Childbirth is an extremely traumatic event for a woman's body. During a vaginal delivery, the muscles of the pelvic floor are significantly stretched and can tear. Cesarean deliveries decrease tearing at the pelvic floor, however the muscles of the abdomen do not fare as well as they are cut and stretched to allow the baby to be retrieved. Let's also not forget the 40 weeks during which the pelvic floor muscles need to support the weight of that growing baby.
Enter pelvic floor physical therapists. As explained on my website, TheMovementMaestro.com, a trained pelvic floor therapist is able to evaluate your pelvic floor via an internal and external exam and assess muscle function directly. Additionally, pelvic floor physical therapists understand the relationship between the pelvic floor and the rest of the body, therefore making them well-suited to identify how dysfunction at a different part of the body could cause pelvic floor dysfunction and vice-versa.
More specifically regarding the aftermath of childbirth, pelvic floor physical therapists, unlike the doctors delivering your baby, are concerned with YOUR functionality, YOUR ability to return to all the tasks required of you on a daily basis, and getting you back to doing all the things that YOU enjoy doing. If I haven’t convinced you yet, here are 7 reasons why EVERY woman should meet with a pelvic floor physical therapist, even if it’s only once, after having a baby.
1. You and your baby shouldn’t be in diapers at the same time.
Although urinary incontinence is common both during and following pregnancy, it is NOT normal. Most women will either be informed by a health care provider that incontinence will go away on its own and to not worry about it, or they will be welcomed into the sisterhood of mothers by a female relative or friend with the sage advice that incontinence is part of having a baby and to just accept it. The only truth regarding these statements is that every time one of these phrases is uttered, a kitten dies. Incontinence indicates pelvic floor dysfunction. While it may resolve over time without formal intervention, the pelvic floor generally remains weak and is working on reserve capacity. To that end, it's not uncommon to see this incontinence returning down the road or following subsequent deliveries. Additionally, urinary incontinence isn’t the only type of incontinence caused by a dysfunctional pelvic floor. Two words for you, ladies: fecal incontinence. Pelvic floor physical therapists treat both urinary and fecal incontinence, often achieving full resolution of symptoms. Save the Huggies for your kid and get in to see a pelvic floor PT.
2. Sex isn’t supposed to hurt.
Tearing is a very real part of childbirth, with the aftermath being scarring and tightening of tissues of the pelvic floor. Additionally, hormonal changes can lead to vaginal dryness. A pelvic floor physical therapist can work with you to decrease scar tissues, loosen tight muscles, and give you helpful hints on how to get your groove back.
3. Your organs should remain on the inside of your body.
The trauma and weakening of tissues that is associated with carrying and delivering a baby can cause what is known as pelvic organ prolapse. In layman's terms, this is when your insides end up on the outside. A falling or sliding out of place of the vagina, uterus, urethra, or rectum can occur, and can vary in severity from slight descent where the organ remains inside the body, to full prolapse where your organs are resting on the treatment table. Google it. It's real. Pelvic floor therapists can not only identify and assess a prolapse (many women don't even know they have the early stages of this), but they can provide exercises to prevent or improve this condition. Hint: there's more to it than just kegels.
4. Your belly button should be the only "hole" in your belly.
As the abdominal muscles stretch during pregnancy, a split can develop at the central connective tissue of your six-pack. This connective tissue is known as the linea alba, and when it separates, it is referred to as a diastasis (di-as-ta-ses) recti. I'm not sure that I need to go into detail as to why having a hole in the middle of your abs is bad, but let's start the list with back pain, core weakness, and breathing dysfunction to name a few. Like incontinence, diastasis recti a very common occurrence, however, it's advisable that you meet with a pelvic floor therapist so s/he can asses the size of it (in finger-widths) and recommend not only exercises to help it close, but movements and activities to avoid so as to prevent it from getting any bigger.
5. Walking and exercising shouldn’t make you feel like your pelvis is going to break into a million pieces.
Many women experience pelvic and low back pain during pregnancy secondary to hormone-related changes that cause laxity in the pelvic ring. Most women think that this pain will automatically go away once that 8lb baby is no longer inside of them. Fast forward a few months and these same women want to kill their partners for helping them get pregnant once they realize that childbirth does not magically rid them of all of their hip/pelvis/low back pain. Pelvic floor physical therapists can help...a lot. Soft tissue techniques, exercises, movement modifications, the list goes on and on. PTs can help with the pain and get you back to being you.
6. C-sections are no joke.
Far too often I hear women say they want to schedule a c-section and avoid the aftermath of a vaginally delivery. Clearly these women have never spoken to anyone who has actually had a C-section. The trauma experienced by the abdominals during a C-section is significant, and often renders a woman unable to do much of anything for a few weeks. Imagine having your abs and uterus cut open, your insides sifted through like a game of hide and seek, a 7lb baby pulled out through a 4-inch incision, and then everything sewed up. I really can’t imagine doing much more than blinking my eyes after something like that, nevermind coughing, sneezing, pooping, or taking care of a human life. Pelvic floor physical therapists help women deal with what comes after the c-section, from regaining abdominal strength to preventing back pain and scar adhesions in the future.
7. Kegels don’t work if you do them wrong.
I have plenty of moms coming into my office telling me how their incontinence never went away even though they tried doing kegels a couple of times. Here’s the deal: 1) If you’re not performing a kegel correctly, utilizing all the layers of the pelvic floor (wait… there’s more than one layer? More on this in upcoming posts), and getting a full 360 degree contraction, you’re squeezing in vain. 2) The pelvic floor works in conjunction with the rest of your ‘core’, and requires not only the participation of the rest of those muscles for proper functioning, but correct pelvic alignment. Long story short, there’s more to it than just kegels. Let a pelvic floor physical therapist assess your ability to perform a kegel and then instruct you on functional exercises to help facilitate normal pelvic floor function.
I realize that once you have a baby you have very little time to take care of you. That is even MORE of a reason to get in and see a pelvic floor PT. A therapist can and will work with you to educate you on things to avoid and empower you with the knowledge of how to TREAT YOURSELF. Additionally, most therapists are super understanding and are more than willing to having you bring in your baby with you if childcare is an issue. Pain, dysfunction, and wetting your pants does NOT have to be your reality following child birth. Pelvic floor physical therapists are here to help. To locate a pelvic floor physical therapist in your area click here.
C. Shante Cofield, PT, DPT, OCS, CSCS