Get to Know Your Body After Baby

Moms, have you ever had any of the following after having a baby?

• bladder leakage

• constipation

• painful sex

• a ‘falling out’ feeling

• baby belly

• back pain

If so, have you ever considered taking a look ‘down there’ to figure out what needs to be fixed? The answer is usually ‘No,’ and the common reasons are, “I’m afraid to look down there!” “I don’t know what normal is….” or “I don’t know what to look for…”

But, what if you could take a guided self-assessment from home that will help you understand your body and postpartum problems…would you take it? Whether you baby is 6 months or 16 years I recommend this assessment; it is an empowering process that will help you understand your body and communicate with your health providers. And you may be completely asymptomatic (“No postpartum problems here!”), but actually have issues like diastasis, pelvic organ prolapse or pelvic floor incoordination that may be inhibiting your core strength, sexual function or bowel & bladder health in some other way.

An easy way to increase your pelvic IQ and improve communication with your pelvic health providers is by understanding your own body first! Here is an overview of what the self-assessment walks you through and why it’s important:

Typical Pregnancy Posture

An upright posture will not only help you look younger it will also help your pelvic floor function properly! Many women offset the weight of their growing belly during pregnancy by developing a typical pregnancy posture; the hips and head thrust forward compared to the upper back. The shoulders also tend to round forward which is reinforced with breast feeding. Our body adapts to what we do on a regular basis; our skeleton tells a story. For example, if you typically carry your child on your right hip, which hip do you think will be higher? And even though you might FEEL symmetrical, your posture may be out of alignment. Why does this matter? Your pelvic floor is a core stabilizer…this means it is ALWAYS turned on to some degree to help you move, however, a typical pregnancy posture may cause the pelvic floor to work harder than it needs to leading to a compromise of one of its other functions like sphincter control.

Diastasis Recti

Diastasis recti is a hot topic at the moment. The buzz is typically about how to get a flat belly after baby. A diastasis recti is a weakening or separation of the linea alba which is a piece of fascia holding your 6-pack muscles (retcus abdominus) together. It makes sense that no matter how many sit-ups or planks you do, if you have separation of the supportive fascia at the front of the abdomen, you may have a belly bulge. But, this is SO important to look at from a functional perspective as it may explain why ‘Kegels’ won’t cure your urinary incontinence or why you have back pain!

Pelvic Organ Prolapse

Pelvic organ prolapse is when the internal organs (bladder, uterus, and/or rectum) drop down towards the vaginal opening due to a lack of support. Moms are particularly suseptable to pelvic organ prolapse after delivery, but women who have never had babies can also have prolapse! Prolapse can cause symptoms like a ‘falling out’ feeling, constipation, difficulty voiding, leaking after standing up from the toilet, or back pain. A surprising study Barber & Maher in 2013 showed that only 3-6% of postpartum women are symptomatic, but 50% of women showed evidence of prolapse on examination! What does this mean? It means that you could have some laxity supporting the internal pelvic organs and not even know it! The theory, “what you don’t know can’t hurt you” does not apply here; simple habits like baring down to poop or improper lifting technique could actually worsen the problem and CREATE symptoms over time! However, a proper exercise program and lifestyle changes could even REDUCE your prolapse!

Pelvic Floor In-coordination

Did you know that 1 in 6 women have difficulty contracting their pelvic floor after delivery? The typical recommendation to “Do your Kegels” ain’t going to cut it if you don’t know how to contract your pelvic floor. In fact, many women diligently perform their pelvic floor exercises to improve problems like bladder leakage only to worsen their symptoms or find out that they were not doing them correctly in the first place! Not only do the muscles of the pelvic floor get stretched, but the nerves do as well which can cause decreased awareness of what your muscles are doing (Contracting? Relaxing? I don’t know!). This guided self-assessment will not only help you understand the strength of your pelvic floor muscles, but also if they are coordinated, which can save you a whole heap of time and frustration!

I hope that my free online mini course “A Mom’s Map to Leak Free Living” helps you understand why leakage is common after delivery, why you might have leakage, and what you can do about it!

Please feel free to comment on this page or in the course and share the self-assessment with your friends!

-Susannah Haarmann, PT, WCS, CLT

Author:

Susannah Haarmann is a physical therapist specializing in pelvic floor and breast cancer rehabilitation. She and her private practice are located in Asheville, North Carolina. Susannah helps streamline other therapists practice with resources like The Bladder Book and The Bowel Book which provide evidence based handouts for practitioners to use in their clinic during patient care. She also creates online coursework for practitioners and the public educating on pelvic health and breast cancer rehabilitation.

Resources:

Henderson, Joseph Welles, et al. “Can Women Correctly Contract Their Pelvic Floor Muscles Without Formal Instruction?” Female Pelvic Medicine & Reconstructive Surgery, vol. 19, no. 1, 2013, pp. 8–12., doi:10.1097/spv.0b013e31827ab9d0.

Schmid, Corina, and Christopher F. Maher. “Epidemiology, Risk Factors, and Social Impact of Pelvic Organ Prolapse.” Pelvic Organ Prolapse, 2013, pp. 1–9., doi:10.1016/b978-1-4160-6266-0.00001-0.