Frequently Asked Questions

First, we talk about your health and birth history, your pregnancy plans and any symptoms you have. Then your pelvic floor muscle function, breathing and abdominal–pelvic coordination are assessed, along with any pain or restricted movement in the area. A physiotherapy plan suited to you is created based on the findings.

Manual therapy may be used if the assessment shows a need for it. What it involves is decided by taking into account tension and restricted movement in the pelvic region, as well as your comfort.

Uterine mobilization means assessing the mobility of the uterus and the tissues around it as part of a physiotherapy assessment and, where appropriate, working on them with manual techniques. It is planned according to your individual needs.

No. An internal assessment is only considered if it is needed; the physiotherapist first explains why and how it would be done. Your consent is obtained before it takes place.

Your plan is based on your health history, pelvic floor assessment, symptoms and pregnancy plans. In addition to manual therapy, exercise, breathing and relaxation work are included in the program as needed.

Pain in the lower back and pelvic area is common in pregnancy. But that doesn't mean you have to live with it. If the pain affects your daily tasks, walking or sleep, you can talk to your healthcare provider and ask for a physiotherapy assessment.

Pelvic girdle pain is felt in the lower back, around the hips, in the groin or in the thighs. It commonly gets worse when you turn over in bed, climb stairs, walk or move your legs apart. A clinical examination is needed for a definite assessment.

First, we discuss where the pain is, when it started and which movements make it worse. Your physiotherapist assesses your movement and the function of your lower back and hip area, then tailors exercises and daily-life advice to your needs.

The choice of exercise should be based on your week of pregnancy, your health and the movements that make your pain worse. Your physiotherapist will show you how to adapt movements. If you have a specific pregnancy-related health condition, share your exercise plan with your doctor as well.

If the pain is getting worse, clearly limits your movement or makes daily life difficult, you can book an early assessment. Appropriate advice and a treatment plan early on make it easier to cope with pain and keep up your daily activities.

Pregnancy and childbirth are among the possible causes of tailbone pain. However, how severe it is and how much it affects your daily life varies from person to person; if it makes sitting, walking or sleeping difficult, you can see your healthcare provider for an assessment.

Sitting for a long time, especially on hard surfaces, as well as getting up and down, bending forward and climbing stairs can make the pain worse. Because the movements that trigger pain vary from person to person, noting when it gets worse helps with the assessment.

Try not to sit in the same position for long, support your lower back when sitting and use a suitable cushion that reduces pressure on your tailbone. Lying on your side can also reduce pressure on the area.

Your physiotherapist finds out when the pain started, which movements make it worse and how it affects your daily life. Your posture, movement and pelvic floor muscles are then assessed to determine suitable exercises and daily-life advice for you.

Some of the pelvic floor muscles attach to the tailbone. In some people, excessive tension in these muscles can affect tenderness in the area; the assessment looks at both the muscles' ability to contract and to relax.

Get an assessment if the pain has lasted for several weeks, is getting worse or limits your daily activities. If tailbone pain comes with a fever or other pain in your abdomen or lower back, you need to see a healthcare provider.

Pelvic pain can occur in pregnancy, but don't ignore pain that is severe or limits your movement. If the pain affects your daily tasks, walking or sleep, talk to your doctor or midwife and ask for a physiotherapy assessment.

The pain may be felt in the groin, at the front of the pelvis, in the hips, in the lower back, or radiating into the thighs.

Your physiotherapist first assesses your symptoms and the movements that make the pain worse. They then work with you on adapting daily activities, exercises and movement strategies; the plan is adjusted to your week of pregnancy and your needs.

Rather than stopping movement altogether, you may need to identify the activities that make the pain worse and adjust how long or how you do them. Decide which exercises are right for you together with your physiotherapist and the healthcare provider who is following your pregnancy.

