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Postpartum Rehabilitation: My Body Just Did What?! pt1

Updated: Sep 24, 2020

Pregnancy and birth are powerful. Your body creates new life, grows a whole human being(s), then undergoes superhuman feats to bring it into the world.

Pregnancy and birth are powerful. Your body creates new life, grows a whole human being(s), then undergoes superhuman feats to bring it into the world. It makes perfect sense that this would have a profound effect on your anatomy, and how it functions. There are a ton of really fascinating moving pieces involved here, from bones to ligaments, to muscles and nerves. But for now, we will focus on the muscle groups who make it all possible.

First of all, you have this awesome set of muscles, called the pelvic floor. They are interwoven, like a super stretchy basket at the base of your pelvis. This group is responsible for controlling your sphincters (without it we’d all be in diapers), enhancing sexual response, and helps guide the baby’s head into the birth canal during birth. The Pelvic Floor muscles support the weight of your growing uterus during pregnancy, so they need to be strong. Then they soften, lengthen and let the baby pass through during birth, so they need to be flexible. All the aerobics of this process can leave this muscle system a bit taxed and overwhelmed. The muscles can be left a little too loose, or get upset and contract, leaving them a little too tight. Either of these conditions can cause problems down the line for their owner and account for many of the discomforts people face after having a baby (“I pee my pants every time I sneeze!”)

Next are the abdominal muscles, these get much attention from nosey folks who want to know when you are going to “get your body back” after having a baby, to which it should always be responded “Holy sh!t I didn’t know my body was missing!!!” accompanied with a healthy eye roll. Your abs are so much more than something people want you to whip into a 6 pack. There are the two long Rectus Abdominis muscles running vertically between your pelvis and lower rib cage, these spread apart during pregnancy to make room for that gorgeous baby belly. There is also a muscle that runs horizontally across your middle to support your internal organs and help you with deep breathing, called the Transverse Abdominis. Along with other abdominal muscles, these help control your posture and core movement, and in pregnancy, all get more flexible to accommodate the baby. Usually, these muscles come back together (mostly) on their own, however, sometimes they stay overly separated. This can cause back pain, posture issues, and that dreaded 4 months pregnant look when you’re not actually pregnant.

Here in the U.S., people receive tragically inadequate postpartum care and support for their healing bodies (not to mention their mental and emotional well being). Most only receive one follow up visit with their care provider at 6 weeks postpartum, during which they get the go-ahead to resume life as usual as long as they’re not bleeding anymore “but what if I don’t WANT to have intercourse and I’m too tired to go to the gym?” Many don’t receive an actual physical examination of their abdominals or pelvic floor, rarely are they educated on the warning signs of pelvic floor dysfunction, or who to call for help. Thankfully this isn’t the case everywhere. Countries that include postpartum physical therapy as part of their standard of care have lower rates of patients with common postpartum complaints, and higher rates of happy people not peeing their pants, and having great sex within the year after having a baby (ok I added that last stat in myself). We can begin to change the standard here in the U.S. by asking for this kind of care from our physicians, nurses, and midwives. And by talking to our family and friends about these issues to spread awareness. Too long has it been normalized and accepted that your body doesn’t work as well after having a baby.

With the right preventative measures during and after pregnancy, many common abdominal and pelvic complaints could be avoided. With the right postpartum care, the body can regain its proper function. Bottom line, people do not need to live in discomfort or pain after having children.

Common signs that you would benefit from postpartum rehabilitation

  • Leaking urine, especially while sneezing, coughing, running, or jumping

  • Incontinence of either the bladder or the bowel

  • Pelvic or lower back pain during exercise

  • Bulging, doming, or protrusion anywhere in the abdomen or pelvis during exertion

  • Pain or discomfort during intercourse

  • Pain or discomfort during bowel movements

Discussed in Part 2

Conditions that can create dysfunction during or after pregnancy:

Our Favorite Pelvic Floor P.T.’s in Denver:

Institute for Birth Healing - Education, physical therapy for core and pelvic floor

Fertile Ground Wellness Center - Chiropractic Care, acupuncture, massage therapy, Maya abdominal massage, placenta encapsulation

Harmony’s Family Cooperative - Diastasis Recti rehab, massage therapy, nutritional counseling

Our Favorite Online Postpartum Fitness and Rehabilitation Programs:

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