---
title: 'Postpartum Symptoms After Six Weeks Worth Paying Attention To'
slug: postpartum-symptoms-six-weeks
lifeStage: postpartum
category: Wellbeing
medicalReviewer: 'Dr Clare Bourne, Consultant Pelvic and Digestive Health Physiotherapist'
reviewerId: 'https://blog.bloume.com/postpartum/medical-board.md#clare-bourne'
lastUpdated: '2026-08-08'
primarySource: 'NICE NG123: Urinary incontinence and pelvic organ prolapse in women'
wordCount: 1293
readTimeInSeconds: 323.25
---

# Postpartum Symptoms After Six Weeks Worth Paying Attention To

The six-week postnatal check is one moment in a longer recovery. If you are past that mark and still noticing leakage, pelvic heaviness, pain with movement or sex, a ridge or dome down your tummy, or scar tightness, those symptoms are worth raising. This article walks through what each one can feel like, what it may point to, and when asking for a physiotherapy assessment is a useful next step.

**Q: Can I ask for a physiotherapy referral if my six-week check has already happened?**
A: Yes. You can ask your GP or health visitor for help with a physical symptom at any point, not only at scheduled postnatal appointments. If you are dealing with ongoing leakage, pelvic heaviness, pain, or scar discomfort, it is reasonable to book a separate GP appointment to talk about a referral to a pelvic physiotherapist.

If you are past the six-week mark and still noticing something that does not feel right, it is worth paying attention to. That might be a heaviness in the vagina, leaking when you cough, or a pulling sensation around a scar. The postnatal check is a chance to talk through your physical and mental health with your GP, though recovery usually takes a lot longer than six weeks. Knowing which symptoms beyond six weeks are worth raising, and what to say when you do, can make that conversation easier.

You do not have to wait for a scheduled appointment either. If something is bothering you, you can ask your GP or health visitor for help at any point.

## When leaking has not eased

If you leak urine when you sneeze, cough, laugh, or move quickly, this is stress urinary incontinence, the most common type of leakage after birth. It tends to happen because pregnancy and birth can weaken your pelvic floor, the muscles that support your bladder. Around one in three women still notice some leaking three months after pregnancy, though that figure is an estimate rather than a firm national statistic.

Keeping up your pelvic floor exercises can help. If the leaking has not started to improve after 3 months of consistent exercise, it is worth speaking to your GP, who can refer you to a specialist physiotherapist. Self-referral to physiotherapy is not available everywhere, so going through your GP is usually the easiest first step.

## Pelvic heaviness or pressure

A feeling of pressure or dragging low in your pelvis, sometimes described as something coming down, or like sitting on a small ball, can be a sign of pelvic organ prolapse (POP). This is when your bladder, uterus, or bowel drops down because the tissues supporting them have been weakened. You might also notice a lump or bulge inside or at the entrance to your vagina. Birth is one of the main reasons this can happen.

If you notice any of these sensations, the next step is to see your GP for an examination. Prolapse is manageable, and getting checked early opens up more options for support.

## Pain with movement or sex

Aching or pain in your lower back, hips, or at the front of your pelvis after birth can be pelvic girdle pain (PGP). It might feel sharp or achy, and is often worse when you walk, climb stairs, or turn over in bed. It can linger after birth. If it has not settled with rest and gentle self-care, a physiotherapy referral is likely to be the most helpful next step.

Pain during sex is common too, especially the first few times. If the pain carries on, it is worth raising with your GP. Breastfeeding can leave you drier than usual, and a water-based lubricant can take the edge off that. If tightness or pain with sex sticks around beyond this, it is a fair reason to ask for a pelvic physiotherapy assessment.

## Doming or coning down the centre of your tummy

If you notice a ridge, dome, or cone shape along the centre of your tummy when you sit up from lying down, cough, or strain, this can be a sign of diastasis recti. This is a common part of pregnancy where the connective tissue between the rectus abdominus muscles that run down the centre of the tummy, thins and widens, to allow your baby to grow. The separation itself is a normal part of how your body makes room for a growing baby. It is when it lingers and causes symptoms that it is worth looking at.

The separation usually improves by around eight weeks postpartum. If doming is still obvious after that, your GP can refer you to a physiotherapist for a tailored assessment. It helps to have any exercises guided by a physiotherapist. 

## Scar pain or tightness

You may have a caesarean scar or a perineal scar from a tear or episiotomy. Some tenderness or numbness in the early weeks is a normal part of healing. With a caesarean scar, once healing is well underway, around six weeks, you should not be feeling significant pain. Ongoing pulling, sensitivity, or pain around a caesarean scar can come from scar tissue through the deeper layers beneath your skin.

