Weeks after I delivered my first child, a baby girl, I finally got a second to think. I could write a book on all the things I wish people would have told me prior to having a child – and not the stuff about taking care of a new baby – it was the recovery of my lady bits! I don’t recall now how that book would have started but I’m sure there would be talk about squeeze bottles for the undercarriage, how scary the first shit can be, frozen maxi pads or how terrifying it is to cut a baby’s fingernails. But one piece of wisdom that reigns clear is that you need to give yourself time to heal – down there!
I hadn’t given any thought to my own pelvic floor beyond scheduling the standard six week postpartum follow up appointment. And really, was not anything to get excited about – and in actuality is a waste of time for most women as providers are not well versed in postpartum care. As much as we love babies in the US there’s still a real stigma around what actually happens to a woman’s body after she gives birth. It’s not like that everywhere – in France new moms often receive la reeducation perineale, which is a government sponsored therapy to help retrain the pelvic floor.
The pelvic floor is a group of muscles that sit like a hammock at the base of your pelvis. They support the bladder, rectum, and reproductive organs and help control bladder and bowel function. The pelvic floor also plays an integral role in childbearing and of course sex. With age, and certainly after having kids, the pelvic floor tends to weaken, and women can start having issues ranging from peeing when they sneeze, laughing or jumping accidents, to painful or lackluster sex. BUT you don’t have to live with it! My classes have been filled with women who have said “thank you for educating us on issues we thought we had just had to deal with. I now know that something common does not mean it is normal.”
Common – but NOT Normal
If you had an arm injury you would go and rehab it – the pelvis is no different. While some women think that a single trip to the gyno can resolve the issues surrounding their pubic region a lot of OB’s only have about 15 minutes per patient. The advantage of a pelvic floor therapist is that they are more specialized in the muscles in the pelvis which is also connected to the core in the back. For that reason, because we see such a great majority of postpartum moms I urgently (shouting from the rooftops) recommend that I at least have a check-in at 6 weeks to see how you are recovering. At 6 weeks – as long as the mother is comfortable, I am happy to help her begin to put “all the things” back where they are meant to be and belong. Don’t get me wrong, our bodies are beautiful and we need to embrace our postpartum bodies but that doesn’t excuse the majority of providers in telling these women that this is something they just have to learn to deal with – and it’s normal. Common – but NOT Normal!
Kegels and exercise that involves contracting the pelvic floor muscles are told that they are a non-negotiable by just about every OBGYN or written in all the magazines. They’ve quoted “all women should be doing them religiously whether you’re 25 or 85.” They have all the handy apps, trackers and trainers – internal ones too, to make it possible.
However, what if you weren’t doing those kegels the correct? What if you have pelvic floor instability? By doing these kegels it could quite possibly make that issue even worse.
Shhhh, It MUST be a Secret
What is scary to me is that no one talks about pelvic floor instability, organ prolapse, or ANY of the major issues that corresponds to pelvic floor dysfunction. There are dermatologists, OBGYN’s, numerous therapists, and MD’s that are making man-made utensils and procedures to fix something that our body can do on its own.
Our bodies are amazing and if given the right information and program to follow it can heal itself. Your body works better as a whole rather than in pieces. It’s time to begin the discussion and end the stigma that it is okay or normal to be peeing our pants or wearing adult diapers in our 30s. Just know that there are options, and I am here to help.