Postpartum Care: Your Recovery Deserves a Plan, Too

By Dr. Alaina Garbens, MD, PhD, FRCSC, MSCP

You can love your baby and still think, “I would really like my bladder back.”

Or want to walk without pelvic heaviness. Lift the car seat without discomfort. Understand why sex hurts, or why your core still feels unfamiliar.

These are reasonable things to want help with. They do not make you ungrateful, impatient or overly focused on your body.

At Élevé, I want postpartum care to make room for those questions. That starts with understanding what has changed, identifying what needs attention and building a plan around the person asking.

Six weeks is a checkpoint, not a finish line

The routine postpartum visit matters. But a date on the calendar does not tell us that every tissue has healed, every symptom has settled or every activity feels comfortable again. Canadian guidance recommends a gradual, individualized, symptom-based return to activity.

You do not need to wait for a routine appointment if something is worsening. And if you are months beyond delivery, persistent symptoms still deserve assessment.

Recovery is not a competition to look or perform as though pregnancy never happened.

“Postpartum” is the context, not the diagnosis

Leaking when you cough is different from leaking with a sudden urge. Vaginal heaviness may be associated with pelvic organ prolapse. Pain, difficulty emptying your bladder and changes in bowel control need their own assessment.

The same applies to the pelvic floor. Some women need help rebuilding strength and endurance. Others need to improve relaxation and coordination, particularly when pain or difficulty emptying the bladder or bowel is present. A useful rehabilitation plan considers both contraction and relaxation, not simply more Kegel exercises.

That is why our approach starts with your story. What changed, your pregnancy and birth history, how you've recovered, your symptoms and goals. Any examination is explained and performed with your consent. ests are selected when they can help answer a clinical question.

A treatment plan, not a predetermined package

Depending on the findings, care may include pelvic-health physiotherapy, progressive abdominal rehabilitation, bladder training, constipation management or support with everyday lifting and activity.

For bothersome pelvic organ prolapse, a fitted vaginal pessary can provide support. Regenerative therapies can help tissue and muscle repair. Persistent or severe symptoms may warrant discussion of established procedures or surgery.

Pain with sex, dryness and scar tenderness also deserve a cause-specific plan. Hormonal changes associated with breastfeeding may contribute, but they are not the only explanation. Lubricants, moisturizers, rehabilitation, regenerative or medical treatment may be considered according to the cause and your goals. Any prescription or procedure needs an individual review of healing, pregnancy considerations and breastfeeding.

The aim is to connect the pieces of care that matter to you, not to recommend every available option.

The rest of you belongs in the conversation

A recovery plan should also consider sleep, mood, nutrition, birth experiences and the practical support available at home.

A registered dietitian may help with recovery and feeding nutrition, constipation or difficulty eating regularly. Psychological or other specialist support may be appropriate when emotional distress or a difficult birth is affecting daily life.

Core function and a possible hernia need clinical assessment. Appearance concerns, including stretch marks or a healed scar, can be discussed and a plan developed.

Where innovation fits

I am interested in approaches that help the body function better using its own tissues and abilities. Energy-based and platelet-based therapies such as platelet rich fibrin can be helpful in restoring collagen and elastin to traumatized tissue. Their potential benefits, risks, limitations and current evidence should be discussed openly. In my practice, they are used as part of a whole personalized treatment pathway, never as a treatment alone for urinary leakage (incontinence).

Your recovery deserves follow-through

Your recovery plan should identify what we are treating, what improvement would allow you do and when to review progress. You should understand your options, feel comfortable asking questions and know when your progress will be reviewed.

While everyone is focused on your baby, our focus is on you. Request a Women's Health Assessment with Élevé. We’ll start with what’s changed and build a plan around what you want to get back to.