Pelvic Floor Postpartum Care- Do you need it?

If you’ve just had a baby, or you are just about to, then maybe, if you have a really great OB/GYN or midwife, you’ve heard of pelvic floor physical therapy . But do you really need PT for your HooHa?

Let’s go over some basics to help you decide.

What is my pelvic floor?

Our pelvic floor is a group of muscles at the bottom of our pelvis. They are shaped like a hammock that holds a number of important things in place. Specifically, the pelvic floor is responsible for:

Body Functions –muscles help us control eliminating waste from our bodies (AKA poop and pee)
Sexual function – helps with lubrication, arousal, penetration, sensation, and orgasm
Support – connective tissues (fascia), muscles, ligaments, and bones that hold things in place structurally. Without this network of supports everything falls out the bottom.
Lymphatics – pumping and regulating fluid flow through the whole body, but particularly in the pelvic region

So, it’s pretty important. It’s amazing that we don’t learn much about it in health class (or anywhere else for that matter). But in general, most people don’t.

Why would Pelvic Floor Physical Therapy help?

So now you have at least some idea of what the pelvic floor does. It also- and this is really amazing- It stretches and moves out of the way to allow an entire baby to pass through. Through an opening that usually is only big enough for, um let’s say a cucumber.

When that happens- there is at least some tissue damage. Kind of like your Vajayjay got sprained. Sometimes it can be worse, depending on what actually happens during delivery.

Now, we know that a sprained ankle, or a recent knee surgery will recover more quickly, and be stronger with more flexibility if you go to Physical Therapy. But that kind of physical therapy just doesn’t sound appealing for sore and tender lady bits.

Fortunately, I assure you- it’s not the same.

How do I know if I need Pelvic Floor postpartum care?

There are generally two lines of thinking.

I know that childbirth significantly affects my body, and I would like guidance about the best ways to help it heal to make sure I get the best results.
Childbirth is a common and natural event and it should heal well on its own. I don’t think I need any help, unless I start to have some problems.

If you are more in line #1- you can have an initial visit with a pelvic floor therapist any time after your delivery. In some countries Pelvic Floor PTs are actually seeing patients while still in the hospital. They provide guidance for self care, lifting strategies, safety, etc. Early visits to an outpatient clinic- within the first 6 weeks after delivery- will help you with questions, start gentle muscle rehab, help you manage pain, help with problems and questions about supports and strategies to manage while you heal. (in case you are wondering, a trained therapist may inspect your vulva, any wounds or stitches, and perineum, but will not do an internal muscle check until after 6 weeks)

If you are more in line #2- you are not alone. Choosing to wait doesn’t mean you’ve missed your chance if something comes up later. While sooner is better to address problems, women can improve even if it’s been years since childbirth. Below is a list of things that can begin after childbirth, and can significantly improve with pelvic floor physical therapy.

If you are having problems with leaking urine, or stool

If you are straining to go- either pee or poop

If you feel heaviness in your pelvis when you stand, walk, or exercise

If you have pain in your back or hips

If you need help to safely return to exercise

If you have concerns about your belly- bulging, weakness, pain

If you had surgery, such as a C-section or episiotomy

If you have concerns about returning to intimacy

If you have pain with walking- and need to hold on to things just to take a step

If you have had tearing or stitches

If sex is painful

If you worry that you are hurting yourself doing every day things, or caring for your baby

If you have questions- about anything “down there”

Most OB/GYNs will see a new mom for a follow up visit 6 to 8 weeks after delivery. Doctors want to determine whether mom is healing, and will either release her for “regular activity” or identify if there is a problem. If you are experiencing any of the symptoms noted above, please discuss them with your doctor, or call a pelvic therapist directly.

In 38 states, including North Carolina, you do not need a referral to see a physical therapist- including pelvic floor PTs.

If pelvic floor postpartum care is important, why am I just hearing about it, now?

Good question. We do not talk about our cha chas. In fact we have a tons of words we use to avoid talking about them. Even when we are talking to a doctor, conversations are brief and can be awkward.

Many doctors don’t refer to pelvic floor PT unless it is an extreme case. That can be partly because they know that it can be difficult to find a qualified pelvic floor therapist. And partly because they may not realize all of the things we can help.

Pelvic Floor Therapists are specialists in all things “pelvisy”. I mean, all of the things that connect with, stabilize, and help control the structure of the pelvis. This includes the abdominal muscles, back muscles, the spine, the bum, and all the things in the hot pocket.

So if you have some concerns, if you had a difficult delivery, of are just looking to be your best after childbirth, an assessment from a qualified pelvic floor therapist might be just the thing that helps you turn your angry snapper back into a cupcake.

I help women with pelvic floor postpartum recovery so they can feel confident about doing all of the things that we, super women can do to care for our families and ourselves. I have an outpatient clinic in Winston Salem North Carolina, and provide in person as well as telehealth treatments. Relief Is Possible.