Healthcare for moms is ripe for a revolution. Currently in the United States, postpartum checkups occur around 4-6 weeks after childbirth and only last about 10 minutes. You may have a brief pelvic examination, talk about future birth control plans, and likely get an “all clear” from your doctor, stating you can return to activity as usual. This means sex, exercise, and work. And that is your postpartum care. No more follow ups. No discussion of common pelvic floor conditions women experience. No discussion about steps to take if problems arise.
Chances are you will not have your abdomen assessed for diastasis recti, a separation of your abdominal muscles that commonly occurs during pregnancy. You may feel and look like you are still pregnant and your diastasis will not be diagnosed. You may have pelvic floor problems like urinary leakage, painful sex, or pelvic organ prolapse and not know that diastasis recti and pelvic floor dysfunction often go hand in hand. You may not know that the crunches you are doing to get your abs back after the baby could be making this condition worse. And you may have no idea that pelvic physical therapy can help. Yup, you’re good. All clear.
Chances are you will not have your pelvic floor muscles tested by your doctor to assess for weakness or spasm. You may go back to running and leak urine. You may do jumping jacks and feel heaviness in your vagina like something is falling out. You may start yoga, which you hear is great for postpartum recovery and have embarrassing vaginal farts. You may get on a spin bike or stair stepper and have excruciating tailbone pain. And you may have no idea that any of this may be due to weak or tense pelvic floor muscles and pelvic physical therapy can help. Yup, you’re good. All clear.
Chances are you will not have a conversation with your doctor about returning to sex and the discomfort or pain many women experience after childbirth. Healing tissue from a vaginal tear or episiotomy may cause a pain with penetration during sex and maybe even cause some bleeding afterwards. Your vagina may be very dry, you can’t orgasm, or you may leak urine when you orgasm. And you have no idea that pelvic physical therapy can help, so you just bear through the pain or avoid sex altogether. Yup, you’re good. All clear.
Chances are you won’t receive education on how to massage your C-section scar. You have bladder problems, groin pain, or constipation all stemming from your scar tissue restriction. You can’t wear jeans anymore, you avoid lying on your stomach, and you don’t like wearing your baby in a carrier because your scar hurts. And you have no idea that pelvic physical therapy can help, so you just deal with it. Yup, you’re good. All clear.
Women’s bodies go through incredible physical, hormonal, and musculoskeletal changes during pregnancy and childbirth. As a pelvic health physical therapist, I have worked with women during pregnancy and the postpartum period for over a decade. I help educate them how to care for their pelvic floor muscles, inform that that any pain, leakage, or prolapse is not normal. I guide them on a safe return to exercise, sex, and activity to meet the increasing demands of their lives.
Time and time again I hear, “I had no idea this type of physical therapy existed” or “why didn’t my doctor tell me about this sooner.” The postpartum care for women is in desperate need of improvement and the awareness of pelvic physical therapy needs to grow. Pelvic Physical Therapy should be standard care for every postpartum woman in the United States. I am baffled that medical professionals send sleep-deprived women home with bleeding vaginas, tender scars, sore breasts and a newborn baby to care for – and all they get are - Yup, you’re good. All clear.
This was originally posted on The Vagina Whisperer by Sara Reardon
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