VAGINAL BIRTH RECOVERY

POSTPARTUM PELVIC FLOOR PHYSICAL THERAPY

What do you do in PT after giving birth vaginally?

PHASE 1 (1-5 weeks)

  • First step is reconnecting with your breath and core engagement so you can use that to support your movements and avoid discomfort

  • Any manual therapy such as spine mobilizations and pelvis alignment and bodywork

  • Lymphatic Drainage Massage and cupping therapy

Phase 2 (6-12 weeks)

  • Continuation and progressing phase 1

  • Assessing DRA (diastasis recti) and strengthening the deep core

  • Strengthening the pelvic floor muscles (not kegels!)

  • Creating an individualized strength and mobility exercise plan for you, all housed in-app

  • If you have pain with insertion when cleared for sex, you will be shown how to use of a pelvic floor wand to perform release work as homework

  • If you tore, you will be shown how to mobilize the perineal tissue

  • Internal vaginal or rectal assessment with patient consent and if necessary

Phase 3 (13+ weeks)

  • Continuation from phase 1 & 2

  • Progressing you to the hardest core and strength exercises in preparation for whatever activity you wish to return to (running, pilates, barre, etc)

  • Improving full body posture and strength and addressing any other aches and pains or pelvic floor concerns

When do we start PT? Do I have to wait 6 weeks?

No, you don’t have to wait 6 weeks! We don’t need to do an internal exam to get started on your rehab, or potentially at all when working together.

We can start as early as you’d like, but 2 weeks postpartum is a great time so we can follow the 5-5-5 rule and allow your body to rest and heal. PT can help facilitate full body healing and bring pain relief to the rest of your body. This happens through lymphatic drainage massage, manual therapy such as joint mobilizations, sacral or pelvic alignment techniques, and cupping therapy.

Be mindful if you use Christian Healthcare Ministries because you receive pelvic floor PT coverage/reimbursement until 9 weeks postpartum- so don’t wait!

What to look for postpartum

  • A common (BUT NOT NORMAL) thing postpartum via vaginal birth is pelvic floor heaviness also known as prolapse, vaginal prolapse, bladder prolapse, there are multiple names for this type of “feeling” as it can come from different organs lowering or bulging into the vaginal canal. This is something that typically happens after hours upon hours of purple pushing (also known as inhaling as much as you can and then holding your breath and pushing down as hard as you can to get baby out) but can also be present prior to pregnancy and birth, but exacerbated postpartum.

  • Another common (but not normal thing) bladder leakage with squatting, laughing, coughing, sneezing, jumping, running, or being startled

  • Pain with insertion or sex

  • Diastasis recti (DRA) any coning or doming appearance at your abdominal midline when you sit up or exercise? We can help that, there are so many myths that surround the healing of DRA- check out my content below to learn more.

  • Rib flare- This is common and normal postpartum because our ribcage just finished widening to make room for baby. What’s NOT normal, is if we let it stay in that “open” position, we use exercise and intentional engagement with the different abdominal layers to move the ribcage back into its normal angle (allowing you to fit back into your pre-baby bras, shirts)

  • Open Pelvis Birth Pattern- This is also common postpartum because our pelvic outlet just widened to allow baby to move through your pelvis. However, it’s not normal for it to stay in that “open” position! We can help it move back into a good position through different strength exercises and manual techniques. Staying in this open birth pattern can contribute to why you may have SIJ pain, round ligament pain in your following pregnancies, or pubic symphysis pain (SPD).