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The Femina Physical Therapy Blog
Featuring original articles by our staff about current events and trends
Explore our insightful blog articles on pelvic health, where we delve into essential topics that empower and educate. From understanding pelvic floor disorders to strategies for conquering infertility, our content is designed for those seeking knowledge and support. We discuss the latest research, expert advice, and practical tips to enhance your well-being and foster a deeper connection to your body.
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Are Crunches for Diastasis Recti Abdominus a Good Idea? Let's Discuss.
What does the most recent evidence say about the best exercises to rehab from DRA?
Diastasis recti abdominis, more commonly seen as DRA, is an extremely common condition that occurs in almost 100% of pregnant women, and is still present in about 32% of women 12 months postpartum (Theodorsen et al).
This article covers:
- The definition of a Diastasis Recti Abdominus (DRA)
- How to know if you have a DRA
- Dispelling myths about abdominal exercises during pregnancy and postpartum
Read more: Crunches for Diastasis Recti Abdominus (DRA): To Crunch Or...
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Learn How Orgasm Improves Postpartum Pelvic Floor Function
Try a naturally occurring strengthening method
Many factors come into play when considering resuming to sexual activity postpartum. Individuals who have just given birth are not only faced with potentially new physical aches and pains, but also shifting family and partner dynamics, which all play a role in painful sex and lowered sexual desire.
One study reported both of these common postpartum conditions as prevalent as 22% experiencing painful sex and 86% experiencing loss of desire2. It is common in postpartum rehabilitation to be prescribed specific pelvic floor exercises in order to help strengthen the pelvic floor.
Read more: How Orgasm Improves Postpartum Pelvic Floor Function
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What do Breastfeeding women need and want? Let's take a closer look.
You’ve had your bundle of joy and you’re working out the kinks of having a new baby in your life and feeding them the best you can. From breastfeeding to return to exercise, there are many challenges that new moms must navigate.
There are a wide range of feeding options, from exclusively breastfeeding to formula/food feeding or a combination of the two. Studies have tried to get a better understanding of what women need in this stage of motherhood, particularly determining what impacts breastfeeding may have on exercise and activity. We know that breastfeeding causes a depression in estrogen which in turn can cause pelvic floor dysfunction like the involuntary leakage of urine with activities such as sneezing, coughing, laughing or exercise defined as stress urinary incontinence. This type of incontinence has been linked to a longer duration of breastfeeding, however its effects are not lasting (Snyder). Breastfeeding people may also have breast-related discomforts such as nipple pain, mastitis, and over/under supply. Any of these symptoms may limit one’s motivation to exercise.
Read more: What do Breastfeeding Women Need and Want? - No One Told...
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Negotiating Physical Activity for Perinatal Mental Health
Exercise is commonly prescribed as one method to help improve one’s mental health (Ekkekakis 2013, Hu et al 2020, Heissel et al., 2023, Stubbs et al 2018, Vella et al 2023). However, a major barrier to begin an exercise routine can often be lack of motivation and fatigue, which is experienced by those suffering from depression (Faulkner and Biddle 2004, Glowacki et al 2017). Postpartum depression and other mental health illness is quite common, with research suggesting a prevalence of up to 20% in new mothers (Bauer et al 2014). Many new moms are told by health care providers to exercise during pregnancy and postpartum. However, advice and guidance on how to overcome barriers to exercising, including mental health barriers, is not addressed often enough.
Most research is focused on the benefits of exercise for mental health support in the general population and postpartum, but rarely addresses the barriers the postpartum population experiences related to mental health. An online survey by Goncalves et al recently set out to fill this gap in knowledge, exploring how women negotiate physical activity for their mental health and the barriers to participating in physical activity associated with mental health illness. 186 mothers were included in the study, from 6 weeks postpartum up until 4 years postpartum, three main themes were found in this qualitative study: barriers to physical activity associated with mental illness, strategies to negotiate being active for perinatal mental health, and guilt associated with not being active enough.
Read more: Negotiating Physical Activity for Perinatal Mental Health
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Sexuality Changes Postpartum Are Common
Sexual Function After Childbirth Can Be Restored With These Tips
In my last blog post, we explored the barriers many women face during the postpartum period regarding return to their sexual lives. Several physical, emotional, and relational components can delay the return to sexual activity, and the enjoyment of it as well. If you missed that post, check it out here.
A qualitative study of over 1000 women was performed in interview style to collect coping mechanisms new moms adapted to deal with all of the changes that come with the postpartum period that impact their sexuality. The women were found to have three different categories of coping mechanisms: emotional, relational, and physical. Summarized below are the common strategies used by women to recover their sexuality postpartum:
Read more: Coping Mechanisms for Sexuality Changes Postpartum
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Why Sexual Function After Childbirth Can Be a Challenge
Disclaimer: This blog post is based on research performed on cis-gendered women
Many women are told at their 6 week postpartum follow-up, that they are cleared for sexual intercourse, however, most women do not return to sexual intercourse at this time frame, for several reasons1,2. If this is you, you are not alone, and you are actually in the vast majority. During this unique time in a woman’s life, she is experiencing physical, emotional, and relational changes that all influence a woman’s sexuality. Physically, many women experience pain with sex, lack of desire, and decreased lubrication2.
One of the biggest causes found to contribute to these symptoms was hormonal changes related to whether a woman is breastfeeding during the postpartum period or not. While breastfeeding can offer a host of benefits, for mom and baby, it can be a cause of pain with sex because of the decreased sex hormones impacting the tissue of the vagina and vulva2,3, leading to a condition called vulvodynia. For more information about this condition, and if this sounds like you, check out this blog post to learn more.
Read more: Barriers to Restoring Sexual Function After Childbirth
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Does my pelvic girdle pain have anything to do with my mood and sexuality?
Many of our patients experience sexual dysfunction and anxiety, depression and chronic pain. These conditions are known to coexist, and we unpack each component of pain, mood and one’s behaviors, desires and attitudes related to sex and physical intimacy.
Pelvic girdle pain is defined as “pain between the posterior iliac crests and gluteal folds particularly in the vicinity of the sacroiliac joint” (Simonds). More simply stated: in the very low area of your back and buttock. Pelvic girdle pain is common postpartum and may impact disability in the fourth trimester. Many are aware of peripartum symptoms such as low back pain, incontinence, pelvic organ prolapse, pain with intercourse, and postpartum depression. Knowing that many women experience pain during and after pregnancy - what can we learn about the effects of pelvic girdle pain? Specifically, what impact does pelvic girdle pain have on symptoms of mood and sexuality?
Read more: Postpartum Sexuality & Mood Changes in Women with Pelvic...
