Do I Need an Internal Examination at My Postnatal Check?

Not necessarily. Depending on your symptoms, your GP may discuss an examination or refer you for pelvic health assessment. They should explain why an examination might help, ask for your consent, and give you the opportunity to ask questions or decline. You can ask for another appointment if you would rather not decide in the moment.

What if My Appointment Feels Too Rushed?

When booking, ask whether you can have a separate or longer appointment for a postnatal or pelvic-health concern. If there is not time to cover everything, ask what the next step is and how to arrange a follow-up. Your maternal postnatal consultation may be booked close to your baby’s check, but it is an opportunity to discuss your own healing, wellbeing, bladder or bowel changes, scar recovery and pelvic-floor symptoms too.

Is It Too Late to Raise a Symptom if My Check Was Weeks Ago?

No. You can book a GP appointment at any point—whether you are eight weeks, eight months or years after birth. Explain that you would like to discuss postnatal pelvic health, bladder or bowel changes, pain, scar recovery, abdominal symptoms or your return to exercise. You do not lose the right to ask for support because you did not mention something at the 6–8 week check.

What Should I Say if I Do Not Know the Right Words?

Describe what happens, when it happens and how it affects your day. For example: “I leak when I cough, run or lift.” “I feel a heaviness or dragging sensation by the end of the day.” “I have to rush to the toilet and sometimes do not make it.” “Sex is still painful.” “I have noticed a ridge or doming along my abdomen when I sit up.” You do not need to know whether something is called prolapse, diastasis recti, stress incontinence or pelvic-floor dysfunction before raising it.

Will Exercise Make My Symptoms Worse Before I Am Assessed?

Gentle movement that feels well tolerated is not automatically something to avoid altogether. But a generic exercise plan cannot account for your birth history, symptoms, healing, fitness level or recovery goals. If activity repeatedly brings on leaking, heaviness, pain, bulging or discomfort, mention that specifically and ask what support or referral would be appropriate. Re-centre’s postnatal pelvic-floor exercise guide explains more about returning to movement after birth.

Can I Ask for Pelvic Health Physiotherapy?

Yes. If you have leakage, urgency, pelvic heaviness or bulging, pain, bowel changes, concerns about scar recovery, abdominal symptoms or difficulty returning to movement, you can ask your GP whether referral to pelvic health physiotherapy is appropriate. Pelvic-health physiotherapy can assess pelvic-floor function, abdominal function, movement and symptom patterns. The exact referral pathway and availability will vary by area.

What to Ask at Your 6–8 Week Postnatal Check: Pelvic Health, Leakage and Recovery

A practical guide to the 6–8 week postnatal check: what to raise about leakage, pelvic heaviness, pain, scars, abdominal changes and returning to exercise.

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Quick Answer

At your 6–8 week postnatal check, tell your GP about any leaking of urine, wind or stool; a sudden need to reach the toilet; pelvic heaviness, pressure or bulging; pain during sex; concerns about a perineal tear, episiotomy or C-section scar; bowel changes; abdominal doming or discomfort; and questions about returning to exercise.

You can also ask whether a referral to pelvic health physiotherapy would be appropriate. You do not need to wait until symptoms are severe, and you do not need the right medical words before you raise them.

The maternal postnatal consultation is separate from your baby’s routine check, although appointments are sometimes booked close together. NHS England describes the GP maternal postnatal consultation as taking place at around 6–8 weeks after birth. NHS England: Improving Postnatal Careengland.nhs

Something I hear often from women after their 6–8 week check is that it felt more like a formality than a conversation. A quick weigh of the baby, a few standard questions, and out the door before anything real got raised.

I have sat across from enough women in that state—still figuring out what happened to their body—to know that ten rushed minutes is not enough unless you walk in with your own list.

The check is not a deadline by which recovery should be complete. It is a chance to begin a conversation.

What Is This Check Actually For?

