All mothers know that pregnancy consists of three stages or trimesters leading up to the delivery of the baby. However, the fourth trimester is the healing stage after childbirth. In recent years the American College of Obstetricians & Gynecologists (ACOG) has taken a more comprehensive stance on postpartum care. Current recommendations are that ideally, all women should have contact with a maternal care provider within 3 weeks of childbirth followed up by ongoing care as needed. ACOG states that physical recovery from birth is one of the components of care that is assessed and in the presence of urinary or fecal incontinence, pelvic floor physical therapy is warranted. In addition to seeking care and guidance for the presence of incontinence there are plenty of other components to consider as well:
· Did you have any tearing of the perineum during childbirth? Have you resumed sex and is this painful now?
· If you had a cesarean childbirth, how is the scar healing? Does the scar feel restrictive?
· Can you connect to your abdomen muscles?
· Can you contract the pelvic floor after childbirth?
· Is there a presence of heaviness felt within the vagina?
· Is the abdominal separation that occurred with pregnancy beginning to heal and come back together? Or is a diastasis present?
· Is there any pain within the pubic bone or tailbone? Low back? Mid back?
· Are you unsure of how to ease back into exercise?
· Are you aware of proper baby/body mechanics and breathing patterns that you should be adopting to avoid increased stress on the body?
Keep in mind that no one person is alike and if there are other concerns or issues that are not listed don’t be afraid to bring it up to your provider. Your postpartum follow up visit is a good time to bring up these concerns and they can refer you out to the appropriate professional.
Remember that you are your biggest advocate!
If you would like a more in-depth explanation about the pelvic floor you can refer to the following blog post.