What to Expect in the Post Partum… And What you are often not told!
By Tamarah Nerreter
I had the opportunity to interview Tamarah in the Spring, do check it out here. Today she shares with us some important facts about post partum recovery and our new mom bodies.
The muscles & ligaments affected by pregnancy will take 4-5 months, possibly more, for full recovery.
Therefore rushing into the gym should not be taken lightly. Abdominal muscles will be stretched, elongated and a mild separation between two abdominal muscles (rectus abdominals) will be apparent for women who make ‘term’ (called a Diastasis rectus abdominus OR DRA), therefore the corset will be weakened and result in poor control of the pelvis, lumbar spine and/or thorax. Often symptoms of perineal (pelvic floor) pain will vary depending on variables of vaginal delivery like pushing time, tearing, episiotomy, or variables with a C-section such as emergency vs planned.
*Join us at the Modern Bump Social on December 3rd and come meet Tamarah*
Something called the ‘Puerperium’, or final phase of childbearing lasts 6-8 weeks post delivery, after which the genital tract returns to a non-pregnant state.
During this puerperium phase, you may have difficulty contracting your pelvic floor muscles because of pain. This may result in disturbance of your continence (ie leakage, urgency, pain, stress incontinence, retention, faecal incontinence).
Therefore experiencing the following during the first 6-8 weeks postpartum can be normal:
- You may feel like your bottom is falling out and not know how you should be standing or sitting
- Pain with sitting
- Following C-section, abdominal and incision pain with laughing, coughing, moving
- Pain in your back, hips, pubic region
- Pain in your neck, shoulders, arms as you adjust to taking care of a baby/breast feeding
- Difficulty controlling urine, gas, stool
- Weakness, especially in abdominal muscles
Pelvic floor muscle retraining exercises can be commenced shortly after delivery; it has been shown to reduce pain, reduce/eliminate low back and pelvic pain and assist in eliminating continence issues. However, if you are uncertain how to connect properly you must seek the expertise of a trained Pelvic Floor Physiotherapist.
What is important to recognize is when normal becomes abnormal.
After the puerperium phase, any of the following that continues past those 6-8 weeks post delivery is abnormal and needs to be addressed:
- Any pain in the body (pelvic, low back, neck etc)
- Continued bleeding
- Issues with any incision (C section, episiotomy, scaring from perineal tear from delivery)
- Any leaking of urine/stool/gas with activities (e.g. running, jumping, laughing)
- Loss of control of urine when there is strong urge to go
- Pressure, bulging in the vagina or rectum
- Pain with intercourse
- Difficulty with any daily activity/task
- Remaining diastasis recti (DRA) of the abdomen that is doming with any activity/task/exercise
If you have any of these issues after the initial 6-8 weeks postpartum, you need to seek assistance from a physiotherapist or your family physician who likely will refer you on to a pelvic floor physiotherapist. Many of these issues are treatable; however, when ignored they do not resolve on their own and can cause long term issues. It is not a good idea to start a core strengthening program at this time, because it is essential to ensure proper functioning of the deep core muscles (pelvic floor, transverse abdominals, multifidus etc.) prior to starting any strengthening program.
It is important to seek out a physiotherapist who is specialized in Pelvic Floor and Pre/Post Partum to address these issues with a proper evaluation. The therapist should be certified to perform a complete internal vaginal examination, as well as be able to assess with real time ultrasound any Diastasis Recti (DRA). The therapist will help you create an individualized program that is focused on you.
Tamarah is a physiotherapist at Diane Lee & Associates and will be joining us December 3 at the Modern Bump Social. Get your tickets now.