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5 Postpartum Exercises That Can Make Your Pelvic Floor Worse

And What to Do Instead

By Dr. Danaya Kauwe, PT, DPT, PRPC | February 2026 | 8 min read

At a Glance

  • The biggest risk factor for postpartum exercise is not which exercise you choose — it is whether your body can manage the intra-abdominal pressure that exercise creates.
  • Crunches, heavy squats, plyometrics, running, and breath-holding during lifts are five of the most common culprits behind worsening postpartum pelvic floor symptoms.
  • Every one of these exercises has a safe, effective alternative that builds strength without overwhelming your pelvic floor.
  • Leaking, heaviness, doming along your midline, or bearing down during a movement are your body’s warning signs that an exercise is too much too soon.
  • A pelvic floor assessment before returning to high-intensity exercise is the single most protective step you can take for your long-term recovery.

You survived pregnancy, you survived delivery, and now you are ready to feel like yourself again. For many women here in Utah Valley — where hiking, running, CrossFit, and staying active are woven into daily life — the urge to get back to exercise is powerful. And it should be. Movement is medicine. Your body was built for it.

But as a pelvic floor physical therapist and a mom who has been through this four times, I need you to hear something: not all exercises are created equal for a postpartum body, and some of the most popular ones can actively set your recovery back.

This is not about fear. This is not about telling you to stay on the couch. This is about understanding what is happening inside your body so you can get back to the activities you love — safely, confidently, and for the long term.

The Common Thread: Unmanaged Intra-Abdominal Pressure

Before we talk about specific exercises, you need to understand the concept that connects all of them: intra-abdominal pressure.

Your core is a pressure system. Your diaphragm sits at the top, your pelvic floor at the bottom, your abdominal muscles wrap around the front and sides, and your deep spinal muscles support the back. Every time you move, breathe, lift, or brace, pressure shifts within this system.

During pregnancy, this system is stretched, weakened, and reorganized. After delivery, it does not snap back automatically. Your pelvic floor may be weak, overstretched, or uncoordinated. Your abdominal wall may have diastasis recti. Your breathing patterns may have changed.

When you perform an exercise that creates a large pressure spike — and your body cannot manage that pressure — it gets redirected downward onto your pelvic floor or outward through your abdominal wall. Over time, this leads to incontinence, prolapse symptoms, or pelvic floor weakness that gets worse instead of better.

That is the common thread behind every exercise on this list.

1. Crunches and Sit-Ups

This is the number one offender I see. Women want to “get their abs back,” and crunches are the first exercise that comes to mind.

Why they are problematic: A crunch creates a sharp, concentrated spike in intra-abdominal pressure. It forces your abdominal wall forward and pushes pressure downward onto your pelvic floor. If you have any degree of diastasis recti — which most women do after pregnancy — crunches will make the separation worse by repeatedly forcing the tissue apart. You may see visible doming or coning along the midline of your abdomen. Meanwhile, your pelvic floor absorbs the pressure that your compromised abdominal wall cannot manage.

The safe alternative: Diaphragmatic breathing with pelvic floor coordination, dead bugs, bird dogs, and Pallof presses. These exercises build genuine core stability — the kind that supports your spine, manages pressure, and actually flattens your abdomen over time — without the damaging pressure spikes. They are also far more functional for real life than a crunch will ever be.

2. Heavy Barbell Squats Too Soon

Squats themselves are not the enemy. Bodyweight squats and goblet squats with proper breathing are excellent postpartum exercises. The problem is when women jump back to heavy barbell back squats before their pressure system is ready.

Why it is problematic: A heavy back squat places significant compressive load through your trunk. Combined with the tendency to hold your breath under heavy load (more on that below), this creates substantial downward force on your pelvic floor. If your pelvic floor muscles cannot counter that force, you may experience leaking, heaviness, or a bearing-down sensation during the lift — all signs that the demand exceeds your current capacity.

The safe alternative: Start with bodyweight squats focusing on exhaling as you stand. Progress to goblet squats, then front-loaded barbell squats, then back squats — increasing load gradually while monitoring for symptoms. The key is matching the load to your current pelvic floor capacity and progressing intentionally, not returning to your pre-pregnancy numbers on a timeline.

3. Box Jumps and Plyometrics

High-intensity interval training and CrossFit-style workouts are hugely popular in Utah Valley, and many women are eager to jump back in — literally. But plyometric movements deserve serious caution postpartum.

Why they are problematic: Jumping generates impact forces of 3–5 times your body weight. Every time you land, your pelvic floor must absorb and respond to that force within milliseconds. This requires a level of pelvic floor speed, strength, and coordination that most women simply do not have in the early postpartum months. Repeated impact before your pelvic floor is ready is one of the fastest ways to develop or worsen prolapse symptoms.

The safe alternative: Step-ups, squat-to-calf-raises, and low-impact power movements that build the same muscle groups without the high-impact landing. When your pelvic floor is ready, you can progress to small hops, then single jumps, then repeated jumps — a gradual impact progression guided by your body’s response.

4. Running Before Your Pelvic Floor Is Ready

As a former NCAA Division I track and field athlete, this one is personal for me. I understand the pull of running. I understand what it feels like to need that outlet. And I also understand — both clinically and personally — what happens when you run before your body is ready.

