Getting pregnant and having a baby does a number on your body, and even if you know it’s coming (you’re producing a whole human inside yourself, after all), you might not realize just how intense these changes are until they’re happening. From fluctuating hormone levels, mood changes, and mental health issues to digestive problms, swelling, and general fatigue, every part of your body is readjusting after you’ve given birth. And it’s all happening at the same time, while you’re trying to care for a newborn.
One aspect of your health that pregnancy affects is your pelvic floor, an area (if we’re being honest with each other) you may not even have heard of before. Simply put, your pelvic floor is a set of muscles and tissues that support your pelvis and all the organs in it, like your bladder, bowel, and internal reproductive organs, per the Cleveland Clinic. That puts it right in the region that’s doing a lot of heavy lifting during pregnancy and childbirth, and your pelvic floor can change quite a bit during that process.
And that’s true no matter how you give birth, says Dr. Rachel Gelman, pelvic floor physical therapist and owner of Pelvic Wellness and Physical Therapy. “Regardless of mode of delivery, a person can experience pelvic issues, due to the physiological changes that occur over the course of pregnancy,” Dr. Gelman tells SheKnows.
What postpartum pelvic floor issues are most common?
Your pelvic floor pays a big role throughout pregnancy and childbirth, and anyone who’s postpartum may experience some major changes, Dr. Gelman says. For one thing, you experience a dramatic decrease in estrogen, a hormone that’s “essential for vulvar and vaginal health,” during the postpartum period. “As a result,” Dr. Gelman says, “people may experience vaginal dryness, pain with sex, vulvar pain, urinary urgency, frequency, dysuria, or incontinence.”
For those who have or attempt a vaginal delivery, there’s also the “amount of pressure and bearing down on the pelvic floor,” Dr. Gelman says, which “can put the birthing person at risk for a pelvic organ prolapse,” meaning that the muscles supporting your pelvic organs become loose or weak. Perineal tearing is also a possibility, which can lead to scar tissue and pain at the vaginal opening. If the tear extends to the anal sphincter, Dr. Gelman says, you might also experience dyspareunia (aka painful sex), fecal urgency, or fecal incontinence (not being able to hold in your poop). Some people may also experience “stretch or compression injuries” to their pelvic nerves, which can impact the pelvic muscles, or injuries to the coccyx (the triangular bone at the base of your spine), Dr. Gelman notes.
A c-section can come with risks as well. The surgical incision made during the procedure “cuts through many layers,” Dr. Gelman says, “and can still impact the pelvic floor muscles and nerves that travel through the abdomen to the pelvis.”
5 tips for your postpartum pelvic floor
Most new moms are recommended to do Kegel exercises for their pelvic floor, which involves repeatedly tightening and relaxing your pelvic floor muscles. And while Kegels can help to strengthen the pelvic floor, they’re “not always the best solution,” Dr. Gelman notes.
If you’re experiencing postpartum pelvic floor issues, here’s what to do:
See a pelvic floor specialist. Expert guidance is essential when it comes to managing postpartum pelvic floor issues, so make sure to set up an appointment with a pelvic floor specialist or pelvic floor physical therapist once your doctor has cleared you to do so. You’ll get an assessment and start an individualized program, Dr. Gelman says, which will address what your body actually needs — in a way that just doing a few Kegels every day may not.
Consider trying an estrogen cream. “I also recommend talking to your healthcare provider about a low dose topical estrogen cream and see if they think it is appropriate,” Dr. Gelman says. “Not everyone needs it, but for some people it can be very helpful.”
Use a Squatty Potty and a bidet. “Bowel movements postpartum can be a struggle, so set yourself up for success,” Dr. Gelman says. A tool like a Squatty Potty puts your body in the proper position for healthy pooping, which is important for pelvic floor health, while a bidet cleans up afterwards without the need for irritating toilet paper.
Do gentle breathing exercises. Try inhaling while counting to four, holding for four, exhaling for four, holding for four, and then repeating, making sure to breathe deeply and slowly into your belly. You can also experiment with other easy breathwork techniques. “It seems simple,” Dr. Gelman says, “but breathing properly helps the pelvic floor move.”
Prioritize rest. “Rest is key,” Dr. Gelman says. She recommends staying hydrated, eating nourishing foods (like bone broth), and going on slow walks if you can to help your body heal in a gentle, holistic way.
Give yourself grace. Pelvic floor issues can be frustrating and isolating, but Dr. Gelman notes that they’re very common. Remember that your body will heal on its own timeline, even if it feels slow. “Society has put a message out the everyone needs to ‘bounce back’ and that healing should be done at six weeks,” she says, but a nine-month pregnancy “warrants at least nine months to recovery.” Factoring in delivery adds “another three months at least,” Dr. Gelman continues, “so I tell everyone to give themselves at least a year to recover from pregnancy.” That goes for your pelvic floor and everything else, too.
Before you go, shop our favorite products to get you through pregnancy:
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