By Dr. Brooke Meinema, DPT, FAFS The pelvic floor consists of a group of muscles…
By Dr. Brooke Meinema PT, DPT, FAFS
Having a baby can be an exciting (albeit terrifying) experience. While we prepare ourselves for the coming baby, we don’t always prepare our bodies for what is to come after delivery. Some individuals may take a birth prep class to prepare themselves for the labor and delivery part, but after delivering the baby, many new moms feel they get left behind. We are all given the time frame for when we can return to activity: 6 weeks for most vaginal deliveries and 8 weeks for most cesarean deliveries. What about after that? Is it safe for me to run again? Why does it feel like my insides are moving around? I’m supposed to be able to have sex again?! So much of our energy is spent trying to keep our new baby safe, happy, and healthy, but that sometimes comes at the expense of our bodies. So let’s dive in to what you can expect and how you can prepare yourself for what is to come when looking to start postpartum physical therapy.
Why do I feel like a snow globe?
What is happening to my organs after delivery? I’ve had one woman describe her abdomen as feeling like a shaken up snow globe: “it feels like my organs are trying to find a new place to settle”. When we are pregnant, our bodies have to shift to create space for the growing baby. Over the entirety of our pregnancy, our bodies adjust to this over the course of months; however, after delivery, our bodies have a dramatic change over a very short time frame. Now, the baby that was taking up all of this space is no longer there, so the rest of the organs can begin to go back to their normal resting positions. This can feel like we are a bit jumbled internally for a period of time.
Let’s talk about sex:
Now that we understand what is happening inside, let’s talk about what we can expect going forward. One thing I talk to many new moms about is sex. Many (but not all) couples look forward to getting cleared to return to sex, which often happens after the 6 or 8 week check-up depending on your provider and type of delivery. While for women some this can be great, others find out it isn’t quite how they remember. After delivery, our hormonal levels quickly decline and can decline even more if the mom is breastfeeding. These hormones help to produce vaginal moisture and keep the tissues plump and happy. As you can imagine, decreasing the hormones decreases the moisture, and, well, things can get a bit dry. Knowing this beforehand can help make the transition to sexual activity a bit easier. Lubrication is your friend postpartum!
Unfortunately, vaginal dryness may not be the only obstacle to overcome. Some deliveries may result in tearing, which can lead to a bit of discomfort during intercourse due to pressure on the scar tissue. If this is creating an obstacle, a dilator or pelvic wand may be able to help, but many others find seeing a pelvic floor therapist can be very helpful for reducing discomfort and helping to ease back into things.
Similarly, some women experience muscle tension and guarding following delivery. Delivering a baby can be traumatic for the muscles in the pelvic floor. These muscles respond just like any muscle does to a strain or painful experience: spasm. Some women experience feelings of tension, pain, and guarding, and this may make returning to sex that much more difficult. Working to reduce tension, open up the hips, and reduce this strain is key. Once again, pelvic wands and dilators can help, but seeing a pelvic floor therapist to address this can be greatly successful for this!
Why am I leaking?
Some women experience leaking after delivery (or even beforehand; there is a lot of pressure going on around your bladder!). As mentioned, your pelvic floor muscles have undergone a lot of stress and trauma, so they may not function how we want them to. Just because this is common, it does not mean that it should be considered your new norm. If you are leaking, seeing a physical therapist to assess your strength, tension, and pressure management can be very helpful.
*For more on leaking, see the previous blog about bladder health.
When can I get back to normal workouts?
Exercise can be a tricky thing to give a hard and firm answer on. Every person’s body recovers differently, so while one person may be able to jump back in to running or HIIT right away, it may take months for someone else. A good rule to stick by is to follow what your body is telling you: if something doesn’t feel quite right, you should probably wait and work up to it. Most women will have some signs of a diastasis recti early after delivery (look into our earlier blog on this for more info), which can make certain core exercises discouraged for a period of time until this is improved, while others may have feelings of heaviness in their pelvic floor, which can make most exercise uncomfortable. Expecting your body to be able to jump right back into your previous hobbies is likely not realistic; gains take time, and allowing your body some grace is really important. An important note to make on all of this: I am certainly not saying don’t exercise! Postpartum exercise is so important for your recovery! My goal is to encourage you to take the steps necessary to return to your regular hobbies in the time your body needs. If you aren’t making progress like you would expect, reach out! We are trained to help people return to their regular hobbies and daily living!
*Please note: I am not a representative for any of these companies. These are brands that I have had people report positive results from and have been able to get a discount code from the company. Each person’s body responds differently, so be sure to look up any ingredients they may have to make sure they work for your body.
- Sliquid: discount code MP20 for 20% off
- Good Clean Love: discount code SAMPLES30 for 30% off
- GoLove (CBD infused lubricant): Save $5 with code comfort
- Desert Harvest: no promo code
- Intimate Rose offers both dilators and wands on their website: save $5 with code BROOKE7
- Milli is an expandable dilator with vibration options: save $30 with code Brooke30
- Ohnut: save $7 with code BROOKE7