The Importance of Pelvic Floor Health For New Moms: Prevention, Healing, and the Michigan Professionals Who Can Help

Typically we don't talk about pelvic floor dysfunction, prolapse, birth injuries, or incontinence out loud. But how in the world are those suffering in silence going to find the right help if we don't talk about it? The physical toll of pregnancy, birth, breastfeeding, and postpartum recovery can take a serious toll on your pelvic floor health if you're not careful. We've put together top tips for new moms, including expert advice from a Women's Physical Therapist who specializes in pelvic floor injury and rehabilitation, to make sure you have the information you need to make informed decisions and take care of your changing body.

But first of all — What is the Pelvic Floor?

The pelvic floor is a group of muscles that form a sling across the bottom of the pelvis. These muscles support the weight of your abdomen and hold your pelvic organs (bladder, uterus, and rectum/bowel) in place. They also play a crucial role in bladder and bowel control, sexual function, and core stability.

During pregnancy, birth, and postpartum, the pelvic floor muscles go through a lot of stretching and strain. This can lead to weakening and lack of muscle tone, which in turn can cause issues like:

• Urinary incontinence (leaking urine when coughing, sneezing, or exercising)
• Pelvic organ prolapse (when pelvic organs drop down and bulge into the vagina)
• Pain during sex
• Inability to fully evacuate the bladder or bowels

Incontinence

This is one of the most common postpartum issues and can be both urinary and fecal. Urinary incontinence is the involuntary leakage of urine, often triggered by actions like sneezing, laughing, or exercising. This occurs because the pelvic floor muscles, which help control the bladder, can become weakened during pregnancy and birth. While it might feel embarrassing, it's important to know that many women experience this, and it's a treatable condition.

Prolapse

Pelvic organ prolapse happens when the pelvic organs (such as the bladder, uterus, or rectum) drop from their normal position and push against the walls of the vagina. This can create a sensation of heaviness or bulging in the pelvic area, and in more severe cases, it might even feel like something is coming out of the vagina. Prolapse is more common in women who have had multiple vaginal deliveries, but it can happen to anyone postpartum.

These conditions, though common, should not be accepted as just "part of being a mom." Addressing pelvic floor issues early on can make a significant difference in your recovery and long-term health.

Pelvic floor muscle weakness is extremely common after having a baby, affecting up to 1 in 3 women. The good news is there are steps you can take to prevent and address these issues throughout your pregnancy and postpartum journey.

During Pregnancy

Even before your baby is born, pregnancy places a significant amount of weight and pressure on your pelvic floor. As your belly grows bigger, pelvic floor muscles have to work harder to support everything. Here are some tips for maintaining pelvic floor strength during pregnancy:

Avoid Bearing Down and Holding Your Breath

Activities like heavy lifting, intense abdominal exercises, and pushing/straining when using the bathroom can place excessive pressure on the pelvic floor. Take it easy, brace your core, and don't hold your breath.

Stay Active (Within Reason)

While you want to avoid anything too high-impact later in pregnancy, staying relatively active with low-impact activities like walking, swimming, pilates, and prenatal yoga can help maintain pelvic floor tone. These muscles are invisible from the outside, so it takes practice to effectively engage the pelvic floor during exercises.

During Labor & Delivery

Giving birth vaginally is a natural process and one that your body was designed to do, but it does place stress on your pelvic floor. The stretching and pressure as your baby descends through the birth canal significantly increases the risk for pelvic floor trauma and muscle tears. There are a few things that can help:

Consider Perineal Massage

Perineal massage involves gently massaging and stretching the area between the vagina and rectum in the weeks leading up to your due date. This can help increase the elasticity and flexibility to accommodate your baby's head.

Breathe Baby Down (as opposed to forceful pushing)

When it's time to push during labor, listen to your body. Pushing gently during contractions with directed breath places less strain on the pelvic floor. Those who prepare for birth with a Hypnobirthing method learn to "breathe baby down," working with the breath, mind, and body to ease baby out when it's time.

During Breastfeeding

While breastfeeding doesn't place much direct strain on the pelvic floor muscles, it does affect other areas that impact pelvic health.

Hormonal Changes

The hormone shifts that occur during breastfeeding, like drops in estrogen, can make connective tissues more lax. This increases the risk for pelvic organ prolapse in the postpartum period.

Staying hydrated, continuing with gentle pelvic floor exercises, avoiding excessive intra-abdominal pressure, and gradually reintroducing core exercises can all help support pelvic floor recovery during breastfeeding.

Postpartum Recovery

After giving birth, your pelvic floor muscles will be understandably stretched, strained, and fatigued. It's crucial to be patient and focus on gentle rehabilitation during this healing period.

Take It Easy

For the first 6 weeks or so postpartum, avoid anything high-impact or too strenuous as your pelvic floor recovers. Walking, pelvic tilts, and very gentle core/pelvic floor exercises are generally okay, but listen to your body. There can be a perceived pressure for new moms to "get their pre-pregnancy body back," but it's normal for this to take 6–24 months.

Manage Constipation

The last thing your healing pelvic floor needs is excessive straining during bowel movements. Stay hydrated, eat plenty of fiber, and use stool softeners as needed to avoid constipation.

Consider Pelvic Floor Physical Therapy

For many women, seeing a specialized pelvic floor physical therapist can provide tremendous relief from postpartum pelvic floor issues. They can properly assess your condition and create a customized recovery plan. Just having someone validate your concerns and give you a plan can be life-changing.

Normalize Pelvic Floor Health

The postpartum period is physically and emotionally demanding for any new mom. Did you know that in France it is common practice for postpartum women to receive comprehensive pelvic floor therapy? If any other part of your body were injured, it would be common to seek rehabilitation. Let's normalize this in Michigan for pelvic floor issues that are impacting quality of life.

Find a Michigan Pelvic Floor Physical Therapist

If the issues described in this article are resonating with you, it may be time to find a local pelvic floor physical therapist. Even if the service is not covered by insurance, you will likely be able to use your HSA/FSA funds. Explore our Collective directory to see if we have a Pelvic Floor PT near you.