With perineal scars, most stitches heal within six weeks, though you might still notice pain, tightness, or discomfort when sitting or having sex beyond that. Both kinds of scar can benefit from gentle scar massage to ease tightness, but only once your six-week check has confirmed the wound is fully healed. If you notice redness, discharge, or a sharp rise in pain at any point, call your GP promptly, as these can be signs of infection that need attention.

> **WARNING**: Do not start scar massage until your GP has confirmed at your six-week check that the wound is fully healed. If you notice redness, pus, or growing pain around a scar at any time, call your GP as soon as you can.

## Asking for more support

Access to postnatal physiotherapy varies from place to place, and it is not always offered automatically. Work is underway to improve access to postnatal pelvic health services, though it is not yet consistent everywhere. If any of the symptoms here apply to you, raising them with your GP is the clearest route to the right assessment. You do not need to wait for them to come up on their own. It can help to name the specific symptom and ask directly whether a referral to a pelvic physiotherapist makes sense.

---

**Q: Can I ask for a physiotherapy referral if my six-week check has already happened?**

Yes. You can ask your GP or health visitor for help with a physical symptom at any point, not only at scheduled postnatal appointments. If you are dealing with ongoing leakage, pelvic heaviness, pain, or scar discomfort, it is reasonable to book a separate GP appointment to talk about a referral to a pelvic physiotherapist.

**Q: How do I know if what I am feeling is a prolapse or just normal postpartum heaviness?**

A feeling of pressure, dragging, or something coming down in your pelvic area, or noticing a lump or bulge inside or at the entrance to your vagina, are the main signs worth checking. The only way to know for sure is a GP examination. If those sensations are there, booking an appointment is the right next step rather than waiting to see if it settles on its own.

**Q: Is it safe to start scar massage at home?**

Gentle scar massage can ease tightness for both caesarean and perineal scars, but only once your GP has confirmed at your six-week check that the wound is fully healed. If you notice redness, pus, or a rise in pain around the scar at any time, call your GP before trying any massage.

**Q: What exercises are safe if I think I have diastasis recti?**

The most useful step is to get a physiotherapy assessment before starting any specific exercises. Some common tummy exercises, including crunches and sit-ups, are generally best left until a physiotherapist has checked the degree of separation and advised what is right for you. Your GP can refer you to a physiotherapist if doming is still noticeable after around eight weeks postpartum.

**Q: When should pain with sex after birth prompt a GP visit?**

Some discomfort during sex in the early weeks after birth is common, and dryness linked to breastfeeding can add to it. A water-based lubricant may help with the dryness. If pain carries on beyond the first few times, or it is affecting your daily life, it is worth talking to your GP, who can assess whether a pelvic physiotherapy referral would help.

### Clinical Sources
- [NICE NG123: Urinary incontinence and pelvic organ prolapse in women](https://www.nice.org.uk/guidance/ng123)
- [NICE (2019) Urinary incontinence and pelvic organ prolapse in women: management](https://pubmed.ncbi.nlm.nih.gov/31008559/)
- [NHS — Your post-pregnancy body](https://www.nhs.uk/baby/support-and-services/your-post-pregnancy-body/)
- [NHS — Your post-pregnancy body](https://www.nhs.uk/baby/support-and-services/your-post-pregnancy-body/)
- [Pelvic health during and after pregnancy](https://www.kch.nhs.uk/maternity/specialist-maternity-support/pelvic-health-during-and-after-pregnancy/)
- [Pelvic Organ Prolapse: - a guide for women](https://thepogp.co.uk/_userfiles/pages/files/resources/232207pogpprolapse.pdf)
- [Pelvic organ prolapse - NHS inform (Scotland)](https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pelvic-organ-prolapse/)
- [Pelvic Girdle Pain and other common conditions in pregnancy](https://thepogp.co.uk/_userfiles/pages/files/resources/23697pogppelvic_girdle_pain.pdf)
- [Pelvic health after having my baby](https://www.bedfordshirehospitals.nhs.uk/our-services/maternity-2/pelvic-health/pelvic-health-after-having-my-baby/)
- [Diastasis rectus abdominus muscle – advice and management](https://www.whittington.nhs.uk/mini-apps/leaflet/?id=579)
- [NHS — Your post-pregnancy body](https://www.nhs.uk/baby/support-and-services/your-post-pregnancy-body/)
- [plymouthhospitals.nhs.uk](https://www.plymouthhospitals.nhs.uk/display-pil/pil-post-caesarean-section-c-section--5733/)
- [thepogp.co.uk](https://thepogp.co.uk/_userfiles/pages/files/pelvic%20health%20videos/postnatal_perineal_scar_tissue_management.pdf)
- [Perinatal pelvic health services](https://www.england.nhs.uk/mat-transformation/perinatal-pelvic-health-services/)

---
Reviewed by Dr Clare Bourne, Consultant Pelvic and Digestive Health Physiotherapist | [Medical Board](https://blog.bloume.com/postpartum/medical-board.md) | August 2026