Pregnancy and postpartum
Pregnancy and childbirth put many physical stresses onto a woman’s body, potentially causing a range of prenatal and postpartum conditions. Prenatally, a woman may experience urinary incontinence (leakage), or low back or pelvic pain, especially in the pubic symphysis or in the sacroiliac (SI) joint. While a woman may develop some of these conditions during pregnancy, the extra stretching and occasional damage to tissues of the pelvis during delivery may worsen her symptoms or cause new ones. A new mother may experience bladder prolapse, uterine prolapse or a prolapse of the rectum. She may also develop bladder or bowel incontinence, difficulty urinating or experience pelvic pain.
If I had a C-section, is there any benefit to seeing a pelvic health physiotherapist?
A woman who undergoes a Caesarean section (C-section) may not experience the same stretching of the pelvic floor muscles as a woman who delivers vaginally, but her body still undergoes a lot of the same stresses. As a result, she may experience many of the same postpartum symptoms that are mentioned above, including pelvic pain. A C-section is also a major surgery that cuts through layers of connective tissue and also impacts the abdominal muscles. Recovering from a C-section means taking time for all the layers of abdominal tissues to heal and then starting to strengthen them again. Some mothers benefit from seeing a pelvic health physiotherapist for assessment of the pelvic floor muscles and to assist with a carefully tailored abdominal strengthening program.
I am worried about a diastasis – should I be?
Postpartum, some women are concerned about a diastasis rectus abdominis (DRA). During pregnancy, our abdominal wall needs to stretch to accommodate the growing baby. This means that the connective tissue that runs down the centre of the abdomen (the linea alba) stretches too. Once the baby is delivered, it takes time for all the stretched abdominal tissue to regain strength. Some women will notice a doming or a sunken appearance of the linea alba when they lift their head, as in a sit up. While stretching of the linea alba is a normal part of pregnancy and may take a while to strengthen postpartum, some women benefit from the guidance of a pelvic health physiotherapist to regain their abdominal strength and return to the activities that they enjoy.