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postpartum pelvic health
Image Courtesy of Hollie Santos via Unsplash | Postpartum Pelvic Health

Postpartum Pelvic Health Recovery Should Start Day 1.

Here are some tips to help you get your postpartum pelvic health (and general health) back on track:

This article focuses on 5 key techniques you can use to improve postpartum pelvic health. It covers diaphragmatic breathing to activate core muscles and kickstart lymphatic drainage, pelvic floor muscle coordination, posture, and the benefits of a pelvic floor evaluation by a physical therapist to begin improving postpartum pelvic health on day 1. It also provides detailed instructions and references scientific studies to provide further research.

1. Breathing With Intention

One of the most important recovery tools for postpartum pelvic health is one that we do all day, but are you doing it with intention? Diaphragmatic breathing can help you tap into your deep core muscles and assist in the healing process. When you focus your attention on breathing into the abdomen you activate the muscles of the core (diaphragm, intercostals, transverse abdominis, and the pelvic floor muscles). This breathing technique also helps to assist the pelvic floor muscles in another important job, lymphatic drainage. This can help eliminate excess waste and inflammation to help with healing. This is a great exercise to begin right after birth, when given the OK by your medical provider.

Additional benefits of diaphragmatic breathing were seen in the study by Fiskin et al., 2018, which concluded improved psychological state and increased mother-baby attachment. Not only are you reaping the benefits but so is the baby!

This can be practiced anywhere but may be easiest lying propped up on pillows/sitting

  • Place one hand on your belly and another on your chest.
  • Inhale through your nose (you should feel your ribs move out to the side and also into your back/bra). You will also notice a slight rise of your abdomen.
  • Then, exhale through your mouth.
  • With inhalation, the pelvic floor muscles should lengthen and with exhalation they rebound.

2. Pelvic Floor Muscle Coordination

It’s not just about the kegel anymore!

The Kegel is a contraction or the shortening phase of a muscle. What is also important is the lengthening phase and the normal resting state of that muscle. This is much easier to understand by trying it out yourself.

  • Step 1: assess what your pelvic floor muscles feel like when you are sitting or at rest. Rate it on a scale from 0 being loose to 10 being clenched.
  • Step 2: attempt to do a kegel or pelvic floor muscle contraction. Ex: imagine trying to stop the flow of urine. Now what do you feel? Where are you on the scale 0-10?
  • Step 3: relax and let go of the kegel or contraction. Where are you on the scale now?
  • What is important is that you return to your “normal” resting number on the scale.
  • Currently, evidence supports the use of postpartum pelvic floor exercises to improve urinary incontinence, sexual function, and overall postpartum pelvic health. (Wu et al., 2018 Sobhgol et al., 2018)

3. Get Evaluated

It is important to understand that pelvic floor dysfunctions are very common but not normal! In a study by Lagaert et al., 2017 they found that 40% of women had pain with intercourse at six months postpartum. Another study, Schytt et al., found 22% of women had stress incontinence even at one year postpartum. These numbers are considered high and have become normalized as a part of having a baby. There is considerable evidence to support pelvic floor physical therapy to treat these common issues. Women are often surprised to find out that by simply improving their postpartum pelvic health, they can return to many of the activities they once did without incontinence or pain.

If you have attempted the first two things listed above and are having any difficulty, please consult with a pelvic floor physical therapist. Some additional signs that you may need to see a pelvic floor physical therapist are: pelvic pain, pain with intercourse, urinary incontinence, bowel incontinence, pelvic organ prolapse and other bowel or bladder issues.

Speak with your medical provider about your postpartum pelvic health and seek out a pelvic floor physical therapist. If you are unable to find one in your area many provide telehealth visits as well. Contact us here for in-office or telehealth in California and virtual consultations worldwide.

4. Posture

The “Mom posture” is a common alignment we see in our practice after a woman has had a baby. There are variations depending on how the Mother was carrying, previous posture, carrying of multiples, etc. Most commonly we will see that the ribcage is flared out or not sitting directly over the pelvis. This can affect all the muscles of the core previously discussed.

Easy technique to improve posture for optimal postpartum pelvic health benefits:

An easy way to realign is to place your hands on your ribcage and imagine stacking your ribs over your pelvis. First practice this in standing and then progress to using it when lifting your baby.

