With so much pressure to “bounce back” after baby, sometimes we forget that we need time to heal after we’ve gone through this miraculous journey of pregnancy and birth, and that things are going to change in our bodies whether we like it or not. Many mums will find that they can no longer “bounce” around without pain or leaking. Here are 4 things mums need to know about their body after baby.
1. Your abs have parted
During pregnancy, your uterus expands and moves up from your pelvis into your abdomen. As your baby grows, it presses out against your abdominal muscles and connective tissue. The linea alba, which is the connective tissue between the two sides of your ab muscles, stretches to accommodate.
Unfortunately, in 40% of mums, an abdominal separation, or diastasis recti, persists after birth. This separation can be the root cause of back and pelvic pain, and can contribute to bladder and bowel control problems. In fact 66% of women with diastasis recti also experience incontinence or prolapse.
Many mums start doing dozens of crunches and sit-ups in an effort to flatten their “mummy tummy” but what they don’t realise is that these types of exercises can cause the abs to separate more, and cause more pelvic floor issues. It is important for mums to educate themselves about the “right” exercises they should be doing.
2. Your organs have sagged
When the uterus moves up into the abdomen during pregnancy, it places pressure on the bladder, bowel, pelvic connective tissue and pelvic floor muscles. Couple this with the pressures of pushing a baby out of the vagina, it’s not surprising that those pelvic organs will feel like they’re falling out after birth.
Approximately 1 in 3 women will develop pelvic organ prolapse, which is when the pelvic organs sit lower in the pelvis. Women who’ve had a forceps birth have a higher risk of prolapse and bladder control issues. Mums who’ve had a c-section can also develop prolapse, especially of their uterus.
The tell-tale signs of prolapse are not just a physical bulge vaginally; women can also experience lower back pain, lower abdominal pain, a sensation of pressure in their pelvis or dragging and heaviness sensations. Bladder leakage is also directly related to prolapse, as well as changes in the urine stream like a slow flow, or needing to go back for a second wee within 5-20 mins, or feeling like you haven’t completely emptied your bladder. Prolapse can be easily diagnosed and addressed by seeing your women’s health physiotherapist, who can fit you for a support device known as a pessary.
3. Your pelvic floor is weaker
Most women will feel the weakness in their pelvic floor soon after birth. From bladder control problems to bowel control problems, tuning into your pelvic floor sooner rather than later can prevent a lifetime of distress.
37% of Australian women suffer from urinary incontinence. This could be bladder accidents due to urgency known as urge incontinence, or it could be stress incontinence which is leaking with coughing, sneezing, laughing, jumping, running, lifting, and even during sex.
The connective tissue that surrounds the urethra can become overstretched, causing it to flop around when a large pressure comes down on the bladder, such as during a sneeze, resulting in bladder leakage. This means your pelvic floor muscles need to work harder to keep you in control.
Faecal incontinence affects 13% of Australian mums, and is directly related to obstetric anal sphincter injury during birth. Women may have difficulty controlling their wind and their bowel motions, and can be a very distressing issue.
4. Your lady bits hurt
One thing women underestimate is the amount of pain we experience when we become mums. No-one talks about the fact that many women experience pain with weeing, pooping, sexy time and even breastfeeding, not to mention the back pain, pelvic pain, neck pain, shoulder pain, wrist pain, c-section pain, and all those annoying pains associated with having to suddenly look after a 4kg+ load, your growing baby.
Up to 90% of women will have a perineal tear during vaginal birth, so off course there will be pain down there. If she suffers a a 3rd or 4th degree tear, then the anal sphincter muscles have also torn, which then needs surgery to repair it. Mums with anal sphincter injury will often experience pain around the back passage (and faecal leakage) for months after birth.
Regardless of whether you’ve had a vaginal birth or a caesarean birth, scar tissue massage is important for releasing the tight painful tissue. A women’s health physiotherapist can guide you on how to do this, as well as release any other muscles that might have tightened up.
Our bodies do change after birth, and though symptoms like pain, incontinence and prolapse are common, they are not normal. There are solutions for all these issues, and it is important to have a women’s health physiotherapy check-up at 6-8 weeks postpartum or as soon as possible. Mums do not have to resign themselves that they have to live with these problems, and they shouldn’t.
Pelvic Floor Exercises
To find your pelvic floor muscles, imagine you are sitting on the toilet weeing, then imagine stopping the flow of the wee. The muscles that squeeze to stop the flow are your pelvic floor muscles. These are the same muscles we squeeze to stop us from passing wind.
It is really important for mothers to do their pelvic floor exercises to prevent and stop leaking and pain, and to provide support for any prolapsed organs. A healthy pelvic floor is important for overall women’s health and wellbeing. Beyond this, the pelvic floor muscles need to be activating optimally through movement and exercise, and basic tasks like lifting your baby.
Credit: Heba Shaheed is co-founder and CEO of The Pelvic Expert (thepelvicexpert.com), a digital wellbeing platform specialising in maternal, menstrual and hormone health.
Find out more about The Pelvic Expert here