What Pelvic Health Issues May a Woman Experience Pre- and Post-Partum?

Here are some of the more common conditions a woman may experience during and after pregnancy. 

Diastasis recti abdominus (DRA or ‘Mummy Tummy’):

DRA is when there is a separation of the rectus abdominus muscle (commonly referred to as your “abs”). As your baby grows during pregnancy, these muscles begin to stretch (which is normal). But, for some women, a DRA persists and can compromise functional core strength, leading to low back pain, a protruding belly and prolapse. Learn more here.

Pelvic girdle pain (PGP):

PGP is when pain occurs around the pelvis, lower back, hips and/or groin area as a result of imbalances in their pelvic and hip muscles. About 20-25% of pregnant women experience PGP, so if you are, you’re not alone!

Incontinence

During pregnancy, women gain weight from both the baby, and internal changes such as an enlarged uterus and increased blood volume. This extra weight places increased strain and pressure on the bladder and pelvic floor muscles, resulting in an increased risk of urinary incontinence (involuntary leakage of urine).

Perineal tears after vaginal birth

Pelvic floors have an incredible capacity to stretch and accommodate for a baby throughout the delivery process. Despite this, these tissues are still susceptible to injury (whether spontaneously as a tear or secondary to a controlled episiotomy). This injury most commonly occurs at the perineum, which is the space between the vaginal opening and the rectum. The perineum plays a key role in maintaining the stability of the pelvic floor musculature. When it's damaged, this can lead to a variety of challenges, including painful intercourse and incontinence. Learn more here

Returning to exercise

Getting back into exercising after giving birth can feel overwhelming and daunting. There is so much information (and misinformation), that can make it difficult to navigate what to do and not do. Can I exercise or do I have to wait at least 3 months? Can I do sit-ups or core work? Should I avoid lifting anything heavy? The truth is: there is no one answer or one-size fits all approach. Every woman’s body and response to carrying a child is different – and every individual has different goals and abilities. An assessment with a Pelvic Health Physiotherapist is an important step to starting out on your fitness journey. Contact our team

How Can Pelvic Health Physiotherapy Help Me?

If you’re pregnant, have had a baby, or planning to have a baby, incorporating pelvic health physiotherapy into your overall care plan can be very beneficial. Speaking to a Pelvic Health Physiotherapist , who sees and treats many women at every stage of her pregnancy journey, is a good place to start. Here are a few ways they can help:

1. Assess the health and strength of your pelvic floor muscles

In order to truly know the state of the pelvic floor muscles, an internal vaginal/rectal evaluation is required and highly recommended. During this exam, the Pelvic Health Physiotherapist will assess if your muscles are too tight or too weak. Based on this, they can tailor a plan to help you bring better balance to your pelvic floor and increase its strength and flexibility.

The prenatal period is a great time to learn how to properly recruit and use the pelvic floor and inner core muscles – and this knowledge can be used in the postnatal period as well. As your due date approaches, your physiotherapist can also help you get your pelvic floor ready for delivery by teaching you perineal massage, as well as discussing optimal labour and delivery positions.

2. Assess for diastasis rectus abdominus or ‘ab separation’

Your Pelvic Health Physiotherapist will also assess the integrity of the soft tissue on your abdomen, which stretches and thins during pregnancy. They will provide techniques to optimize its movement prenatally – and to regain the strength of your abdominal muscles post-natally.

3. Assess for and treat pelvic girdle pain or low back pain

During pregnancy and after delivery, some women experience pain in the pelvic girdle or low back. This can be very painful, and even debilitating, in some cases. A Pelvic Health Physiotherapist can assess the root cause(s) of your pain, treat this pain with education, hands-on techniques, and develop a home exercise plan to help you self-manage your symptoms.

4. Help with scar tissue after a vaginal or Caesarean section delivery

Whether you birthed your baby by C-section or vaginally and had some amount of tearing of soft tissues, scar tissue management is an important component of postnatal recovery. Scar tissue is often less flexible than other tissue and can lead to painful intercourse, bladder and abdominal pain, bowel dysfunction and urinary incontinence. Your Pelvic Health Physiotherapist can help to soften the scar tissue and desensitize the tissues so that you can get back to the activities you love – without the pain. 

How Do We Approach Treatment?

Pregnancy is a profound experience that represents the true power of our pelvic floor! At Proactive Pelvic Health Centre, we’re dedicated to helping destigmatize issues related to pelvic health, and empowering individuals to take control of their bodies. We are proud to have created a safe, comforting and positive space for our clients to talk about their pelvic health, and connect to solutions to regain confidence and control.

Our approach to treating pre- and post-natal pelvic health issues is holistic and evidence-based. Before pelvic floor treatment begins, your Pelvic Health Physiotherapist will take your full medical history and thoroughly discuss your current problems and symptoms. They will then conduct an initial assessment (preferably in your second or third trimester) and then a post-natal assessment about 6-8 weeks after childbirth (once your midwife or doctor has given you clearance to resume regular activities). Your treatment plan will be personalized to your needs, goals, and abilities.

A variety of techniques will be used, as detailed in the section above, to help optimize the health of your pelvic floor and inner core and help you reach your goals.

Additional Resources:

Check out our YouTube videos to learn more about the role of the pelvic floor in pregnancy. Here are a few we selected: