What No One Tells You About Your Postpartum Body

Dr. Brenda Heinecke is the owner and founder of Revitalize Physical Therapy, with locations in Wauwatosa and Hales Corners, and also a brand new mama! Today she joins us with an honest discussion of those postpartum body surprises no one tells you about and how physical therapy can help! Thank you to Revitalize Physical Therapy for sponsoring this post. 

postpartum body

During pregnancy, you probably spent countless hours researching what to expect during each trimester, which baby gear is best, and all the options for labor and delivery. But you most likely did not expect some of the crazy things that happen after having your baby. I know because I work with women just like you on a daily basis, and I am currently writing this while holding my 3-week old son! I realized that no one wanted to talk about the less desirable changes that can occur during and after pregnancy, except for having to wear those mesh underwear and those ridiculously large pads after birth! But what about the first time you pee a little during a sneeze, or your achy hips after a walk? Read on to learn more about the most common issues for your body after having your baby.

Incontinence

Have you had the unfortunate experience after baby where you suddenly sneeze, only to then notice that you’ve leaked and are now stuck with urine-soaked underwear? Incontinence is common amongst women, but not normal.

Did you catch that? Peeing your pants on the regular is NOT. NORMAL. And you don’t have to live with it.

postpartum incontinence

There are an estimated 25 million people in the U.S. that suffer from incontinence. Incontinence is considered any leakage at any time other than the first 6 weeks postpartum (yes that includes jumping on the trampoline).  It can happen because of weak pelvic floor muscles, nerve damage from childbirth, and also from pelvic floor muscles that are “too tight”, meaning the muscles cannot relax well.

You’ve probably also read or been told that you should just do Kegels to fix this issue…which can definitely help if you are doing them properly, but they are only part of the solution. As a pelvic floor physical therapist, I assess not only the strength of the pelvic floor muscles, but also the endurance, coordination, reflex component, and differentiate between the fast and slow twitch muscle fibers (which control quick or slow muscle contractions). All of these components must be working properly in order to prevent incontinence and often times, there is one, if not more, that are not.

Pregnancy wreaks havoc on our pelvic floors so it is common to have issues with the pelvic floor muscles.  And unfortunately, these issues are exacerbated during menopause so I always stress for women to fix them after baby rather than continue to wait till it gets worse.  Plus, wouldn’t it be nice to run around with your kiddos at the park without wearing a pad? Check out a first-timer’s experience with pelvic floor therapy at Revitalize and consider if it might be right for you!

Get your free copy of “7 easy ways to end incontinence and get your life back” HERE

Diastasis Recti

This term is for a condition where the abdominal muscles separate down the middle of your abdomen, forming a bulge along the middle when the abdominals are being tensed, like when doing an abdominal crunch. It typically occurs during pregnancy with 60% of pregnant women being diagnosed with a diastasis recti.

It is unclear why this affects some women and not others but research has shown there to be risk factors including obesity, increased muscle tone of the abdominals, performance of abdominal exercises, and increased abdominal pressure.  

So what’s the big deal?  

Well, once the abdominal muscles separate, they can no longer provide the necessary support for the trunk. This can lead to back pain and/or pelvic pain over time. Most women also report feeling “unsupported” and “unstable” through their core, which limits their ability to hold their babies, push strollers, and carry anything heavy. It’s also important to understand that it is highly unlikely that the muscles will come back together after pregnancy and will continue to lack support unless proper training is done.

Some easy changes you can make if you are pregnant or postpartum to minimize this separation is not holding your breath during exercise, avoiding constipation and straining to void, and avoiding abdominal crunches for exercise.

Painful Intercourse

Yup, we’re going to go there. Let’s talk about sex, baby. 

Fast forward to 6 weeks postpartum when you get the okay to resume intimate activities (or 6 months or whenever you get around to it since it may not be a top priority for you as a new sleep-deprived mom to a newborn and we’re all friends here, so let’s be real).  60% of women experience painful intercourse in the postpartum period and it can be extremely limiting.

Sex shouldn’t hurt. Period. Women do not have to endure painful intercourse, regardless of how many glasses of wine you drink (yes, this is advice that is frequently given by medical professionals and the internet).

painful intercourse after baby

Hormonal changes can lead to vaginal dryness after baby so if the pain feels superficial or “scratchy,” you could try an over the counter lubricant. If pain occurs with deeper penetration, the likely culprit is overactive pelvic floor muscles and trigger points. If you had any vaginal tearing or an episiotomy during childbirth, you will have scar tissue as the body’s natural healing response. Often times, this scar tissue can be painful during intercourse and potentially even limit your ability for penetration.

In my work as a pelvic floor physical therapist, I see women frequently with these issues and many of them have suffered for months, if not years, with painful intercourse or inability to have intercourse. I really feel for these women because I see firsthand how frustrating it is for them and how much it affects their life and relationship.

If you are suffering from painful intercourse, it is best to have it assessed in order to determine the cause and what the best treatment plan would be in order to resolve it. And that treatment plan shouldn’t include drinking more wine (unless you’re really enjoying that Malbec), giving it more time, or just tolerating the pain. Every woman deserves better than that!

Back, Hip and Pelvic Pain

Let’s get real, after delivering a baby, your body just HURTS. Your muscles are sore, you’re exhausted, and your pelvic region has seen better days. But then after a few days, and the initial soreness and pain subsides, you may start feeling more pain and tightness in your back, hips and pelvic floor.   

Your body produces a hormone called relaxin during pregnancy that helps the joints and ligaments loosen in order to expand for delivery. This hormone continues to be produced while breastfeeding so women often have joint laxity in the postpartum period if they are nursing. Due to this, the bones and joints can shift slightly which makes your muscles work harder to help stabilize the area. This can lead to tightness in the muscles and ultimately pain or soreness.

Gentle stretching can help alleviate the muscle tightness and also help decrease pain. If you don’t notice a change in your pain, pain is worsening, or it is limiting your activity or ability to properly care for your little one, seeking help from a medical professional such as a pelvic floor physical therapist, can help.  These symptoms may indicate issues with your healing and are also problematic when they are affecting activities in your day-to-day.  

Revitalize Your Postpartum Body

Pregnancy and birth put women’s bodies through a lot and no matter what your birth experience looked like, that postpartum transition can come with changes that are quite the shock! At Revitalize Physical Therapy, we want to work with you to help you reclaim a new confidence in motherhood with a body that works with you instead of against you! We have locations in Hales Corners and Wauwatosa and would love to meet you very soon. 

Revitalize Physical TherapyDr. Brenda Heinecke is a pelvic floor physical therapist and owner of Revitalize Physical Therapy.  She specializes in helping women live healthy, active lives. Dr. Heinecke frequently presents on these topics to further educate women in the community.  In addition, she has a special interest in working with female athletes during and after pregnancy. You can learn more at www.Revitalize-PT.com

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