Pelvic Floor Rehabilitation After Childbirth
Have given birth and suffer from any of the following: you have accidents (urinary incontinence), you experience difficulty holding yourself, you know every bathroom and may even avoid joining a trip because you worry you may need toilet stops? If you are reading this, nodding in agreement and identify with one or more of the situations described, you may be suffering from a disorder related to weakness of the pelvic floor. If, in addition to this, you suffer from pain during sexual intercourse, your pelvic floor muscles may be excessively contracted, and we will explain what this all has to do with your recent pregnancy.
Get to know the pelvic floor muscles
The pelvic floor muscles are a deep muscle group forming a hammock shape, located in the bottom of the pelvis, giving it its name. These muscles are part of the sphincter system, for urinary and fecal control alike. They support the pelvic organs, take part in normal sexual functioning and more.
The pelvic floor muscles after childbirth
Pregnancies, births, combined with middle age, pain and various diseases, can affect the functioning of the pelvic floor muscles. During pregnancy, your body undergoes hormonal changes that also affect your pelvic floor muscles, which stretch and weaken. Pregnancy and vaginal delivery may weaken the pelvic floor muscles supporting the uterus, urinary bladder and anus. Weakening of these muscles may cause mild urinary incontinence during sneezing, laughter or coughing. Usually this improves within a few weeks, but sometimes it may have a long term effect. During childbirth, particularly when the infant’s head emerges, the perineum stretches greatly and may sustain tears and cuts of varying degrees, from superficial skin cuts to more significant tears that may cause weakening of the pelvic floor muscles.
Important
Important
During pregnancy it is already recommended to practice strengthening the pelvic floor muscles by contracting them. Exercising during pregnancy and of course after pregnancy and childbirth helps prevent phenomena such as urinary incontinence and prolapse of the pelvic organs (uterus, urinary bladder, rectum). You can exercise while seated, walking and anywhere convenient, but when you start practicing you will usually find it easier to feel the contraction while seated.
Exercise and strengthen the pelvic floor muscles immediately after childbirth
Immediately after childbirth, you can and should start training and strengthening your pelvic floor muscles. The exercise does not damage the sutures (stitches), if you have had any, but increases the blood supply to the area, promoting healing. The exercise can even reduce pain caused by the sutures.
The exercise stages
Emphases for the exercise
- It is important to take care to rest between one contraction and the next. Rest for at least the contraction duration: after contracting for 3 seconds, rest for at least 3 seconds.
- Try to make sure not to stop breathing during the exercise. A good way of doing so is counting out loud for how long each contraction lasts in seconds: 1, 2, 3 and so on.
- Try to combine the contraction of the pelvic floor muscles with each exertion that you make during the day: when you lift your infant, when you work out, cough, laugh or sneeze.
The clinical treatment of pelvic floor muscle rehabilitation
If you have tried practicing as above and feel no improvement, do not hesitate to ask for help. The first stage on the way to treatment is to consult your gynecologist, who will sometimes refer you for an investigation by a physician in the urogynecology field, who deals with dysfunction of the pelvic floor in general and dysfunction of the urinary bladder in particular. The medical authorities will also refer you to a physiotherapist who is especially trained or who specializes in pelvic floor physiotherapy. This is the first line of treatment for urinary incontinence disorders.
The clinical treatment for pain during sexual intercourse after childbirth (postpartum dyspareunia)
Pain and difficulty in sexual intercourse can also be solved by physiotherapy. If you suffer from pain during sexual intercourse, related to birth or otherwise, you should know that physiotherapy for rehabilitation the pelvic floor works on reducing pain by relaxing the muscles, both through relaxation practice and techniques and by manual intervention. The treatment is internal but is not painful, as its purpose is to reduce pain. The treatment is done by a licensed physiotherapist who has had special training, and according to each individual’s progress rate. Based on experience gained in the clinical world, these treatments are effective and usually help reduce the pain within a small number of sessions.
You may be ashamed or fearful, but it is natural and understandable, but it is a pity that you should suffer when there is a readily available, effective and proven solution that can relieve pain and improve your quality of life.
Financing physiotherapy sessions for pelvic floor rehabilitation
The treatments are covered by the basket of health services and are obtainable through your HMO, at physiotherapy centers nationwide. When you book an appointment, remember to ask for a physiotherapist who has been trained in pelvic floor rehabilitation.
