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Pelvic Floor Recovery after Childbirth: Expert Input

The pelvic region is a common source of pain for post-partum women.

Going through childbirth is a big task for your body, whether you deliver via C-section or vaginally. It is important to remember that while you were pregnant your body went through some major changes in order to make this happen. This means that while you might feel excited to get back to your pre-pregnancy routine, your body is still catching up in this “fourth trimester.”  As we all know, the pelvic floor is stretched and weakened after the baby is born, leading to pain in the pelvic area. It needs time & attention to recovering, so the need arises for a pelvic health therapist.  

Working with a pelvic health physical therapist during your pregnancy & after childbirth is the best shot at ensuring less pain, good stability, and effective movement strategies to avoid things such as incontinence or prolapse.

5 Tips for Better Recovery by The Expert

Dr. Anietie Ukpe-Wallace, pelvic health physical therapist shares 5 helpful tips to help create less strain on your body after childbirth and ease better recovery.

  1. Wear external support or brace for your midsection during the first few days or weeks until you work on building back your internal strength. This will help with creating support for your abdominal muscles and take some of the strain off of your back, especially with all of the lifting and carrying you will be doing with the baby.
  2. Be mindful of how you are carrying yourself. You carried the baby for 9 months and the body is very good about forming habits, so you may notice that you are still walking and standing as if you were still pregnant. Notice how much weight you are putting into the front of your body and look to see if you can have it shift to the back so more weight is in your heels. You will see that as soon as you do that, which will take some strain off of your low back and help you start to tap into your core muscles working to help stabilize your body.
  3. Watch your breathing. Our body is one big pressure system and how you breathe can have a huge effect on your core stability, pelvic floor health, and back. When we put too much pressure on our abdominal cavity or belly (i.e. belly breathing) that can put more strain on our pelvic floor muscles which could lead to prolapse or incontinence. If you aren’t breathing through your ribcage, that can create stiffness in your diaphragm muscles and lead to mid-back pain due to the lack of flexibility present. So when breathing, take a 4-second inhale through your nose and feel expansion in your ribcage and when you exhale, blow out for 6 seconds through your mouth and feel the movement of the ribcage downwards and belly button gently being drawn up and in towards your body.
  4. Go Slow. Exercises to work on rebuilding strength and support in the body should start off slow as your body is still recovering from childbirth, so working with diaphragmatic breathing is one place to start. That same mode of breathing can then be taken into various positions such as on hands and knees or in tall kneeling to challenge and feel the work of the deep core (transverse abdominal muscles) and pelvic floor muscles working to help provide stability. When you work on the full movement of the diaphragm muscle, you will have an impact on the strength and mobility of the deep core and pelvic muscles which will provide better support for the pelvic organs from prolapse and fewer opportunities for leakage. 
  5. Massage: However, if you find that doing these exercises doesn’t make a difference for your incontinence, prolapse, or pelvic pain, it will be important to see if there is possibly pelvic muscle tension present which can happen after a traumatic birth, long pushing stage, perineal tearing or cesarean section. In those cases, massage may be recommended to help ease the tension of the muscles so they have the pliability needed to contract and be flexible. When that is addressed, then building strength can be done to provide the needed support. 

Exercise is one of the best ways to combat pain by using the body in ways that it can adapt to the new changes. Post-partum women struggle to regain strength and balance.

Exercises to Manage Pelvic Pain

Deep core activation on hands and knees:

Come onto hands and knees with shoulders under wrists and hips under knees

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, and maintain a neutral spine.

Without changing the position of the spine, breathe into the rib cage and belly and as you exhale, gently blow air out of the mouth as you feel the lower abdominal muscles lift up and into the spine, again without changing the positioning of the spine.

Tall kneeling halos:

Standing Single leg deadlift:

About Dr. Anietie Ukpe-Wallace:

Dr. Anietie Ukpe-Wallace, PT, DPT, also known as Tia, is an orthopedic and pelvic health physical therapist who specializes in providing a continuum of care and support from pregnancy loss to postpartum all while emphasizing the importance of self-care. She is a Doctor of Physical Therapy in Oakland, CA where she offers both telehealth and concierge/in-home therapy services through her practice, Self-Care Physio. In addition, she works as a women’s health coach, host of her former podcast, The Masterful Art of Self-Care, and an amateur pole and Lyra artist. She is a wife, mother to her 7-year-old daughter, and cat mom.

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