The 6–8 week maternal postnatal consultation is an opportunity to discuss your physical recovery, emotional wellbeing, contraception and any concerns affecting daily life. That can include bladder or bowel changes, pain, pelvic symptoms, scar healing and questions about returning to activity. NHS England: Improving Postnatal Careengland.nhs

NICE postnatal guidance recommends discussing a woman’s general health, wellbeing and concerns during postnatal contacts. NICE: Postnatal Care (NG194)guidelinecentral

This sits inside a longer arc that starts in pregnancy and continues through postnatal recovery. Think of the 6–8 week check as a first waypoint—not the point at which the chapter on your body after birth closes.

Common Is Not the Same as Fine

Leaking when you cough, a feeling of pelvic heaviness by the end of the day, pain during sex, or a ridge along your abdomen during effort can occur after birth.

But common does not mean you have to ignore it.

Symptoms that persist, worsen or affect your day, confidence, comfort, relationships or ability to move as you want to are worth raising with a GP, midwife, health visitor or pelvic health physiotherapist. NHS pelvic-health services list leakage of urine or stool, difficulty controlling wind, vaginal heaviness or bulging, and pain during sex among concerns that deserve support. NHS: Pelvic Health During Pregnancy and Beyondsath.nhs

You do not need to decide for yourself whether a symptom is serious enough. That is what the appointment is for.

Leaking, Urgency and Bowel Changes

Leaking urine or wind, needing the toilet urgently, or noticing that your bladder or bowel does not feel the same as before pregnancy are all reasonable things to bring up—even if they feel minor.

The pattern matters. Leaking with coughing, sneezing, laughing, lifting or exercise can be different from a sudden, hard-to-delay urge to pass urine. Some women experience both. NICE guidance advises clinicians to assess the type of urinary incontinence because the pattern helps guide the right management. NICE: Urinary Incontinence and Pelvic Organ Prolapse in Women: Management (NG123)scribd

You could ask:

“I am leaking when I cough, run or lift. What should I do next?”
“I am suddenly desperate to get to the toilet. Is this something I should be assessed for?”
“My bowel habits feel different after birth. Is that something I should mention?”
“Would a referral to pelvic health physiotherapy be appropriate?”

If you are not sure how to describe it, simply explain what happens, when it happens and how it affects your day. You do not need the clinical label first.

For more support, see re-centre’s guide to urinary incontinence.

When It Feels Like Something Is Coming Down

A feeling of heaviness, pressure, dragging, or something “coming down” in the vagina can be associated with pelvic organ prolapse. Prolapse describes one or more pelvic organs, such as the bladder, uterus or bowel, bulging into the vagina because the supporting tissues have changed. St George’s NHS: Pelvic Organ Prolapsestgeorges.nhs

Some people find it helpful to picture the pelvic floor and supporting tissues as a hammock-like support system. Pregnancy and birth can place those tissues under greater strain.

But symptoms alone cannot confirm whether you have prolapse, what type it may be, or how significant it is. A proper assessment can help clarify what is happening.

Ask directly:

“I feel heaviness or pressure by the end of the day. Could this be a pelvic-floor or prolapse symptom?”
“I have noticed a bulge or a feeling that something is coming down. Can this be assessed?”
“Could constipation, lifting or time on my feet be contributing to how this feels?”
“Would an examination or pelvic health physiotherapy referral help clarify this?”

See re-centre’s pelvic organ prolapse guide for a fuller explanation of symptoms, support options and when to seek care.

Pain, Sex and Scar Recovery

Pain during sex, discomfort around a perineal tear or episiotomy scar, or a C-section scar that remains painful, tight, numb or concerning are all worth mentioning.

In my work, this is often the last thing women raise—if they raise it at all.

You can ask:

“Can we check whether this scar is healing as expected?”
“I am still having pain during sex. What support is available?”
“What should I expect from recovery after my particular tear, episiotomy or C-section?”
“Would pelvic health physiotherapy be appropriate for scar, pelvic or sexual pain?”

