Postnatal Pelvic Floor Exercises

Postnatal Pelvic Floor Exercises

 This information is provided as a general information and a guide only and clients are advised to consult with their own caregiver for further advice.

The ups and downs of the pelvic floor muscles after birth.

Congratulations! Being a new mum is exciting but it does mean that your body has gone through a lot of changes over the last 9 or 10 months and now is the time to focus on recovery of muscle strength and function. Pelvic floor muscles are a funnel shaped trampoline like group of muscles under your bladder, uterus and bowel that help with bladder and bowel control and support of these pelvic organs. Pelvic floor muscles also have important sexual functions and help support the back and pelvis.

 

  • Women who have had a baby are around 3 times more likely to wet themselves as women who haven’t had a baby. 1 in 2 pregnant women suffer urine leakage even in their first pregnancy. 1 in 3 continue to leak afterwards.
  • Descent or prolapse of the pelvic organs (bladder, uterus and or bowel) may also affect women post natally. Around 30% of women are estimated to have some pelvic organ prolapse but mostly it is asymptomatic or minor.1 in 10 women undergo surgery to help with prolapse, 1 in 5 have repeat surgery and 1 in 3 further surgery. Prevention and early management is preferable if possible! 

 

All women must perform pelvic floor muscle exercises regularly even if they have no symptoms at the time as it is effective in preventing and reducing incontinence and helping prolapse but just like when you take medication the dose has to be right.

  • After birth even if you have had a caesarian delivery, seek advice of your hospital Physiotherapist and attend the Physiotherapy Post natal Class. 
  • A Physiotherapist can show you how to correctly use your abdominals and your pelvic floor muscles in this post natal period.
  • Seek advice from your midwife or physio after birth on how to use ice and use your bowels effectively. 
  • Avoid lifting anything heavier than baby for 6 weeks and then continue to avoid heavy lifting for at least 3 months. Get assistance with heavier housework jobs. Remember, you only have one pelvic floor.
  • Rest is super important! Make sure you rest horizontally for periods of 20-30 minutes daily for at least 6 weeks to allow the pelvic floor and abdominals to rest. For the first 2 or 3 weeks, rest for 2 hours accumulated over the day.

 

  • To exercise the pelvic floor, begin 24-48 hours after birth in a lying position with a squeeze and lift of the pelvic floor muscles. Start with a gentle 3 second hold, rest for 3-6 seconds and repeat 3 times.  Do this 3 x daily. Seek further advice on when to start exercises again however if your perineum is painful or you have had an extended tear or episiotomy.
  •  As time goes by you will aim to squeeze and lift more intensely.  When you cough, sneeze, laugh, blow your nose, or lift baby or anything else, squeeze and lift up hard inside and also gently activate your low, deep abdominals.
  •  As your body continues to recover after birth, increase the long holds up to 8 seconds. Make sure you contract as hard as you can without holding your breath, tightening your upper tummy, bottom or thigh muscles. Do up to 8-12 repetitions but aim to increase the difficulty of the exercise by trying to squeeze in sitting, then standing.
  •  After 3-4 weeks add in strong quick squeezes at the last few seconds of your long holds.. Just squeeze and lift up, and again and again the rest completely. This is just as important as the lift part of the exercise as many women hold tension in the pelvic floor muscles which can cause pain just if it was your shoulder muscles or buttocks that were overly tense.
  •  Exercise the pelvic floor in different positions especially if you are getting stronger. Continue to exercise 3 x daily until you have no symptoms of pelvic floor weakness, and can hold strongly for 8 seconds, 8 -12 times. This may take several months. Continue to exercise the pelvic floor muscles to fatigue 1 x daily and continue to use them in every day activities.
  • It is essential for the pelvic floor to be able to fully relax as well as be strong otherwise pelvic pain, sexual problems, urinary frequency, voiding dysfunction, constipation, hip or pelvic girdle pain amongst other conditions can manifest. Ensure that between tightening the pelvic floor,that you fully let go. If you have any of the above mentioned problems consult your care giver.

 

Be aware that studies looking at learning pelvic floor muscle exercises from a handout or verbal instruction show that 50% of women use incorrect muscle action and 25% actually use straining action that can weaken the pelvic floor. Therefore, individual explanation and assessment of correct technique is recommended for all women particularly pregnant and postnatal women even if you have no symptoms.

 

Individual assessment is essential if you are experiencing any difficulty with the exercises or problems with bladder, bowel or sexual function. Seek help early.