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
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, and prenatal yoga (our personal fave!) can help maintain pelvic floor tone.
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.
Push Effectively
When it's time to push, listen to your body. Pushing gently and only during contractions, without holding your breath, places less strain on the pelvic floor.
During Breastfeeding
While breastfeeding doesn't place much direct strain on the pelvic floor muscles, it does affect other areas that impact pelvic health. Listen to Jenn Lormand, women’s physical therapist and co-creator of Tighten Your Tinkler share posture tips to minimize pelvic floor stress when breastfeeding.
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. Follow these tips:
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.
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.
Normalize Pelvic Floor Health
The postpartum period is physically and emotionally demanding for any new mom. Prioritizing pelvic floor health through proper precautions and rehabilitation exercises may not be at the top of your list, but it's so important for long term wellness. 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, right? Let’s normalize the same thing for pelvic floor issues that are impacting quality of life.
On the Podcast
To go deeper on pelvic floor health and the connection to breastfeeding I sat down with Jenn Lormand of Tightenyourtinkler and had the privilege of soaking up all her knowledge and passion for the work she does. Jenn and her business partner, Christina Walsh, have a combined 36 years of experience supporting women through prolapse, diastasis recti, and more. The Journal of Women’s Health Physical Therapy featured their holistic protocol that helps women relieve pelvic floor issues, and they have turned that protocol into their Signature Program, which can be completed in the comfort of one's own home. Jenn & Christina are on a mission to show more mamas what’s possible for their health while honoring their dignity, time, and season of life.
Check out our "Spilling the Milk: Breastfeeding Chats" conversation (transcript available) on YouTube or download from your favorite podcast app!
I had not thought about the impact of breastfeeding posture on a nursing mom's body, including pelvic floor health, but Jenn has thought a LOT about this and shares incredibly valuable insight and tips that I WISH I had when I was nursing babies hunched over in a chair for many hours/day.
Breastfeeding Posture Tips for New Moms
In addition to sharing her personal experience with birth injury and breastfeeding, Jenn drops some super valuable knowledge bombs on Breastfeeding Ergonomics.
The number one positioning mistake Jenn sees nursing moms make that causes more pee leaks, urgency, and other pelvic floor problems.
How lack of shoulder stability from improper technique can lead to the dreaded “neck hump” and/or rotator cuff injuries.
Three easy-to-implement techniques moms can start using today to correct their feeding posture (plus how moms should hold their phone to prevent a rounding of their back).
Free Resources & Discounts for New Moms
Jenn did not come to the podcast empty-handed, in fact, she has SO MUCH for our community.
Use Coupon code SPILLTHEMILK for $50 off your purchase of either Healing from Home or their Signature Program, learn more at tightentyourtinkler.com. And you CAN pay with your HSA or FSA card if that’s helpful!
In addition, be sure to download these awesome free resources today:
90/90 decompression for back and hip relief/ diaphragmatic breathwork as a nervous system reset https://www.tightenyourtinkler.com/backandhiprelief
6 week follow up appointment checklist for new moms https://www.tightenyourtinkler.com/6-week-appointment-checklist