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How can pelvic floor physiotherapy help YOU after giving birth to your child?

Ever since you have had your baby, do you worry about leaking when you cough, sneeze or laugh? Do you find yourself running to the bathroom more frequently because you are worried that you may not be able to hold it? Do you notice a bulging of your abdomen when you get up from lying down? Is sexual intercourse painful? Do you feel significant heaviness or like something is “falling” out of your vagina? If you can relate to any of these questions, then the most important thing for you to know is that you are not alone and that there is help and treatment for you. It is common around the 6-8 week mark post-partum, for mom’s to receive a check up from their obstetrician or they may already be receiving care from their midwife. It is important to speak up and discuss your symptoms and concerns at this time. An assessment by a trained pelvic health physiotherapist may also be beneficial. A pelvic floor physiotherapist is trained to assess and help you manage the following:

  1. The strength and endurance of your pelvic floor muscles
  2. The coordination of your pelvic floor muscles with the rest of your core during dynamic movement
  3. Bladder and bowel habits /postures/strategies to optimize emptying
  4. The flexibility of your pelvic floor muscles
  5. Incision mobility of your caesarean or perineal scar
  6. The extent of the separation between your rectus abdominals with functional movement and exercise
  7. The presence of pelvic organ prolapse (POP) – when the organs in your pelvis (bladder, uterus, and/or rectum) drop down into the vaginal canal causing sensations of heaviness/pressure or a bulge in the vagina

Your pelvic floor treatment with a pelvic floor physiotherapist includes a lot of education on strategies to support your body as it continues to heal from labour and delivery. As a pelvic floor physiotherapist, I spend time showing you where your pelvic floor muscles are on a model and how they function. An internal assessment is the gold standard for helping you properly identify how to contract and relax your pelvic floor muscles. Recent studies show that approximately 1/3 of women with stress urinary incontinence, who were only verbally directed on pelvic floor activation, were unable to do so correctly[i] .

Pelvic floor muscle training is not necessarily the complete “answer”. There are many resources that suggest doing “Kegels” after childbirth.   Pelvic floor muscles can be lengthened and weak, but they can also present as shortened or tight and weak even after having given birth vaginally. The symptoms may present the same way (i.e. urine leakage) but the treatment is very different. Simply contracting a shortened/tight pelvic floor will only make the symptoms worse. Increased tension in the pelvic floor muscles can also contribute to painful sexual intercourse. An assessment by a pelvic floor physiotherapist can determine why you are having pain. I will provide you with a tailored program based on what your pelvic floor muscles are doing.

Pregnancy, labour, and delivery causes profound changes to a female body. You are rewarded with the presence of a new life to cherish and love. At the same time, it can be very isolating and worrisome when your body feels “different” and unlike the way it was before baby arrived.  A pelvic health physiotherapist helps you understand your pelvic floor anatomy and how your body is healing during the post-partum phase. We help you identify areas of weakness and/or tension to get your pelvic floor and core stronger, more flexible and better coordinated. With the proper guidance from a pelvic health physiotherapist, your pelvic problems can be significantly improved and even resolved.

[i] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3551249/

Leeanna Maher
ALPHA Health Services- Registered Physiotherapist and Pelvic Floor Physiotherapist
For questions or to book with Leeanna email: info@alphahealthservices.ca