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You may not have thought much about your perineum or pelvic floor before you conceived but now that you’re pregnant (or in postpartum) it may be demanding your attention. We encourage you to listen to Sophie’s interview with renowned women’s health physiotherapist, Sue Croft in episode 380. Sue shares everything you need to know about your pelvic floor in pregnancy and postpartum, including the management of prolapse.
For now, here are five things you should know about your postpartum pelvic floor:
The pelvic floor muscles stretch like a hammock from the pubic bone (at the front) to the coccyx or tailbone (at the back) and from side to side. They support the pelvic organs (the bladder, bowel and uterus), and the urethra, vagina and rectum pass through them. The front group of pelvic floor muscles work to prevent unintentional urination, while the rear group does the same for bowel motions, and together they play an important role in sexual function and enjoyment.
In pregnancy, thanks to weight gain and the weight of your baby, your placenta and amniotic fluid, your pelvic floor is under more pressure. Subsequently, the muscles and tissues stretch and have a tendency to weaken. Pregnancy hormones also contribute to this; they allow your muscles to soften and stretch more easily in preparation for birth.
The pelvic floor muscles work tirelessly in labour and birth, hence it takes time for them to recover in postpartum. Age plays a significant role in pelvic floor recovery; if you’re 35 or older, your muscles won’t bounce back as well as a younger mother (this is relevant to everyone, regardless of how you birthed your baby). However, spontaneous recovery does happen, even when prolapse is diagnosed in early postpartum.
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If you experience a heavy or dragging sensation in your pelvis, this may be a symptom of prolapse. The word prolapse means ‘to fall out of place’ and when we are discussing pelvic floor prolapse, it means one of the pelvic organs (Pelvic Organ Prolapse – POP) sags or may bulge into the vagina. This occurs when the pelvic floor muscles, ligaments and tissues that work to support the organs are torn or stretched, and therefore can’t hold the organs in place.
All bodies are different and likewise, all pelvic floors are different. When you leave hospital or see your GP or obstetrician at your 6-week checkup, they may mention pelvic floor exercises or ‘kegels’. Unfortunately being guided by exercises in a pamphlet isn’t always helpful (sometimes undirected pelvic floor exercises can do more harm than good). A women’s health physio is incredibly beneficial to your postpartum recovery and long-term pelvic floor health; they will explain your pelvic floor to you, highlight any areas of concern and educate you about correct exercise.
If you want to know more, we encourage you to tune into episode 380 of the podcast, where Sophie interviews women’s health physio, Sue Croft about the pelvic floor in pregnancy and postpartum.
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If you’re in the third trimester you’re no doubt thinking about all that’s to come; labour, birth, and a precious newborn baby. There is so much to look forward to and prepare for. But often, we spend so much time thinking of what our baby needs that we rarely think about ourselves. So, we’re here to gently encourage you (read: implore you!) to start thinking about your post-birth recovery. It’s generally quite a slow process and for many women, especially first-time mothers, it can be quite confronting. We don’t want to scare you but research shows that realistic expectations pave the way for a positive postpartum experience
Typically occurring between day 3-5 after birth, breast engorgement is a common symptom in early postpartum when your milk comes. It can also occur later in your breastfeeding journey if your baby sleeps for longer and misses a feed, or drops a feed during the day or night. It can cause your breasts to be full and hard and this can cause pain and make it tricky for your baby to latch. Essentially, your breasts can feel like they’re about to explode which is quite disconcerting.
You may have heard some nightmarish stories about mastitis and frankly, it’s not something you want to contend with at any stage of your breastfeeding journey. It’s most common in the first three months postpartum but it can strike at any time, particularly if your baby has reduced their feeds, is starting to sleep for longer periods at night or you’re weaning.
In early postpartum, breastfeeding and sleep challenges are common and can contribute to anxiety and overwhelm. Unless you have a private midwife, there’s a distinct void of health services in postpartum which makes it challenging to access professional support. It’s definitely beneficial to be aware of this in pregnancy so you can adequately prepare for postpartum.
Firstly, if you’ve recently birthed your baby and your bleeding has increased, don’t delay in seeking medical attention. It’s recommended to present to the emergency department at your local hospital and explain that you’ve recently given birth and you’re concerned about your blood loss. You may be experiencing a postpartum haemorrhage.