a significant separation of the abdominal muscles, will need additional care," explained Amy.

Sometimes even straightforward deliveries can lead to urinary and bowel changes. "After a c-section or following an epidural or spinal, some people may experience difficulty fully emptying their bladder. This happens because the usual sensation of bladder filling can be altered after pregnancy. Optimal defecation, bowel and gut health are also imperative for any new mum's recovery."

The fourth trimester.

While it's important to think about pelvic health at any stage of pregnancy, the days and weeks following birth can feel particularly significant.

In the weeks after birth, Amy encouraged women to keep things simple and gentle. "Rest, move gently, and notice how your body feels," she said. "Every recovery is different, whether you've had a caesarean or a vaginal delivery — the first few weeks are a time to focus on small, manageable movement."

"Many people may start with gentle pelvic floor exercises, focusing on small contractions and full relaxation in between. Over time, it can be helpful to gradually increase the duration or intensity as strength improves," explained Amy.

"Starting at the 4–6 week mark, some people find they are able to engage their core and pelvic floor more confidently, making it a suitable time to reintroduce general fitness activities. It's always best to check with a health professional before starting or progressing any exercise, especially after surgery or childbirth."

Amy is also passionate about self-care during this period, emphasising that mum's wellbeing matters just as much as bub's. "If mum doesn't fill her cup, she can't fill anyone else's," she said. "I see these beautiful mums doing everything they can to hold it together. Everyone has tough days. You don't need to do it alone."

While there's a lot of advice online, Amy suggested seeking professional guidance from a pelvic floor physio to understand what's right for your own body. "It's important to find someone you trust," she said. "Don't ignore persistent pelvic pain, heaviness or discomfort — it's not something you just have to accept. Taking care of yourself is important, and valuing your wellbeing helps you enjoy life to the fullest."

Visit Ramsay Health Plus to learn more.

This information is general in nature and does not replace the advice of a healthcare professional. As with any medical condition, always seek health advice from a qualified healthcare professional.

Featured image: Supplied.

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