Postpartum Myth Busting and Pelvic Floor Physical Therapy

May
21
2020

You just brought life into this world and are feeling like superwoman; however, this feeling may be halted as you are discovering some things might not be working or feeling as they once did prior to delivery. One of the problems regarding postpartum care is the misconception that symptoms are a “normal” following childbirth whether that be from a vaginal or C-section delivery. Physical side effects of childbirth should not be written off as normal. In fact, Gynecologist and Director of the Center for Chronic Pelvic Pain and Vulvar disorders, Dr. Amy Benjamin, M.D., mentioned that one of the greatest barriers women face during pregnancy and postpartum is the “myth of normalcy.” If your pelvic floor is functioning as it should, then you should be able to maintain bowel, bladder, and sexual function without limitations. Yes, that means you should be able to maintain urinary and fecal continence even when you sneeze, cough, laugh or lift your little one, and intercourse should be a joyful experience with your partner. Unfortunately, common pathologies such as incontinence are often ignored and believed to be a normal part of being postpartum. Or you may hear, “Do your Kegels.” Well, I am here to bust that myth, and let you know that the kegel is not always the answer; in fact, these can make the problem worse depending on the state of your pelvic floor musculature. Incontinence is a very treatable condition and doesn’t need to be a part of your life. Let’s face it; your little one will grow up and want to take on the bounce house. You don’t want to be the mom standing on the sidelines afraid to get in and jump because you may leak urine. Generally speaking, the sooner you seek intervention the quicker your recovery and we want to help you.

Another pregnancy and postpartum concern are Diastasis Recti (DR). A DR is a separation of the connective tissue between your rectus abdominous muscle(think 6 pack muscle). This is fairly common during pregnancy since you need to make room for your little being and should resolve postpartum. Less than a 2 finger width separation is generally considered normal however if it is larger than this your abdominal core support is compromised and you are at risk for other pelvic dysfunction such as prolapse. You want to prevent worsening of this separation and there are several binding or taping techniques; which can be useful temporarily. Another myth is “I have a 6 pack my core is strong, or in order to strengthen my core I need to do a lot of crunches.” This is also a common misconception. In fact, if a DR is present you want to avoid Rectus Abdominous heavy activities (such as crunches and other core movements) as this can worsen your DR. Instead you want to focus on a specifically tailored core program that your pelvic floor PT designs for you depending on your specific case.

Let’s talk about the big one…sexual intercourse. You just had a baby and maybe intercourse is not feeling the same, but this must be normal right? Wrong! Even if you had a C-section delivery you are still at risk for pelvic floor dysfunction. It is believed that you are actually at a higher risk for dysfunction with a C-section delivery than with a vaginal delivery. With a C-section, the doctor will cut through all 4 layers of your abdominal support to retrieve your little one. That creates a lot of instability within the global body system. So in order to stabilize the pelvis, the pelvic floor muscles may take over. This can create a shortening of pelvic floor musculature creating dysfunction within the pelvis and be a cause for pelvic pain. Also, the scar from the C-section can cause dysfunction as the fascia line (connective tissue) inserts into the clitoris, which is the same place as several 1st layer pelvic floor muscles. Essentially, you have a roadblock from the scar which can create unequal pulling as well as making sexual climax difficult and even painful. A vaginal delivery also can cause dysfunction of the pelvic floor muscles. Ladies this may not come as a shock but childbirth is a trauma to the body! Like any other trauma, muscle dysfunction is common as certain muscles can spasm to protect areas or they can become lengthened or even torn during the birthing process. This can also make intercourse painful and climax difficult/ painful. The good news is you don’t have to live with the pain and there is help out there; we want to help you! It is recommended to get cleared by your medical provider prior to pelvic floor physical therapy following the delivery of your child. Generally, the sooner you get in for a pelvic floor physical therapy assessment the better the outcomes tend to be. Schedule your appointment today! We can’t wait to meet you.


MORGAN MYMONPT, DPT

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SouthOCPT May 21, 2020

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