Where does it hurt, and what were you doing when you first noticed it. We ask that before anything else, because "back pain" after a baby is four or five different problems that get one name, and the fix depends on which one you have.
Most of it isn't the birth. The birth gets blamed, but the pattern we see over and over is a woman picking up and putting down a growing weight thirty or forty times a day, feeding for hours with her head dropped, sleeping in pieces, and doing all of it with a trunk that was stretched for nine months and hasn't been asked to work since. The spine is fine. The muscles that are supposed to hold it up are behind.
That's good news in a dry sort of way. Pain that comes from load and position gets better when you change the load and the position.
At a glance
The 10-Minute Floor Reset
- 1
Lie on your back, knees bent. Breathe into your ribs and belly, 10 slow breaths, 4 seconds in, 6 out.
- 2
On each exhale, gently draw your pelvic floor and lower belly in, hold 3 seconds, then relax fully. 8 reps.
- 3
Pelvic tilts: exhale and flatten your low back into the floor, inhale and release. 10 slow reps.
- 4
Knee to chest, one leg at a time. Hold each side 30 seconds, breathing out as the hip opens.
- 5
Hands and knees: cat-cow, 8 slow rounds, moving with your breath. Sore wrists? Rest on your fists.
- 6
Child's pose, knees wide, 5 breaths. Then stand, shoulders back, 3 breaths before you lift baby.
Where it hurts tells you most of it
Between the shoulder blades, up into the neck, sometimes a headache that starts at the base of the skull. This is feeding posture. Look at yourself the next time the baby latches: chin down, shoulders forward, bringing your body to the baby instead of the baby to you. Eight to twelve feeds a day, twenty minutes each. Nobody's upper back tolerates that for long. Pumping does the same thing, with the added habit of leaning in to watch the bottle fill.
Low back, across the belt line, both sides, worse by evening or after a long stretch of carrying. This is the lifting one. Crib rail up, baby at the far side, you bend at the waist and reach. Car seat carrier in one hand, swung up and out of the car with a twist. Baby on one hip while you do everything else with the other hand. Every one of those asks the low back to hold a load it's supposed to share with the deep abdominals and the glutes, and right now those aren't showing up.
One side, low, just above the buttock, sometimes into the groin or a little way down the back of the thigh. It catches when you roll over in bed, stand on one leg to put pants on, or climb stairs. This is the sacroiliac joint, and it's the one most tied to pregnancy itself. The ligaments around the pelvis loosen to let the baby through, and they take months to firm back up. Most women who had this late in pregnancy keep some of it after.
Right at the front, over the pubic bone, same triggers. Same family, same approach, but worth naming so you know it's a known thing.
Tailbone. Hurts to sit, especially on something soft, and hurts going from sitting to standing. Usually from pushing, sometimes from forceps or a long second stage. Slow, but it does settle.
If you've got two of these at once, that's normal. Pick the loudest one first.
What we'd have you do this week
Breathing first, because it's the thing everyone skips and it's where the deep core comes back from. Lie on your side or your back with knees bent. Breathe in and let the ribs widen sideways and the belly rise. Breathe out through pursed lips, slowly, and at the end of the breath notice the lower belly draw in on its own and the pelvic floor lift a little. Ten breaths, three or four times a day. You can do it while feeding once you've got the feel of it.
Then the transverse abdominis on its own. Same position. Breathe out and gently draw the lower belly toward the spine without pulling the ribs down or holding your breath. Hold five seconds, let go completely. Ten reps. Add pelvic floor work: ten holds of five seconds, then ten quick ones, lying down until that's easy, then sitting, then standing.
If you can't feel the pelvic floor at all, or it feels heavy, or you leak when you cough or lift the baby, or sex hurts, or the gap down the middle of your belly is two finger-widths or more and hasn't changed over several weeks, see a pelvic floor physical therapist. That isn't a last resort. It's the normal next step.
Fix the feeding setup once and it pays off every feed. Sit back against something. Feet flat or on a stool. A firm pillow or two under the baby so the baby comes up to you. Shoulders down. Look at the baby by lowering your eyes, not your head. Side-lying for night feeds, if you can stay awake for it, takes the load off entirely.
Lifting: bring the baby close before you lift, bend at the knees and hips instead of the waist, breathe out as you come up. Drop the crib rail if it drops. Change diapers at hip height. Carry the car seat with two hands in front of you or, better, leave it in the car and carry the baby. Swap hips, or stop using the hip altogether and use a carrier.
Walk. Five to ten minutes at first, flat ground, adding a few minutes every couple of days. Walking helps all five of the pains above. Beyond walking and the breathing and core work here, ask your OB-GYN or midwife before you start exercising, especially after a cesarean. No crunches or sit-ups in these months. They load the exact tissue you're trying to close.
Heat on the low back or between the shoulders, twenty minutes, is fine. Sleep in whatever position hurts least, with a pillow between the knees if it's the sacroiliac one. Protein at every meal and more water than you think you need. If you're breastfeeding, do not cut calories to shrink the belly. It won't help your back and it will cost you milk.
For the sacroiliac pain specifically: keep the knees together when you roll in bed and when you get out of the car, sit to put pants on, take stairs one at a time if you have to. It feels fussy. It works.
Going deeper on your own case
Keep a short note for a week: where it hurt, what you'd just done, what time of day. Three or four entries a day is plenty. By the end of the week the pattern is usually obvious, and you'll know which section above to work hardest on.
The lifting and feeding kinds usually ease noticeably in two to four weeks of changing the setup and doing the breathing and core work daily. The sacroiliac kind is slower, often several months, and flares with how much you've been on your feet. Tailbone pain can take a few months too. What we can't give you is a date. It depends on the birth, the baby's size, and how much help you have at home.
A few things need a provider today, not a plan: back pain with a fever, bleeding that soaks a pad an hour, chest pain or shortness of breath, pain or swelling in one calf, new numbness in the groin or inner thighs, new loss of bladder or bowel control, a bulge in the belly that hurts, or any thoughts of harming yourself or your baby. Call your provider or 911.
Otherwise, if what you've read matches, give it the week. If it isn't shifting after four weeks, or it's one-sided and getting worse, or it wakes you on its own rather than when you move, that's when we'd want a provider to examine the pelvis and spine and rule out the things that aren't about posture and load.
If you want the breathing and core sequence laid out so you can just follow along, it's in our guide, The 10-Minute Mom Pooch Reset.
The 10-Minute Mom Pooch Reset
The 12-week, 10-minute-a-day core and belly plan for exhausted moms: the gap check, breath-to-core, three phases, kitchen-counter and naptime routines, food that helps, and 6 printable trackers.
See the plan →Not sure yet? Take the free 2-minute quiz
Educational content from the Mom Pooch Reset team. Not medical advice for your specific situation. Get clearance from your OB-GYN or midwife before exercising after birth, and see a pelvic floor physical therapist for leaking, pain or a bulge.
