Everyone knows that having a child could be painful, but most assume that once labour is over, the hard work is done. Unfortunately, a significant number of new mothers experience pelvic issues after childbirth. Luckily, seeing a physiotherapist can alleviate complications, and prevent future injuries.
What are the risks?
Vaginal birth can impair pelvic health, and postpartum pelvic dysfunctions are common. 35% of new mothers experience urinary incontinence, and 20% suffer from severe pelvic floor muscle injury. This is after normal vaginal birth, when all of the body – but especially the abdomen and pelvis – goes through a lot of physical change and stress. Muscles stretch and weaken throughout pregnancy, and can tear or suffer nerve damage during labour. Complications are not limited to vaginal birth though; mothers delivering via caesarian can also suffer from pelvic floor issues, although it is less likely.
You are more at risk from postpartum pelvic floor issues if you:
- Have twins or triplets
- Have had children before
- Are an older mother
- Suffer from obesity
- Have had pelvic surgery in the past
- Suffer from constipation or a chronic cough
Although pelvic floor issues are common, they are not normal side effects of childbirth, and so symptoms should be investigated and treated. Without proper care, pelvic floor issues can escalate.
What are the symptoms?
Postpartum pelvic floor issues can manifest in several ways, including:
- Urinary or bowel incontinence, including small leaks (for example, when sneezing or coughing)
- Increased urinary frequency or urgency
- Pain during sex
- Pelvic pain in general, which can exhibit in the lower belly, tailbone, or in the lower back
- Pelvic organ prolapse
If you experience any of these symptoms later than six weeks after childbirth, or have any other unusual pain or discomfort, consult your doctor.
How can a physio help?
The simplest and easiest way to treat pelvic floor dysfunction is with the help of a qualified physiotherapist, who can assess the root cause of the problem, and lead you through exercises that help resolve symptoms by strengthening muscles and restoring function. The initial assessment may include an internal exam, which is the best method for determining the condition of the pelvic floor. It may also include some bowel and bladder screening to identify any associated concerns.
Pelvic floor exercises are the best way to strengthen and retrain pelvic floor muscles; these can include kegel exercises, as well as some others focussed on core strength and bladder training. A physiotherapist can also educate you on how to safely return to normal exercise.
In very severe cases, pelvic surgery may be recommended to repair damaged muscles or to rectify organ prolapse.
Physiotherapy isn’t just helpful after childbirth; it can also assist with posture, back pain, breathing techniques and protecting the pelvic floor during pregnancy, which in turn reduces the risk of pelvic floor dysfunction postpartum.