Pelvic Floor Therapy After Pregnancy

Often during pregnancy and childbirth, cesarean section ( c-section), or vaginal delivery, pelvic floor muscles can be stretched and sometimes damaged. This can lead to functional problems of the pelvic floor, which can include:

• Urinary incontinence
• Urinary frequency or urgency
• Fecal incontinence
• Pelvic organ prolapse
• Pain with sexual activity
• Scar pain (may be lower abdominal from a c-section or near the vaginal opening from a vaginal delivery)
• Low back pain or pelvic pain
• Diastasis Recti (separation of the abdominal muscles)

Luckily, these issues can be treated through outpatient pelvic floor physical therapy. Our physical expert Dr. Natalie specializes in treating women’s health always perform a thorough patient history and examination with each of patient to help to create the most appropriate and individualized treatment plan. When treating a woman following childbirth, patient education is often focused on where and what the pelvic floor is, as well as its functions. The functions of the pelvic floor are:

• To provide postural support
• To support the pelvic organs (bladder, bowels, and uterus)
• To help control the bladder and bowels
• To contribute to sexual function

Openly discussing with patients their goals for physical therapy is an important step in treating women with pelvic floor dysfunction, as it can be devastating. Some women are afraid to leave the house or take their baby for a walk because of discomfort or leakage. If her goal is to be able to push her baby in a stroller for five blocks, then that is what we focus on.
It is important for new moms to wait at least six weeks after delivery before starting therapy, so their bodies has a chance to heal. Pelvic floor physical therapy following childbirth varies depending on the patient’s complaints and goals, however treatment sessions may include:

• Strengthening exercises for the pelvic floor, legs, or abdominal muscles
• Stretching or relaxation exercises for shortened or painful muscles
• Scar massage
• Coordination exercises 
• Behavioral modifications and patient education
• Biofeedback for strengthening or relaxing muscles
• Modalities such as heat, ice, or electrical stimulation

An important part of pelvic floor physical therapy is homework for patients to work on outside of therapy sessions. By doing exercises and stretches at home, patients can progress in physical therapy more quickly, while learning how to help manage their condition independently.