The 4th Trimester: Postpartum Pelvic Floor Health

Pregnancy pelvic floor physical therapy evaluation after c-section; mother trying for VBAC!

Bringing a new life into the world is a wonderful and transformative experience that comes with a range of emotions, challenges, and adjustments. As a pelvic floor physical therapist, I’ve have the privilege or working closely with countless of women after giving birth. I witness their triumphs as well as their struggles firsthand.

Giving birth takes a huge toll on a mother’s body. Sadly, postpartum care often falls short of addressing the unique needs of new mothers. One critical issue that often goes overlooked is the lack of emphasis on pelvic floor rehabilitation prescribed by physicians. I personally believe that all new moms need to get evaluated by a pelvic floor physical therapist. All moms deserve the best care out there! If mom isn’t taking care of herself, how can she be her best self to take care of her kid(s)?!

While focus is understandably on the baby’s health, it is essential to not neglect the well-being of the mom! Pregnancy and childbirth place significant stress on the pelvic floor muscles and surrounding structures, leading to a range of issues such as urinary or fecal incontinence (leaking urine), pelvic pain, pelvic organ prolapse, and diastisis recti (abdominal separation). These struggles can persist long after childbirth and impact one’s quality of life.

Pelvic floor physical therapists (PFPTs) can help strengthen the muscles of the pelvic floor and core, which become weak after labor and delivery (yes, the pelvic floor is affected for BOTH vaginal and c-section births). This alone can significantly decrease the risk of pelvic organ prolapse and diastisis recti! PFPTs can also help manage pain that comes with giving birth whether it’s low back pain or pain with intercourse. During labor and delivery, physicians may perform an episiotomy; there also may be tearing that occurs from pushing, or some moms need to have a c-section. All of this results in a scar. Scar tissue needs to be desensitized and mobilized in order to prevent pain and decrease the risk of further discomfort. Working on your scars also helps to prevent functional mobility deficits and unlocks those lower abdominal muscles a bit more.

Every woman will have a different postpartum journey. I’ve seen some women bounce back after a few months, but I’ve also worked with women who need more time... up to 1.5 years! This is where the value of PFPTs truly shines. We can create individualized treatment plans that are tailored to a mom’s specific needs and goals. I’m not going to have the same plan of care for a mom who had a c-section delivery and a mom who had a vaginal delivery. These customized plans empower mothers to regain their physical strength, enhance their overall well-being, and foster a positive postpartum experience!

Postpartum pelvic floor physical therapy evaluation after c-section