Urinary incontinence can occur in pregnancy, but that doesn't mean every woman will experience it. If your symptoms keep coming back or affect your ability to exercise or your daily life, mention them to your doctor or midwife and ask about pelvic floor physiotherapy.

Coughing and sneezing briefly increase the pressure inside your abdomen. When the pelvic floor muscles can't respond to this pressure quickly enough, a few drops of urine may leak; this is called stress urinary incontinence.

Pelvic floor exercises are suitable for many people. However, it is important to work the right muscles and to be able to relax them fully. A physiotherapist assesses your muscle function and shows you whether the exercises are right for you and how to do them. NICE recommends supervised pelvic floor muscle training for stress or mixed urinary incontinence.

Your physiotherapist asks when you leak, how long it has been going on and how it affects your daily life. The assessment looks at how your pelvic floor muscles contract, relax and coordinate.

Yes, constipation is one of the most common complaints in pregnancy. Hormonal changes can slow down bowel movements; iron supplements and changes in daily habits can also play a part.

Gradually adding fiber-rich vegetables, fruit, legumes and whole grains to your diet, drinking enough fluids and moving regularly, if it is appropriate for your pregnancy, can help. As you increase your fiber intake, increase your water intake as well.

Not every medication is equally suitable during pregnancy. If diet and daily habits don't bring relief, talk to your doctor, midwife or pharmacist before using any laxative.

Some people find it difficult to relax their pelvic floor muscles or coordinate them with their breathing during bowel movements. Your physiotherapist assesses your toilet position, breathing and your pelvic floor muscles' ability to relax, and gives you advice that suits you.

If constipation lasts a long time, causes significant discomfort, or comes with severe abdominal pain or blood in your stool, talk to the healthcare provider following your pregnancy. If you take medication or supplements, also mention your constipation to your doctor.

Hemorrhoids in pregnancy occur when the veins around the anus become swollen. Constipation and straining during bowel movements, combined with the increased abdominal pressure of pregnancy, can make symptoms worse.

You may notice itching, tenderness, pain or a lump you can feel around the anus. You may see bright red blood after a bowel movement.

Eating more fiber-rich foods, drinking enough fluids and staying active in a way that suits your pregnancy can help prevent constipation. It is also important not to put off going to the toilet and to avoid straining for long periods.

Not every product is considered the same way in pregnancy. Talk to your doctor, midwife or pharmacist before using a cream, suppository or any other medication.

Your physiotherapist assesses your toilet habits, your breathing during bowel movements and your pelvic floor muscles' ability to relax. If needed, they aim to make bowel emptying easier with advice on toilet positioning and reducing straining.

Mild swelling on both sides in the feet and ankles can occur, especially later in pregnancy. However, if the swelling increases suddenly, also becomes noticeable in your face and hands, or comes with other symptoms, tell your doctor or midwife right away.

Leg cramps or pain can occur in pregnancy. Regular, gentle movement, especially moving your ankles, supports circulation and helps ease cramps.

Try not to stay in the same position for long, take short walks during the day and gently move your ankles while sitting. Raising your legs in a comfortable position while resting may also feel good. But if your symptoms persist, be sure to get them assessed.

If you have urinary or fecal leakage, pelvic pain, a feeling of vaginal pressure, or difficulty contracting and relaxing your muscles, you can come in for an assessment. But even if you have no symptoms, you can get pelvic floor physiotherapy guidance to prepare your muscles for birth.

Your physiotherapist first listens to your health and pregnancy history, symptoms and expectations. Your pelvic floor muscle function is then assessed together with your breathing, abdominal muscles and movement habits. Your muscle function is checked with an EMG biofeedback device.

Kegel exercises focus on contracting the pelvic floor muscles, but relaxing these muscles is just as important. If you feel pain or excessive tension during exercise, or you're not sure whether you're working your muscles correctly, get support from a physiotherapist.

No. The assessment considers not only muscle strength but also the ability to relax, endurance and coordination with breathing. Depending on your needs, contraction and relaxation exercises, breathing work, EMG biofeedback, movement adjustments or manual therapy are used; not everyone gets the same exercises.

