The weeks after birth are hard on a body that has just done something enormous, and then asked to feed, carry and soothe a baby around the clock. Low back and pelvic pain that linger from pregnancy, a tailbone that hurts every time you sit to feed, a neck and upper back that ache from feeding positions, sore wrists from lifting the baby, and a tight caesarean scar are all common, and gentle osteopathy helps with most of them. As an osteopath, I restore movement to the pelvis, back and ribs, treat the coccyx and scar tissue with external techniques, and help you set up feeding and carrying so the pain does not keep coming back.
I am Aloïs Ruetsch, an English-speaking osteopath and manual therapist in central Nice, with 15 years of practice and more than 10,000 consultations. If you see a chiropractor or a manual therapist back home, a French osteopath is the closest equivalent.
This article covers the aches that follow birth, what osteopathy can and cannot do, how it fits with your midwife and the French system of pelvic floor rehabilitation, and the warning signs that need a doctor.
The essentials
- After birth, pain comes from loosened pelvic ligaments, a tired lower back and pelvic floor, the tailbone, feeding and carrying postures, and scar tissue after a caesarean.
- Osteopathy uses gentle techniques to free the pelvis, spine, ribs and coccyx and to soften a healed scar; the specific evidence for postnatal osteopathy is limited, and I say so.
- Most mothers need one to three sessions; the pelvic floor is rehabilitated separately with a midwife or physiotherapist, which the French system prescribes for every mother.
- Bring the baby to you when feeding, swap carrying sides, use a wedge cushion for tailbone pain, walk daily and return to running only when your pelvic floor is ready.
- Heavy bleeding, fever, a severe headache, chest pain, a swollen painful calf, a red or leaking wound, or feeling unable to cope need your midwife or doctor. In France, dial 15 or 112 for emergencies.
What causes pain after giving birth?
The ligaments that softened during pregnancy take months to firm up again, so the pelvis and lower back remain vulnerable while you lift a baby, a car seat and a pram dozens of times a day. Pelvic girdle pain from pregnancy often lingers for weeks after birth, and a long second stage, a forceps or ventouse delivery or a very large baby can bruise or strain the coccyx, which then hurts every time you sit, especially on the hard chairs of a Nice café.
Feeding adds its own strain. Hours spent looking down at the baby, hunched over a breast or a bottle, tighten the neck, the mid-back and the ribs, and tension headaches are common. Lifting with the thumb and wrist stretched causes a painful tendon problem at the base of the thumb that mothers know as mummy thumb. After a caesarean, the scar can feel tight or pull when you stand straight, and the abdominal wall takes time to regain its support. Broken sleep lowers the threshold for all of this, and far from family, in a new country, it can feel overwhelming. That is normal, and help exists.
What does an osteopath actually do after birth?
I start with the story of the pregnancy and the birth, what hurts and when, and the check-ups you have had with your midwife or obstetrician. I assess the pelvis, lower back, coccyx, ribs, neck and wrists, and the scar if you had a caesarean, always with your consent and at a pace that suits you. The baby is welcome in the room.
Treatment is gentle: soft-tissue work on the lower back, buttock and hip muscles, slow mobilisation of the pelvic joints, the lumbar and thoracic spine and the ribs, muscle energy techniques to rebalance the pelvis, and external techniques around the sacrum and the tailbone. Under French law, osteopaths perform no internal pelvic examinations or manipulations, so the coccyx and the pelvic floor are treated from the outside only, and pelvic floor rehabilitation itself is done by a midwife or physiotherapist. Once a caesarean scar is fully healed and your doctor is happy, I use gentle scar mobilisation to soften the tissue and ease the pulling. Thrust manipulations of the neck require a medical certificate of no contraindication, so I use gentle articulation there. Every session ends with advice on feeding posture, lifting, carrying and sleep.
Does osteopathy work for postnatal pain?
Manual therapy has good evidence for low back pain and neck pain as part of a package with advice and exercise, and that applies to the back and neck pain of new mothers. Specific research on osteopathy after childbirth is limited, with few and small studies, so I do not claim more than the evidence allows: most mothers I see find that a session or two eases the pain and lets them move, feed and sleep more comfortably, and that is the honest summary.
For tailbone pain, gentle external treatment, a wedge cushion and time help many women, though a badly injured coccyx can take months. For a tight caesarean scar, scar mobilisation is widely used and well tolerated, with limited formal evidence. For bladder leaks, heaviness in the pelvis or separated abdominal muscles, the right care is pelvic floor and abdominal rehabilitation with a sage-femme or kinésithérapeute, which is prescribed and reimbursed in France, and I refer you for it rather than treating it myself. Osteopathy complements this care; it does not replace it, and osteopaths in France do not make medical diagnoses.
When can I start, and how many sessions will I need?
For neck, upper back and wrist pain from feeding and carrying, you can come as soon as you feel up to it, even in the first weeks. For the pelvis and lower back I usually wait until after your postnatal check, around six to eight weeks, unless the pain is stopping you functioning, in which case gentle treatment earlier is reasonable with your midwife’s agreement. A caesarean scar is treated only once it is fully healed and your doctor has given the all-clear.
