It’s common knowledge that a person’s body goes through many changes during pregnancy. However, did you know that it doesn’t just end after delivery? Do you know what happens to your pelvic floor after birth? Of course, you probably know that the body will change, but even after delivery, the body is still changing… or in other words, recovering! This affects many organs such as the uterus, genitals, bladder, bowel, muscles, and joints. A person’s hormones are affected after delivery as well, although everyone’s experience is different.
The main point is, a person may experience postpartum symptoms after delivery; many of which involve the muscles of the pelvic floor. But no worries; many postpartum symptoms can be managed with pelvic floor physical therapy. By training the pelvic floor to improve coordination and flexibility before pregnancy, you can actually encourage easier recovery!
What Happens to Your Pelvic Floor After a Vaginal/Middle Opening Delivery
So, let’s talk about what happens to your pelvic floor after birth, and what symptoms you can expect to possibly experience after delivery.
During and after a vaginal/middle opening delivery, the pelvic floor muscles become stretched and at times may sustain trauma such as tearing or cutting. The pelvic floor is affected throughout the duration of the pregnancy. The muscles have to account for the additional weight of a growing baby inside the body, increase fluid retention, handle an additional organ (placenta) as well as the added work of coordination in order to support the spine, due to the lumbar curve increasing during pregnancy (up to 50 degrees). It may also experience some tissue damage due to the tearing, cutting, ripping, and/or avulsion during the birthing process.
Due to the stretching and weakening of the pelvic floor muscles, a person who has given birth may experience pelvic floor conditions such as bladder incontinence, fecal incontinence, painful intercourse, scar pain, back pain, pelvic pain, perineum pain, constipation, frequent urination, diastasis recti (separation of the abdominal muscles), or pelvic organ prolapse.
Pelvic organ prolapse may be more common in those who have had multiple pregnancies or more difficult birthing experiences. Other factors that may contribute to the risk of prolapse include the delivery time (how long spent “pushing”), birth weight, age of the birthing person, previous pelvic surgical history, excessive straining, constipation, or repetitive heavy lifting with improper posture. As for the other symptoms listed previously, these occur to many people after giving birth, usually within a few weeks to a few months of the delivery, and vary from person to person.
Diastasis recti occurs in about two-thirds of pregnant people. It affects the muscles in the abdominal canister, a system of muscles that consists of the diaphragm, transverse abdominis, pelvic floor muscles, and the multifidus. This can result in lower back pain and poor abdominal canister coordination when lifting, breathing, and/or defecating. A person is more likely to experience Diastasis Recti if they are over the age of 35, have had multiple pregnancies, have carried heavier pregnancies, or are of small stature.
But there’s no need for worry, these symptoms aren’t something that you’re necessarily doomed to deal with forever. Despite what the media and society deems “normal,” many people can manage and treat many symptoms after childbirth with proper attention to their pelvic floor. For example, it’s common to experience incontinence after childbirth, just not for a long time! The symptom should stop within 6 – 8 weeks of delivery; otherwise, you’ll need to refer to a pelvic floor physical therapist.
Think of it like this: the pelvic floor went through a lot of work while the baby was being carried and delivered from the body. After this incredible process, it’s a bit uncoordinated and will need proper training and guidance to help return to normal function. For a while after the birthing process, you’ll experience symptoms pertaining to your pelvic floor due to it being in a very new situation after all the very hard work it was put through.
Another part of the healing process that one should be aware of is the possibility of painful insertion (such as during a pelvic exam, menstrual product, or sexual activity). This can be due to hormone-related dryness, tearing, and painful scar tissue from tearing or episiotomy (a surgical cut sometimes made at the vaginal/middle opening during the birthing process).
Everyone’s case is different, and so you may experience a different set of symptoms from another person. However, anyone who becomes pregnant can benefit from giving their pelvic floor some extra care and attention before, during, and after delivery!
Tips to Care for Your Pelvic Floor After a Vaginal/Middle Opening Delivery
One important tip is to pay attention to your body. Experiencing symptoms for 6 – 8 weeks is a sign that your body may need extra attention. For example, if you experience incontinence (urinary or fecal) after 4 – 6 weeks of delivery, you may have pelvic floor dysfunction and should consult a health professional. You should also do so if you feel a “heaviness” in the pelvic region, which could be a sign of pelvic organ prolapse.
For overall care of your body after a vaginal/middle opening delivery, you should consult with a pelvic floor physical therapist in order to receive education and care to properly maintain the health and function of your pelvic floor muscles; especially after the physical trauma your body experienced during birth. They can help you with any postpartum symptoms you may experience after childbirth, such as the ones listed previously, in order to help you have a healthier body and higher quality of life after birth…allowing you to properly focus on your baby!
What Happens to Your Pelvic Floor After a Cesarean Delivery (C-Section)
This type of delivery is a surgical delivery of a baby and accounts for nearly one-third of all deliveries in the United States. This type of delivery can be chosen for many reasons, such as the baby not delivering head-first, umbilical cord issues, the birthing person having high blood pressure or heart disease, previous cesarean, mechanical obstruction such as a fibroid, or many other reasons that vary from person to person.
During this type of delivery, many layers of tissues including the abdominal muscle wall and uterus are cut in order to remove the baby. Not only are these muscles cut, but they have already undergone many changes including stretching and position changes while carrying the baby. Therefore, it is very important to properly care for these muscles after delivery. What happens to your pelvic floor after birth is different in the case of a c-section, due to the baby exiting the body in such a different way. However, because the body has already experienced the added weight and stretching up to the point of delivery, some of the postpartum symptoms may be similar to that of a vaginal/middle opening delivery.
There is a lot of misconception around c-sections, such as that they are “easier” in terms of experience and recovery, but this is not necessarily true.
