Let’s Talk About It
The pelvic floor often gets ignored during regular checkups in postpartum, but are vital to our sexual and reproductive health. I talked about pelvic floor muscles during pregnancy in my previous blog post and now it’s time to talk about some of the nitty gritty details of pelvic health and postpartum. While our bodies expand and change in beautiful and often uncomfortable ways during pregnancy, they also go through A LOT during labor and birth. Our perineum has to stretch during vaginal birth and that, along with tearing, can have an impact on your pelvic floor health in postpartum and beyond.
Many new moms experience pelvic floor issues after vaginal birth and don’t seek treatment because women’s health is often stigmatized. So let’s talk about it! It’s the only way to push back and normalize the experiences of birthing people.
Once again, I reached out to Dr. Rachel Parrotta, DPT, for her take.
Certain exercises like this bridge can help strengthen core and pelvic muscles
“The pelvic floor muscles undergo a very large stretch during vaginal birth and the pelvic region can be quite swollen in the first few weeks post-partum,” said Dr. Parrotta. “These factors can make it very challenging to coordinate your pelvic floor muscles (aka ‘Find your Kegel’) in the first few weeks after birth. Learning and practicing pelvic floor muscle coordination prior to birth can help develop ‘muscle memory’ that will assist you in postpartum recovery.”
I have oft heard phrases like “birth will wreck your vagina” said to new moms and it’s untrue. As Dr. Parrotta mentioned, the vagina and pelvic muscles largely expand. But, here’s the thing – they are meant to do this. After vaginal birth, your pelvic floor is bound to be swollen and aggravated. So, it’s completely normal to experience some postpartum incontinence and perineal discomfort in the following weeks.
What’s Not Normal
If you experience any of the following after you’re six-weeks pospartum, visit your care provider and seek out a pelvic health specialist:
- Pain during sex
- Perineal pain
- A heavy feeling or pressure in your perineal area
- Difficulty urinating or passing a soft bowel movement
Your pelvic health is important. A healthy pelvic floor after postpartum can lead to better sexual satisfaction for you, more stability in your pelvic region, and better outcomes in future pregnancies.
Pelvic PT can be intimate, but it shouldn’t feel invasive. Find a practitioner you trust and get evaluated, because your health is worth it.
The pelvic floor is the layer of muscles that stretch under the pelvis and support the inner organs (bowels, uterus, and bladder). I had never heard of the pelvic floor until I started learning about pregnancy and birth. Even though I was already suffering from and getting treated for a pelvic floor dysfunction long before I became pregnant, no one, not my OB or physical therapist, explained what the pelvic floor muscles did and how they could impact my well-being.
Turns out, as I would later learn, my pelvic floor could wreak a lot of havoc on my body during pregnancy and labor. My pelvic instability lead to symphysis pubis disorder that caused excruciating pelvic girdle pain that still lingers today, one year after I gave birth. The pulling on my pelvic muscles also lead to a lot of back pain.
To learn more about pelvic health, I reached out to Rachel Parrotta, DPT, a pelvic health physical therapist.
“I believe that all people would benefit from learning about their pelvic floor muscles prior to giving birth,” Dr. Parrotta said. “Since we are often unfamiliar with these muscles, it can be difficult for people to use their pelvic floor muscles in ways that help facilitate both birthing and post-partum recovery.”
Imagine, you are in labor and your care provider says, “Okay, it’s time to push.” Many birthing people may feel that bearing down feeling, that urgent need and desire to push. However, receiving an epidural can prevent people from experiencing bearing down and even from pushing effectively because the abdominal and pelvic floor muscles feel numb. Care providers do something called “coached” or “directed pushing” until the laboring person gets the hang of how to push. Your care provider will tell you when and how to push in accordance with your contractions.
This happened to me. I got an epidural during back labor and didn’t have the bear down feeling until my water broke. My midwife coached my pushing because I wasn’t using my pelvic floor muscles correctly. She told me I wasn’t doing right. She got frustrated and impatient with me. She actually shoved her finger up my bum WITHOUT INFORMED CONSENT to pinpoint the muscles I should be using – an action that still makes me shudder and feel small to this day. I don’t want this to happen to you.
Ideally, we want our pelvic floor muscles to be relaxed during the second stage of labor (pushing), as tensing those muscles can actually delay birth. You can go to a professional like Dr. Parrotta to identify your pelvic floor muscles and learn how to use them for pushing BEFORE labor.
“Learning about your pelvic floor muscles prior to birth can help prepare for a more effective pushing phase of birth, especially if a person is planning on birthing with an obstetrician and/or with an epidural,” said Dr. Parrotta.
Pushing your baby into the world is a powerful action that we are all capable of doing. Exploring your pelvic floor to ensure its health and learn about its abilities can make an impact on your birth and postpartum experiences.