Common Postpartum Pelvic Floor Symptoms that are NOT Normal

Pelvic Pain, Leaky Bladders, and More

Incontinence (AKA peeing your pants or leaking) is a common postpartum pelvic floor symptom, but that doesn’t mean it’s NORMAL. If you are experiencing any type of bladder trouble, that could be a sign that you need to consult a physical therapist that specializes in pelvic floor therapy. Amanda Fisher, PT, DPT, acknowledges that incontinence relating to pelvic floor issues is common but not after 6 weeks, “In reality, if you are leaking at 6 weeks postpartum, there is a high percentage you will STILL BE LEAKING at 12 weeks postpartum and EVEN 5 years postpartum.” There are other signs that you may be experiencing pelvic floor issues in addition to incontinence as well.

Fisher gives a list of 9 common (but not normal!) types of pelvic pain: 

  • Pelvic pain with daily activities such as sitting, exercise, or stress
  • Painful intercourse
  • Pain with tampons, menstrual cups, or speculum exams 
  • Bowel movement pain
  • Pregnancy pain
  • Period pain
  • Orthopedic pain
  • Pain from other conditions like endometriosis, IBS, fibromyalgia, etc.

Normalizing the “Personal” and “Private”

Nicole Tsetsilas, Certified Strength and Conditioning Specialist – NSCA, discusses the same problem of society normalizing postpartum issues that aren’t actually normal. Tsetsilas states, “We treat labor like such a natural process that women get stigmatized that this is how life is now. Like oh, I had a baby, of course I pee my pants now. Actually, your body isn’t supposed to do that. That’s the sign of a problem.”

Recognizing aspects of women’s health that should be addressed is something that women need to be openly discussing with one another. Tsetsilas further talks about how to fight against a culture that perpetuates “women are supposed to suffer in silence, that we’re not supposed to talk about our problems.” An open discussion about what is and is not normal postpartum helps women bond and share their stories!

Normalizing talking about the “personal” and “private” is a crucial aspect of advocating for women’s health. It’s time to get vocal about what is happening to our bodies whether it is with our doctors, daughters, friends, or family!

Stretch or Strengthen? 

The pelvic floor consists of muscles. Kegel exercises are a great way to strengthen your pelvic floor by working that group of muscles! Kegels work by contracting and relaxing your pelvic floor muscles; contract your muscles and hold for 5 seconds then release for 5 seconds. Repeat up to 10 times, 3 times a day. 

Although Kegels are a coveted method for strengthening the pelvic floor, they are not the only solution to pelvic pain or incontinence. Women’s pelvic health specialist Danielle Butsch, PT, DPT, weighs in on this by stating if you are experiencing complications and are simply told to “‘Go do Kegels,’ that’s inadequate.” Kegels are not the only remedy for pelvic pain and related symptoms.

Some women need to stretch their pelvic muscles rather than strengthen them. Butsch says, “A lot of people need to down-train, not up-train. You need to loosen up the tissue and do some manual work [to relax it]. You don’t need [patients] Kegeling away.” Not every woman’s body is the same prepartum or postpartum and not every solution is one-size-fits-all.

Prioritizing Your Postpartum Pelvic Floor

Your doctor may release you to have sex or begin exercising after 6 weeks postpartum, but just like how Kegels aren’t the perfect solution, the 6-week mark isn’t necessarily the perfect time to restart prepartum activities. In fact, there are some issues that OBGYN’s may not be able to see at the standard 6-week appointment.

Tsetsilas addresses “the disconnect when you go to that 6-week appointment- you should automatically have to go to physical therapy or to a pelvic floor specialist to get evaluated. Those are the experts.” Ultimately, it’s beneficial for you to see a physical therapist prior to engaging in postpartum sex or exercise to prepare your body and your pelvic floor. 

It’s time to speak up for yourself and advocate for your postpartum health! You take all of the proper steps to ensure your baby receives primary care, why wouldn’t you take the same measures for yourself? It’s so important to take care of yourself and prioritize your health.

The takeaway? Consult a physical therapist that specializes in pelvic floor therapy if you are experiencing issues! Just because symptoms may be common, that doesn’t mean they’re normal. You’ll learn more about your body like if you need to stretch or strengthen that pelvic floor, tackle painful sex, and prevent peeing yourself!