Pregnancy changes everything. Physically, emotionally, mentally… nothing stays the same. And while it’s widely accepted that expecting mothers need regular checkups, ultrasounds, and nutritional support, there’s one key professional missing from most pregnancy care plans: the physiotherapist.

Yes, the body is designed to carry and birth a baby, but that doesn’t mean it happens without strain. The body works overtime during pregnancy, and without the right support, discomfort can build, recovery can drag, and quality of life can dip unnecessarily.

So why isn’t physiotherapy seen as standard? It should be.

Here’s why every pregnant woman benefits from having a physiotherapist as part of her care team, and what a difference it can make from the first trimester to well beyond birth.

The Physical Demands Are Huge

It’s not just about the bump. Pregnancy impacts posture, muscles, ligaments, joints, and even breathing patterns. Hormones like relaxin loosen the ligaments to prepare the pelvis for birth, which is important, but it also leaves joints vulnerable and less stable.

That, combined with extra weight, a shifted centre of gravity, and altered movement patterns, can trigger a whole range of physical symptoms:

• Back pain, especially lower back pain, is caused by a change in posture and pressure on the spine
• Pelvic girdle pain occurs when the pelvis becomes more mobile and unstable
• Hip or groin discomfort, often from muscle imbalances or added pressure
• Sciatica or nerve pain due to compression or inflammation near the spine
• Postural issues, including rounded shoulders and swayback
• Incontinence or pelvic floor dysfunction is common but not “normal,” and definitely treatable

Without help, many women accept these symptoms as part of the package. But they shouldn’t have to.

Physiotherapists Help Prevent Issues Before They Start

The best thing about including a physio early in pregnancy is how proactive it can be. While a lot of people only turn to physiotherapy when something starts to hurt, it can be far more valuable as a preventative step.

A qualified pregnancy physiotherapist can assess posture, muscle strength, pelvic alignment, and even breathing mechanics. From there, they can provide specific exercises, movement strategies, and support tools to keep the body moving well as it changes.

This can help prevent pain before it starts, and it sets a stronger foundation for both birth and recovery.

Supporting the Pelvic Floor: A Non-Negotiable

The pelvic floor holds more than people realise. It supports the bladder, uterus, and bowel. It also plays a critical role in continence, sexual function, core stability, and childbirth.

Pregnancy puts a lot of pressure on this area, and birth — especially vaginal birth — adds more. Weakness, tension, or dysfunction in the pelvic floor can lead to issues like incontinence, pelvic organ prolapse, or painful intercourse.

Many women think these symptoms are an unavoidable part of motherhood. They’re not.

A physiotherapist trained in pelvic floor health can:

• Assess and guide – checking for strength, tension, coordination, and proper engagement
• Teach safe techniques – how to activate, relax, and train the pelvic floor effectively
• Offer tailored strategies – for exercise, posture, and pressure management throughout pregnancy
• Support birth prep – helping reduce tearing risk and assist with pushing techniques

It’s an area that deserves more attention, and physios are uniquely equipped to provide it.

Exercise During Pregnancy: Do It Right, Not Just Often

Exercise is highly recommended during pregnancy, but it’s not as simple as “just keep moving.” Not all exercises are safe or beneficial for a pregnant body. What worked before might not work now, and the wrong approach can cause more harm than good.

Physios can create exercise plans that:

• Respect the changes in the body
• Avoid positions that strain the abdomen or pelvis
• Include safe strength training and mobility work
• Help manage symptoms like swelling, fatigue, or dizziness
• Prepare for the physical demands of labour

This kind of individualised support makes it easier to stay active, feel confident, and protect the body from unnecessary strain.

Birth Preparation Is Physical Too

There’s so much focus on what’s happening during birth — the timing, the positions, the breathing. But the lead-up to birth is just as important.

Physiotherapists can help prepare the body for labour in very practical, physical ways. That might include:

• Techniques to encourage optimal baby positioning
• Hip and pelvic mobility drills
• Perineal massage instruction to reduce tearing risk
• Breathing strategies for better oxygen flow and core control
• Labour positions that reduce pain and support natural movement

All of this helps reduce the fear and uncertainty around birth, giving women more tools and more trust in their bodies.

Recovery Isn’t Instant; It Needs a Plan

Postpartum recovery is one of the most overlooked phases of a woman’s health journey. The body doesn’t just bounce back. It needs time, care, and guidance, especially if there was tearing, a caesarean, or pelvic floor trauma.

Physiotherapists support recovery in a few important ways:

• Postnatal assessments, including abdominal separation checks
• Guidance for returning to movement safely
• Help with pelvic floor rehab
• Support for pain or ongoing symptoms (back, pelvis, scar tissue)
• Monitoring for signs of prolapse or incontinence

This kind of care can make the difference between a drawn-out, frustrating recovery and one that feels supported and empowering.

It’s Not Just Physical

Physiotherapists also offer emotional reassurance. Many pregnant women feel unsure about their symptoms or afraid to move “wrong.” Having a trusted professional to explain what’s happening in the body and how to manage it can be incredibly grounding.

Movement becomes less intimidating. Pain becomes less mysterious. Birth becomes less scary.

When women feel more connected to their bodies, they feel more confident in the process. That can change everything.

So Why Isn’t It Standard?

Physiotherapy is often viewed as something you turn to once a problem starts. But for pregnancy and postnatal care, that mindset doesn’t work. It leaves too many women dealing with preventable pain or long recoveries.

Adding a physiotherapist to the care team from early pregnancy should be as normal as booking a scan or seeing a midwife.

The Care That Shouldn’t Be Optional

Pregnancy isn’t a nine-month event. It’s the start of massive, ongoing changes to the body. Supporting those changes with expert, physical care is not a luxury. It’s a basic need.

Every pregnant woman deserves the right to move well, prepare confidently, birth safely, and recover fully. Physiotherapists help make that possible.

It’s time they were recognised as a core part of the team, not an afterthought.