Not every pregnant woman without symptoms needs a physiotherapy assessment. However, if you find it hard to identify or relax your pelvic floor muscles, have had pelvic floor symptoms before, or would like personalized exercise advice for pregnancy, an assessment can be planned around your needs.

Depending on the assessment, manual techniques for the tissues of the abdomen, hips or pelvic region are added to your physiotherapy plan. The type of technique and your position are chosen based on your week of pregnancy, your symptoms and your comfort.

There is no fixed number of sessions that applies to everyone. How often you come is decided together, based on your symptoms, the assessment findings, any difficulties you have doing the exercises and your progress.

If your doctor has cleared you to exercise, you don't have to wait for a particular week. If you haven't exercised before, it's best to start with short, gentle sessions.

Yes. In pregnancy Pilates, movements are adapted to your week of pregnancy, your energy and your symptoms; exercises that increase abdominal pressure or require lying on your back for long periods are modified.

Yes. After your initial assessment, your program can continue with online sessions; if you live outside Istanbul, you can get support online.

The classes cover how your diaphragm moves as you breathe in and out and how it coordinates with your pelvic floor muscles. Through body awareness exercises, you learn to feel these movements and experience how you can use your breath, your pelvic floor and other parts of your body during labor contractions.

When you breathe in, your diaphragm moves down, and your pelvic floor follows this movement by lengthening and relaxing. When you breathe out, your diaphragm rises and your pelvic floor returns to its starting position. In class, we don't just talk about this coordination; we help you notice it in your own body.

A contraction is the work of your uterine muscles; you don't need to squeeze your pelvic floor separately with each contraction. In class, we practice continuing to breathe without holding your breath during a contraction and softening your pelvic floor as much as possible. The stage of labor and your healthcare team's guidance also shape what you do in the moment.

There is no single breathing technique that works for everyone. In class, we practice noticing your breath, keeping it flowing without holding it, and finding ways of breathing out that feel comfortable for you. Breathing and relaxation techniques can be used during labor according to your own preference.

During the pushing stage, uterine contractions and your body's urge to push work together. In class, we focus on getting to know your pelvic floor muscles and experiencing relaxation; during birth itself, the timing and way you push are guided by your body's signals and your healthcare team.

Yes. By trying different positions and movements, you can notice which ones feel more comfortable for your body. Movement and choice of position during labor may vary depending on your needs in the moment, your health and your birth team's recommendations.

No. By trying different positions and movements, you discover which ones feel more comfortable for your body. During labor, your choice of position depends on your needs in the moment, your health and your birth team's recommendations.

No. In class, we focus on feeling the muscles, contracting them when needed and then being able to relax them. When preparing for birth, understanding how your pelvic floor functions goes well beyond simply practicing squeezing.

First, we talk about your birth history, your recovery and the symptoms that brought you in. Then we assess your breathing, your ability to contract and relax your abdominal and pelvic floor muscles, and your everyday movements. The assessment is guided by the symptoms you describe and by the limits you feel comfortable with.

There is no single waiting period that applies to every assessment. If you have symptoms, you can speak with your doctor or a physiotherapist without waiting for your postpartum checkup; the assessment is planned with your type of birth and your recovery in mind.

No. An internal assessment is not done for everyone and is never performed without your consent. If it is considered helpful, the physiotherapist first explains why and how it would be done; if you prefer not to have one, we can continue with an external assessment and conversation.

Having had a C-section does not mean you can't have a pelvic floor assessment. Pregnancy itself affects the pelvic floor; your abdominal wall, healing around the incision and your everyday movements are also assessed according to your needs.

The right timing and approach can vary depending on your postpartum condition and on factors such as stitches, tears or pain. If you're not sure you can correctly contract and relax your pelvic floor muscles, get personalized guidance from a physiotherapist before increasing your exercises.

