The Ultimate Guide To Your Pelvic Floor After Birth
We’ve all been there at some point…
You’re shopping at the grocery store, enjoying the rare peace and quiet, when you start to feel the urge to sneeze. Before you became a mom, you wouldn’t think anything of it. Now, a simple sneeze can cause you a world of embarrassment.
Dealing with your pelvic floor after birth is absolutely necessary. It’ll save you from these horror-scenarios and many other unpleasant symptoms that you should NOT have to deal with.
That’s why I am so glad to have Valerie from A Peach in the Queen City here to guest post on this very important topic. Valerie tells you everything you need to know about your postpartum pelvic floor: what it is, what weakens it, and–most importantly–how you can heal it with simple but effective exercises.
What is your Pelvic Floor?
This post may contain affiliate links. If you make a purchase from one of the links I will make a small commission at no charge to you. Blunders in Babyland does not diagnose, treat, or give out any professional advice for any medical conditions. **Valerie: I am not a Physical Therapist or doctor and this is not medical advice, but it is an account of my own personal experience with help from my personal Pelvic Physical Therapist.**
I like to hope by now you have at least heard the words pelvic floor mentioned a time or two.
If you have never heard about your pelvic floor, well, I suggest you keep reading. 😊
What exactly is your pelvic floor, and what does it do? Why is your pelvic floor so important?
Your pelvic floor is a muscle that holds your bladder and rectum in place.
Think of a hammock, it is this amazing place to lay especially when you first get it, but over time, the hammock starts to sag and give more and more. Unfortunately, with hammocks, you can’t exactly work them back to original form.
Lucky for us, your pelvic floor is a muscle, and it can be easily strengthened back to proper form. Much like our other more popular muscles (biceps, triceps, abs, etc.) we have to work them for them to be strong.
Our pelvic floor is the same way.
What Causes a Weak Pelvic Floor?
We often don’t notice that we have a weak pelvic floor until after childbirth, when your muscles are weak from pregnancy and birthing a human, or we don’t notice until we are much older.
Here is the truth, though: You don’t have to have ever have a child to have a weak pelvic floor. In fact, men have a pelvic floor too!
Here’s some signs and causes of a weak pelvic floor:
- Do you squat when you pee? You are weakening your pelvic floor.
- Do you pee a little when you run, skip, hop, or cough? That is a sign of a weakened pelvic floor.
- Constipated (With no other underlying medical cause)? You guessed it! You likely have a weak pelvic floor.
- Low back pain? Could be a weakened pelvic floor.
- Pain during sex? Yup! That’s likely your pelvic floor too.
- Pregnant or have just given birth? Now, this pelvic floor weakness is somewhat out of your control, but it doesn’t have to be.
Your Pelvic Floor During Pregnancy
What Happens to Your Pelvic Floor During Pregnancy?
As we talked about above, your pelvic floor is like a hammock that goes from the front of your pelvis to your backbone. It holds up your bladder and rectum. During pregnancy you have a lot of changes going on from hormones to physical body changes. These changes take a toll on your body.
The changes in hormones and the stretching of your uterus as the baby gets bigger weakens your pelvic floor and your abdominals.
This alone is why it is important to do pelvic floor and abdominal exercises during pregnancy that are safe. Doing pelvic floor exercises during pregnancy can help with childbirth and postpartum.
Pelvic Floor Exercises During Pregnancy
Part of strengthening your pelvic floor is also strengthening your abdominals and your hip muscles.
I have gone through Pelvic Physical Therapy, and my Physical Therapist all of my exercises focused mostly on strengthening my core and hips.
Bao Bei Maternity has a whole highlight saved on their Instagram called “Prenatal Core” which is absolutely fantastic. The breathing exercise they demonstrate is a great way to help strengthen your core. They show many different positions the exercise can be done in for pregnancy.
So, the first exercise is to focus on your core. Helping keep your deep abdominal muscles strong will help your pelvic floor. Having a strong core will also help with low back pain as well. NCT.org.uk has a small list of some great exercises you can do during pregnancy as well. They discuss “stomach exercises” which are the core exercises I just mentioned from Bao Bei.
If you prefer it written out go to NCT.org.uk or you are visual go to Bao Bei’s Instagram highlight “Prenatal Core”. NCT also mentions “Pelvic Floor Exercises” these are what we consider kegels. I will talk about these further in the post. What I do like about their write up of the pelvic floor exercise is they actually tell you the proper way to do a kegel. Again, we will talk about this a little bit further down.
You can do “Pelvic Tilts” in a wall sit position. Your legs are at 90 degrees with the floor and your back is flat against the wall. Engage your core by bringing your belly button to your spine. Your back should be flat against the wall (no space between the wall and your lower back).
Start by holding your core (while still breathing) for 3 seconds and increase as you begin to feel stronger (you can hold for up to 10 seconds if you feel you are ready).
Release then repeat 10 times.
Lastly, you can get a birthing ball/exercise ball and do hip circles. These help your hip flexors, you are also engaging your core, and they take the pressure off your pelvis.
