Welcoming a new life into the world is an incredible journey, but it brings about significant changes to a our bodies. One area that often experiences a lot of stress and transformation is the pelvic floor. Many expecting and new mothers have questions about what pelvic floor health during pregnancy and postpartum, why it’s so important, and how to care for it.

Today, I had the pleasure of speaking with Khyati Merchant, a dedicated physical therapist and pelvic floor specialist at Lotus Physical Therapy and Pelvic Health. Khyati shared her expertise on pelvic floor health during pregnancy and postpartum, addressing common misconceptions, offering practical advice, and highlighting when it’s crucial to seek professional help. Get ready to gain valuable insights that can empower you throughout your motherhood journey!

Listen to our interview here

Alicia Insley Smith: today I am interviewing a pelvic floor and physical therapy specialist who’s going to talk to us about pregnancy and postpartum. Khyati, welcome! Can you tell us a little more about Lotus Physical Therapy and Pelvic Health and what you specialize in?

Khyati Merchant: Thank you so much, Alicia. I really appreciate for giving me an opportunity today to be here and to share valuable information for all the wonderful women out there. I’m Khyati Merchant, a physical therapist and the founder of Lotus Physical Therapy and Pelvic Health. We specialize in pelvic health conditions from a musculoskeletal perspective. In addition to pelvic health, we also treat various orthopedic issues such as hip, lower back, and knee pain.

What makes our practice unique is that we are completely mobile—we bring physical therapy directly to our patients’ homes. We tailor individualized therapy programs in the comfort of their own space.

Alicia Insley Smith: Wonderful! Let’s start with the basics. For expecting moms who are new to this, can you explain what the pelvic floor is and why it’s so important, especially during pregnancy and postpartum?

Khyati Merchant: Absolutely. The pelvic floor, as the name suggests, forms the “floor” or base of the pelvis. The bottom part of the pelvic bones is open, and this area is filled with layers of muscles, ligaments, and connective tissue.

These muscles support vital organs like the bladder, bowel, and—specifically in women—the uterus. Beyond organ support, the pelvic floor muscles play a crucial role in maintaining urinary and bowel continence, sexual function, and providing stability to the pelvis, hips, and lower back.
It’s also a key component of our core. So, during pregnancy and postpartum, when these areas undergo a lot of changes and stress, pelvic floor health becomes especially important.

Alicia Insley Smith: What are some common misconceptions you encounter about pelvic floor health?

Khyati Merchant:

One of the most common misconceptions is that pelvic floor therapy is just about doing Kegels. That’s definitely not the full picture. The pelvic floor is designed to work automatically in coordination with other core muscles, and its function is much more dynamic than simply “squeezing and lifting.”

Another misconception is that pelvic floor issues only affect women—particularly after childbirth. In reality, both men and women have pelvic floors and can experience dysfunction. While women are more prone due to hormonal changes, childbirth, and menopause, men also experience issues such as urinary incontinence and pelvic pain.

We even see pelvic floor issues in children—often related to constipation, straining, or withholding bowel movements. Conditions like rectal prolapse can occur, even in younger kids.

And finally, there’s a myth that a little bit of urine leakage after childbirth is “normal” and should be expected. While it’s common, it’s not something you should have to live with—treatment options are available.

Alicia Insley Smith: You mentioned leakage after childbirth not being “normal”
How long postpartum should a new mom consider it “normal,” and when should she seek help?

Khyati Merchant:
Great question. Recovery timelines vary for each individual and each pregnancy, but if you’re still experiencing leakage after 8 to 12 weeks postpartum, it’s a good idea to consult a pelvic floor therapist.
Even if you feel strong and symptom-free, it’s important to return to high-impact activities—like running—with caution. These activities place significant stress on the core and pelvic floor. I usually recommend waiting until around 12 weeks and having an assessment before returning to intense exercise.

Alicia Insley Smith:
Can you walk us through what someone can expect during a pelvic floor physical therapy consultation and first appointment?

