Changes to the Pelvic Floor with Vaginal Delivery
During a vaginal delivery your tissues become stretched to allow for the baby to pass through the vaginal canal. The stretching process leaves the pelvic tissue swollen and bruise similar to a pulled or torn muscle in another region of your body. Swelling and stretching of musculature can result in decreased function of a muscle ultimately decreasing strength. Furthermore the levator hiatus widens to allow for the baby to move through the vaginal canal. Research indicates that levator hiatus widening also results in women who experience a caesarean section thus indicated that a caesarean section does not completely protect against structural anatomical changes of the pelvic floor.
Risk factors for excess widening of the levator hiatus
- Vaginal delivery
- Use of forceps or suction
- Larger baby
- Dysfunctional pelvic floor musculature prior to pregnancy
- Muscle or ligament tear during delivery
What might I experience while my pelvic floor is healing?
How long will it take for my pelvic floor to heal after delivery?
Much like a torn muscle elsewhere in the body, tissue healing takes time. Though tissue healing itself is only 4-6 weeks, most research indicates that pelvic floor musculature will heal within 6 months as it may take up to 6 months to fully regain strength (1,2).
What can I do to facilitate healing and prevent pelvic floor dysfunction?
Similar to any muscular injury it is important to start retraining them as soon as possible. Many new moms may benefit from education and retraining on how to find and use their pelvic floor muscles after delivery. Others may need to relearn how to relax the pelvic floor. Knowing where to start and how to properly perform your exercises is essential for recovery.
Exercises to try after delivery:
- Deep abdominal strengthening: pull belly button towards your spine and hold. Avoid holding breath (hold 3 seconds, repeat 10x)
- Kegals: Visualize stopping the flow of urine and gas as the same time. Squeeze and lift (hold 3 seconds, repeat 10x)
- Walking: slowly progress your time walking outside with your little one
Practical tips for your back
- Try to make sure that when you are changing a diaper or clothing that the table is at waist height to avoid bending at your back
- When lifting up your little avoid bending over to pick the infant you, kneel down and then lift
- More tips in this PDF by www.utexas.edu
What can physiotherapy do for me after postpartum?
A physical therapist will complete a full exam determining what treatment approach will help you to heal and strengthen effectively. They will utilize manual therapy, education and develop a personalized exercise program for you to follow. They will also education you on when you can safely increase your level of exercise.
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Pregnancy & Pelvic Health Physiotherapist in Burnaby BC
This blog was written by Heather Baker, our physiotherapist at Absolute PhysioCare in Burnaby BC. She has completed additional coursework in pelvic health and is an advocate for physiotherapy treatment of incontinence.
If you are experiencing any of these symptoms, or have any questions regarding women’s health, feel free to book an appointment at Absolute Physio Care. Call us at 604-558-CARE (2273) or get in touch with us online!