Is This the New Normal for Your Pelvic Floor?
Just as every pregnancy is different, so is recovery. Length of recovery can vary from woman to woman and from birth to birth. The pelvic floor is dynamic and it is amazing how it can change during pregnancy and childbirth. As a result, some women may experience urinary leakage, pelvic pain, healing following a tear, vaginal bulge, or bowel problems (constipation or leakage) following childbirth.
What Changes Will Go Away and When?
In a study of women following childbirth, the following occurred:
- Vaginal bulge – 3 out of 4 women who experience bulge symptoms 8 weeks after delivery will no longer feel a bulge at 1 year.
- Urinary incontinence – urine leakage related to coughing & sneezing may still persist at 1 year. The good news is that this can be improved with pelvic floor physical therapy specific for women or by using a device that is placed inside the vagina (a pessary). This should be something you bring up with your clinician at your 6-week postpartum visit.
- Constipation improves in over 50% of women by 1 year following childbirth.
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Returning to Physical Activity
When can you return to exercise? It is different for women who had vaginal or Cesarean childbirth. Be sure to ask your clinician* before increasing your exercise. All women can start pelvic floor exercises soon after childbirth. That may help your pelvic floor healing.
*Clinicians include: doctors, nurse midwives, nurse practitioners, physician assistants, pelvic floor physical therapists
It is common for women to become less fit during pregnancy. You should not expect a quick return to the level of fitness that you had before you had your baby. Women who had vaginal childbirth can slowly increase exercise around 6 weeks postpartum, but fitness improvements will vary. The belly muscles stretch a lot. It may take 6 months or longer to reach previous belly strength and function. Yet, there are many benefits to improving your fitness. Remember patience is key!
The Female Pelvic and Reconstructive Surgery clinic is a part of CLS Health. CLS Health is a multi-specialty group with over ninety providers providing comprehensive inpatient and outpatient care in Baytown, Friendswood, Webster, Pasadena, League City, and surrounding areas. For more information, or to schedule an appointment with Dr. Danny Mounir, call 281-993-9817
During and after pregnancy, you may feel you are going to the bathroom to empty your bladder more often. This may also be associated with urge to urinate and possibly even urinary leakage.
In a study of women following childbirth, about 50% saw improvement of urinary urgency at 1 year following childbirth.
In a study of women following childbirth, 60% saw improvement of urinary frequency at 1 year following childbirth.
Urinary incontinence is the leaking of urine that you cannot control. This can happen with physical activities, with coughing or sneezing and/or with feeling an urgent need to urinate.
Leaking of urine with physical activities can occur in up to 25-30% of women following childbirth. This can improve over time, but if it is still present at your postpartum visit, you should discuss this with your clinician.
Control of gas and stool can change after delivery. Accidental bowel leakage is the leaking of stool or gas that you cannot control.
Constipation, or hard stools, can happen for many reasons. Some women can experience bothersome feelings of incomplete emptying of stool or a sensation of stool being stuck. Improving stool consistency, or making it softer, can help.
Constipation improves in over 50% of women at 1 year following childbirth.
Pelvic organ prolapse is when the bladder, bowel, or uterus drop down in the vaginal canal. Symptoms of prolapse vary for each woman and treatment options depend on the level of bother. New sensations of prolapse following a delivery may improve within the first year.
In a study of women following childbirth, 75% of women who feel a bulge improved by 1 year following childbirth.
After delivery, the pelvic floor can experience many changes. The pelvic muscles and nerves have stretched to allow the baby to pass through the birth canal. Most of the time, the muscles recover without any symptoms. Unfortunately, some women have described a sense of looseness and decreased overall sensation. Pelvic floor physical therapy can be helpful to engage and strengthen the pelvic floor muscles.
After childbirth, pain in the vagina or pelvis can occur. Pain may be related to healing of vaginal tissue/muscles following a tear during delivery.
Pain during sex may occur after delivery. This can be due to healing vaginal tissue, thinning of the vaginal tissue due to hormonal changes, or changes in the vaginal canal. Talk with your clinician if you are experiencing any of these symptoms.