5. A Regular Excercise Routine Incorporating Pelvic Exercises

For the greatest impact on postpartum pelvic health, it is important to incorporate all of these techniques into an exercise routine.

Making sure to use your breath, good alignment and proper core activation with all your exercises. It is easiest to start with these techniques separately and once you feel like you have a good grasp on one, start combining them. The end goal is to be able to master all of these and be able to return to your preferred exercise or sport.

To start your own path to improving your postpartum pelvic health, contact us for an appointment here.

 

References

  • Fiskin G, Sahin NH, Effect of Diaphragmatic Breathing Exercise on Psychological Parameters in Gestational Diabetes: A Randomised Controlled Trial, European Journal of Integrative Medicine (2018).
  • Sobhgol, S. S., Priddis, H., Smith, C. A., & Dahlen, H. G. (2018). The Effect of Pelvic Floor Muscle Exercise on Female Sexual Function During Pregnancy and Postpartum: A Systematic Review. Sexual Medicine Reviews. doi:10.1016/j.sxmr.2018.08.002
  • Wu, Y. (Maria), McInnes, N., & Leong, Y. (2018). Pelvic Floor Muscle Training Versus Watchful Waiting and Pelvic Floor Disorders in Postpartum Women. Female Pelvic Medicine & Reconstructive Surgery, 24(2), 142–149. doi:10.1097/spv.0000000000000513
  • Lagaert, L., Weyers, S., Van Kerrebroeck, H., & Elaut, E. (2017). Postpartum dyspareunia and sexual functioning: a prospective cohort study. The European Journal of Contraception & Reproductive Health Care, 22(3), 200–206. doi:10.1080/13625187.2017.1315938
  • Schytt E;Lindmark G;Waldenström. “Symptoms of Stress Incontinence 1 Year after Childbirth: Prevalence and Predictors in a National Swedish Sample.” Acta Obstetricia Et Gynecologica Scandinavica, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/15453888/

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I just wanted to thank you for everything you've done for me for the past 19 months. I literally could not have reached my goals without you and your practice. You gave me the courage to keep moving forth with my treatment no matter how afraid and anxious I was. You were always there to answer questions and made this whole process so much easier than I expected it to be.

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Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

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After having my second baby via C-section I searched for months to try to find help for my lower back pain and separated abdominal muscles. I finally came across Heather Jeffcoat via a mommy blog. I reached out to her via email and set my first appointment. My first appointment went amazing … she listened to what my symptoms, check my separation and explained to me in detail what the next steps would be. Not only did my abdominal separation go from 3 to about 1 -1/2 but my back has pain has significantly reduced. I’m personally recommending all my mommy friends to Heather!

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Testimonial by Fritzette H.

I went to Heather after the birth of my third child. It was lucky, really, that I was referred to her, because my doctor had referred me to a surgeon for a possible hysterectomy or pelvic wall rebuild. Thankfully, I went to Heather before undergoing either surgery, she was able to fix the problem. She has studied extensively in women's health--even written a book about it--and was able to diagnose my problem, suggest a course of treatment (6 weeks), and then follow through with said treatment. By the end, as she said, I was as good as gold. Boy, was it worth it! Though uncomfortable to talk about, much less write about, it is worth getting the word out there. If you have painful intercourse, especially after birth or other trauma, the treatment may be as simple as Physical Therapy (with Heather, of course). I highly recommend her.

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My last appointment with Heather was over 6 years ago but I still think of her every day. I don’t take for granted that I can easily get out of bed, care for my two active and busy young boys, run, play tennis, clean my house, or sit at a desk for several hours at a time. None of these tasks were easy for me before meeting Heather. Eight years ago my car was struck from behind by a tractor trailer that was estimated to have been speeding. I spent 3 years working with different PTs and Drs trying to heal and move on with my life. When I became pregnant and the hormone relaxin that “relaxes” all the joints of the body and the additional weight gain erased all my progress and I was suddenly in a lot of pain again. My OB sent me to Heather for one last try.

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As someone who suffered the debilitating physical and emotional effects of vaginismus (as well as a complicated history of back injuries) for more than 15 years, I thought a "normal" life was just a fantasy. Then I found Heather.

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