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Pelvic Floor Physical Therapy for Moms

100 Comments / Mom Life / By

You don’t have to pee your pants after having a baby.

If you have ever had a baby vaginally or via cesarean, you should go see a pelvic floor therapist. If you had zero complications while giving birth, you should go see a pelvic floor therapist. If you had a traumatic birth and did not receive therapy afterwards, you should go see a pelvic floor therapist. If your baby is 3 months old, 3 years old, or 10 years old, and you did not see a pelvic floor therapist after giving birth… well, you get the idea.

Okay, okay, what the hell is a pelvic floor?

Your pelvic floor is the TRUE core of your body, not that six pack of abs that we all dream of.

It’s a hammock of muscles that stretch from your pubic bone to your tail bone and from side to side. For men and women, it is the support system for bowel and bladder. For women, it is ALSO the support system for your uterus (where your baby grows during pregnancy). Whether you had a vaginal delivery or cesarean delivery, your pelvic floor supported your growing baby throughout pregnancy, and boy does it take a beating. Increased weight on your pelvic floor muscles from your growing baby weakens it. Common pregnancy symptoms begin to crop up such as hemorrhoids, pain, pressure, weakness, etc which starts to become more noticeable as the baby becomes considerably bigger. You might even pee yourself. Then, if you push the baby out, of course you should expect there will be considerable damage to the tissues and internal structures of your body. Or, if you deliver the baby via abdominal surgery, you can certainly expect a different rehabilitative process in addition to the recovery which should happen to your pelvic floor as well. 

Imagine this:

You find out you’re pregnant, and you are hopefully thrilled and exuberant. There are no outward physical signs yet, no basketball belly or crazy food cravings, but you know there is the tiniest flicker of life blooming inside of you. As you grow and as your body changes, you experience novel aches and pains that you may have never had before. Anything from an aching back to pressure in your vagina to hemorrhoids to pelvic pain. After 9 months, you are ready to give birth, and your baby is placed on your bare chest soon after delivery. He/she is beautiful and crying and confused, and you are probably overwhelmed with any sort of emotion- exuberance, happiness, grief, sadness, relief. Whatever you feel at this time, that is your right. The first six weeks pass, and you find yourself at your *one and only* follow-up appointment after birth (unless you’ve had complications since then). A few cursory questions, likely no physical exam unless requested, and you are told to resume normal activities without hesitation. Easy peasy, you think. Grow a baby for 9 months and expect full recovery after a couple of weeks, what a breeze! Except… maybe you don’t feel totally normal after all. You think about the other moms who seemingly are fully recovered even before their follow-up. Those who resume sexual intercourse after only a few weeks. Those who are back to CrossFit and running, yoga and working full-time, hiking long distances and running the household without a hair out of place. So your doctor expectantly asks you, “is everything back to normal?” You say yes, even though you know that you don’t feel normal.

The problem is our healthcare system and our culture tell us that we should be back to normal within 6 weeks after giving birth.

I don’t know a single woman who has given birth and truly, honestly felt completely normal after only 6 weeks.

Women are stamped with badges of honor for being the most busy, the most successful, the most like themselves before having the baby… the most skinny after giving birth, the most physically active. This is simply not realistic or fair for any of us, and it encourages behavior which further causes damage to our already exhausted pelvic floor. 

Here is a radical idea… what if we praised postpartum women for resting, sleeping, eating nourishing foods, soaking in warm baths, and bonding with her baby?

Did you know:

  • You can see a pelvic floor physical therapist therapist (PFPT) even while you are pregnant! Those aches and pains and incontinence issues can be addressed before ever giving birth. A PFPT will be able to provide appropriate exercise, education, and treatment to help make your pregnancy be more comfortable. 
  • You can/should see a PFPT after you are no longer pregnant! There is still much, much healing to be accomplished after 6 weeks. Even if you only have time for one visit to a physical therapist to get checked out, that’s better than none. A PFPT will be able to provide education about your recovery and how to keep you the most safe and healthy while your body continues healing. 

Most types of traumatic physical injury (broken bones, sprains, aches and pains, weakness, surgeries, etc) will lead to a referral to a physical therapist. They will teach you about the affected body part and provide a treatment plan to help rehabilitate you back to normal as safely as possible. They will tell you what to do, what not to do, how to manage the discomfort, and you will receive copious amounts of education to manage your condition. Since having a baby myself, I have wondered why it is that women usually have to request their own referral to see a pelvic floor physical therapist after the most physically intensive and gnarly experience of their lives. With common occurrences such as internal and/or external tissue tearing, bleeding, hemorrhoids, pain, joint laxity, weakness, and so on, it only makes sense that we would see a specialist before resuming “normal activities” after only 6 weeks. Untreated issues with the pelvic floor can lead to prolapse (a body part literally bulging out of your vagina or rectum), constipation, painful intercourse, incontinence, and/or pain in your back, vagina, rectum, and pelvis (just to name a few).  We owe it to our bodies after growing and nurturing a human. We owe it to ourselves mentally and emotionally. It is self-care in the exact sense of the word. I digress.

We, as women supporting one another, have to be the change in the system. We have to talk to our friends about this, especially our friends who are mothers. We have to advocate for ourselves and for our bodies.  It starts with advocating for yourself.

breastfeeding mom
Me after I got home from graduating pelvic floor PT, feeling loud and proud!

My Instagram post the day I graduated <3

Check out my post on The Fourth Trimester and how to prepare for those 3 months following childbirth

What was your most comforting type of self-care in those early postpartum days? Let me know below!

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