Khyati Merchant:
Of course! The first session begins with an in-depth conversation. We go over your medical history, pregnancy and birth experience—including labor duration, any tearing or interventions—and current symptoms or concerns. If it’s been about 6 to 8 weeks postpartum and you had a vaginal delivery, we may perform an internal pelvic floor assessment—only if you’re comfortable. We don’t use any special tools, just gloved hands, and we make sure the area has healed enough first. We also assess posture, breathing, muscle strength in the hips and lower back, and how well everything is working together. This gives us a holistic view of how your body is functioning.

After the evaluation, we create a personalized treatment plan. Depending on your needs, we may schedule sessions weekly or every other week and adjust as we progress toward your goals.

Alicia Insley Smith:

Let’s talk about exercise. What are some simple movements or stretches pregnant women can do to support pelvic floor health? And are there any exercises they should avoid?

Khyati Merchant:
Movement and flexibility are key during pregnancy. Gentle stretches like hip circles, deep squats, and poses like Happy Baby (if comfortable) are excellent for pelvic mobility and preparing the body for birth.
I also recommend keeping the sides of the trunk—the flanks—mobile. As the baby grows and the diaphragm gets compressed, keeping the rib cage area flexible can really help with breathing and labor.

As for what to avoid—it really depends on the individual. If you weren’t lifting weights or doing high-impact workouts before pregnancy, it’s not a great time to start. But if you were previously lifting and your body is tolerating it well—with good breathing, no dizziness, and proper form—it’s generally safe to continue with some modifications.

Always listen to your body.

Alicia Insley Smith:

What about pregnancy-related discomfort likeback pain or sciatica
—can physical therapy help?

Khyati Merchant:
Absolutely. Back pain and sciatica are incredibly common during pregnancy. As your posture shifts and your center of gravity changes, your muscles begin to compensate, often unevenly. That imbalance can lead to strain, tightness, and pain.
In PT, we identify which muscles are overworking and which ones need support. We use manual therapy, posture training, and targeted exercises to help restore balance. We may also release tight muscles and mobilize the spine or pelvis, which can significantly improve comfort and sleep.

Alicia Insley Smith: What are some signs that a pregnant woman should seek out physical therapy?

Khyati Merchant: If you’re experiencing ongoing pelvic heaviness, pelvic or back pain that interferes with daily life or sleep, or urinary or bowel incontinence—those are clear indicators. Painful intercourse, chronic constipation, or difficulty fully emptying the bowel are also signs. Occasional discomfort may be common, but persistent symptoms should be addressed.

And beyond treating symptoms, it’s also valuable to gain awareness of how your pelvic floor is functioning. Knowing how to coordinate breathing, pushing, and muscle control before labor gives you an advantage during delivery.

It empowers you to connect with your body and make more informed decisions.

Alicia Insley Smith: Let’s talk about Kegels. What’s the difference between just doing Kegels and properly activating the pelvic floor? How can someone tell if they’re doing it right?

Khyati Merchant:
That’s an important distinction. A Kegel is essentially a pelvic floor contraction. But doing it correctly means isolating the pelvic floor muscles—not squeezing your glutes or inner thighs—and lifting them upward toward your abdomen.
You should be able to do this while breathing normally. Many people unconsciously hold their breath or recruit other muscles, which defeats the purpose.
A good test is being able to hold a pelvic floor contraction for 10 seconds and repeat it 10 times, all while breathing steadily. If you can do that, you likely have good pelvic floor endurance. But the best way to ensure you’re doing it correctly is with a professional assessment.

Alicia Insley Smith:

Diastasis recti is something many postpartum women hear about. Can you explain what it is and how it affects the body?

Khyati Merchant: Of course. Diastasis recti is a thinning and separation of the “six-pack” muscle, known as the rectus abdominis. It’s completely normal to experience this during and after pregnancy—almost all postpartum women have it to some extent.

What’s important is how your deeper core muscles reactivate after birth. Rest is essential in the early postpartum period, and then gradually we want to retrain the deeper core muscles to support your body again.

Diastasis recti affects the way pressure is distributed in your abdomen. If it persists, it may mean you’re relying too much on the superficial abdominal muscles rather than engaging your deeper core, which can throw off your entire core system.

There’s been a lot of discussion in the research world—some saying it’s normal, others saying it’s a problem. The truth is, it’s common, but we need to look at how well your core system is functioning together—how your deep abdominals, pelvic floor, hip, and back muscles are coordinating to create stability and mobility.

