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. This makes 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 comes with these pelvic changes. When the deep core muscles are weakened, your spine and pelvis lose some of their usual support. This can contribute to back pain after delivery and changes in posture after birth.

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

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

If you also have sudden numbness, weakness in your legs, or any loss of bladder or bowel control, please get urgent medical help from your doctor or your nearest emergency department. These symptoms need to be checked straight away.

Why does pelvic pain after delivery continue for some women?

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

The body is a connected chain from your feet to your head. When the pelvis shifts, your spine, hips and knees make up for it. That is why back pain after delivery can be felt far from the pelvis itself. It is also why a rotated pelvis can affect the way you walk and how comfortable one knee feels.

How is pelvic alignment after delivery checked 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 taken away. A tilt, rotation or leg-length difference that causes pain under upright load may flatten out and look normal on a scan done lying down.

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. You simply stand still inside the machine.

The image lets your clinician measure the exact position of the pelvis compared with your spine, hips and legs. If one side is higher, or the pelvis has stayed rotated, it will show clearly. This whole-body view is what makes ScanAlign standing EOS imaging especially useful for alignment concerns after delivery.

What helps the pelvis recover after delivery?

Recovery is usually a mix of time, slowly building up load and, in some cases, targeted physiotherapy. These are the general approaches most often recommended.

• Pelvic floor rehabilitation. Rebuilding pelvic floor strength helps support the joints from below. A specialist physiotherapist can guide you through safe steps.
• Core recovery. Gentle deep-core work, especially for diastasis recti, helps steady the pelvis and reduce back pain after delivery. 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 repeated one-sided loading.
• Slow return to exercise. Building up load slowly gives the ligaments time to firm up. Jumping straight back into running or heavy lifting while relaxin is still present can make symptoms last longer.
• Alignment assessment. If symptoms carry on beyond the early months, a standing whole-body image gives your physiotherapist or consultant the structural detail they need to fine-tune your plan.

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

There is no single rule. As a general guide, most women can be scanned from around three months after a normal (vaginal) delivery, or around four months after a caesarean section. By this point, early healing is well underway. Any alignment problems that remain are more likely to show the pelvis's settled position, rather than short-term swelling after delivery.

If you are still breastfeeding, relaxin may stay raised, so your alignment could keep changing. 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 your hormones return to normal.

Your six-week check after delivery is a good time to talk to your doctor about symptoms that are not going away. If pain continues beyond that point, an alignment assessment becomes more relevant.

Who benefits from an alignment assessment after delivery?

Before you start treatment, or change the one you are on, it is worth getting a detailed diagnosis. Knowing whether the cause sits in the pelvis, the legs or the spine changes what will actually help.

Frequently asked questions