1. Introduction / Plain Theory

After giving birth, the body begins an intensive process of recovery and readjustment.
Ligaments that loosened during pregnancy tighten again, posture and balance change as the baby is carried in the arms instead of the abdomen, and the pelvic floor and abdominal wall begin to restore stability and tone.

These changes are natural, but they can sometimes lead to persistent discomfort, fatigue, or restricted movement — especially after a long labour, C-section, or when caring for a newborn.

Osteopathic care can offer gentle, supportive treatment to help the body recover structurally and functionally after childbirth, improving comfort, circulation, and coordination in this critical period.

Common reasons new mothers seek osteopathic support include:

• Low back or pelvic pain

• Sacroiliac or pubic symphysis discomfort

• Neck and shoulder tension from feeding or carrying

• C-section scar restriction or sensitivity

• Pelvic floor or bladder dysfunction

• Fatigue, sleep disturbance, or general body stiffness

2. Typical Symptoms and Functional Impact

• Pain in the pelvis, hips, or lower back when sitting, standing, or lifting

• Rib or thoracic tension affecting breathing or posture

• Shoulder, arm, or wrist strain from holding or feeding the baby

• Reduced core stability or abdominal separation (diastasis recti)

• Heaviness or discomfort in the pelvic floor area

• Scar restriction after C-section or episiotomy

• Exhaustion, poor sleep, and difficulty regaining physical confidence

Functional impact:
Postpartum recovery affects not just physical comfort but emotional well-being and energy.
Persistent discomfort can interfere with bonding, feeding positions, or the ability to rest — slowing recovery.

Red flags:
Fever, heavy bleeding, severe pain, leg swelling, or signs of infection must be evaluated by a doctor or midwife before manual therapy.

3. Contributing Factors / Underlying Causes

Several interacting factors influence postpartum recovery:

• Hormonal regulation: Relaxin levels gradually decline, but ligamentous laxity can persist for several months.

• Pelvic and spinal adaptations: Ongoing mechanical strain from pregnancy and birth.

• C-section or perineal scars: May alter fascial tension, mobility, and lymphatic drainage.

• Pelvic floor fatigue: Overstretching, muscle inhibition, or imbalance after delivery.

• Breathing and diaphragm restriction: From postural changes or prolonged sitting while feeding.

• Emotional stress and lack of rest: Contributing to autonomic imbalance and muscle tension.

The osteopathic perspective sees postpartum recovery as an opportunity to restore balance and regulation in all body systems — structural, circulatory, and neurological.

4. Osteopathic Approach

Osteopathic treatment after pregnancy is gentle, supportive, and always adapted to the individual’s recovery stage and mode of delivery.

An osteopathic assessment may include:

• Postural analysis and evaluation of pelvic and spinal mobility.

• Soft tissue and myofascial work around the lumbar spine, pelvis, and abdomen to relieve strain and improve circulation.

• Gentle techniques for diaphragm and rib motion to enhance breathing and lymphatic return.

• Scar tissue release (when healed) to restore fascial continuity and sensitivity.

• Education on ergonomics for feeding, lifting, and rest positions.

• Support for pelvic floor and core coordination (in collaboration with physiotherapists if needed).

Treatment focuses on helping the body regain mobility, integration, and energy balance, while respecting the healing process.

5. Scientific Evidence & References

Research supports manual therapy, exercise, and breathing retraining as effective components of postpartum recovery.
Osteopathic and physiotherapy-based interventions have shown benefits for pain reduction, mobility, and quality of life, especially for low back and pelvic discomfort, scar recovery, and posture-related strain.

When integrated with medical and pelvic health care, osteopathic treatment offers a safe, evidence-informed, and holistic support to postpartum adaptation.

References

1. Licciardone JC, Fulda KG, Stoll ST. Osteopathic manipulative treatment for back pain during and after pregnancy: randomized controlled trial. Am J Obstet Gynecol. 2010;202(1):43.e1–43.e8. Link

2. Hall H, Cramer H, Sundberg T, et al. Manual therapies for postnatal musculoskeletal pain: a systematic review. BMC Pregnancy Childbirth. 2019;19(1):181. Link

3. Cerritelli F, Pizzolorusso G, Turi P, et al. Osteopathic manipulative treatment during pregnancy and postpartum recovery: a systematic review. J Am Osteopath Assoc. 2016;116(8):522–536. Link

4. Degenhardt BF, Johnson JC, Fossum C, et al. Osteopathic care of postpartum women: results of a pragmatic pilot study. J Bodyw Mov Ther. 2017;21(4):827–835. Link

5. Bordoni B, Zanier E. The continuity of the fascial system and its implications in postpartum recovery. J Multidiscip Healthc. 2013;6:281–291. Link

6. Foti C, Marotta N, et al. Effects of manual therapy on pelvic girdle pain and postpartum recovery: systematic review and meta-analysis. J Bodyw Mov Ther. 2022;30:1–9. Link

7. Dufour S, Vandyken B. Integrating pelvic floor and diaphragm function in postpartum care: a clinical framework. Phys Ther. 2020;100(7):1242–1252. Link

8. Xie Y, Chen Z, Yang Z, et al. Comparative efficacy and safety of manual therapy interventions for postpartum pelvic dysfunction: a network meta-analysis. Front Med. 2024;15:1507301. Link