Any woman who delivers her baby vaginally will experience a number of changes to her pelvic floor. It’s all part of the birth process, and it’s unique to each mother.
“Birth is as different for every woman as pregnancy is, and what you experience afterward during recovery is just as different,” said Patricia Calhoun, MD, FAAFP, medical director of Women’s Health Strategy at Baptist Health.
The pelvic floor is a group of muscles and ligaments that stretch across the pelvic bones. It supports all your pelvic organs, including your bladder, bowels, uterus, and vagina.
“It encompasses all the female muscles that help us control our urine, control our bowel function, and also contribute to our sexuality,” said Dr. Calhoun.
During vaginal childbirth, pushing seven to eight pounds of baby out through the pelvic floor can, unsurprisingly, put some stress on a mother’s body.
“When that happens, there is stretching of the muscles of the pelvic floor,” Dr. Calhoun adds. “Sometimes there are partial or more significant tears, and sometimes there’s an episiotomy (an incision made in the perineum during childbirth). Fortunately, there’s a lot of stretch down there but when those muscles stretch, they still have to get back to normal.”
While recovering at home, moms may notice some urinary incontinence or discomfort. But Dr. Calhoun says any issues occurring after childbirth should be brought to your doctor’s attention, especially if they affect your quality of life.
“If you’re experiencing urinary or bowel incontinence after delivery, you should definitely talk with your OB/GYN,” she said. “Some other red flags would be fever, unusual pain, or if you’re just unsure whether or not what’s happening is normal.”
For mothers of more than one child, particularly if they were delivered vaginally, keeping the pelvic floor strong is especially important. Dr. Calhoun said with each pregnancy, the weight of the uterus places more strain and stress on the “sling” of the pelvic floor.
“Multiple pregnancies can lead to more pelvic floor and incontinence issues, so it’s important to keep those exercises up,” she said.
So how can new and veteran moms get their pelvic floor back in shape?
“Your recovery may take weeks to months to feel back to normal, and quite honestly, the body may never get back to as tight a pelvic floor musculature as before vaginal delivery,” Dr. Calhoun explained. “That doesn’t mean it can’t be functional and you can’t have continence and pleasurable intercourse, but things are going to be different. I’ve delivered five babies and I understand. Doing pelvic exercises were key for me for long-term pelvic floor health, but you have to do them correctly.”
Kegels are the most well-known pelvic floor exercise, but all the Kegels in the world won’t do any good unless they’re done properly.
“There’s a large number of people who just don’t do them correctly,” said Dr. Calhoun. “That’s why you might want to consider going through a program like Baptist Health’s Total Control. It’s a medical exercise program for strengthening your pelvic floor muscles, lower back muscles and abdominal muscles because they all contribute to pelvic health. It’s an evidence-based program and a no-medication, nonsurgical way to improve issues related to incontinence.”
Total Control is one of many wellness programs offered by 4her Center for Women, a unique collection of educational programs and health care resources for women.
For more information about Total Control and other women’s health offerings from Baptist Health, visit 4her, or call (904) 202.4437.
Good information but it’s important to add that cesarean birthing moms also suffer from pelvic floor dysfunction, scar adhesions and referred pain from those adhesions. For ALL birthing mothers, understanding how the body works and learning how to re-train those pelvic floor muscles in conjunction with the deep core stabilizers will help recover and heal from the effects of childbirth. As a previous Master Trainer for Total Control, I can attest that the program was very good and won’t do harm, but has not been updated for the most recent research which has changed the structure of postpartum pelvic floor and core re-training programs. Nevertheless, so glad to see more awareness and education.