Bringing a new life into the world is a miraculous and joyous experience, but the postpartum period can be accompanied by a range of physical challenges that extend beyond the commonly expected discomforts. Here’s some insight from a pelvic floor specialist and prolapse specialist into pelvic pain after giving birth and potential pelvic floor problems.
Is Postpartum Pelvic Pain Normal?
While certain pains, such as vaginal soreness, breast tenderness, and muscle soreness, are deemed common during the initial weeks after delivery, some women find themselves grappling with persistent or unexpected pains beyond the standard recovery period. Postpartum pelvic pain, though common, should not be dismissed as normal, and understanding its root causes can pave the way for effective solutions and regaining your quality of life with the help of a pelvic floor specialist.
Diastasis Recti: A Common Culprit
During pregnancy, the rectus abdominis muscle undergoes a natural separation at the linea alba, the connective tissue holding it together, allowing the belly to accommodate the growing baby. While this split typically closes after delivery, around 1 in 3 women may still experience a separation greater than 2 centimetres after six weeks. This pelvic floor problem, known as diastasis recti, can compromise the effective functioning of core muscles. To compensate, other muscle groups, such as the hip flexors, low back, gluteal, or pelvic floor, may work overtime, leading to hip pain, back pain, buttock pain, or pelvic floor dysfunction.
Pelvic Instability: The Impact of Hormones
Hormones play a crucial role in pregnancy, affecting not only vaginal tissues but also the pelvic girdle. Relaxin, a hormone released during pregnancy, increases the laxity of ligaments supporting joints to facilitate the expansion of the pelvis for labour. While this is essential for the birthing process, it can result in pelvic instability, especially when combined with weakness, laxity, and changes in posture. Pelvic joints, including the acetabulum, sacroiliac joint, and pubic symphysis, may experience separation due to reduced ligament support. The body attempts to compensate by tightening surrounding muscles and altering posture, potentially leading to hip pain, back pain, tailbone pain, pubic pain, buttock pain, and pelvic floor problems.
Persistent Pelvic Floor Dysfunction
The pelvic floor, a group of muscles shaped like a bowl at the bottom of the pelvis, bears the brunt of pregnancy and childbirth. The increased weight of the baby, postural changes, and the demands of labour contribute to the strain on these muscles. In cases where these muscles are overworked and pushed beyond their limits, pelvic floor dysfunction may occur. This condition manifests as vaginal pain, perineal pain, tailbone pain, low back pain, pelvic pain, anal pain, painful intercourse, painful urination or bowel movements, pain while sitting or exercising. Pelvic floor dysfunction can also present as urinary issues, pelvic organ prolapse, constipation, or incontinence, and must be treated by a prolapse specialist – the earlier, the better!
Seeking Solutions for Postpartum Pelvic Pain
Understanding the causes of postpartum pelvic pain is the first step towards finding effective solutions. For many women, the pain may resolve on its own after childbirth, but for others, it persists into the postpartum period. Seeking professional help from a prolapse specialist or pelvic floor specialist is crucial for a comprehensive evaluation and tailored treatment plan.
Here are some potential solutions:
- Physical Therapy and Biofeedback: Biofeedback-based physical therapy offers a non-medication approach to treating pelvic floor dysfunction. Trained pelvic floor physical therapy specialists guide individuals through exercises, including breathing techniques, muscle strengthening, and relaxation exercises. Biofeedback, often using probes and abdominal pads, provides real-time feedback on pelvic floor movements during simulated defecation, helping individuals retrain their pelvic floor coordination.
- Diastasis Recti Rehabilitation: Rehabilitation for diastasis recti involves targeted exercises to strengthen core muscles and encourage the closure of the abdominal gap. A pelvic floor specialist can create a personalised program to address specific needs and gradually improve muscle function.
- Hormonal and Structural Support: For cases of pelvic instability, addressing hormonal changes and providing structural support may be beneficial. This could involve targeted exercises to stabilise the pelvis, posture correction, and supportive devices such as belts or braces.
- Lifestyle Adjustments: Simple lifestyle adjustments, such as increased water and fibre consumption, improved positioning during bowel movements, and regular exercise, can contribute to overall pelvic health.
- Specialised solutions: In more serious cases, such as pelvic floor prolapse, it’s important to see a prolapse specialist as these conditions do not resolve on their own or with physical therapy. They can assist you with non-surgical solutions like a pessary or microenergy acoustic pulse therapy, or with pelvic floor surgery if needed.
Empowering Postpartum Well-Being
Postpartum pelvic pain is common, but it should not be accepted as the new normal. By recognising the underlying causes and seeking appropriate solutions to this pelvic floor problem, women can empower themselves to navigate the postpartum period with comfort and well-being. Whether through physical therapy, targeted exercises, lifestyle adjustments, or surgery, addressing postpartum pelvic pain with the help of a pelvic floor specialist and prolapse specialist is a crucial step towards reclaiming the joy and vitality that should accompany the arrival of a precious bub.