In this blog when we refer to women/females we are referring to those presumed female at birth.
Setting the Scene
So you’ve done the 9 months, you’ve done delivery and your beautiful baby has arrived into the world. Congratulations!
But now for the rehab part…..
Why is Exercise So Important?
It is recommended that you start pelvic floor exercise during your pregnancy. Why? because there is so much pressure and weight onto the pelvic floor at this time. Pelvic floor exercise helps to prevent bladder leakage and pelvic floor weakness, plus, sets you up ready for the postnatal period.
Anyone who has had a vaginal delivery will need to do some exercise to regain strength in this important part of the body.
It is also recommended that those who have had a caesarean exercise too. You may have laboured before an emergency caesarean which may stress the pelvic floor. The pelvic floor is also needed in conjunction with abdominal muscle exercises recommended for all women after delivery (See our “abdominal separation” or “DRAM” blog).
Meanwhile, the pelvic floor muscles provide support for the pelvic organs. The pelvic organs are the bladder, uterus/vagina and bowel. The muscles help with bladder and bowel control and sexual function.
But I Haven’t Started Exercising Yet…
If you didn’t get going in pregnancy, don’t worry. At any stage of life we can start. Without a doubt, you will be encouraged by all your caregivers to “do pelvic floor exercises” after your baby is born.
But we know that for many women, there is a certain mystery regarding what you should actually do.
The plain fact is, that no one can actually confirm that you are doing the right thing without at least an ultrasound or at best, an internal examination. As Pelvic Health Physios , we have ultrasound available in all consultations. We can always start assessment with ultrasound and the option for an internal examination is there if needed.
Is Pelvic Floor Exercise Safe To Do Soon After the Birth?
Firstly, let’s reassure you that pelvic floor exercise is safe to do as soon as the baby is born. The American College of Obstetricians and Gynaecologists publishes world respected guidelines based on best evidence, regarding exercise in pregnancy and after the birth.
They recommend pelvic floor exercise as soon as you feel able after the birth of your baby.
If your Obstetrician advises a different plan, follow your Obstetrician’s advice.
How Do I Know I Am Exercising Correctly?
When you contract the muscles, they will give a sense of tightening at the bladder, bowel and vagina.
You should feel any of the following sensations:
- lifting
- indrawing
- drawing up
- tightening
- closure
- The feeling is like stopping urine mid -stream (which is a one-off test rather than an exercise to do regularly) or stopping the passage of wind
But, if the muscles have weakened a great deal, you may not feel any of the above! Also, if you didn’t practise before the baby was born, you have nothing to compare with.
It may take time for the muscles to start moving sufficiently to give you those sensations.
You should not feel the following sensations:
- pushing down
- bulging
- bearing down
- opening
- widening
- downward pressure
You can always use a mirror at home to look at the perineum (that’s the area at the entrance of vagina, exit of the bladder and bowel). You should literally see the vagina close and draw up towards your tummy and away from the mirror). If in doubt, come in for a check with a pelvic health physio
But I Have a Tendency to Have a Tight Pelvic Floor. How Should I Exercise?
This is a topic for a blog of its own.
Some people are prone to holding muscle tension in their pelvic floor.
This may have led to painful sex in the past or other pelvic area problems. We also know that women who have had pregnancy related pelvic girdle pain, are prone to pelvic floor muscle tightness. Coccyx pain can link to pelvic floor tightness. Are you someone who holds all the stress of life in your muscles? Pelvic floor may hold stress too.
When muscles are tight, they don’t tend to work properly and can become weak. If you have any concern that you have tight pelvic floor muscles, a vaginal delivery doesn’t necessarily fix this. You will need to learn to relax the muscles before you can strengthen them. Your exercises will have a very different focus in the early rehab days.
If in any doubts about your pelvic floor wellbeing, come in for a check.