Pelvic Floor During Pregnancy: Supportive Clothing
One thing that can really help your abdominals and your pelvic floor is having a supportive belly band during pregnancy.
Bao Bei Maternity is a great place to get a truly supportive belly band. I wore it during pregnancy and postpartum, and I could definitely tell the difference when I didn’t have it on. They call it a sports bra for your bump, and it really is.
They also have leggings and underwear to support you during pregnancy and postpartum. I will be investing in them if I have another child.
The belly band and leggings were created by a Physical Therapist who knows what you need to be supported through pregnancy and postpartum. She has you, your core, and your pelvic floor in mind.
I am not an affiliate of Bao Bei. I just REALLY like and believe in their product because I used it myself. I want you to have the best!
Now, we have touched on what to do during pregnancy, but what about postpartum?
Seeing a Pelvic Physical Therapist for Your Pelvic Floor After Birth
What does a Pelvic Physical Therapist do Postpartum?
Did you know that in the UK at 6 weeks postpartum all new moms are REQUIRED to go to Pelvic Physical Therapy?
I was floored when my Pelvic PT told me this. I won’t get on my soapbox about postpartum care in this country, but the fact that you have to even beg for a referral here in the US is absurd.
Moving on. 😊
Here’s what a Pelvic Physical Therapist can do for you:
- A Pelvic Physical Therapist can check you for Diastasis Recti, and they will give you exercises to correct that. Because you should NOT be doing any kind of major exercising if you have Diastasis Recti as you will only make things worse and it won’t heal.
- They can also assess the strength of your pelvic floor, and they will give you exercises to strengthen it.
- Pelvic Physical Therapists also work internally, so if you are having pain during sex before or after pregnancy, they can help you with that as well.
- They can massage your c-section scars or your episiotomy scar. If you had to have anything sewn up, a Pelvic Physical Therapist can give you proper techniques to break up your scar tissue.
How do you get in to see a Pelvic Physical Therapist?
You should ask for a referral to Pelvic Physical Therapy at your 6-week postpartum check.
If you don’t feel as if you need it then, I would definitely keep an eye on your symptoms and never be afraid to ask your OB for a referral no matter how far postpartum you are. I was almost 9 months postpartum before I asked for a Pelvic PT referral.
Also, don’t let your OB tell you that all you need to do kegels. There is a proper way to do a kegel, and there are other aspects that need to be strengthened as well before jumping to kegels.
We will talk about kegels later on.
When should you see a Pelvic Physical Therapist?
I personally believe you should go see one as soon as you are cleared by your OB (6-8 weeks postpartum). Even if you only go for one visit, it will be worth it.
If are you starting to pee when you cough, sneeze, laugh, run, walk, move, etc.? This is NOT normal. I have so many friends who talk about this as if it is a normal part of life and something they should just accept.
It absolutely is NOT! This is when Pelvic PT would be perfect for you. Are you going to the bathroom more frequently? Pelvic Physical Therapy!
Did you have a c-section, an episiotomy, vaginal tearing of any kind? A Pelvic Physical Therapist can help with your scar.
It DOESN’T matter how far postpartum you are.
Pain of any kind in your pelvic region is worth going to a Pelvic Physical Therapist first. Simply ask your OB to send in a referral.
Pelvic Floor Exercises After Birth
Maybe you aren’t quite ready to see a Pelvic Physical Therapist, or your OB doesn’t quite want to give you a referral just yet, here are some postpartum pelvic floor exercises you can do in the meantime.
1 Pelvic Tilts
You can now do your “pelvic tilts” lying flat on the ground. Your feet and knees are no more than hip width apart. Engage your core by bringing your belly to your spine and closing the gap between your lower back and the floor. You are tilting your pelvis toward your nose (if that is a better visual).
Hold for 3-5 seconds at first, release, and repeat 10 times for 3 reps.
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2 Clam Shells
You can begin to do “clam shells”. These are great for the hip flexors. You lie on your side knees at 90 degrees. Your feet should be in line with your spine. Without rotating your hips and keeping your feet together, raise the top leg, hold for a beat, and close. (Be sure your hips are not coming forward and engage your core.)
Repeat this 10-15 times on each side for 3 reps.
*You can add a resistance band right above your knees once you feel the clams are getting too easy without it.
3 Hip Bridges (Bridge Pose)
Lying flat on your back, knees bent and hip width apart, engage your core, and lift your hips off the ground. Making a straight line from your knees to your head. Hold at the top for 3 seconds then come back down.
Repeat this 15 times for 3 reps.
4 Hip Bridge with a Squeeze
You will need a small ball for this exercise. I used a stuffed ball we had around the house.
Again, you are flat on your back, knees are bent and no more than hip width apart, and the ball is between your knees. Engage your core (lower back to the floor) and lift your hips. At the top of the lift, squeeze the ball between your knees (3 second squeeze), release and lower.
Repeat 15 times for 3 reps.
