“Who Stole My Vagina?” and Other Postpartum Problems

After you deliver your precious child, your body should bounce right back, right?

Just when you thought all the challenges of pregnancy had passed, you put your pants on to leave the hospital and realize the body you’ve known all your life is a little bit different now. Often times we ask ourselves, ‘Why aren’t I back in my jeans yet? When will I feel enough energy to get back in shape? Who stole my vagina and when will I get it back? Who forgot to mention these things could happen?!’

Throughout pregnancy and delivery, whether vaginally or through caesarian, a woman’s body, including her breasts, abdomen, pelvic floor muscles, tissue, and nerves, are stretched and pulled, all in the name of a normal uncomplicated pregnancy and delivery. And when complications do occur, the body can take even more of a beating.  There are many common symptoms women may experience as a result of pregnancy and childbirth: pain (back, tailbone, hips, vagina, rectum, bladder, pelvic floor, neck, shoulders), incontinence (loss of control of feces or urine), urgency or inability to empty bladder, pain during sex, diminished or absent orgasm, abdominal muscle weakness and/or separation, and a tough time with exercise. I’m often asked two questions, ‘Am I the only one?’ and ‘Is this my new normal?’ Embarrassment prevents a lotof women from asking these questions out loud, but there is help available!

Incontinence, an involuntary loss of urine, gas, or feces, is a result of the stretch and pressure on the pelvic floor muscles, nerves, and tissue during pregnancy and delivery. It’s very common – 50% of women experience incontinence one year after they deliver their first child.One normal vaginal or instrumental delivery increases the risk of incontinence alone more than three to four times, and anal injuries showed a four time increase in the risk of incontinece.1

There are several factors out of your control that increase a woman’s risk of perineal and pelvic floor injury. Unfortunately, the vaginal tearing and/or episiotomy performed during a vaginal delivery can lead to future issues with pelvic floor muscles. 2These muscles are important for continence, sex, and the support of pelvic organs. After delivery, women commonly experience pain with intercourse that can affect arousal, lubrication, orgasm, and global sexual functioning.3  

Another common symptom that arises during pregnancy is diastasis recti, a separation of the rectus abdominus muscles (also known as your abs). During pregnancy, these muscles separate as your abdomen expands. 50-60% of women at 6 weeks postpartum experience diastasis recti. Unfortunately, due to the weakening of the muscles, it can lead to incontinence and back pain in postpartum women. 

Scars of the abdomen (from c-sections), vagina or rectal tissues (from tearing or episiotomies) can cause persistent pain and lead to discomfort, pain with intercourse, urinary urgency/frequency, or even back pain. These scars can adhere to surrounding tissues during healing, limiting the mobility required for everyday movements. 

So what’s a woman to do?

Pelvic floor physical therapy at BreakThrough Physical Therapy can easily treat many of these issues. We identify problematic muscles and scar tissue, then develop a treatment plan based on yourneeds. This treatment plan can include:

  • Motor control exercises
  • Retraining pelvic floor muscles to address incontinence
  • Scar mobilization to increase pliability of the tissues and reducing pain, itching or sensitivity
  • Manual physical therapy to address difficulty with pain during vaginal intercourse or penetration
  • Myofascial trigger point release to address hypersensitivity to the restricted painful tissue caused during trauma to the muscles during delivery

The biggest takeaway is that there ARE solutions to these problems, and I hope you feel comfort in knowing that you are NOT alone.  You only get one body in this life, and it’s my goal to make sure you feel comfortable and at your absolute best in it! If you have specific questions, I’m happy to help – send me an email at nicoleh1@breakthrough-pt.com, or schedule a free screen!

Nicole Hodges PT, DPT, ATC
Physical Therapist
Certified Pelvic Health Practitioner
Break Through Physical Therapy
910-920-4903
NicoleH1@breakthrough-pt.com

 

References: 

1. Johannessen HH1, Stafne SN2,3, Falk RS4, Stordahl A5, Wibe A6,7, Mørkved Prevalence and predictors of double incontinence 1 year after first delivery.S2,8. Int Urogynecol J. 2018 Mar 2. doi: 10.1007/s00192-018-3577-7.

2. Aasheim V1, Nilsen ABV, Reinar LM, Lukasse M.Perineal techniques during the second stage of labour for reducing perineal trauma. Cochrane Database Syst Rev. 2017 Jun 13;6:CD006672. doi: 10.1002/14651858.CD006672.pub3.

3. Barbara G1, Pifarotti P2, Facchin F3, Cortinovis I4, Dridi D5, Ronchetti C2, Calzolari L2, Vercellini P5. Impact of Mode of Delivery on Female Postpartum Sexual Functioning: Spontaneous Vaginal Delivery and Operative Vaginal Delivery vs. Cesarean Section.J Sex Med. 2016 Mar;13(3):393-401. 

4. Sperstad JB1, Tennfjord MK2, Hilde G3, Ellström-Engh M4, Bø K1. Diastasis recti abdominis during pregnancy and 12months after childbirth: prevalence, risk factors and report of lumbopelvic pain.. Br J Sports Med. 2016 Sep;50(17):1092-6. doi: 10.1136/bjsports-2016-096065. Epub 2016 Jun 20 

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