Why it is problematic: Running is a repeated single-leg impact activity. Each stride generates 2–3 times your body weight in ground reaction force, and your pelvic floor must respond to that force thousands of times per run. Current evidence-based guidelines recommend waiting at least 12 weeks postpartum before returning to running, and only after a pelvic floor assessment confirms your muscles can handle the demand. Running with an underprepared pelvic floor is one of the most common causes of postpartum incontinence that women dismiss as “normal.”

The safe alternative: A structured walk-to-run progression. Start with brisk walking, then introduce walk-run intervals — for example, 1 minute of jogging followed by 2 minutes of walking — and gradually shift the ratio as your pelvic floor tolerates the load. Strengthening your glutes, calves, and pelvic floor before and during this progression makes a significant difference. Learn more about the full timeline in our return to running guide.

5. Breath-Holding During Lifting (Valsalva Maneuver)

This is less about a specific exercise and more about a habit that makes every exercise riskier. Many women instinctively hold their breath during the hard part of a lift — and it is one of the fastest ways to overwhelm a postpartum pelvic floor.

Why it is problematic: Holding your breath and bearing down (the Valsalva maneuver) creates a massive pressure spike inside your abdomen. That pressure has to go somewhere. In a postpartum body with a weakened pelvic floor or diastasis recti, it goes down and out — pushing on your pelvic floor and bulging through your abdominal wall. Over time, this pattern can contribute to prolapse, worsen abdominal separation, and train your body to rely on pressure instead of muscle coordination.

The safe alternative: Learn to exhale on exertion. Breathe out during the hardest phase of the movement — the standing phase of a squat, the pressing phase of a push-up, the lifting phase of a deadlift. This simple change coordinates your diaphragm and pelvic floor so they work together instead of against each other. It feels counterintuitive at first, especially if you are used to bracing hard, but it is one of the single most impactful changes you can make for your postpartum recovery.

Why Assessment Should Come Before Exercise

Here is the truth that I wish more women heard before they downloaded a postpartum workout program: every body is different after pregnancy. What is safe for one woman at 8 weeks postpartum may not be safe for another at 6 months.

A pelvic floor assessment takes the guesswork out of your return to exercise. Instead of following a generic timeline or waiting for symptoms to appear, you know exactly where your body is — your pelvic floor strength and coordination, your abdominal wall integrity, your breathing patterns, your readiness for impact — and you build your program from that foundation.

As someone who competed at the Division I level in track and field, I can tell you that elite athletes do not return from injury without an assessment and a progression plan. Your postpartum body deserves the same standard of care. Pregnancy and delivery are among the most physically demanding events your body will ever go through. Treating your return to exercise with the same intentionality as an athlete returning from injury is not excessive — it is appropriate.

Frequently Asked Questions

How soon after giving birth can I start exercising?

Most women can begin gentle walking, diaphragmatic breathing, and pelvic floor activation within the first few weeks postpartum. However, higher-intensity exercises like running, jumping, and heavy lifting should wait until your pelvic floor and core have been assessed by a pelvic floor physical therapist — typically around 6 to 12 weeks postpartum, depending on your delivery and recovery. Being “cleared” at your 6-week checkup does not mean your pelvic floor is ready for high-impact exercise.

Are crunches safe after having a baby?

Traditional crunches and sit-ups are one of the most problematic exercises postpartum. They create a large spike in intra-abdominal pressure that pushes down on your pelvic floor and can worsen diastasis recti by forcing the abdominal wall apart. Safe alternatives include diaphragmatic breathing with pelvic floor engagement, dead bugs, and bird dogs — exercises that build core stability without the harmful pressure increase.

When is it safe to start running after pregnancy?

Current evidence-based guidelines suggest waiting at least 12 weeks postpartum before returning to running, and only after a pelvic floor assessment confirms your muscles can handle the repetitive impact. Running generates forces of 2–3 times your body weight with every stride. If your pelvic floor cannot manage that load, you risk developing or worsening incontinence and prolapse symptoms. A pelvic floor PT can guide a gradual return-to-running program tailored to your body.

Can I do squats postpartum?

Yes, but with important modifications. Bodyweight squats and goblet squats with proper breathing are generally safe and beneficial. The issue arises when women return to heavy barbell back squats too quickly, especially while holding their breath. Heavy load plus breath-holding creates significant downward pressure on the pelvic floor. Start with lighter loads, focus on exhaling during the effort phase, and progress gradually based on how your pelvic floor responds.

How do I know if an exercise is too much for my pelvic floor?

Your body gives clear signals when an exercise is creating more demand than your pelvic floor can handle. Warning signs include leaking urine during or after exercise, feeling heaviness or a bulging sensation in your pelvis, visible doming or coning along the midline of your abdomen, pelvic or low back pain during or after a workout, and needing to bear down or hold your breath to complete a movement. If you notice any of these, scale back and consult a pelvic floor PT before continuing.

About the Author

Dr. Danaya Kauwe, PT, DPT, PRPC

Pelvic Rehabilitation Practitioner Certified • NCAA Division I Athlete • 4x Postpartum Mom

Dr. Danaya is the founder of Radiant Pelvic Health & Wellness and a board-certified pelvic floor specialist serving Utah Valley. She combines 2,000+ hours of direct pelvic patient care with the lived experience of four very different postpartum recoveries. At least half of every session is education—she wants you to understand your body well enough that you don’t need her forever.

Read Dr. Danaya’s full story →

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