Your Pelvic Floor After The Birth

You’ve done it! After all that preparation and waiting, your beautiful baby is finally here. From this point on, it is very easy to just focus on that little bundle and not to consider your own needs. Thinking about your pelvic floor as soon as your baby is born, and building some exercises into your daily routine from the outset, is vital if you are to ensure that your body recovers fully from the delivery. Most of the damage that leads to prolapse or leakage later on in life actually happens with the first delivery. Having a third or fourth degree tear, a forceps delivery, or a long pushing stage can increase your risk of developing bowel or bladder problems after the birth or later in life.

In the first few days after the birth, you will probably feel a bit bruised and sore.  If you have had stitches or a third or fourth degree tear (a tear that reaches your back passage) then you may feel some pain and swelling too. Beginning your pelvic floor exercises as soon as you can will help the perineum (the area between your vagina and back passage) heal and will reduce some of the swelling. You can’t rip any stitches or do any harm by starting your pelvic floor exercises early. In fact you are more likely to do damage by NOT doing them! If you have had stitches then doing regular pelvic floor exercises can help make your scar heal with more elasticity. This is important to prevent it feeling uncomfortable during sex.

In the early days, try not to spend too long on your feet and make a point of resting lying down rather than sitting. If you begin to ache or feel heavy, or you notice that your lochia (the bleeding you have from your vagina after the birth) increases, you have been upright too long.

Start your pelvic floor exercises by lying down or sitting and make sure you feel completely relaxed. Take a few slow breaths in and out and then, on a breath OUT, gently pull up and in down below as though you are trying to stop yourself passing wind or going for a wee.  When you first start, you may not feel a great deal happening as the area is often numb. Don’t be too concerned about this as the feeling will gradually return over the next few days and you will begin to have some control over your pelvic floor muscles again. At this stage, it is fine to just try a few ‘twitches’ of your pelvic floor every hour or so.

As you begin to regain feeling over your muscles, try to hold on for longer, anything up to 10 seconds. It is very important to breathe normally whilst you hold the contraction and to allow at least 10 seconds in between each exercise to allow the muscles time to relax completely. Over the next 6 weeks you should aim to do them every time you feed your baby but at the very least, three times a day. Once you feel comfortable with this, try up to 10 quick contractions in a row. Again, it is important to breathe normally whilst you do this.

After your 6 week check, if you still find it difficult to feel what is happening, then you can begin to use the Educator. This will help to give you the confidence that you are using the correct muscles. If nothing is happening at all or if any leaking you are experiencing is not getting any better, ask your GP to refer you to a Women’s Health Physiotherapist. You may need to use the Peristim to give your pelvic floor muscles a helping hand.  Your Physiotherapist will be able to show you how to use the machine and then you can take it home to use every day. As your muscles recover, the Aquaflex cones can help to become stronger each day. Start off with a light weight and then gradually increase the weights as your pelvic floor becomes stronger.

By 3-6 months, you should feel as though your pelvic floor muscles belong to you again but it can take some women a year before they feel their muscles have fully recovered.

By Alison Bourne MA (Cantab) BSc MCSP ACPWH

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