Mom Stages - New Motherhood

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Very little is written about the changes in a woman's body after birth. As many of the changes are 'messy' or make women feel embarrassed, woman are reluctant to discuss them, even if their closest friends. In the fourth of a multi-part series, Jodi Cleghorn looks at the pelvic floor musculature in the weeks after giving birth.

Pelvic Floor

The pelvic floor musculature has several important functions including providing vital support for organs such as the stomach, small intestines, bladder, uterus and rectum. They also contribute internal muscular support for the spine and are responsible for bladder and bowel control.¹

Women who have a long labour or a large baby are at a greater risk of prolapsed uterine, bladder and bowel after birth, but that is not always the case, as Genevieve tells. "Three days after birth I thought I was constipated. On the toilet when I went to wipe myself, after some directed pushing, I felt a bulge coming from my vagina," says Genevieve, of her post orgasmic birth experience with a 3kg second baby. "My first thought was OK, well it shouldn't be there, it's coming from me, lets shove it back where it came from -- and that's what I did. Fortunately, I got it back in the right spot. My midwife diagnosed it as a prolapsed bowel wall. With the care I received from my midwife, taking liquid colloidal silica, eating 12 eggs a day and having lots of bed rest, my midwife was barely able to tell there was a weakness at my six-week appointment."

In the days after birth, many women find their pelvic floors relaxed. "The big thing for me after birth was that I actually wet my pants at one point. I wondered what had happened to my control," says Fiona, the mum of a 15-month daughter. "I've always prided myself on having excellent pelvic floor control."

Initially, many women struggle with the management of a weakened pelvic floor. "There was lots of running to the toilet as I struggled to get control. For about four weeks after birth I would have times when I couldn't pee when I wanted to and other times when I would suddenly wee in the middle of the shopping centre," says Angie, mum of two daughters. "I tried to be more consistant with my PFE's* which I believe helped a lot."

Simple activities such as sneezing, coughing, lifting and standing can cause urine leakage. The pelvic floor like any other muscle group needs to be regularly toned with exercises. Women know that they're meant to do them, they can be done just about anywhere, the pay off is almost immediately, yet pelvic floor exercises are easily forgotten.

The pelvic floor muscles need to be activated properly, as Mandi discovered, to be effective and she recommends that women read My Pelvic Floor/Flaw during pregnancy. "I don't think that I was doing effective pelvic floor exercises," she says. "My pelvic floor is not activating properly, and I regret that I didn't prepare myself for the possibility of pelvic floor trauma and dysfunction. It would be wonderful if antenatal educators and midwives were able to assess pelvic floor activation during pregnancy and refer to a specialist if necessary."

It is mostly unknown that the pelvic floor muscles tone the vagina and are directly responsible for the amount of sensation a woman and her partner feel during intercourse. The more control a woman has over the muscles within the vagina and pelvic floor, the more pleasure she is able to receive and give during sex.²

"The first sex we had after birth...I just couldn't feel a thing, and I had always been multi-orgasmic," says Fiona, of her first sexual encounter six weeks after birth. "There was no sensation. I could feel that he was there, but not that constant feedback that something was happening. I had to do my pelvic floor exercises or I didn't see the point in having sex."

The intensity, duration and feelings a woman has towards the changes to her pelvic floor are what makes her experience uniquely her own. The length of labour, the size of the baby, the tone of the pelvic floor during pregnancy and the regularity and correct practise of pelvic floor exercises will all impact on the tone of the pelvic floor in the early weeks after birth. 

*PFE: Pelvic Floor Exercises

References

¹ "Sex, Birth and the Pelvic Floor" by Jeni Drew, in Down to Birth (2008:1).

² My Pelvic Floor/Flaw: information every woman should know by Mary O'Dwyer, published by Red Sok

For personal assistance in toning the pelvic floor see your obstetrician, gynecologist, a specially trained physiotherapist or Feldenkrais practitioner.

Yoni Yearning and Checking Changes are used with the permission of Annie Evett.

Jodi Cleghorn is a mother, writer and editor, feminist and social geographer. Jodi is the co-author of Reclaiming Sex After Childbirth: the survival guide with Annie Evett, with whom she co-owns the Reclaim Sex After Birth website. Jodi remains a regular features contributor to Down to Birth magazine. Jodi lives in Brisbane, Australia with her partner Dave, son Dylan, the fish of Bo and Keats the Cat.

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