Postpartum Pelvic Floor: Everything That May Happen

Pregnancy is an amazing time in a woman’s life. But it brings so many changes and potential challenges that most women are not aware of, especially the pelvic floor. The female pelvic system is an interconnected network of nerves and muscles that controls functions involving the bladder and sexual function. So, it’s hardly surprising that during pregnancy and childbirth, the area is affected. If the muscles get damaged, it can cause problems for new moms, many of which catch you unawares. But since the urogynecology field keeps growing, healthcare professionals can better comprehend how the pelvic muscles are affected by pregnancy and delivery and how to help moms who’ve experienced injuries.

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It’s also good that women know how to care for their pelvic floor, especially if you had an episiotomy, perineal tear, or an instrumental vaginal delivery such as using suction or forceps. After delivery, taking care of your pelvic area should help prevent issues, including prolapse. Read on to learn more about everything that happens to the pelvic floor after delivery and what you can do.

Causes Of Pelvic Issues During Pregnancy & Delivery

The levator ani muscle is responsible for two main functions in the female body, including supporting the pelvic organs and vagina and maintaining bowel and urinary continence. As pregnant women approach their third trimester and get ready for delivery, these muscles have to work harder to support the baby’s growth and delivery.

So, according to Baby Center, the supportive pelvic floor muscles and tissues can stretch and weaken during pregnancy and get strained during delivery. Over 30% of moms who deliver vaginally will experience pelvic trauma that causes damage to these nerves and muscles, which can be caused by different levels of perineal injury, including an episiotomy or tears and delivery via suction or forceps.

The Woman’s Center Adds that several risk factors can also increase the chances of pelvic floor muscle damage, including:

  • Increased delivery time – Pushing for over 90 minutes may heighten the risk of damage.
  • Large birth weight– If a baby is born with higher-than-average birth weight, the mom is most likely to experience pelvic issues.
  • Maternal age – the older the mom is, the higher the chances of experiencing postpartum pelvic issues.
  • Previous pelvic surgery
  • Poor diet
  • Smoking

Common Postpartum Pelvic Issues

Common signs of pelvic muscle issues include incontinence, prolapse, and even pelvic pain lasting months or years after delivery. Here are several pelvic problems women may experience after delivery:

  • Incontinence– When your pelvic floor becomes weak or damaged, it’s common to leak urine (stress or urinary incontinence), wind, or in rare cases, stool (fecal incontinence). Urinary incontinence linked to a bladder prolapse (cystocele) can be problematic. A rectal prolapse (rectocele) can lead to constipation, inability to hold stool or gas, incomplete bowel movements, and sexual dysfunction.
  • Prolapse – The levator ani supports pelvic organs. If those nerves and muscles are badly damaged, the vaginal walls and uterus may start to collapse into the vaginal canal. This is known as pelvic organ prolapse, which may not happen until years after delivery. The condition has unpleasant consequences, so women are advised to start exercising their pelvic floor muscles after delivery. These exercises help get back control of your bladder and bowel. Pelvic-perineal dysfunctions are among the most prevalent postpartum diseases in women. Lifespan.org estimates that 35% of new moms experience urinary incontinence after delivery, and 20% of first-time moms experience extreme pelvic floor muscle injury even though they had a normal pregnancy and childbirth.


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How To Increase Pelvic Floor Recovery

Here’s what you can do to help improve your pelvic floor recovery:

  • Maintain personal hygiene – Keep the area clean and dry, wash the perineum with water, gently pat yourself dry after taking a bath, wipe from front to back after using the bathroom, and don’t rub the area.
  • Ice and compression– It’s typical for the vaginal area to swell and be inflamed after delivery. Ice and compression help lower this and offers pain relief. You can request healthcare professionals to put maternity pads in the freezer, which you can put inside your underpants to provide compression.
  • Pain relief – Doctors normally prescribe pain medication after delivery, which you should take as recommended.
  • RestDr. Colin Wash advises moms to get enough rest the first 14 days after delivery to prevent gravity from adding more pressure on the pelvic floor.
  • Posture– Maintaining optimal posture the first days postpartum sets you up for an improved pelvic floor and core recovery. Sit and stand upright, as an upright position is optimal to begin exercising your pelvic and deep abdominal muscles.
  • Mindful movement – Be careful of how you move to avoid putting pressure on your pelvic floor. So, instead of sitting straight up to get out of bed, roll to one side. Also, avoid lifting heavy items in the first few weeks postpartum.
  • Start doing your Kegels– You can start to do pelvic floor exercises as soon as you feel ready – even a day after delivery. This circulation increases to the area while reducing swelling. It’s important to note that you automatically use these muscles when you cough or sneeze, so it’s safe to start exercising them as soon as possible. It may be initially hard to feel these muscles because the nerves in the area are overstretched during delivery. Still, keep doing your Kegels. Also, don’t worry if you didn’t start Kegels soon after childbirth. You can begin pelvic floor exercises anytime and will still get to enjoy their benefits. The idea is to start small, that is, 4 to 5 gentle floor contractions while nursing the baby and increasing them over time. A common misconception is that women who had a C-section won’t experience pelvic floor issues. However, the baby’s weight in the uterus on the pelvic floor is enough to cause pelvic floor weakness after delivery. So, Kegel exercises are important for all moms.


Treating Postpartum Pelvic Issues

It’s important to note that most postpartum pelvic symptoms such as urinary and bowel incontinence tend to resolve after several months. But if they don’t, here are several things you can do to prevent postpartum issues:

  • Physical therapy and pelvic floor exercise– Kegel exercises prevent and also treat pelvic floor issues. It’s common for a physical therapist to recommend this comprehensive treatment for these issues. Also, your gynecologist may recommend pelvic rehabilitation therapy. It strengthens the muscles and tissues of the pelvic floor, reducing the symptoms. You can go to a pelvic floor physical therapist, who will check your muscles to evaluate whether they’re responsible for your symptoms.
  • Surgery – Every year, almost 400,000 women in the United States undergo surgery for incontinence or prolapse. Follow up with your doctor after delivery to check for pelvic muscle damage. It may be necessary to have corrective surgery done to ensure your body recovers from the strain of pregnancy and delivery.


Sources

Baby Center, Dr. Colin Wash, Lifespan.org, The Woman’s Center


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