The journey of motherhood is an incredible experience, but it can also take a toll on your body. Pregnancy and childbirth put immense strain on your pelvic floor muscles, those hidden heroes that support your bladder, bowel, and uterus. While some discomfort is expected during postpartum healing, many new moms experience more significant issues like urinary incontinence, pelvic pain, or weakened core strength that can impact how they function during their day or their ability to care for their newborn or older children. This is where pelvic floor therapy comes in – a specialized form of physical therapy that can help restore function and well-being in your pelvic region.

But when is the right time to start pelvic floor therapy after having a baby? Traditionally, the answer was "wait at least six weeks," aligning with the typical postpartum check-up. However, recent research and a growing understanding of pelvic floor health paint a different picture. Let's explore the factors to consider when deciding the best time to embark on your pelvic floor therapy journey.

Why Pelvic Floor Therapy Matters After Pregnancy and Birth

Think of your pelvic floor muscles like a hammock cradling your organs. During pregnancy, your baby grows, putting significant weight and pressure on this hammock. Childbirth, especially vaginal delivery, can further stretch or weaken these muscles. This can lead to a variety of problems:

· Urinary incontinence: Leaking urine when you cough, sneeze, laugh, or exercise.

· Fecal incontinence: Difficulty controlling bowel movements.

· Pelvic pain: Discomfort or pain in the pelvic or lower abdominal area, including during intercourse.

· Urinary urgency: Feeling a sudden, intense need to urinate that may be difficult to control.

· Pelvic organ prolapse: When organs like your bladder or uterus bulge into the vagina.

· Diastasis recti: Separation of the abdominal muscles.

These issues not only affect your physical comfort but can also impact your emotional well-being and daily activities.

Traditional vs. Modern Approaches to Starting Pelvic Floor Therapy

Previously, the prevailing advice was to wait at least six weeks postpartum before starting pelvic floor therapy. This timeframe was consistent with initial postpartum healing and ensured doctors could clear you for physical activity. However, many women experience pelvic floor issues right after delivery or within the first few weeks.

We now know that starting pelvic floor therapy before six weeks, sometimes right away after giving birth, regardless of delivery method (vaginal or cesarean) can be beneficial for many women. In some countries, women have a pelvic therapy visit before ever leaving the hospital. The ideal time is “as soon as you feel ready.”

Early postpartum is a time for rest, healing and adjusting to caring for your newborn. Those early weeks can sometimes feel overwhelming, especially with your first baby. So don’t feel pressured or rushed, just know that you don’t have to wait if you feel ready sooner or have symptoms that are impacting your daily function.

If able, consider starting pelvic physical therapy during pregnancy to help preemptively prepare and know what you can do to help support your early postpartum healing and recovery until you feel more ready for an appointment at the clinic again.

Factors to Consider When Deciding When to Start

There's no one-size-fits-all answer to this question. The ideal time to start pelvic floor therapy depends on several factors:

· The severity and type of your symptoms: Early intervention is more helpful for severe symptoms like significant incontinence or pain.

· Grade 3 or 4 perineal tearing: Larger perineal tears impact more muscles of the pelvic floor extending beyond the perineum into the anal sphincter or even the rectal canal

· Maternal birth injury: Pelvic physical therapy can provide education on how to help your body heal and recovery from a birth injury

· Your doctor's recommendations: Discuss your concerns and symptoms with your doctor.

· Your overall health and recovery: Some women may feel ready for therapy and more activity sooner.

· Your comfort level: Don't feel pressured to start therapy before you're ready. Focus on taking care of yourself and bonding with your baby.

What to Expect During Pelvic Floor Therapy

A pelvic floor therapist will conduct a thorough evaluation, which may include:

· Discussion of your symptoms and medical history.

· Assessment of your alignment, posture and body movements.

· A physical examination to assess pelvic muscle strength and tone.

Based on the evaluation, your therapist will develop a personalized treatment plan. This may include:

· Pelvic floor exercises: These targeted exercises can strengthen and retrain your pelvic floor muscles.

· Manual therapy: Techniques like massage and mobilization can help improve blood flow, reduce pain, and promote healing.

· Lifestyle modifications: Your therapist might recommend adjustments like bladder training techniques or changes to your daily routine to improve function.

How to Find a Pelvic Floor Therapist

Look for a therapist who specializes in women during pregnancy and postpartum. Advanced specialty training is required to assess internal muscles of the pelvic floor, so make sure your therapist can provide both internal and external evaluation and treatment.  If you are unsure about an internal muscle assessment, just talk with your therapist to develop a treatment plan to your comfort level.

Pelvic Floor Therapy at Movement is Medicine

Our pelvic floor therapist, Dr. Meghan Karol, helps women with a wide variety of pelvic conditions including postpartum recovery. Dr. Meghan loves spending one-on-one treatment time to provide empowering education to her patients helping them integrate their self-treatments and lifestyle changes into their practical day to day lives. With three young boys at home, Dr. Meghan knows life doesn’t slow down just because mom isn’t feeling good. Call us today to learn more about how Movement is Medicine can help keep you active with all your life.