Most mothers need one to three sessions of manual therapy spaced two to four weeks apart, and the habits you take home do much of the work. Tailbone pain and a tight scar sometimes need a few more visits spread over a couple of months. If a problem is not improving, I say so and refer you to your midwife, doctor or a physiotherapist.
What can I do myself in the meantime?
When feeding, bring the baby up to you with pillows rather than bending down to the baby, sit with your back supported and vary positions through the day. Carry on alternate sides, keep the baby close to your body when lifting, and bend from the knees for the car seat and the pram. A carrier with wide, well-adjusted straps spares the neck and shoulders on the Promenade des Anglais.
For tailbone pain, sit on a wedge or ring cushion, lean slightly forward and avoid soft deep sofas that tip you back onto the coccyx. Walk a little every day, outside if possible, and build up slowly; most guidance suggests waiting about three months and a pelvic floor check before returning to running or impact sport. Do the pelvic floor exercises your midwife has shown you. Heat relaxes a tight back, and a pharmacist in Nice can advise on pain relief that is compatible with breastfeeding. Sleep when you can, accept help, and do not expect your body to be back to normal in six weeks.
When should you see a midwife or doctor instead?
Call for emergency help if you have heavy bleeding that soaks a pad an hour or passes large clots, chest pain or breathlessness, a painful swollen calf, a sudden severe headache, especially with vision changes or swelling of the face and hands, or a fit. These can be signs of haemorrhage, a blood clot or postpartum pre-eclampsia, which can occur up to six weeks after birth. In France, dial 15 (SAMU) or 112.
See your midwife or doctor promptly for fever, foul-smelling discharge, a wound that is red, hot, leaking or opening, pain or burning when passing urine, a headache that is much worse when sitting up after an epidural, constant abdominal pain, or numbness in the saddle area. Bladder or bowel leaks and a feeling of heaviness or a bulge in the vagina are common and treatable, and belong with your midwife or a specialised physiotherapist. If you feel persistently low, anxious, unable to sleep even when the baby sleeps, or unable to cope, tell your midwife or doctor; postnatal depression is common and treatable, and in France the 3114 helpline is available day and night.
Osteopath, midwife, physio or chiropractor: who should I see in Nice?
Your sage-femme (midwife) is the central figure after birth in France, with home visits in the first days and the postnatal check, and she prescribes pelvic floor and abdominal rehabilitation, which a midwife or a kinésithérapeute carries out. For back, pelvic, tailbone, rib, neck or wrist pain without warning signs, an osteopath is a sensible first stop, and no referral is needed. Osteopaths and chiropractors are very similar hands-on professions; in France the osteopath is the everyday equivalent, with a five-year state-recognised degree, and chiropractors are far fewer.
Your médecin généraliste or gynaecologist handles wounds, infections, bleeding, mood and prescriptions. Pharmacies advise on pain relief compatible with breastfeeding, SOS Médecins visits homes, and 15 or 112 are for emergencies. Osteopathy complements this care; it does not replace it.
How do I see an English-speaking osteopath in Nice?
Message me on WhatsApp at +33 7 71 27 24 25 or book online via Doctolib. My clinic, Pôle Ostéo, is at 22 rue Gounod in the Musicians’ quarter of central Nice, with a lift, space for a pram and no objection to a baby in the room. A session lasts about 45 minutes and costs €90 at the clinic. I am open seven days a week, often with same-day availability, and I consult in English, Spanish and French.
If leaving the house with a newborn is too much, I visit homes, apartments, villas and hotels in Nice and along the nearby Côte d’Azur coast for €120, with no surcharge for evenings, weekends or same-day calls. I take card or cash and give you a receipt for your insurance or mutuelle, in English on request. No referral is needed in France to see an osteopath or manual therapist.
In practice
Illustrative example, details changed. A British mother living in Nice came in ten weeks after a long forceps delivery with tailbone pain so sharp that she fed her baby standing up and dreaded car journeys. Her midwife had checked the pelvic floor and found nothing alarming. The coccyx and the muscles around the sacrum were tender and guarded, the pelvis stiff on one side, and there were no warning signs. Two gentle sessions of external work around the sacrum and tailbone, mobilisation of the pelvis and lower back and release of the buttock muscles, together with a wedge cushion and a better feeding set-up, made sitting bearable within a fortnight, and she continued her pelvic floor rehabilitation with her midwife.
Frequently asked questions
Is an osteopath the same as a chiropractor?
How soon after birth can I see an osteopath?
Can you treat my caesarean scar?
Do you treat the pelvic floor or bladder leaks?
Can I bring my baby to the appointment?
Book an English-speaking osteopath in Nice
Clinic at 22 rue Gounod (€90) or a visit to your hotel, villa, yacht or home in Nice (€120, no surcharge). Seven days a week, often same day. Write in English, Spanish or French.