Leaking urine when you cough or move, sudden urgency, fecal incontinence or straining to empty your bowels, pelvic pain, pain during sex, and a feeling of heaviness or pressure in the vagina can all be reasons for an assessment. These symptoms can occur during pregnancy and after birth; pelvic health physiotherapists offer assessment and rehabilitation for them.

Urinary incontinence can happen after birth, but experiencing it doesn't mean you can't get help or that you have to live with it. If leaking keeps happening, makes you avoid exercise or affects your daily life, you can come in for an assessment.

We talk about the situations in which you leak, whether you experience urgency, how often you go to the bathroom and how long the problem has been going on. Then we assess your ability to contract and relax your pelvic floor muscles and to coordinate them with your breathing and movement.

It's important that the exercise works the right muscles and that the muscles relax after each contraction. That's why it's better to first assess how your pelvic floor muscles function and then decide on the exercises and technique that suit you.

Yes. Urinary incontinence doesn't only affect people who have had a vaginal birth; pregnancy itself can affect the pelvic floor. If you have symptoms, you can be assessed regardless of how you gave birth.

Not having a bowel movement for a few days after birth can happen. Still, if your discomfort is increasing or the constipation continues, talk to your midwife, family doctor or physician.

This worry can lead you to put off going to the bathroom, especially after a tear or an episiotomy. Try not to hold your breath and push hard on the toilet; if you have pain or concerns about your stitches, ask your birth team for personal advice. If you keep having trouble with bowel movements, you can also share this with your physiotherapist.

Place your feet firmly on the floor; if needed, use a low footstool so your knees are slightly higher than your hips. Lean forward a little and try to relax your belly and pelvic floor as you breathe out. Rather than straining for a long time, getting up and trying again later will feel more comfortable.

An assessment is needed if you often strain, feel that stool gets stuck at the bowel opening, feel you can't fully empty, or spend a long time on the toilet. The physiotherapist checks whether your breathing and pelvic floor muscles can relax during bowel movements and tailors the approach to your findings.

Being unable to hold in gas is a different symptom from fecal incontinence, but it is still a problem with control around the anus. If it started after birth, happens often or affects your daily life, tell your doctor or pelvic floor physiotherapist.

For some people, symptoms may ease during recovery; however, when and to what extent this happens varies from person to person. If symptoms continue or get worse, or if you had a severe tear during birth, contact your healthcare team without waiting for your follow-up appointment. After tears involving the anal sphincter muscles, support options including physiotherapy can be considered for bowel control problems.

First, we talk about the type and frequency of the leakage and when it started, along with your birth history and bowel habits. Then we assess your pelvic floor muscles' ability to contract and relax, their coordination with your breathing and, if needed, the function of the muscles around the anus.

Not always. Muscles that cannot contract at the right time or have trouble relaxing need to be assessed just as much as weak muscles. That's why exercises should be planned based on an examination and your symptoms, and a physiotherapist should decide whether they are right for you.

This sensation can occur with pelvic organ prolapse, but on its own it is not enough for a diagnosis. The healing of tissues after birth or other pelvic floor problems can cause similar sensations.

Symptoms may be noticed shortly after birth or become more noticeable over time. Besides when they began, what makes them worse and how they affect your daily life are also important in the assessment.

First, we talk about your birth and health history, when the feeling of pressure gets worse, and your bladder and bowel function. Then we assess the strength, relaxation and coordination of your pelvic floor muscles.

You don't need to stop all exercise; however, which movements suit you depends on your symptoms. If vaginal pressure, heaviness or a bulging sensation increases during activity, talk to your physiotherapist or doctor to review the type and intensity of your exercise.

A doctor's examination is needed to find out what the bulge is. If you also have difficulty urinating or emptying your bowels, be sure to mention it. Treatment options for prolapse symptoms are planned based on your symptoms and examination findings; in some cases, your doctor may also consider options such as a vaginal support device (pessary).

