Postpartum pelvic floor rehab—when it’s time for more than Kegels

With all the changes women experience during pregnancy, it can be difficult to know what is considered “normal” postpartum and what is concerning, especially when it comes to pelvic anatomy. At some point in your pregnancy, you likely heard your provider mention Kegels. Perhaps you diligently remembered to do them daily, or maybe it fell off your radar.

It’s important for women to perform Kegel exercises, also known as pelvic floor contractions, during pregnancy to prevent long-term pelvic floor issues such as incontinence. “The pelvic floor is stressed during both pregnancy and delivery, so the more a woman can strengthen the pelvic muscles before delivery, the better chance she has of avoiding the need for pelvic floor rehab postpartum,” explained Rafael Unda Rivera, MD, Western OB/GYN, A Division of Ridgeview Clinics.

What contributes to pelvic floor issues

Women who experienced a delivery that required the use of forceps―or who suffered pelvic trauma from delivering a larger baby or having a prolonged birth―are at a higher risk of pelvic floor issues. In addition, women with the following risk factors are more prone to pelvic floor concerns.

  • History of incontinence
  • Elevated body mass index (BMI)
  • Tobacco use, which decreases blood supply in the tissue, affecting the healing process
  • Three or more pregnancies
  • Advanced maternal age while pregnant
  • History of pelvic organ prolapse

When to consider postpartum rehab

Women who did not experience significant pelvic trauma during childbirth should be able to resume Kegel exercises in the weeks following delivery to help regain pelvic floor strength. However, women who experienced trauma—as with any injury—may need to wait several weeks to first allow for healing. It takes about three months for the muscles and ligaments to return to normal.

At the six-week postpartum appointment, your provider will discuss normal recovery and what is not considered typical. If you continue to experience any of the symptoms listed below three months postpartum, contact your provider for a referral to Ridgeview Rehab to learn if you are a candidate for pelvic floor rehab.

  • Leaking urine with coughing, sneezing or with sudden movement
  • Increased urinary frequency
  • Difficulty emptying bladder
  • Pain in the pelvis, abdomen, lower back or tailbone
  • Pain during intercourse
  • Bowel issues

Benefits of strengthening the pelvic floor

In addition to regaining bladder and/or bowel control, rehab helps with core (abdominal) support, a return to normal pelvic anatomy and helps to eliminate pain during intercourse.

Long-term, a healthy lifestyle is necessary for a healthy pelvic floor. “Rehab is not a permanent solution; women should continue with any prescribed exercises as instructed in physical therapy even after rehab has finished. In addition, a wholesome diet, regular exercise and avoiding unhealthy habits such as smoking are important to prevent pelvic floor issues from returning,” said Dr. Unda Rivera.

It is never too late to regain control and full function of your pelvic floor. If you feel you could benefit from pelvic floor rehab, schedule an appointment with your provider or one at Western OB/GYN, A Division of Ridgeview Clinics.


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