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Lend me your ears (or pelvic floors, rather). You might be currently pregnant, or in the throes of postpartum recovery and thinking of the many needs of your little one. However, we don't often think of (or know) what we need after birth, particularly when talking about “down there.”
Let’s get right to it! We’re talking how to prepare for postpartum healing after a Cesarean or vaginal birth, and how pelvic floor physical therapy can help.
The “birth bag” gets so much attention. But along with this, plan to assemble items for what I like to call your “vag-bag” to have waiting for you when you get home. Below is a list of my top five vag-bag items.
A Peri Bottle is a small squeeze bottle used to cleanse your perineal and vulvar area. This after-birth must-have can be filled with warm water or witch hazel to cleanse your “down there” if you have stitches, hemorrhoids, or just after using the bathroom, as you will likely be sore after birth.
You will need all the ice packs. Ice helps decrease inflammation, swelling, and pain, and speeds up the healing process. If you've experienced a Cesarean birth, use ice over your abdominal incision. Following a vaginal birth, you may want to nestle an ice pack in your mesh undies for 20 minutes several times a day for the first 3-5 days after birth.
Whether you have a Cesarean or vaginal birth, you will experience lochia (vaginal discharge and bleeding) afterward and will want to have lots of maxi pads on hand. Lochia will be very heavy for the first 1-2 weeks after birth, so I recommend super absorbency pads for the early days. Bleeding and discharge will slowly decrease over the following 4-6 weeks, at which point you can transition to thinner pads and liners.
Waist trainers are often marketed to postpartum moms as a way to “shrink” the waist and hips after giving birth. However, these waist trainers can place pressure down onto your pelvic floor. Enter… Compression Garments! Compression garments lift from the outside of the pelvic floor region and abdomen, and help you engage the muscles in your core. The focus is less on “squeezing” the waist and more on gently “hugging” your lady bits and abdomen.
If you have been pregnant or given birth, it’s important that you check in with your body regularly. If anything at all seems abnormal, you should see a pelvic floor physical therapist. Honestly, all postpartum women should see a pelvic floor therapist to ensure that you’re healthy and your body is healing! Your body changes a lot from the 10 months you are pregnant, to giving birth, and then postpartum.
If you’re newly postpartum, check in with a pelvic PT around 6 weeks postpartum for a comprehensive abdominal and pelvic floor assessment. If you are months, years, or even decades postpartum, pelvic floor PT can still be an amazing resource to help overcome and prevent pelvic floor problems.
Your pelvic floor is a basket of muscles that support your pelvic organs and play a role in bowel, bladder, and sexual health. Common pelvic floor-related issues that lead patients to pelvic PT include:
Bowel issues (constipation, hemorrhoids, straining, or leakage)
Bladder issues (urinary leakage, frequent urination, difficulty starting stream, incomplete bladder emptying)
Sexual health issues (painful intercourse, difficulty achieving orgasm)
Pain (tailbone pain, vaginal pain, pain with tampon insertion or pelvic examinations, painful menstruation, or abdominal or perineal scar pain)
Weakness (abdominal separation or diastasis recti, pelvic organ prolapse, pelvic heaviness, or pressure).
In every state in the US, an individual can see a pelvic floor physical therapist without a physician’s referral. However, some (but not all) insurance companies or clinics will require a referral. Just in case, check in with your obstetrician, midwife, or primary care doctor to get a referral and a recommendation to a pelvic PT in your area. Here are a few topics you will want to discuss at your visit.
Share any lingering questions that you didn’t have a chance to ask at the time of birth, or any concerns about your delivery. In addition, you may have questions about what interventions were chosen and how later births may be affected.
Discuss any lingering physical symptoms you have, such as leakage (urinary or fecal), pelvic pressure, prolonged postpartum bleeding, or any pain that you are experiencing, including abdominal, lower back, pelvic, and hip pain. Ask your medical provider what to do if symptoms arise after your visit as you increase activity and return to sex, exercise, or work.
Finally, ask if your medical provider can refer you to a skilled pelvic floor physical therapist. A pelvic physical therapist will perform a thorough exam to assess abdominal and pelvic floor muscle function and help you return to the activities you love pain-free and leak-free. If your physician does not have a pelvic PT they work with closely, here are two directories to find a Pelvic Health PT in your area: here and here.
Talking to your partner about this might feel weird. But I assure you, your partner does not want you to suffer in silence. Sharing your fears, concerns, or what you are experiencing can relieve a huge amount of stress and provide support as you seek the care you deserve.
Life with a newborn can be… busy. Try to have conversations about your health in an environment with the least amount of interruptions possible (television off, phones down, and baby sleeping… if you can plan that sort of thing). Even consider when you and your partner are on a walk with your baby in a stroller, as it may present fewer distractions.
Whatever the time or environment, share not just what you are experiencing physically, but also how you're feeling emotionally. Pelvic floor symptoms can affect your sexual desire, socialization, exercise habits, and even mood. Having these conversations is part of the process of getting you back to doing the things you love and feeling like yourself again.
Going through pregnancy and giving birth is amazing, sometimes scary, and truly transformative in every aspect of your life. As a pelvic health physical therapist, my passion and my goal is to help every person going through this special time in their life to feel empowered and informed. I hope this piece helped you... and your pelvic floor… on that journey.
Related Reading: What to Know About Postpartum Mental Health
Sara Reardon PT, DPT, WCS is a board-certified pelvic health physical therapist and mom of two. She is the founder of The Vagina Whisperer, a pelvic floor education and fitness platform to help women worldwide prevent and overcome pelvic health conditions. You can find her on Instagram @the.vagina.whisperer or TikTok @thevagwhisperer.
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