Postnatal Recovery: What Happens Beyond the Six-Week Check

The six-week postnatal check with your GP has long been the traditional milestone that signals "you're cleared to return to normal activities." But for many women, six weeks is just the beginning of recovery — particularly after a complicated delivery, perineal trauma, or abdominal surgery.

What the six-week check doesn't assess

In most UK GP practices, the six-week check is a brief appointment that covers contraception, mental health screening, and general wellbeing. It typically does not include an assessment of pelvic floor function, abdominal muscle separation (diastasis recti), or readiness to return to exercise. This is a significant gap in postnatal care.

Diastasis recti: the separation most women don't know they have

Diastasis recti — separation of the rectus abdominis muscles — affects up to 60% of women at 6 weeks postnatal. If not identified and managed, it can contribute to lower back pain, pelvic girdle pain, and a persistent "mummy tummy" appearance. A women's health physiotherapist can assess the degree of separation and provide a targeted rehabilitation programme.

Return to running: not at six weeks

Running places significant load on the pelvic floor. Current evidence-based guidance suggests women should not return to running before 12 weeks postnatal, and only after a thorough pelvic floor assessment. Returning too soon increases the risk of prolapse and stress incontinence.

When to seek a women's health physiotherapy assessment

• Any leaking of urine, faeces, or wind
• Pelvic heaviness or a sensation of bulging
• Lower back or pelvic girdle pain
• Any concern about your abdominal muscles
• Before returning to exercise, particularly high-impact activity