You may notice a bulge or doming along the midline when getting out of bed or using your abdominal muscles. This appearance alone is not a diagnosis; a physiotherapist or doctor assesses your abdominal wall and how it functions. If there is a noticeable swelling or pain, a doctor's examination may also be needed.

Exercise helps improve the strength and movement control of the abdominal wall. How much the distance between the muscles changes differs from person to person. That's why the exercise program is based on the assessment findings. The European Hernia Society states that physiotherapy can be considered before surgical options are explored.

You don't need to stop every abdominal exercise. If you notice obvious doming along the midline, pain or difficulty with control during an exercise, the way you do the movement, its difficulty or your breathing can be adjusted. The right exercises for you are chosen based on your assessment and goals.

Yes. Diastasis recti is related to the stretching of the abdominal wall during pregnancy and can occur after any type of birth. Along with how you gave birth, the assessment also takes into account your recovery and your symptoms.

No. Measuring the gap is only one part of the assessment; the tension of the abdominal wall, how the muscles work, and breathing and movement control are also important. The European Hernia Society's 2 cm criterion helps with the definition, but on its own it does not determine your exercise needs or treatment plan.

Early movement in the hospital or after discharge is guided by your healthcare team's recommendations and your general condition. There is no single required start date for a more comprehensive physiotherapy assessment; incision healing, pain and your needs are taken into account. Check with your doctor before starting exercise or scar work.

Massage can be considered once the incision has fully closed and there is no scab, discharge or sign of infection. If the wound is still healing or there is redness, warmth or discharge around the incision, do not massage it; talk to your healthcare provider.

Six weeks does not automatically mean you are cleared to exercise. NICE recommends returning to activities such as driving, carrying heavy items and regular exercise once you feel fully recovered from the C-section and have no pain or physical restrictions. If you are unsure about your recovery, ask your doctor or physiotherapist for a personal assessment.

Changes in sensation and tightness around the incision are addressed in the assessment. Once wound healing is complete, the physiotherapist looks at tenderness, sensation to touch and scar mobility to decide on the right approach. If your symptoms are getting worse or the wound looks different, see your doctor first.

Abdominal exercises should be chosen with your incision healing and your symptoms in mind. Lighter work involving breathing and trunk control may be suitable at first, and the difficulty is increased gradually over time. Don't continue movements that cause pain or noticeable discomfort around the incision.

You can ask for an assessment if you have perineal pain when sitting or walking, tightness around the scar or sensitivity to touch. Also share any difficulties you have with using the toilet, exercising or having sex with your physiotherapist. The assessment helps clarify which tissues and movements your symptoms may be related to.

No. Along with pelvic floor muscle strength, your ability to relax, coordinate and engage these muscles at the right moment is also assessed. Depending on your needs, the plan may include breathing work, movement adjustments, muscle awareness or, once the wound has fully healed, work on the scar tissue.

Wound healing comes first. Touch or massage of the scar tissue is considered only after the wound has fully closed and a healthcare professional has said it is appropriate. If you have any concerns about how your wound is healing, talk to your midwife or doctor before starting physiotherapy.

Yes. Pain that appears when walking, turning in bed, climbing stairs or standing on one leg may be related to how the pelvic girdle and surrounding muscles are working. The physiotherapist assesses the movements that increase your pain and your trunk and hip control during movement, then creates a plan that suits you.

Starting pelvic floor exercises straight away may not be right for every kind of pelvic pain. Along with muscle strength, the ability to relax and to coordinate with other muscle groups is also assessed. Exercises should be chosen according to your symptoms after a physiotherapy assessment.

You may not need to stop every activity completely, but loads and movements that clearly increase your pain should be adjusted for a while. Your physiotherapist helps you adapt activities such as carrying your baby, lifting from the floor and returning to exercise to your current capacity.

