You leak a little when you sneeze, laugh or lift the car seat. Or there is a heavy, dragging feeling by the end of the day, or sex has been uncomfortable since the birth. Someone has told you this is common after a baby, which may be true, but common does not mean you have to put up with it. What most people want to know before booking is simple: what actually happens at the first pelvic floor appointment, and will I be asked to have an internal exam?
Here is the short answer. The first visit starts with a conversation and an external assessment. An internal exam is sometimes useful, but it is never automatic. Your physiotherapist explains what it involves and why it may help, and it only happens if you agree. You can say no, or stop at any point, and still be assessed and treated.
General information only, not a diagnosis. Our physiotherapists, chiropractor and massage therapists assess every patient first.
Ready to talk to someone?
What happens at your first visit
Pelvic floor physiotherapy at Trust Care is one to one, in a private treatment room. The appointment usually moves through three parts.
The conversation. Expect questions about your birth (only what you are comfortable sharing), bladder and bowel habits, any leaking, heaviness or pain, sex, sleep, and what you want to get back to. That might be running, lifting your toddler, or simply getting through a workday without planning around the washroom. Some of these questions feel personal. They are asked because the answers change the plan.
The external assessment. Your physiotherapist looks at breathing, posture, your abdominal wall (including any separation of the abdominal muscles), your hips and back, and how you move during tasks that bring on symptoms.
The internal assessment, only if appropriate and only with your consent. Sometimes an internal exam is a useful way to check how the pelvic floor muscles contract and relax. Your physiotherapist will explain why it might help in your case, what it involves, and what the alternatives are. Then they will ask.
It is your choice.
You leave with an explanation of what is likely contributing to your symptoms and a starting plan, usually a small number of specific exercises rather than a long list.
Consent, privacy and your choices
In Alberta, an internal pelvic exam is a restricted activity. The College of Physiotherapists of Alberta requires a physiotherapist to complete additional training and hold specific authorization before performing one. You can check any physiotherapist’s authorizations yourself using the College’s Verify a Physiotherapist tool.
The College is also clear about consent. It should be informed and ongoing, and you can withdraw it at any time. In practice that means you can agree to one part of the assessment and not another, ask to pause, or ask questions before anything happens. The College’s guidance for physiotherapists also includes discussing the option of having a support person or chaperone present.
Is it worth booking, or will it settle on its own?
Some changes after birth do settle over the first weeks and months. Others hang on.
Signs that an assessment is worth considering include:
- leaking with coughing, sneezing, lifting or exercise that is not improving
- a strong urge to go that is hard to hold
- heaviness, pressure or a feeling of something bulging in the vagina
- pain with sex, inserting a tampon, or sitting
- difficulty controlling wind or bowel movements
- wanting to return to running, lifting or high-impact exercise and not knowing where to start
Pelvic floor muscle exercises are widely recommended after birth. Britain’s National Institute for Health and Care Excellence (NICE) advises encouraging them for everyone who has recently given birth. It also advises considering a supervised 3-month programme after an assisted (forceps or vacuum) birth, a birth with the baby facing up, or an injury to the anal sphincter.
The research has an honest limit worth knowing. A large Cochrane review found that general exercise advice given to everyone after birth has not reliably reduced leaking later on, and that the evidence for treating ongoing leaking after birth is still uncertain. That is part of why an individual assessment matters: it checks whether exercise is right for you, how to do it correctly, and what else may be contributing, instead of handing everyone the same sheet.
How soon after the birth can you come in?
If you are unsure whether it is too early, call the clinic. The team can tell you what the first appointment would look like and what it would cost.
When to contact your doctor or midwife first
Pelvic floor physiotherapy is not the right first step for every symptom after birth. MyHealth Alberta advises calling your doctor or midwife, or the 24/7 New Parent and Newborn Line at 1-833-805-BABY (2229), right away if you have:
- heavy vaginal bleeding (soaking through one or more pads in an hour, or passing clots bigger than an egg)
- a fever or chills, or vaginal discharge that smells bad
- new or worse belly pain
- difficulty emptying your bladder
- pain, redness or swelling in your calf, the back of your knee, thigh or groin
- feeling sad, anxious or hopeless for more than a few days
Call 911 for chest pain, shortness of breath, passing out, a seizure, or thoughts of harming yourself or your baby. The full list is on MyHealth Alberta’s signs of an emergency after childbirth page.
Practical questions before you book
Do I need a referral?
No. You can book physiotherapy in Alberta without a physician referral. Some extended health plans ask for one before they reimburse, so check your policy.
Is it covered by my benefits?
Most extended health plans in Alberta cover physiotherapy, usually up to an annual limit and sometimes at a percentage. Trust Care direct bills more than 40 insurers. Bring your policy and certificate number, and the clinic will check what is available before you are treated. Details are on the direct billing page.
What should I wear and bring?
Comfortable clothing, your benefits details, and a short list of anything you want to ask. If it helps, write down when symptoms happen and what brings them on. Notes on your phone are fine.
Where is the clinic?
Trust Care is at 14415 Miller Boulevard NW in North Edmonton, with parking directly outside and a ground-level, wheelchair-accessible entrance. Hours are Monday to Friday 9 am to 7:30 pm and Saturday 9 am to 4 pm. The Miller location page has directions.
Important: This article is general information only. It is not medical advice and it cannot be used to diagnose or treat any condition. Every patient is assessed first by one of our registered physiotherapists, our chiropractor or our registered massage therapists before any treatment, and your care plan is based on that assessment. If you have symptoms, please book an assessment.
Booking your pelvic floor assessment
If leaking, heaviness or pain since the birth is getting in the way of your day, or you simply want to know what is going on before you return to exercise, a first assessment is a reasonable next step.
You stay in control of what happens in the room.
Book a pelvic floor assessment or call (825) 525-2983 and ask for pelvic floor physiotherapy. The booking form does not ask for any medical details. More about the service is on the pelvic floor physiotherapy page.
Sources
- College of Physiotherapists of Alberta. What Patients Need to Know about Restricted Activities (2023).
- College of Physiotherapists of Alberta. Pelvic Health Guide (updated 2023).
- NICE. Pelvic floor dysfunction: prevention and non-surgical management (NG210) (2021).
- Woodley SJ, et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews, 2020.
- MyHealth Alberta. Signs of an Emergency After Childbirth: Care Instructions (current as of July 2026).
This article is general information, not a diagnosis or a substitute for an in-person assessment by a Registered Physiotherapist.
