Pelvic Floor
During pregnancy your pelvic floor has to support the weight of the baby and ensure the continence mechanism is maintained with any increase in intra-abdominal pressure. During vaginal birth, the pelvic floor need to relax and stretch to allow for the birth of the baby through the vaginal canal.
Risk factors for pelvic floor dysfunction include, a long pushing stage of labour or a very quick delivery, baby >4kg, instrumental delivery i.e forceps and episiotomy or tears. Even if you had a caesarean section, the weight of the baby sitting on the pelvic floor for almost 9 months can mean It is not as strong as it was pre-pregnancy.
Signs of pelvic floor dysfunction:
- Feeling of pelvic heaviness
- Visual vaginal bulge
- Bladder leakage with coughing, laughing or sneezing
- Urinary urgency and frequency
- Impaired bowel health
- Sexual pain
It is super important to review with a pelvic health physiotherapist to get a comprehensive assessment and management plan for your pelvic floor rehabilitation. This will allow you to reach you postpartum return to exercise goals in a safe way without putting further stress on your pelvic floor.
Abdominal wall
The abdominal wall is made up of the Rectus Abdominus, Internal and external obliques and traverse abdominals. These work closely together for postural stability, core strength and functional movements.
During pregnancy, the Rectus Abdominus needs to lengthen and sometimes separate to allow for the growing uterus. Your midwife or Obstetrician may have mentioned an ‘abdominal separation’ in the first couple of days postpartum, or you may have noticed some doming when you sit up out of bed.
In the first few weeks postpartum, use this time to rest your abdominal wall and body to allow for natural healing to occur. When you feel ready or from ~4+ weeks postpartum, your physiotherapist can perform an abdominal wall assessment.
This entails isolating different muscle groups and loading them gently to see what capacity they have for exercise. You will then receive a home exercise program than includes abdominal wall rehab, as well as other strengthening exercises to reach your exercise goals.
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