After a c-section, a person may experience symptoms similar to the vaginal birthing postpartum symptoms (incontinence, pelvic pain, pain with sexual intercourse, and so on) but with differences such as feeling lower abdominal pain from the surgery, scar pain and sensitivity, difficulty bending or lifting, reduced flexibility in the hips or lower back, and uncoordinated core muscles.
A c-section can take up to 6 weeks to heal; if you experience pain around the scar after 6 weeks, you may want to see a professional about poor healing; and follow up with a pelvic floor physical therapist.
Tips to Care for Your Pelvic Floor After a Cesarean Delivery (C-Section)
It’s advised that after childbirth, a person should wait a minimum of 6 weeks and gain approval from your healthcare provider before slowly resuming modified activities in order to give the body ample healing time. Pelvic floor physical therapy can help manage symptoms and promote proper healing similar to that of a vaginal/middle opening delivery, as mentioned before. The pelvic floor physical therapist creates an individualized program for their patients that will allow them to coordinate and use their muscles properly again, and get back to their normal life activities.
However, there are some differences in the care needed for a vaginal/middle opening birth and c-section delivery, such as the attention to the scar and its healing process. Soft tissue mobilization techniques can help allow for better flexibility, decrease itching, provide moisture and help desensitize the tissue area.
Also, as mentioned before, one possible symptom of both vaginal/middle opening deliveries and cesarean deliveries is diastasis recti, which occurs when the stomach appears to “stick out” as a result of the abdominal muscles widening. The healing of this symptom becomes a bit more complicated with cesarean deliveries, due to the scar tissue. Therefore, care from a professional is essential for proper healing.
How a Pelvic Floor Physical Therapist Can Help You Before Delivery
As mentioned earlier, the pelvic floor can be trained and worked on ahead of delivery in order to prepare the body and aid with healing. It’s incredibly important to prepare your body properly with safe and professionally recommended techniques and/or exercises; which is where a pelvic floor physical therapist will come in handy!
They will assist you with strengthening, stretching, coordination, and muscle awareness which will prepare the muscles ahead of time to help physically prepare the body. This will give you the knowledge of proper posture during the daily activities you’ll be encountering while pregnant.
By working with a pelvic floor physical therapist, you’ll also be helping your future self out, by helping prevent the likeliness of certain postpartum symptoms, preventing possible injury, and preparing for easier healing overall. You will learn about self-advocacy, meaning you’ll gain the confidence to take action in your personal health journey and essentially represent yourself in order to give your health the attention it deserves! You’ll also be familiar with how to maintain strength and flexibility during your pregnancy by learning and becoming comfortable with techniques beforehand from your pelvic floor physical therapist.
Not only will you be preparing physically, but by working with a pelvic floor physical therapist, you may gain more confidence mentally in the pregnancy journey after speaking with a professional and having their advice to help you along the way. Your pelvic floor physical therapist can help you before, during, and after your pregnancy; and it’s totally okay to rely on them with your questions and guidance. It’s what they’re here for!
How a Pelvic Floor Physical Therapist Can Help You After Delivery
By now you should be more familiar with what happens to your pelvic floor after birth, but what can you do to assist your body in the healing process? Caring for your pelvic floor postpartum can assist with a range of symptoms mentioned before, such as incontinence, organ prolapse, pelvic pain, diastasis recti, and painful intercourse, to name a few. After delivery, working with a pelvic floor physical therapist can help you regain function to your pelvic floor muscles, as well as help you learn and gain better control of them. In order to manage and relieve symptoms, as well as continue your normal daily activities again, it’s important to give your muscles the proper care and healing.
A pelvic floor physical therapist will guide you on safe exercises that are right for your needs, address your personal symptoms and how the two of you can work together to relieve them. They will educate you and train you on regaining control of your pelvic floor muscles and restrengthening them.
Overall, practicing proper pelvic floor care after delivery allows you to have a healthier body and a better lifestyle long-term.
How We Can Work Together
Although you may be very focused on learning or preparing for your new baby and how you will care for them, are you giving your body the same attention? Now that you have learned what happens to your pelvic floor after birth, you may be considering what you can do to help give your body an easier recovery or relieve yourself of postpartum symptoms.
No matter your age, if you are a person who is planning to be pregnant, already pregnant, or postpartum, pelvic floor physical therapy can benefit you. By working with a pelvic floor physical therapist, you can prepare your body for pregnancy by improving awareness, flexibility and coordination of your pelvic floor muscles; which will allow for easier healing and less stress incontinence (or even none at all in some cases) after birth. Preparing your pelvic muscles allows your body to be more capable of handling the changes that occur throughout pregnancy.
You may be thinking, “I do kegels at home! I’m already preparing enough on my own!” However, this is often a misconception. Many people unfortunately are not doing their at-home pelvic floor exercises correctly; not to mention, kegels may not always be right for your individual needs. Doing the wrong exercises after labor may actually worsen symptoms and not give you the benefits you were hoping for, so it’s important to get the advice of a professional before performing exercises at home.
Working with a pelvic floor physical therapist ensures you are getting the correct care for your individual needs. Pelvic floor physical therapy before, during, and after pregnancy is completely safe when done correctly with the help and guidance of a professional. Not only will you have the benefit of a more manageable pregnancy, but you will also help your body maintain strength and flexibility long-term. Pelvic floor physical therapy is essential for your long-term personal health as well as your quality of life! So now that you are more aware of what happens to your pelvic floor after birth, you are more prepared to give your body the care and attention it needs.
Want to consult with Dr. Laura Meihofer and get started on your pelvic floor health journey?
P.S. If you have any questions about postpartum symptoms, or pelvic floor health in general, head over to Instagram and let’s connect in the DMs!
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