You do not need to minimise discomfort because you are newly postnatal. Persistent, severe or worsening pain should be assessed. NHS: Your Body After the Birthnhs

A Gap in Your Stomach Does Not Mean You Are Broken

Many women notice a gap, softness or a ridge along the midline of the abdomen after birth. This is often described as diastasis recti: a widening and change in the connective tissue running along the middle of the abdominal muscles.

It is not a tear, and it does not mean your body is broken.

A visible gap, softness or doming does not tell you everything about abdominal function. If you are concerned about pain, a new localised bulge, abdominal discomfort, movement confidence or returning to exercise, it is reasonable to ask for advice or assessment.

If you had a C-section, scar healing and abdominal function may bring additional questions. Read re-centre’s guide to healing after a C-section.

A useful question is:

“I have noticed doming, a gap or a bulge along my abdomen. Can you advise whether this needs assessment and what a sensible return to movement might look like for me?”

A new, painful, tender or concerning localised bulge should be assessed rather than assumed to be diastasis recti.

Asking About Pelvic Health Physiotherapy

You do not need to already know that pelvic health physiotherapy exists—or know whether it is definitely right for you—before this appointment.

If you are describing leakage, heaviness, pain, bowel changes, scar concerns or abdominal symptoms, it is reasonable to ask:

“Is pelvic health physiotherapy available through the NHS in my area?”
“Would a referral be appropriate for my symptoms?”
“If a referral is not available locally, what are my options?”

If pelvic-floor exercises are not helping after birth, the NHS notes that a GP may refer you to a physiotherapist. NHS: Your Body After the Birthnhs

A Simple List to Take to Your Appointment

You can say:

“Since giving birth, I have noticed the following and I would like to discuss whether I need support or a referral.”

Any leakage of urine, wind or stool—and when it happens.
A sudden need to reach the toilet, frequent urination, or difficulty emptying your bladder or bowels.
Pelvic heaviness, pressure, dragging or a vaginal bulge—and what seems to worsen or relieve it.
Pain during sex, pelvic pain, or a scar that remains painful, tight, numb or concerning.
Abdominal doming, a new localised bulge, discomfort or questions about diastasis recti.
Your confidence and readiness to return to lifting, running, impact exercise or sex.
Whether pelvic health physiotherapy is available locally and whether a referral would be appropriate.

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Frequently Asked Questions

When booking, ask whether you can have a separate or longer appointment for a postnatal or pelvic-health concern. If there is not time to cover everything, ask what the next step is and how to arrange a follow-up. Your maternal postnatal consultation may be booked close to your baby’s check, but it is an opportunity to discuss your own healing, wellbeing, bladder or bowel changes, scar recovery and pelvic-floor symptoms too.
Describe what happens, when it happens and how it affects your day. For example: “I leak when I cough, run or lift.” “I feel a heaviness or dragging sensation by the end of the day.” “I have to rush to the toilet and sometimes do not make it.” “Sex is still painful.” “I have noticed a ridge or doming along my abdomen when I sit up.” You do not need to know whether something is called prolapse, diastasis recti, stress incontinence or pelvic-floor dysfunction before raising it.
Gentle movement that feels well tolerated is not automatically something to avoid altogether. But a generic exercise plan cannot account for your birth history, symptoms, healing, fitness level or recovery goals. If activity repeatedly brings on leaking, heaviness, pain, bulging or discomfort, mention that specifically and ask what support or referral would be appropriate. Re-centre’s postnatal pelvic-floor exercise guide explains more about returning to movement after birth.
Yes. If you have leakage, urgency, pelvic heaviness or bulging, pain, bowel changes, concerns about scar recovery, abdominal symptoms or difficulty returning to movement, you can ask your GP whether referral to pelvic health physiotherapy is appropriate. Pelvic-health physiotherapy can assess pelvic-floor function, abdominal function, movement and symptom patterns. The exact referral pathway and availability will vary by area.