After you have a baby, the care and concern over the baby’s well-being is pretty intense. I remember the hours and days following the birth of my first child– it seemed that every hour someone was coming into the hospital room to check her vitals, run some tests, and make sure she was eating well. In order to be released from the hospital, I had to prove that I had a pediatrician appointment within two days of her delivery. Following that, she had a two-week check, followed by a one-month check. Everyone was so concerned about the health of my baby – which do not mistake my point – is incredibly comforting and important, but what no one seemed to be very concerned about was my health as the mother.
After a quick chat with my doctor the day after I delivered, I was told that I should come back in for a check-up six weeks later. Six weeks?! Towards the end of my pregnancy, I was expected to come in for check-ups every few days, but now that this baby had exited my body, no one wanted to check on my health for six weeks? The whole thing seemed very strange to me.
Why was everyone so concerned about the health and well-being of my baby, but no one seemed all that concerned about my health as the mama?
During the birth of my first baby, I had a second-degree tear. At the hospital, I was told that the stitches would dissolve in a few weeks and I would be as good as new. At my 6-week check up, my care provider asked how I was feeling down there. I told her that things were still pretty tender and sore. She assured me that can be very normal and that it would probably get better with time. The problem is that it didn’t. My husband was waiting (as patiently as he could) for that 6-week check because he knew that was usually when doctors give the green light for sex to resume. Since all looked intact, my midwife told me there was no physiological reason that we couldn’t resume intimacy, but to listen to my body and wait until I was ready. We tried and tried, but every time, it literally felt like I was being ripped open again.
There’s nothing sexy about your wife wincing or crying during sex. I was a first-time mom and no one really talks openly about this stuff, so I thought that I just needed more time, that things would get better. I was also experiencing other issues – pain in my low back, pain in my hips, and bladder leakage – all symptoms I also thought were normal postpartum and would fix themselves with time. That October, 6 months after I gave birth, I finally went back to the doctor to see if there was something that I could do.
She referred me to a pelvic floor physical therapist.
I’m going to stop here and do a little explaining, in case, like me, you’re sitting there thinking, what is a pelvic floor physical therapist? Pregnancy and birth take a toll on our bodies and just like any other “injury”, your body may need help learning how to function normally again. And yes, there’s a PT for that! Your pelvic floor is the muscles and tendons that literally hold up your pelvis and keep your pelvic organs in the correct places. In order to grow and sustain a pregnancy, a woman’s pelvic floor has to stretch, her hips have to widen, and her organs have to move. Further injury can occur when a woman physically pushes an infant through the birth canal, although pelvic floor dysfunction is not limited to women who have vaginal births. Because there are so many changes during pregnancy, a C-section mama can have just as many pelvic floor issues.
A normal PT (or any other kind of care provider) may be able to address some of the physiological issues a woman experiences post-pregnancy, however, a pelvic floor PT receives specific training in the function and healing of this specific muscle group and can perform both external and internal therapy.
I was a little nervous to go see a therapist for the first time, which is a little strange seeing as I had just had a baby and had been poked and prodded in all my private spaces for months. I think I just didn’t know what to expect. Because the pelvic floor is responsible for so much, my first appointment was spent assessing all of my issues, talking about my gynecological health history, and answering a lot of questions (bend this way, does that hurt? When I push here, is that tender? Do you ever leak when you sneeze? When you have sex, where does it hurt?…etc). Some of the therapy was external and some was internal. I imagined that internal therapy might feel painful or be a little awkward, but the therapist was so incredibly kind, personable and professional that I immediately felt at ease.
It was nothing like going to the gynecologist – no stirrups or metal tools, and the therapist was great at communicating what was going to happen. Through manual assessment, she was able to determine that some of my muscles were too tight and spasming (literally “kicking” my husband out) while others were weak and not efficiently supporting my core, causing alignment issues and pain in my hips and back. She also had an internal sensor (think computer-like tampon) that she was able to use to gather great data to see what was functioning well and what was not. Each visit, she’d assess both externally and internally to see how things were improving and what still needed work and she’d send me home with weekly exercises and practices. Through manual work and daily exercises, I finally started to feel like myself again. I was able to wear my baby, go for walks, and run around at the park without thinking about how much my hips and back hurt. And my husband and I were finally able to have pain-free (and eventually enjoyable) sex again, which for me was such an important part of reclaiming my life and feeling like myself again.
When I got pregnant with my second child, I thought I’d do everything I could while I was pregnant to stay strong and prevent some of the pelvic dysfunction that I had with my first. I took weekly prenatal yoga classes, went swimming all summer, and walked every day. Despite all of my efforts, after the birth of my son, I still experienced many of the same postpartum pain and issues that I had with my first – only this time I was armed with the knowledge and knew to ask for a prescription for pelvic floor PT at my follow-up OB appointment. My therapist told me that while staying active and doing a lot of stretching and breathing while pregnant was incredibly beneficial to my health and the baby’s health, some women still experience some inevitable pelvic floor issues and some women are more genetically prone to have certain issues than others. She also told me that she sees women while they are pregnant to work on some preventative things. Wish I’d known that!
Before visiting a therapist, I thought what I think so many new mamas think – that my issues were normal, that things would get better with time, and that I just needed to do some kegels to get things back in working order down there.
What I learned after working with a therapist was that while pelvic floor dysfunction is a very common thing after pregnancy and birth, it often doesn’t just fix itself with time.
Here’s what I wish someone had told me before I had my first baby:
- In order to get the care you need, you might have to advocate for yourself. Women’s postpartum health is not the main priority in this country.
- Don’t ignore symptoms of pelvic floor dysfunction. If you’re having residual low-back or hip pain, painful intercourse, incontinence, or diastasis recti (unclosed gap in abdominal muscles), go see a doctor and consider seeing a pelvic floor PT. According to my PT, it is never normal for anyone to experience bladder leakage.
- Not asking for help and ignoring the symptoms can actually put you at risk for health issues later in life.
- Things can get worse with subsequent pregnancies if you don’t get the care you need.
- Sex after a baby does not have to be painful or sensation-less. It might feel embarrassing to ask for help, but intimacy is important and you deserve to have good sex!
- Talk to your friends about this stuff. I bet you’d be surprised to know you aren’t alone in this.
- It’s important to take care of yourself.
 may be able to address some of the physiological issues a woman experiences post-pregnancy, however, a pelvic floor PT receives specific training in the function and healing of this specific muscle group and can perform both external and internal therapy.){kind=link}