The weeks and months after a newborn arrives seem to revolve around one thing: baby.
It’s easy to put mama’s health needs aside.
When uncomfortable symptoms creep up—pelvic pain or low back pain, urinary leaking or painful intercourse—many women may choose not to seek health treatment.
Corewell Health pelvic floor physical therapist Ciera Ward—and the whole Corewell Health team of pelvic floor therapists—want to help change that.
“Women will come in and fill out our questionnaire and say, ‘I guess it’s not that bad. I don’t know if I should even be there,’” Ward said. “No problem is too small to work on and no problem is too big to work on. We just don’t have to be living with these symptoms.”
Ward encourages new moms to seek help during pregnancy and in the postpartum period.
“These are things that are very common after delivery, but they’re not normal,” Ward said. “There is a place they can go for help.”
Pinpoint the symptoms
Pelvic floor therapists are specially trained to help address problems involving the muscles, ligaments and tissues that hold the pelvic organs in place.
Needless to say, it’s an area that endures a lot of changes during pregnancy and after childbirth. The effects can linger, making the pelvic floor muscles weaker or, sometimes, even tighter, Ward said.
And it can lead to a host of problems, including pelvic pain or weakness, urinary leaking or incontinence, constipation, lower back pain, painful intercourse or diastasis recti—a separation of the abdominal muscle along the center of the belly.
That’s where pelvic floor therapy comes in.
The team of pelvic floor therapists that Ward works with, all women, meet with patients to identify their symptoms. A therapist may also complete an exam with the patient, which may include an internal vaginal or rectal exam if the patient is comfortable with this.
Once the therapist has an idea of what’s causing the problem, she’ll develop a treatment plan that may include exercises, manual therapy and other non-surgical options.
Incontinence is one of the more common symptoms Ward sees in postpartum patients. This can entail what’s called stress incontinence, or minor leaking when sneezing, coughing, laughing, lifting or exercising.
It could also involve urgency incontinence, the inability to hold urine when you feel an urge to go. This can happen at any stage, from right after childbirth to years later.
Ward’s first message to patients: This is common.
Her second: There are solutions.
“Typically, there is some pelvic floor weakness from the trauma and changes of delivery,” Ward said. “And sometimes the muscles are too tight, which makes them weaker functionally.”
‘It is more talked about now’
Most women think the answer is just to keep doing Kegel exercises, which involve contracting and releasing the pelvic floor muscles.
“Kegels are a piece of the puzzle, but it is not the whole pie,” Ward said. “There is a time and a place when they should be used and when they should not.”
Certain factors can put some women at higher risk for postpartum pelvic floor problems, such as traumatic birth involving vacuum or forceps, family history, a longer second stage of labor, maternal age of 35 or older and C-section scarring.
Pelvic floor therapy is not new, but it is has grown in popularity in recent years, said Jessica Flood, an outpatient rehabilitation supervisor.
In years past, the symptoms experienced by new moms were often accepted as “just the way it is,” Flood said. But it doesn’t have to be that way.
“It is more talked about now,” Flood said.
And pelvic floor therapy isn’t just for new mothers. Women can experience pelvic floor problems even if they’ve never given birth—and therapy can help.
Pelvic floor therapists also treat sexual trauma survivors, menopausal women with pelvic floor changes, children with problems voiding the bowel or bladder, men with prostate problems and many others.
“They can meet the patient where they’re at,” Flood said.
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