The pelvic floor is made up of a group of muscles and connective tissue that provide support for your spine and pelvis, and for your pelvic organs – the bladder, the uterus and the bowel. The pelvic floor muscles are one of the most important muscles in a woman’s body and are one of the four core muscles. Co-founder of The Pelvic Expert, Heba Shaheed shares how you can restore your pelvic floor after giving birth.
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Common Postnatal Pelvic Floor Problems
After birth, there are a number of common problems that occur in the pelvic floor. It doesn’t matter if a woman has had a vaginal birth or a c-section birth, the pressures and hormones of pregnancy can put a woman at risk.
Women may experience bladder or bowel leaks, back pain, pelvic pain, sexual pain, pelvic organ prolapse, perineal tears and/or abdominal separation. These are all signs of a dysfunctional pelvic floor and core.
Bladder & Bowel Leaks
37% of Australian women suffer from urinary incontinence. This could be bladder accidents due to urgency known as urge incontinence, or it could be stress incontinence which is leaking with coughing, sneezing, laughing, jumping, running, lifting, and even during sex.
The connective tissue that surrounds the urethra can become overstretched, causing it to flop around when a large pressure comes down on the bladder, such as during a sneeze, resulting in bladder leakage.
Faecal incontinence affects 13% of Australian mums, and is directly related to obstetric anal sphincter injury during birth. Women may have difficulty controlling their wind and their bowel motions, and can be a very distressing issue.
Pelvic Organ Prolapse
1 in 3 mothers will experience some degree of pelvic organ prolapse, which is when one or more of the pelvic organs sags down lower in the pelvis. This is due to an overstretch of the connective tissue holding the organ up. After vaginal birth, bladder prolapse is quite common, and could be the root cause of urinary incontinence. Caesarean births can also result in prolapse, but usually of the uterus.
Other symptoms of prolapse include:
– Incomplete emptying
– Slow stream
– Start-stop stream
– Dragging or heaviness sensations in the pelvis
– Lower back pain
– Lower abdominal pain
– A bulge vaginally
– Sexual pain
All pregnant women will develop some degree of diastasis rectus abdominis (DRA) by the end of their pregnancy, and 40% of women still have this abdominal separation at 6 months postpartum. DRA is the stretch of the connective tissue, known as the linea alba, between the two sides of the abdominal muscles.
The presence of DRA can give the appearance of a pooching belly, and 66% of women with DRA will also have at least one related pelvic floor dysfunction, such as urinary incontinence, fecal incontinence or pelvic organ prolapse. Fixing the DRA can sometimes fix the pelvic floor issues, as it is the root cause.
At least 50% (and up to 90%) of mums will experience some type of pain after birth, whether it’s back pain, pelvic pain or sexual pain. Back and pelvic pain are often related to extended periods of carrying, feeding and poor posture, as well as weakness in the core muscles.
Sexual pain can be linked to perineal tearing and scar tissue, as well as to pelvic floor muscles that are tense and non-relaxing. In these cases, it is best to see a women’s health physiotherapist so that she can teach relaxation and release strategies for the pelvic floor muscles.
Pelvic Floor Exercises
To find your pelvic floor muscles, imagine you are sitting on the toilet weeing, then imagine stopping the flow of the wee. The muscles that squeeze to stop the flow are your pelvic floor muscles. These are the same muscles we squeeze to stop us from passing wind.
During pregnancy and after birth, women are encouraged to do regular pelvic floor exercises, because the growing baby and uterus, combined with hormonal changes, creates pressure down on the pelvic floor.
It is really important for mothers to do their pelvic floor exercises to prevent and stop leaking and pain, and to provide support for any prolapsed organs. A healthy pelvic floor is important for overall women’s health and wellbeing.