5 Hip Bridge with Abduction
Flat on your back, knees together, engage your core, and raise your hips off the ground. At the top, send your knees in opposite directions without rotating your hips; bring them back together and lower. (It doesn’t have to be that far.)
Repeat 15 times for 3 reps.
*A resistance band can be added just above the knees if the exercise becomes too easy.
6 Lower Trunk Rotations
As a mom who had a c-section, this was my favorite exercise to do. I could feel the stretch in the region of my scar, and it made me feel so much better.
You are flat on your back, knees bent and together. Engage your core (lower back to the ground). Without rotating your hips, send your knees to the right until you feel the stretch in your lower back, then come back up and repeat on the left side. Repeat 10 times for 3 reps.
Your shoulders and back should stay on the ground.
**All of these exercises should be slow and controlled.
How to Properly do a Kegel
There will be many of you, mostly postpartum, whose doctors will tell you to just do kegels. They also don’t tell you how to properly do a kegel. Sure, kegels will help, but not if you don’t know how to do them right way. And, as you have seen above, strengthening your pelvic floor isn’t just about doing a kegel.
So, kegels are actually contracting the muscle. It is like stopping the flow of urine (which you should not do) or holding in a fart. I have also heard pretending as if your vagina is drinking up through a straw.
When you do a kegel, you should not be utilizing any other part of your body. You shouldn’t be using your abs, or hips, or any other muscle to help you do a kegel. If you are, then they aren’t going to help you.
It should feel as if you have sucked your vagina up.
It is also recommended to use a mirror so you can see your pelvic floor go up, or even your finger so you can feel the tightening.
Once you have the kegel down without using other parts of your body, you will need to relax your pelvic floor and then lengthen it.
Just like a bicep curl. You come up to tighten the muscle and then you lengthen the muscle as you come out of the curl.
To lengthen your pelvic floor muscle, it is like peeing or letting out a fart. Pay attention to how your body releases urine. This also is done without using any other part of your body.
- Kegel (stopping the flow of urine, holding in a fart, drinking through a straw with your vagina)
- Relax your kegel (back to neutral)
- Lengthen or bring your pelvic floor to the floor (peeing, letting out a fart)
- Do this 5 times throughout the day
Once you have mastered these kegel exercises, you can add them to your exercises from above. You can also try to start holding your kegel a little longer each time.
Pelvic Floor Exercises After a C-Section, Episiotomy, or Tearing During Birth
A Pelvic Physical Therapist can show you how to properly break up your scar tissue, and they can help you with any pain you might be having from these events.
Note that you will be quite sore after your first session because they get deep down into your tissues with their massage technique to really break up the scar tissue.
This is why even just one visit to get the technique would be life changing. You could then go as needed after that.
You can start the process at home.
**I can only attest to c-section scars, and these techniques may or may not be the same for vaginal tears.
Once cleared by your OB, start by sliding the skin above your scar up toward your belly button. This breaks up the fascia (saran wrap over your muscles/tissue). Do the same for the skin under your scar but slide it toward your feet.
If you are comfortable, you can start massaging your scar back and forth in a circular motion and then up and down.
Do not do this if your scar is still tender.
Pelvic Floor Resources: Instagram Pelvic Floor, Pregnancy, and Postpartum Gurus to Follow
If Pelvic Physical Therapy isn’t covered by your insurance or you can’t get a referral, the exercises above are a great way to get started.
However, there are some great ladies I personally follow on Instagram that I think can also be helpful for your pregnancy and postpartum journey.
- Pelvicguru1 – She is a pelvic physical therapist and gives you the technical side of your pelvic floor. She mostly teaches other Pelvic Physical Therapists.
- The.Vagina.Whisperer – I love her account. She is also a Pelvic Physical Therapist, but her account isn’t just about your pelvic floor but real life and postpartum life as well. I really like how she sprinkles in education with real life.
- Mommy.labornurse – Her account is amazing for pregnancy, labor, postpartum. She has personal and informative posts.
- Bao Bei Maternity – Their Instagram account has everything you need from pregnancy to postpartum and they talk with several different Pelvic Physical Therapists. They touch on all the subjects that seem taboo still to this day. Experiencing Sciatica or Varicose Veins during pregnancy? They can help you with that as well. Not only that, they have amazing products for pregnancy and postpartum as well.
I have learned a lot from these ladies plus my own Pelvic Physical Therapist. They are all worth the follow.[mailerlite_form form_id=24]
Your Pelvic Floor is Important Don’t Neglect It
You can do all of these exercises even before you get pregnant. Having a strong pelvic floor is great for pregnancy, labor, and the rest of your life.
Do NOT accept peeing when you move, frequent bathroom breaks, pain during sex, a painful scar or area around the scar.
These things are not normal and you DO NOT HAVE TO LIVE WITH THEM. If you would like more basic pelvic floor information or need to know if you should see a Pelvic Physical Therapist, you can check my posts “What is Your Pelvic Floor” and “When to Seek a Pelvic Physical Therapist”.