Seeing a physical therapist after giving birth in America is not standard care, but it should be.
In France all women are seen and evaluated by a pelvic floor therapist after birth and often have 6 to 12 weeks of post-partum care. This approach to the care of women in my opinion should be part of every post-partum plan. Rehabilitating the pelvic floor after giving birth either vaginally or by cesarean section should be just as common as rehabbing a knee or shoulder after an injury or surgery to that area.
What Happens to the Body and the Pelvic Floor ?
The body during pregnancy is in a state of natural dysfunction. The body is going through major changes that include ligament laxity, weight gain, postural change, compressing of the abdominal organs as the baby grows, decreased breathing capacity, weakening of muscles that support the pelvic floor. The pelvic region is made up of muscles, ligaments and bone structures just like all other areas of the body. These structures undergo changes during pregnancy and birth. The pelvic floor muscles are so important as they act like a sling that hold up all of the organs in our abdominal cavity as well as support the back. During pregnancy they also have the job of holding up the growing baby, which places tremendous strain on those muscles which results in weakness. Birthing a baby although an amazing experience is very traumatizing to the area. When delivery time arrives these muscles are again taxed as they need to spread to allow for vaginal delivery and are impacted by the incision during a caesarian section. Often women in natural birth experience tearing and require sutures. All this leads to weakness that can have long lasting effects.
A cesarean section involves a very large incision in the abdominal region which results in scarring and can cause problems later down the line from the restrictions in the soft tissue known as the fascial restriction. This can lead to pelvic pain, pain with intercourse and urinary problems. Myofascial Release is an excellent manual therapy that can heal these problems.
Common Complaints Post-Partum
Common complaints post partum are urinary leakage, pelvic pain, back and or hip pain and overall weakness and fatigue. Separation of the abdominal muscle called diastis recti is common occurrence and treatable. Most of these issues are a result of the breakdown and weakness of the core of the body. This a specific group of muscles that need to act in unison and requires evaluation by a trained therapist to determine where the weakness is as well as how the muscles are working together. Return to “core exercise” classes without an individual evaluation can actually create more strain and weakness.
The good news is all of these things can be restored with a little help from a physical therapist trained in Women’s health. Pelvic pain, pain with sex, scarring, leakage when you laugh, sneeze or exercise should not be part of a woman’s “new normal”.
Find a Woman’s Health Physical therapist who can help relieve all of these issues, get rid of the pain and restore normal strength and mobility.