Whether you have given birth via vaginal delivery or a C-section, your pelvic floor muscles may become stretched or damaged during the processes of pregnancy and childbirth.
Although this is normal and not always a cause for concern, it can cause functional problems of the pelvic floor that manifest as urinary or fecal incontinence, urinary urgency or frequency, pain during sexual activity, pelvic organ prolapse, pelvic pain, lower back pain, diastasis recti, or scar pain.
Many of these issues can be fully treated with outpatient pelvic floor physical therapy. However, new moms need to wait for at least six weeks after delivery before they begin this type of therapy to give their body time to heal from childbirth.
Why Is It Better To Wait?
This time period coincides with the typical gynecological checkup that women are advised to undergo six to eight weeks postpartum. Although official guidelines from the American College of Obstetrics and Gynecologists have recently changed to acknowledge that women need individualized support and may need obstetric care within the first three weeks after giving birth, it is still best to wait the full six weeks before beginning pelvic floor therapy.
However, women with specific and immediate concerns, such as significant pelvic pain or urinary incontinence, may wish to have a preliminary appointment to discuss their condition and establish a plan of action earlier. Although most physical therapists will not conduct an internal exam too soon after delivery, much can be done externally to alleviate the problem. Physical therapists can also guide women on ways they can facilitate their recovery and the proper ways to lift their body, along with recommended positions for breastfeeding.
Once six weeks have passed, women may find that pelvic floor therapy can dramatically improve their quality of life. Some women are hesitant to leave their house following birth because they are concerned about leakage or discomfort, and some may struggle to push their baby in a stroller or lift the baby up. Therapy can help them resume normal functioning.
Pelvic floor physical therapy after childbirth may include some of the following components, depending on the patient’s specific goals and complaints:
- Coordination exercises
- Biofeedback to strengthen and relax muscles
- Patient education
- Behavioral modification
- Scar massage
- Strengthening exercises targeting the pelvic floor and abdominal muscles
- Electrical stimulation
- Relaxation exercises and stretching for painful or shortened muscles
- Heat or ice
In addition, patients will be given “homework” in the form of exercises and stretches that need to be performed regularly at home to give their progress a boost.
Why Is Pelvic Floor Therapy Recommended After Childbirth?
The pelvic floor serves many functions, including controlling the bladder and bowels, providing postural support, and supporting pelvic organs such as the bowels, uterus, and bladder. It also contributes to sexual function. Therefore, many aspects of a woman’s life can be impacted if her pelvic floor is not in optimal condition.
Throughout pregnancy, increasing pressure is placed on the pelvic floor muscles, causing them to become stretched or weak. In some cases, they may react by over contracting, causing them to become tense. This means that the process of pregnancy on its own is enough to cause pelvic floor dysfunction, regardless of how the baby is delivered.
In addition, during a vaginal delivery, newborns pass through an opening in the pelvic floor which can cause the muscle to tear and develop scar tissue. The pelvic floor can stretch as much as three times its normal resting length during a vaginal delivery, which can also cause problems.
In addition, many mothers-to-be experience changes in posture as their pregnancy progresses and their stomach grows. This can increase the arch of their back because of the weight of their stomach pulling it forward, leading to strain on spinal joints and the muscles and ligaments supporting the spine and can manifest as lower back pain. Although this pain may recede in the weeks after delivery, some women will continue to experience chronic back pain after pregnancy.
Abdominal muscles, not surprisingly, are also often affected by pregnancy as they stretch to accommodate a growing baby. This can lead to core muscle weakness that can exacerbate back pain. It may also cause a problem known as diastasis recti. Many people believe that this is chiefly an aesthetic concern, but it can also cause back or pelvic pain.
A pelvic floor physical therapist will have specialized training in assessing and treating postpartum women who are experiencing all types of pelvic floor dysfunction. Even those who are not experiencing specific problems, such as urinary incontinence or pain, may still benefit from pelvic floor therapy as it can help them restore their muscles to avoid future issues.
Reach out to the Women’s Healthcare Team
Women’s bodies are designed to support pregnancy and childbirth, but sometimes additional help is needed to restore normal function following delivery. Get in touch with the women’s healthcare team at Raleigh Gynecology & Wellness to find out whether the changes you are experiencing postpartum could be improved with pelvic floor therapy.