How Does Your Pelvis Recover After Giving Birth?

What happens to your pelvis during pregnancy and birth?

Your body releases the hormone relaxin to loosen the ligaments around the pelvis, making room for your baby to pass through. The two halves of the pelvis at the front (the pubic symphysis) and the sacroiliac joints at the back all become more mobile. This is normal and necessary.

After delivery, relaxin levels drop and your ligaments slowly tighten. For most women, the pelvis returns close to its original position within a few months. But for some, the joint surfaces do not settle evenly. One side may sit slightly higher, or the pelvis may stay rotated. You might not notice this at all, or you might feel it as ongoing pain in your lower back, hips or groin.

Diastasis recti, a separation of the abdominal muscles, often accompanies these pelvic changes. When the deep core muscles are weakened, your spine and pelvis lose some of their usual support. This can contribute to postnatal back pain and altered postpartum posture.

What are the signs your pelvis hasn't fully recovered?

Ongoing pelvic girdle pain after birth is the most common sign. But the effects of a pelvis that has not fully realigned can show up in several ways.

If you also experience sudden numbness, weakness in your legs, or any loss of bladder or bowel control, please seek urgent medical attention through your GP, 111 or A&E. These symptoms need immediate assessment.

Why does postnatal pelvic pain continue for some women?

Several factors can slow or prevent full pelvic recovery. Often more than one is at play.

The body is a connected chain from your feet to your head. When the pelvis shifts, your spine, hips and knees compensate. That is why postnatal back pain can be felt far from the pelvis itself, and why a rotated pelvis can affect your gait and knee comfort on one side.

How is postnatal pelvic alignment assessed standing up?

A standing, weight-bearing image is the most reliable way to see how the pelvis sits under real load. When you lie down for a standard X-ray or MRI, your muscles relax and gravity is removed. A tilt, rotation or leg-length difference that causes pain when you stand may flatten out and appear normal on a lying-down scan.

An EOS scan captures your entire skeleton, from your head to your feet, in a single standing image. It uses about 90% less radiation than a standard X-ray, around ten times less. The scan itself takes only a few seconds and you simply stand still inside the machine.

The resulting image lets your clinician measure the exact position of the pelvis relative to your spine, hips and legs. If one side is higher, or the pelvis has stayed rotated, it will show clearly. This level of whole-body context is what makes ScanAlign standing EOS imaging particularly useful for postnatal alignment concerns.

What helps postnatal pelvic recovery?

Recovery is usually a combination of time, gradual loading and, in some cases, targeted physiotherapy. Here are the general approaches most commonly recommended.

• Pelvic floor rehabilitation. Restoring pelvic floor strength helps support the joints from below. A specialist physiotherapist can guide you through safe progressions.
• Core restoration. Gentle deep-core work, particularly for diastasis recti, helps stabilise the pelvis and reduce postnatal back pain. Avoid high-impact exercise until your core can handle the load.
• Carrying and feeding habits. Switching the hip you carry your baby on, and setting up supported feeding positions, reduces repetitive one-sided loading.
• Gradual return to exercise. Building load slowly gives the ligaments time to firm up. Jumping straight back into running or heavy lifting while relaxin is still present can prolong symptoms.
• Alignment assessment. If symptoms persist beyond the early months, a standing whole-body image gives your physiotherapist or consultant the structural detail they need to refine your plan.

How soon after birth can you have a pelvic alignment scan?

There is no single rule, but as a general guide, most women can be scanned from around three months after a vaginal birth, or around four months after a caesarean section. By this point, early healing is well underway and any lingering alignment issues are more likely to represent the pelvis's settled position rather than temporary post-delivery swelling.

If you are still breastfeeding, relaxin may remain elevated, so your alignment could continue to change. That does not mean a scan is pointless. It means the result is a snapshot of where you are now, which your clinician can use to guide rehabilitation. A follow-up image later can show whether things have shifted further as hormones normalise.

Your six-week postnatal check is a good time to discuss persistent symptoms with your GP. If pain continues beyond that point, an alignment assessment becomes more relevant.

Who benefits from a postnatal alignment assessment?

Frequently asked questions