Pelvic Floor Health: Essential PT During and After Pregnancy

By: Amanda Gotschall PT, DPT

Early in my career, I noticed many women 20+ years after childbirth having a lot of dysfunction and pain in their bodies and I wondered why? Most, if not all the time, the root cause of their pain was from a dysfunctional pelvic floor.

Common Issues Post-Childbirth

In many cases, these women were never taught how to correctly do a Kegel, they never received scar massage on their cesarean section or Perineum scars, they didn’t even know pelvic floor PT existed. Thankfully, pelvic floor PT is now more understood and well-known. Many, if not all, women need at least one pelvic PT session post-birth to address any issues they are having and to prevent long-term issues in their pelvic floor, low back, sacrum, etc.

Preventing Long-Term Issues

I have found the most ideal way to prevent long-term issues is to get a baseline assessment during pregnancy around 28-32 weeks. Then, two postpartum sessions to address any issues from childbirth to return to activities, such as yoga and running, in a safe and functional way.

Pregnancy Assessment

During the initial pregnancy assessment, we will do a pelvic floor exam (ideally internal if cleared by your medical care provider) to determine the strength and coordination of your pelvic floor. During this visit, we will also assess your ability to push, which is extremely important for effective pushing during labor and more comfortable bowel movements. We will also demonstrate how to perform proper perineal massage to reduce your chances of tearing. We will also address any restrictions or pain in your hips, pelvis, and spine that could affect your birth. We will give exercise guidelines to help prevent injury (including Diastasis recti considerations) to improve outcomes of your birth. Lastly, we will guide you on how to safely move during your first 6 weeks postpartum.

Postpartum Assessment

During your postpartum assessment, ideally around 6 weeks postpartum, we will perform a re-assessment of your pelvic floor and core strength and coordination. We will assess for diastasis recti and any other pelvic floor issues. Then, give you an exercise routine and treatment to address anything we find during the examination. We will do a spinal, pelvis, and hip assessment and treat whatever is needed to help improve your function. If you are interested in returning to a specific exercise like running, cross-fit, yoga, etc. We will start an exercise routine that will prepare for you to return to these activities and further progress you at our next session.

As you can see, there is a lot we need to do to prepare your body for birth and the postpartum period! I am very passionate about pelvic floor work and the changes we can make early on to prevent long-term issues. Even if you are not able to seek physical therapy early on, once you are postpartum, you are always postpartum, and there is so much we can do to heal your body months and years later.

If you have questions, feel free to reach me at amanda@anewupt.com or 970-480-7118.

You can also check out my website for more information: https://www.anewupt.com/about

Happy healing!