What's Happening

So, You Had a Baby, Eh?

by E. Anne Patron, DPT

Once postpartum, it is very beneficial to get checked out by a pelvic floor physical therapist. The birth of a child, though an incredible experience, can be traumatic to the pelvic floor, even if the labor and delivery was normal. No matter if you had a c-section or vaginal delivery, a pelvic floor evaluation is helpful — that baby puts a lot of stress on your pelvic floor for all of those months. A physical therapy examination postpartum is helpful to assess the tone and tenderness of the pelvic floor, to check for a separation at the abdomen (called a “diastasis recti”), as well as to assess the low back and other supportive body parts post-baby. Your body, unfortunately, does not always just “go back to normal” once the baby is born — you carried a tiny human for nine months — it might need a little help to remember what “normal” is.

It is a common misconception that once you’ve had a child, leakage is to be expected. This is false. It is common after pregnancy to experience incontinence, or leakage, but it is not normal. Some women who experience leakage immediately postpartum have a significant improvement in their leakage less than three months after giving birth, but this does not happen with everyone. You might have some pelvic floor weakness, tenderness, or extra tension in your pelvic floor that is causing you to leak. Do not think that you have to live with leakage. Get treatment: You are not broken after giving birth.

Another thing that women might report after giving birth is a feeling of heaviness in their vagina. Some women report feeling as though their genitals are going to come out of their body with too much standing, too much activity, or by the end of the day. This could be due to “pelvic organ prolapse,” which is essentially ligamentous weakness in the lumbopelvic complex, most commonly due to childbirth. The pelvic floor could also be weak — which could create some leakage issues.

Did you tear while giving birth? Was the birth traumatic (forceps, vacuum, prolonged pushing, emergency c-section, excessive blood loss, etc.)? All of these things have the potential to increase the risk for scar tissue and pain postpartum. You may develop increased muscular tension and tenderness in your vagina that could make sitting, sex, walking, and normal everyday activities painful. Pelvic floor physical therapists can help with all these symptoms by using manual stretching techniques (both internally through the vagina and externally), as well as teaching women how to relax their pelvic floor musculature (if they are holding tension). Awareness is one of the major keys to being successful in pelvic floor physical therapy and we can help you to become more aware of those muscles! Once you are more aware of your pelvic floor muscles, it is much easier to control them.

Do you have breast pain with breastfeeding? Repeated bouts of mastitis or clogged milk ducts? Back pain due to breastfeeding and caring for baby? This is all treatable in physical therapy, too! We can use therapeutic ultrasound to decrease inflammation of the breast tissue and teach you some manual techniques to ensure that all ducts remain functional. Back pain can arise due to muscular imbalances in the body postpartum, which is exacerbated by doing selective repetitive motions while caring for your baby. We can help you strengthen your spine and get you feeling back to normal postpartum.