Pelvic girdle pain, back pain and bladder symptoms are the three things maternity physiotherapy departments say they see most in pregnancy. They are treatable, the service is there, and the part nobody writes down is how you get into it. The answer is set by your maternity hospital, not nationally, and two of the three Dublin hospitals do it in opposite ways.
The short version
- Who refers you
- Your maternity team, at any point in the pregnancy
- The catch
- One Dublin hospital states it does not accept direct GP referrals at all
- Refer yourself
- Possible at the Coombe for bladder symptoms, through a form
- Your first appointment
- Usually a group class, not one to one
- Not everything
- The hospital service treats pregnancy-related conditions only
Your GP is not always the door
Citizens Information gives the national rule: to get physiotherapy as a public patient you need a referral from your GP, your public health nurse or a hospital. That is true of the general public physiotherapy system, and it is the advice almost everyone repeats.
The maternity hospitals run their own service alongside it, and they do not agree with each other. The National Maternity Hospital says its service is referral-based and that your GP, midwife or doctor can refer you, with GPs able to email a referral straight to the physiotherapy department. The Coombe says the opposite in one line: it does not accept direct GP referrals for physiotherapy. There, you are referred by your medical team, and it can happen at any point during the pregnancy.
So the same sentence of national advice, follow it and ask your GP, is the right move at one hospital and a wasted appointment at another. Nothing on either page tells you that, because each is describing only its own door.
Ask at your next antenatal visit before you book a GP appointment. Your midwife is on the medical team at every one of these hospitals, which means she is a valid referrer everywhere, whatever the local rule about GPs. It is one question at an appointment you already have.
Where you can refer yourself
The Coombe, which refuses GP referrals, is also the one that lets you start the process yourself, for one symptom. Antenatal patients with bladder symptoms can fill in a self-referral form and are offered a place in its Antenatal Bladder class. If you still need to be seen individually afterwards, the physiotherapist arranges it.
That is narrower than it sounds at first: it is a route for one kind of problem, not a general door. For pelvic girdle pain or back pain at the same hospital you still go through the medical team.
What the service will not treat
This is the part that saves a wasted referral. The National Maternity Hospital states that its physiotherapy department treats conditions associated with pregnancy only. If you had a bad back before you were pregnant, or a problem that is not connected to the pregnancy, the hospital says plainly that it is safe to keep seeing your own physiotherapist for it.
So the question that decides your route is not how much it hurts. It is whether the pregnancy caused it. A pre-existing problem that pregnancy has made worse is worth describing in exactly those words when you ask, because that is the distinction the department is working from.
Your first appointment is probably a class
People picture a one-to-one appointment and are thrown when a class invitation arrives instead. It is not a fob-off, it is the design. The Coombe says that for the most common conditions a group class is the first line of treatment, that it often settles the symptoms on its own, and that a one-to-one appointment is organised afterwards for anyone who still needs one.
Two practical things follow. At the Rotunda, some appointments are telephone or Zoom rather than in person, and the hospital asks you to read the appointment letter carefully rather than travelling in on an assumption. And some of its in-person classes do not happen at the hospital at all: there is a back pain and pelvic girdle pain class in a primary care centre in Corduff on Thursday afternoons, and individual appointments for pregnant and postnatal patients in Roselawn. Babies are welcome at those.
Miss an appointment without ringing and you can lose the service, not just the slot. The Rotunda states that if you do not attend and have not phoned to cancel or reschedule, you are discharged from the service under its non-attendance policy. If something comes up, the phone call is the whole difference.
If you are not booked into a Dublin hospital
The three hospitals above publish their rules, which is why they can be described. Most units do not, and that absence is the answer in itself: there is no national antenatal physiotherapy rule to look up, so the only reliable source is your own unit. Ask the same two questions, who can refer me and can I refer myself, and you will have the local rule in a sentence.
Outside the hospital there is a second, separate system. Citizens Information says the HSE may provide physiotherapy in your community but that it is not available in all areas, and that you may be prioritised for it free of charge if you hold a medical card or a Health Amendment Act Card. So the community route is patchier than the hospital one, and it is means-related in a way the maternity hospital route is not.
What it costs
Maternity care itself is free under the Maternity and Infant Care Scheme if you are ordinarily resident, with no medical card needed, and Citizens Information confirms that physiotherapy is available through the public health service in hospitals on an in-patient or out-patient basis.
If you go privately, fees vary and Citizens Information tells you to ask the physiotherapist directly, because there is no set rate. You may be offered a reduced fee if you hold a medical card. Revenue gives relief on qualifying health expenses at the standard rate, and its wording matters: relief applies to physiotherapy if you are prescribed, referred or advised to by a practitioner. Booking privately with nobody having advised it may not qualify, so mention it at an antenatal appointment first and keep the receipts.
What to have ready when you contact them
Your hospital number is the thing people go looking for mid-call. The Coombe asks for your full name, your hospital number and the class you want when you email its physiotherapy department, and it is a fair guess that any unit will want to find your file the same way. The Rotunda department answers by phone and email within core hours, which it gives as 8.00am to 4.15pm, Monday to Friday.
What this guide does not do
It does not tell you which exercises to do, whether your pain is normal, or whether you should be seen urgently. Those are clinical questions and a website is the wrong place for them. The HSE publishes pelvic floor exercises for pregnancy and says they matter during it, not only after, but if something hurts or has changed, the people to tell are your midwife, your GP or your maternity unit, and they are the ones who decide your care.
See your health steps in order
Answer a few questions and get your own plan: the appointments, the checks and the paperwork, in the order they happen, each linked to the official page it comes from. Free, no account, about three minutes.
Official sources
- The National Maternity Hospital: Pregnancy and Postnatal Physiotherapy (who can refer you, the pregnancy-related-conditions-only rule, what the service treats)
- The Coombe Hospital: Physiotherapy Department (antenatal referral by the medical team, no direct GP referrals, the bladder self-referral form, classes first)
- The Rotunda Hospital: Physiotherapy (core hours, telephone and Zoom appointments, community classes, the non-attendance policy)
- Citizens Information: Physiotherapy services (the national referral rule, community availability, medical card priority, private fees and tax relief)
- HSE: Pelvic floor muscle exercises (why they matter during pregnancy, not only after)
- Revenue: What are qualifying expenses (physiotherapy relief and the referred-or-advised condition)
Facts checked against the official pages on 14 September 2026. This is general information, not medical advice, and it does not decide your care. The HSE and your maternity unit provide these services and make every clinical decision; Revenue decides tax relief. Hospital referral rules are set locally and change without notice, so always confirm with your own maternity unit, and speak to your midwife, your GP or a physiotherapist about your symptoms.