Understanding your Postpartum Pelvic Health
There are so many physical sacrifices that your body will go through to grow and birth a child! These sacrifices don’t always have to lead to life long changes to your health. The best way to start helping your body to heal and mend after pregnancy/child birth is to first understand what is going on with your body. Becoming mindful of the changes that have taken place and what your body will be going through in the months to come is the first step to recovering well!
The first eight to twelve days after delivery when all the structures have been very heavily stretched and are in the process of healing. During this period, you must take great care not to do too much. Really concentrate on spending this time BONDING with your new baby and your partner.
The left and right bones of your pelvic girdle are joined at the front by a narrow section of cartilage and ligament. This is called the pubic symphysis, or symphysis pubis. As the pelvic bones loosen during pregnancy, the pubic symphysis can temporarily separate. This is not a dangerous condition. But it can be painful.
While your baby grows during pregnancy, your centre of gravity shifts forward and remains forward in the postpartum period. This typically results in a forward rotation of the pelvic bones, leading to increased load, decreased functional stability and increased wear and tear of the SI joints. The pregnancy hormone relaxin (which we touch on in my last blog), increases the size and elasticity of connective tissues (ligaments, muscles) and will remain in the body for up to five months. This is why a new mother’s joints are so fragile (50% experience back pain) and why any high-impact activity puts tremendous stress on the pelvic floor and the abdominal organs.
Pelvic floor muscles
Speaking of pelvic floor, do you know anything about yours?
Your pelvic floor, in short, is incredible. You engage your pelvic floor when you pee, have sex, orgasm, stand up, sit down, exercise — just about everything! Yet its an area that not a lot of people pay any attention to! It sits like a hammock within your perineal area, connecting to your bladder, urethra, vagina, anus, and rectum. Your bladder, bowels, and uterus rest on it, and crisscrosses front-to-back and side-to-side from your pubic bone to tailbone.
It can move up and down; control the opening and closing of your urethra, vagina, and anus; and it contains a lavish network of fascia and connective tissue. And it’s massively affected by the weight of pregnancy and the trauma of vaginal birth (or pushing before an unplanned C-section), as it stretches, elongates, and experiences soft tissue damage.
See, the pelvic floor is like any other muscle in your body but honestly way cooler because it handles a ton of superpower work. Becoming more mindful and realizing that the pelvic floor is an important part of the body especially for women, you’ll start to see that it reacts, recovers, and deserves attention just like, say, your neck, or bicep.
Here is an easy exercise for you to get started!
Start exercising your pelvic floor muscles when you’re lying on your back. Or you may find it easier to do your exercises in a relaxing bath to begin with.
• Breathe in, and as you breathe out, gently squeeze your pelvic floor muscles. Try not to pull in your tummy muscles. Just focus on pulling your pelvic floor muscles up and in, as if you’re trying not to wee or pass wind.
• Hold the squeeze for four seconds or five seconds, at first, while you continue to breathe in and out as normal.
• If you are tightening your upper tummy muscles (above your belly button) or your buttocks, you’re trying too hard!
Once you’ve got the knack, hold each pelvic floor squeeze for between eight seconds and 10 seconds, while breathing normally. You can start to gentle work your pelvic floor right after you have had baby (if you can remember during those first couple days).
Remember the pelvic floor is used automatically every time you sneeze or cough, so its okay to start working it right after baby!
During pregnancy, the growing uterus in conjunction with pregnancy hormones that soften connective tissue, stretches the muscles in the abdomen. This can cause the two large parallel bands of muscles that meet in the middle of the abdomen (rectus muscles) to become separated by an abnormal distance — a condition called diastasis recti. A mid line of more than 2 to 2.5 finger-widths, or 2 centimeters, is considered problematic. Diastasis recti can occur anytime in the last half of pregnancy but is most commonly seen after pregnancy when the abdominal wall is lax and the thinner mid line tissue no longer provides adequate support for the torso and internal organs. Diastatsis recti reduces the integrity and functional strength of the abdominal wall and can aggravate lower back pain and pelvic instability.
The Pelvic Organs
Your uterus has seen a lot of action, and it isn’t over yet. While recovery from a vaginal delivery versus a C-section will pose different challenges, there are also many similarities: Afterpains, which feel like menstrual cramps, begin shortly after you deliver and last for two or three days. These contractions help your uterus start to shrink to its pre-baby state. Over about six weeks, your uterus contracts to its original size, eventually lowering itself behind the pubic bone.
After a C-section there still may be loss of sensation around the healed incision site due to adhesive scar tissue. This scar tissue goes deeper than just the surface and has the potential to interfere with the mobility of the uterus and surrounding structures.
If you have any questions or concerns about the pelvic pain you are experiencing give us a call at 905-892-1318 to book an appointment with me! (When recovering make sure you are getting clearance from your OB or midwife before seeking out any alternative therapies).
You deserve to live your best life each and every day!
Click here to book an appointment and discover what Mercier Therapy has to offer you!
Nathan Lambert, DOMP