So you've made it through the process of a 9 month pregnancy and have delivered a new life into this world. Congratulations on your new little one! This is such an extraordinary feat our bodies are capable of, and the amazing changes that happen to your body certainly do not stop after labor and delivery. The post partum phase, also known as the 4th trimester, involves so many changes in hormones, as well as physical, mental, and emotional fluctuations. Once your little one is here, so much attention is focused on them, and the focus on the mom is not always prioritized as much as it should be. If you are breast feeding for example, you are continuing to keep this little life alive and your diet and hydration are very important for both you and the baby. You are also having to get up frequently with the baby which significantly affects your sleep and is crucial for healing, hormone regulation, and mental health. This list goes on and on. You may have constipation, leaking urine, or experience frequency of urination. If you had a C-section you are also healing from a major abdominal surgery where 7 layers of abdominal wall have been cut through- this is a big deal! You also could be struggling with a separation of your abdominals, called diastasis recti, due to your pregnancy putting significant stress on the tissues surrounding your belly. Your recovery is so important and should not be put on the back burner. We may need to revisit the saying of, "put your oxygen mask on first before helping others." This should not be taken lightly. Everything listed above is covered and assessed with Post Partum Pelvic Floor Physical Therapy. Let's begin with breast feeding. Yes, this is sustenance for the baby, but the process can be very challenging for your body if you do not put yourself first.
Posture- Prevent Neck and Back Pain:
You may or may not be breast feeding your baby. Regardless, some of this will still apply to you because you are feeding and holding your baby frequently in a lot of these positions. Positioning while feeding your baby is very important for the health of your spine. The right positioning will help with posture and prevent you from getting neck, shoulder, and back pain. It will additionally help with the ability of your baby to latch on and feed. It's an adjustment and learning curve, but it can all be taught with Post Partum Pelvic Floor Physical Therapy, sometimes in conjunction with a lactation consultant. Your therapist will review your posture with nursing the baby. You may prefer one side for these activities which can cause asymmetries leading to dysfunction. You may have difficulty with maintaining ideal posture with these activities because life gets in the way and it takes training for your remember these positions. This is where Post Partum Physical Therapy can be very useful. You will be provided with exercises you can perform before and after nursing or after prolonged positioning with your baby. These activities will help to counter any posture that is not ideal and strengthen the muscles that will help you maintain it. This will all help with your recovery and preventing any neck, shoulder, and back pain.
Leaking Urine, Frequency of Urination, and Constipation
These are three symptoms commonly present Post Partum and are foundational pelvic floor issues that are directly in the Pelvic Floor Physical Therapy realm. And believe it or not, all three are very related to each and have similar treatments. After having a baby there are many physical changes to your pelvic floor and positioning of your pelvic organs. There are additional changes to your nervous system and dis-regulation of the motor control of your pelvic floor and abdominal muscles. These are factors that can lead to potential symptoms of leaking with various activities, feelings of needing to frequently urinate, as well as constipation or straining with bowel movements. These are very disruptive symptoms that can also persist into later life stages. It's always better to start with Pelvic Floor Physical Therapy as early as possible. You can start treatment as early as the first week, but an internal examination of your pelvic floor won't be performed until after you are cleared at your 6 week check-up.
C-sections
If you end up needing this surgery to ensure optimal safety and health of you and your baby, keep in mind that this is a major abdominal surgery. This surgery involves cutting through 7 layers of abdominal wall in addition to internal organs. Recovery after this surgery should not be taken lightly and your rehabilitation is very important. Pelvic PT can play a major role in early treatment, helping with optimal transitions and breathing techniques to decrease stress on the incision. A crucial role of Pelvic PT is in helping to keep scar tissue mobile. Collagen will continue to lay down on the scar for up to a year or more. Early treatment of this is important for internal organ health, abdominal strength, as well as helping you with an additional pregnancy if you make the decision to have another baby vaginally after a C-section.
Diastasis Recti
A separation of the rectus abdominus, otherwise known as the "six-pack" muscle, is a very natural consequence of pregnancy. While Pelvic PT during pregnancy can help to reduce it, some separation will typically occur due to having so much stress put on those external abdominals. Whether you have a higher degree of separation, or just a minor one, Pelvic PT for diastasis recti in the post partum period is important to receive earlier that later. This will ensure that you heal as quickly as possible as your body is recovering. However, once post partum, always post partum! You can receive Pelvic PT at any stage in life and usually experience a full recovery, or at minimum a significant reduction in your separation.
Prolapse
This is yet another natural consequence of giving birth vaginally. You will have a slight descent in your pelvic organs early on due to the major event of pushing a baby out of your pelvis! The bladder is more predisposed to descending lower into the vaginal canal right after delivery. However, you can also have prolapse of the uterus and rectum, these are a little less common. Most do not a have a severe prolapse and there is a lot to do to improve outcomes early on with Pelvic PT. The more likely scenario is to have a very minor prolapse which will naturally heal. However, Pelvic PT will significantly improve this when received early on and help you get back to your activities as quickly as possible by teaching the most effective pressure management of your pelvic floor.
Pain with Intercourse
Again, there are many changes in your pelvic floor and pelvic organ positioning after giving birth and this can potentially lead to painful intercourse. First and foremost, do not push yourself into having intercourse after your six week check-up just because you are "cleared for it." You should make sure it is something your body feels ready for and that you want to participate in. Because of the trauma the pelvic floor muscles experience from giving birth, your body can sometimes have a trauma response with penetration. This means the muscles will feel guarded and not be receptive to this activity. Pelvic floor physical therapy can help you to work up to this with as many tools as possible in order to get back to intercourse not just pain-free, but back to feeling enjoyable.
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