Yes, pain can occur, especially in the first months after birth; but being common does not mean you should ignore it. If the pain persists, gets worse or makes intimacy difficult, you can talk to your doctor or a pelvic floor physiotherapist.

There is no single date that applies to everyone. Healing of stitches, whether bleeding has stopped, your physical comfort and whether you feel ready are all considered together. If it hurts the first time, you do not have to continue; there are also ways to be intimate without penetration.

Kegel exercises may not be suitable for every case of painful sex. If the pelvic floor muscles are already tense, focusing only on contracting them can make your symptoms worse. A physiotherapy assessment looks at both how the muscles contract and how they relax, and exercises are chosen accordingly.

Vaginal dryness can cause friction and discomfort during sex; the NHS notes that pain after birth can sometimes be related to dryness. Water-based lubricants may make things more comfortable for some people. If dryness or pain continues, talk to your doctor.

When you can return to light movement depends on the type of birth, your healing and your health; there is no single start date for everyone. Before moving on to more intense exercise, pain, bleeding, pelvic floor symptoms and movement capacity should be assessed. If you had a C-section or complications, talk to your doctor before starting intense exercise.

The six-week checkup is an opportunity to talk with your healthcare provider about your recovery; on its own, it does not mean you are ready for all exercise. For running, jumping and heavy strength training, your symptoms, tissue healing and exercise capacity should be taken into account.

Stop the movement and note which exercise and what intensity brought on the symptom. If it keeps happening, adjust the type of exercise, the load or your technique together with your physiotherapist. An exercise plan that suits you will be created alongside a pelvic floor assessment.

After a C-section, the surgical incision in the abdomen and its healing are also part of the assessment. Progressing from everyday movement to more intense exercise is staged with pain and incision healing in mind.

Deciding based only on how much time has passed since birth may not be enough. The physiotherapist assesses your strength, balance, walking and control during higher-load movements, and whether you have pelvic floor symptoms during exercise. Your return plan is built on these findings and your goals.

You can come for an assessment if you have urinary leakage, frequent urination, constipation, difficulty emptying your bowels, pelvic pain or pain during sex, if you have been diagnosed with infertility or if you are having trouble getting pregnant. If you have had pelvic floor treatment or surgery in the past, you can also discuss your current function and needs with a physiotherapist.

Even without symptoms, you can request a consultation to get to know your body and your pelvic floor muscles better. Based on your history and goals, the physiotherapist decides which areas of the assessment are meaningful for you.

No. Exercises are chosen according to muscle strength, the ability to contract and relax, your symptoms and your goals. If there is excessive muscle tension or pain, focusing only on squeezing exercises may not be appropriate.

Physiotherapy assesses areas such as pelvic pain, pain during sex, pelvic floor muscle function and restricted movement in the abdomen and pelvis. The approach is based on your symptoms and your medical treatment.

There are studies on how manual therapy and physiotherapy affect pregnancy rates, but the evidence in this area is limited and study methods vary. A 2024 review rated the quality of evidence in manual therapy studies as low to moderate and highlighted limitations such as small sample sizes and a lack of control groups. For this reason, physiotherapy should not be seen as a fertility treatment; it can be used alongside your fertility team for physiotherapy goals identified as appropriate in your assessment.

Manual therapy is planned according to the findings of the assessment and the physiotherapist’s clinical judgment. Techniques involving pelvic tissue and mobility are explained to you, and their suitability is assessed in light of your health history and your consent. These techniques do not replace a medical infertility workup.

Yes, a physiotherapy assessment may be considered, especially if you have pelvic pain, pain during sex, tenderness around an incision or restricted movement. Your diagnosis and any procedures you have had are taken into account, and the approach is based on your symptoms. Diagnosis and treatment of endometriosis remain with your doctor.

It is best to discuss your need for physiotherapy and its timing with your IVF team. Especially during ovarian stimulation, egg retrieval or embryo transfer, which techniques are used should be planned around your treatment schedule and your healthcare team’s recommendations.