Common Pelvic Floor Issues Part 1

Congratulations on your newborn! As someone who is going to have their first baby in four months, my mind is still trying to wrap its head around how a little human is going to come out of me – but you are proof that it can be done! It’s amazing how powerful women’s bodies are to be able to grow this little human inside of you, push them out, and then somehow still continue function while taking care of this new person on little to no sleep.

Sometimes though, our bodies just need a little more guidance with recovering (in France, the government believes that everyone would benefit some more guidance as all women postpartum receive free pelvic floor physiotherapy).

Today’s post will talk about three common pelvic floor problems to look out for after having a baby. Part 2 will be about five things you can do for a healthier pelvic floor postpartum.

But first, what are some common problems that can happen postpartum?

Stress Urinary Incontinence (SUI)

• You might have this if you have urinary leakage when coughing, sneezing, laughing, jumping (trampoline park anyone?), running, or going from a sitting to a standing position

• You might leak a little, or a lot – either way, SUI is often due to weak pelvic floor muscles.

• It’s not a surprise that they may be weak after giving birth, especially after a vaginal delivery – the muscles were being stretched a lot! The good news: they can be strengthened

• 3 out of 10 women have SUI in the first 3 months postpartum1, and this tends to increase with age2

Pelvic Organ Prolapse

• This is when your vaginal wall starts falling in towards itself – this can happen at the front (with your bladder pressing into the vaginal wall), at the back (with your rectum pressing into the vaginal wall), or from the top (with your cervix/uterus pressing dropping downwards into the vaginal wall)

• 4 to 5 out of 10 women have this, but fortunately it only causes problems in 3-6% of women3

• If you have symptoms, you may feel a heaviness or downward pressure in your vagina, a feeling of something bulging out your vagina, or difficulty fully emptying your bowel or bladder. It does not usually cause pain.

• Over-stretching of the vaginal wall, pelvic floor weakness, doing things that put too much pressure downwards on your pelvic floor (e.g. straining for a bowel movement) can lead to this

Pain With Sex

• Pain or discomfort with vaginal intercourse postpartum is not uncommon, especially if you had severe tearing, an episiotomy, instrumental delivery, or if you already had pain with sex prior to your pregnancy

• For those who had a vaginal delivery (no episiotomy or instrumentation), one study found that 3 out of 10 women had pain with sex at 3-months postpartum, 2 out of 10 at 6-months postpartum, and 1 out of 10 at 12-months postpartum4

What can you do about these issues?

Stay tuned for Part 2 on five tips for a healthier pelvic floor.

That being said, if any of these issues are very disabling for you, or you have been struggling for a while with them, I would encourage you to see a pelvic floor physiotherapist for more individualized guidance.

References:

1. Woodley SJ, Boyle R, Cody JD, Mørkved S, Hay-Smith EJC. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2017.

2. Dumoulin C, Hay-Smith EJC, Mac Habée-Séguin G. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2014.

3. Barber MD, Maher C. Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J. 2013 Nov 19;24(11):1783–90.

4. Rosen NO, Pukall C. Comparing the Prevalence, Risk Factors, and Repercussions of Postpartum Genito-Pelvic Pain and Dyspareunia. Sex Med Rev. 2016 Apr;4(2):126–35.