It’s both safe and advisable to consider pelvic health physiotherapy after childbirth. An initial assessment can be scheduled at any point during the postnatal period. Based on this assessment, your physiotherapist will determine the frequency of follow-up sessions and devise a personalized treatment plan to support you throughout your recovery.

Pelvic health physiotherapy after birth can help: 

• To practice your activities safely: Some activities, such as running and jumping, require strong pelvic floor muscles. To avoid urinary incontinence and genital proplases, it is recommended to do pelvic floor muscle exercises before returning to your activities.
• To treat urinary incontinence and overactive bladder: Pelvic floor exercises improve symptoms of stress urinary incontinence (related to coughing, sneezing, jumping and heavy lifting) in 74% of women. Those exercises combined with bladder training can also reduce symptoms of urge urinary incontinence and overactive bladder (related to incontinence with urge feeling to urinate, frequent urination, and reduced ability to hold urine) in 67% of women.[1]
• To reduce symptoms related to genital prolapse: Genital prolapse occurs when a pelvic organ (i.e., the bladder, uterus or rectum) slips down into the vagina. The main causes of genital prolapses are pregnancy, vaginal delivery, constipation, obesity and chronic cough. All of these risk factors weaken the pelvic floor muscles and other tissues. The optimal support for pelvic organs occurs when the pelvic floor muscles, ligaments, and other associated tissues function correctly. Pelvic floor muscle exercises help to reduce symptoms of genital prolapses, which are mainly a sensation of heaviness or pulling in the vagina, pain in the perineum and sensation of having an overly full rectum.[2]
• To reduce a diastasis recti and improve your core: Approximately 40% of women experience diastasis recti six months after childbirth. The initial approach to addressing this condition involves strengthening the transversus abdominis, which are core muscles. Following this, tailored abdominal exercises can be performed based on individual strength levels.
• To treat perineal pain and pain with intercourse: Following vaginal tears, some women may experience ongoing discomfort in the perineal area. This discomfort is often caused by scar tissue adhesions, leading to pain during daily activities, difficulty with urination or bowel movements, and discomfort during intercourse. Scar tissue massage can be effective in reducing these adhesions. Additionally, pain during intercourse may occur even in the absence of scar tissue, and pelvic floor rehabilitation can help alleviate it. Various approaches, such as pelvic floor exercises to improve relaxation and coordination, muscle relaxation techniques, and stretches for the pelvic floor muscles, can be employed to address these issues.
• To take care of your Cesearian section scar: A Caesarean section can also result in scar tissue adhesions. These adhesions can cause pain and weaken the abdominal muscles. Scar tissue massage can be beneficial in improving flexibility in these tissues.

What to expect at the assessment in pelvic health physiotherapy?

This treatment is appropriate at any time after the birth.

The initial assessment comprises a one-hour individual pelvic health evaluation conducted by a registered women’s health physiotherapist. Depending on the purpose of the consultation, it may include a postural examination, an abdominal evaluation, and a perineal assessment. Additionally, a vaginal assessment may be conducted six weeks post-childbirth.

 

 

References:

1. Dumoulin, C., Cacciari, L. P., & Hay‐Smith, E. J. C. (2018). Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane database of systematic reviews, (10).

2. Hagen, S., & Stark, D. (2011). Conservative prevention and management of pelvic organ prolapse in women. Cochrane Database of Systematic Reviews, (12).