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Top 3 Pelvic Floor Issues After Birth

Updated: Jul 13, 2022

We recommend that all Bright Earth clients do pelvic floor therapy after the birth of their child - sometimes even during pregnancy! We know that the mantra of "I just peed a little. Hazard of having kids." runs deep in the parenting community but we are trying really hard to help combat the misinformation and bring joy back to jumping on trampolines, sex, and just not having to rock a panty liner on a daily basis in general. Read on to learn a little bit more about your pelvic floor from Dr. Michelle and we hope to see you Saturday, July 9, 2022!

Guest post by: Dr. Michelle Wall, founder and owner of Moms in Motion PT.

We see a lot of postpartum patients at Moms in Motion PT, and many of them have one of these 3 common issues. Not all birthers will experience one of these symptoms, but many will have at least one, if not two or even all three. If you have given birth multiple times, these issues tend to become even more prevalent.

The 3 most common pelvic floor issues following birth are leaking, pelvic organ prolapse, and painful sex. First, let’s dive into each of these conditions and learn a little more about what is going on in the body.

Urinary Incontinence/Leaking

Leaking, also known as incontinence, has several types. The two most common types women experience after birth are urge urinary incontinence and stress urinary incontinence. Urge incontinence is when you have a sudden urge to urinate and if you don’t go right away, you leak. Stress incontinence occurs when you have a quick stress to the body such as sneezing, coughing, laughing, or jumping. You can have one or the other, or both together.

Sometimes incontinence will go away on its own as your body recovers, but sometimes it sticks around. Leaking happens to so many women (1 in 3 who have had a baby), that many believe if you have babies, you pee your pants. But it doesn’t have to be that way! We have many different tools in pelvic floor physical therapy that can help decrease and even eliminate leaking.

Pelvic Organ Prolapse

Pelvic organ prolapse is when one of the pelvic organs protrudes into the vaginal canal. The bladder, uterus, or rectum can bulge into that space. This can cause discomfort, pressure, and heaviness. It may feel as though you are sitting on a ball, as if something is in the way, or it just doesn’t feel right.

There are various degrees of pelvic organ prolapse, from 1 to 4. Grade 1 is mild and the organs are bulging into the vagina but do not come to the opening. Grade 4 is severe and the tissues are actually protruding past the opening of the vagina. All forms of prolapse can benefit from pelvic floor physical therapy, and often getting treatment can help women avoid surgery.

Lifestyle modifications are particularly helpful with prolapse including: eating a high fiber diet, drinking plenty of water, avoiding constipation, not straining for bowel movements, and managing abdominal pressure during lifting and coughing. In pelvic floor physical therapy, we talk a lot about how to “manage pressure” and what that looks like in daily life.

Dyspareunia/Painful Sex

Painful sex, also known as dyspareunia, by definition sounds simple, but there are many factors at play. If you are breastfeeding, your estrogen is lower than usual, which can cause vaginal dryness and discomfort. If you had a perineal tear during delivery, the tissues may still be healing and can cause pain with penetration. Even if the tissues are healed, there were major changes to the vagina if you delivered vaginally or even if you got to the pushing stage, and can cause pain. Birth trauma can also cause pain with sex, especially when in the position you birthed in. There are other factors as well, that are beyond this blog post, which can be addressed by a pelvic floor physical therapist.

Diastasis Recti/Ab separation

Now for a little bonus content. Although diastasis recti is not a direct pelvic floor issue, it can have implications for the pelvic floor, so I want to mention it here as well.

Diastasis recti is a separation of the rectus abdominis, or the “6 pack abs” muscle. The fascia naturally separates and lays down new connective tissue to accommodate a growing baby. Every woman who carries their baby to term will experience diastasis. Some women’s separations will close on their own by 6 months, but about 50% will continue to have the separation.

Diastasis can be symptomatic, and pelvic floor physical therapy can help. Diastasis often goes hand in hand with incontinence and prolapse, so it is important to know if you are experiencing one because of the other! Other symptoms of diastasis are low back pain, pressure in the pelvic floor, difficulty with lifting, and pain with sex.

When people continue to have diastasis, there is usually a pressure issue going on. This means that whether through daily activities such as lifting your baby, getting out of bed, or standing up from the couch, or other activities such as workouts, there is too much pressure being put directly to the front of the abdomen.

Many women also dislike the visible “pooch” that occurs with diastasis. Although we tend to focus on symptoms and assuring you can do daily activities and your hobbies safely, we also understand that looks matter to many of our patients and we always want our patients to feel good in their bodies!

If you have given birth (no matter if it was a few weeks ago or many years ago) and are experiencing any of these symptoms, reach out to a local pelvic floor physical therapist. If you are local to the Twin Cities, Minnesota, we highly recommend Michelle - she is PHENOMENAL.

Learn more about the pelvic floor, core, and more at our upcoming IN-PERSON workshop on July 9th at 10:00am at Fairwood Park in Richfield! There will be a learning portion followed by a core and pelvic floor-focused workout led by physical therapist Michelle Wall from Moms in Motion PT.

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