Ultimately, we want to create a well-managed pressure system in the abdominal cavity so your body functions efficiently. Diastasis recti is common, but it can affect the way your body moves and feels postpartum.

If you’re experiencing symptoms like “coning”—a visible bulge in the midline during effort—that’s a sign to get assessed.

That doesn’t mean you can’t exercise or do curl-ups, but we need to look at how you’re activating your pelvic floor and deep core muscles. Are you using them effectively? Are you experiencing pain or strain? If yes, it’s time to consult a professional.

Alicia Insley Smith: So if someone has coning, is that when they need to see someone to assess how they’re using their muscles?

Khyati Merchant: Yes, absolutely. Coning can indicate an imbalance in how you’re using your pelvic floor, core, and even muscles higher or lower in the chain—like your neck, shoulders, or feet. Everything in the body is connected.

The pelvic floor isn’t just supposed to activate when we consciously think about it—it needs to work automatically in response to movement and demand.

Alicia Insley Smith: How does physical therapy help with the healing process for diastasis recti?
Is it similar to other types of physical therapy, or is it specialized?

Khyati Merchant: Postpartum physical therapy is unique. Our main goal is to assess how well your pelvic floor and deep abdominal muscles are coordinating. It really depends on where you are in your postpartum journey and what your goals are.

We focus a lot on how you’re using your core system during movement. The body is smart—it’ll find a way to get the task done, even if it’s not the most efficient or healthy. That’s where issues can creep in years down the line.

So yes, this kind of therapy is different from traditional orthopedic PT. We assess posture, pressure management, how your pelvic floor is working with your hips and back, and whether there are issues like prolapse. Everything is customized and very detailed.

Alicia Insley Smith: What is one piece of advice you would give every pregnant woman regarding pelvic floor health?

Khyati Merchant: If you need help, get it. Think about it this way: if you have a knee or shoulder replacement, your doctor will refer you to PT automatically. But when it comes to your pelvis—which goes through an incredible amount of change during pregnancy and delivery—people often assume they should just “bounce back.”

I strongly believe every woman should get a pelvic floor assessment at least once postpartum. Understanding your pelvic health is vital.

Alicia Insley Smith: And if someone is hesitant or embarrassed to talk about their pelvic floor issues, what would you say to encourage them?

Khyati Merchant: I get it—it feels very personal. But start by talking to someone you trust, like a friend or sister. That can help make the conversation feel less intimidating.

Know this: you are not alone. More than 80% of women experience issues like incontinence or discomfort at some point. Pelvic floor health is essential for everyone, and talking about it is the first step to getting help.

Another tip: educate yourself. Read blogs, join support groups, or check out trusted resources like the American Physical Therapy Association. Locally, the Greater Charlotte Pelvic Collaboration has helpful information as well. So we will link to those.

On the bottom of this blog so that they can find those resources.

Alicia Insley Smith: How can our listeners find you online if they want to connect with you?

Khyati Merchant: You can find me at www.lotusptph.com. I’m also on Instagram as @lotusptph, where I share videos and tips.

Pelvic floor health isn’t just about one area—it’s about your entire body. Keep moving, stay strong, and don’t hesitate to reach out for help.

Alicia Insley Smith: Thank you so much for speaking with us today, Khyati!

Khyati Merchant: Absolutely, thank you!

And if anyone listening has questions, feel free to leave a comment at the bottom or you can get in touch with Khyati or myself and we will try to get the answers for you. Thank you.
https://www.lotusptph.com/ https://www.instagram.com/lotusptph/

Taking care of your pelvic floor health during pregnancy and postpartum is an essential aspect of your overall well-being. Khyati’s expert insights highlight the importance of understanding your body, addressing concerns proactively, and seeking professional help when needed. Don’t hesitate to connect with Lotus Physical Therapy and Pelvic Health for personalized support. Whether you are looking for prenatal physical therapy here in Charlotte or postpartum recovery pelvic floor support in Fort Mill SC she can guide you. We’ll also link to the resources Khyati mentioned below.

Additional Resources:

American physical therapy association https://www.apta.org

Greater Charlotte Pelvic Collaboration https://www.charlottepelvictherapy.com/

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