If you’re experiencing postpartum pelvic floor dysfunction (PFD, you’re probably wondering: are these troublesome issues going to go away? The answer depends. For many women, symptoms such as pelvic pain, urine leaks, painful sex, and the urge to urinate improve significantly in the 12 months after giving birth. For others, specialist treatment is necessary. Keep in mind that it’s normal for your body to take months to recover from pregnancy and childbirth. Over the first six months, your pelvic floor muscles and tissues are literally remodeling themselves. Breastfeeding, hormones, and other factors can all impact the speed of your healing process.
Plus, if you had a tear in your vagina or perineum during delivery or forceps were used, your pelvic floor muscles may take longer to heal. That’s why it’s a good idea to be patient with your recovery and talk to your healthcare provider about what’s normal or not, especially if it’s affecting your quality of life.
When to seek more help
If you’re still experiencing symptoms three to six months after childbirth, you may want to consider seeing a urogynecologist—also known as a pelvic floor specialist. Urogynecologists have training in both urology and gynecology, making them uniquely qualified to treat pelvic floor issues.
Urogynecologists specialize in pelvic reconstructive medicine, which can involve a range of treatments and services, including:
- Medications for stress incontinence (urine that leaks when you cough, sneeze, or jump)
- Bladder surgery or injections for stress incontinence
- Pelvic floor muscle training
- Referrals to pelvic floor physical therapy
- Surgical vaginal wall repairs
- Vaginal pessary fittings for stress incontinence or pelvic organ prolapse
When it comes to surgical interventions, your urogynecologist may recommend waiting until you’re done having children, depending on the exact surgery, and exploring non-invasive treatment options such as biofeedback—which uses low-grade electrical currents—or pelvic floor physical therapy first.
What is pelvic floor physical therapy?
A pelvic floor physical therapist will start by assessing your muscle strength, tone, and coordination during an internal exam. Based on the findings, they can teach you techniques and exercises to strengthen or relax your pelvic floor muscles, depending on what is needed.
Factoring in your health condition and goals, your physical therapy plan may involve:
- Behavior modifications (e.g., bladder habits, fluid intake, and diet)
- Body awareness, posture, and movement training
- Exercises to strengthen, relax, or massage muscles
- Exercises to help with urine leakage (AKA Kegels)
- Using biofeedback to stimulate and coordinate muscles
- Diaphragmatic belly or chest breathing techniques
Reviewed by the Ovia Health Clinical Team
Sources:
- American College of Obstetricians and Gynecologists Staff. (ACOG) “Pelvis Support Problems.” ACOG. Accessed August 2024. https://www.acog.org/womens-health/faqs/pelvic-support-problems
- Hill AJ et al. Trajectories of pelvic floor symptoms and support following vaginal delivery in primiparas between third trimester and 1 year postpartum. Female Pelvic Med Reconstr Surg. 2021 Aug 1; 27(8): 507–513. doi: 10.1097/SPV.0000000000001068
