Childbirth and your pelvic floor

What’s normal, what’s not and how to keep your body strong and pain-free

A woman’s body goes through an incredible physical journey during pregnancy. Pregnancy, as well as the labor and delivery process, requires your abdominal and pelvic floor muscles to stretch and support your growing baby. But after baby arrives, mom can be left with a few issues that, unfortunately, many doctors won’t proactively address.

We may joke about moms peeing every time they sneeze, but it doesn’t have to be that way.

You don’t have to live with wearing a pad whenever you do jumping jacks, experiencing pain during sex or having a stomach “pooch” because you can no longer engage your abs.

To find out what moms can do to prevent and address these issues, we consulted Sara Reardon (aka The Vagina Whisperer), a pelvic health physical therapist who specializes in the treatment of pelvic floor dysfunctions and a mom to two boys, ages 3 and 1. “I wanted to help people who didn’t know where to get help—or that there IS help,” Sara said. “I love working with patients and bringing awareness to this area, as a therapist and as a woman who recently gave birth too.”

While she strongly encourages moms to consult a physical therapist throughout pregnancy to prevent pain, prep for childbirth and head off postpartum issues, she also shared five tips for new moms in those first three months after birth:

1. See a physical therapist within four to six weeks after delivery. The American College of Obstetricians and Gynecologists just released new guidelines recommending a postpartum check-up with your OBGYN within three weeks after birth as well as ongoing care, rather than the current one-and-done six-week appointment. While this is great progress, many doctors don’t go into detail about pelvic floor muscle recovery—and you don’t have to wait until issues crop up to see a PT. Check with your insurance about coverage, get a referral if needed and book an appointment. In countries like France, pelvic floor therapy is the norm for new moms, not just something you do to fix issues or do “damage control.”

2. Move your body. Start with walking the day or two after giving birth. If you need to break it up, go for two shorter walks. The key is to listen to your body. Many moms think exercise needs to be a full-out-or-nothing thing, but gentle movement has so many benefits: it increases blood circulation, promotes healing and boosts mood.

3. Practice diaphragmatic breathing. Slow, deep breathing that expands the belly also relaxes the pelvic floor and will help you connect with those muscles. It can also help you relax, which encourages letdown while breastfeeding. This breathing can be used while performing kegel exercises. Focus on exhaling and contracting your pelvic floor muscles to build that mind-body connection.

4. Engage in safe, functional movements. Moms have to move, lift and bend all day long. Bring mindfulness to your daily movements, like lifting your baby out of the crib and carrying the car seat, and use proper body mechanics to protect your healing muscles.

5. For moms who had c-sections, perform scar massage on your incision. Some moms experience numbness or sensitivity around their incision. Start by gently touching a few inches away from your scar. You can use a cotton ball, washcloth or makeup brush if you’d like. Then at a few weeks postpartum, move to massaging over the scar itself. This type of massage prevents scar tissue restriction, an issue that can contribute to pelvic and back pain, bladder problems and painful sex.

And what does Sara suggest new moms avoid? High-impact activities, like running and CrossFit. “I know new moms are anxious to get back to ‘normal’ and feel like ‘themselves’ again, but especially if you haven’t seen a therapist, it’s important to learn (or relearn) HOW to do exercises and modify them if needed to promote stability and strength,” Sara said. Proper form and muscle engagement is crucial to protecting your body as it changes in that newly postpartum period. In the meantime, yoga is a great option for practicing breathwork, core engagement, relaxation and self-care.

When it comes to your pelvic floor, it’s normal to experience some bleeding, discomfort and vaginal or c-section incision pain in the first weeks after birth. However, some things aren’t so normal and should be addressed by a healthcare provider, including:

  • Persistent pain that lasts more than six weeks after birth
  • Pelvic pressure, or a feeling like something is “falling out,” which may be a sign of prolapse
  • Painful sex
  • Urinary incontinence

No matter what type of pregnancy, birth or postpartum experience you have, be proactive and use the resources available to you. If something doesn’t feel right, look into it. So many moms simply suffer in silence, but you don’t have to live with pain, peeing, pelvic pressure, or a pooch. While a new baby requires a lot of time and attention, take care of yourself. You’re worth it.