A woman’s postnatal body can be a difficult thing to navigate. This body is no worse or better than the body you had before pregnancy – it is simply changed. Embracing these changes is where the difficulty comes in, as some of them might be changes you weren’t anticipating at all!
Luckily, there is a lot that can be done to prepare the body for postnatal life, and prioritise health and healing after birth. In this guide, we’re going to break down the truth about the postnatal body so you can better understand the changes that might come, and how a physiotherapist can help you navigate them. Let’s dive in!
The Truth About the Postnatal Body
What does pregnancy do to the body? From a physiotherapist’s perspective, here are some truth bombs to keep in mind.
FACT: The pelvic floor muscles can be impacted by both birth and pregnancy, resulting in muscle weakness. One of the leading causes of urinary incontinence is pelvic floor muscle weakness. This can occur with any mode of delivery.
FACT: Although very rare, pelvic joints can become injured during natural childbirth.
FACT: Approximately 40% of women who have been pregnant or delivered a baby will experience some degree of pelvic organ prolapse. This might range from very mild, asymptomatic laxity of the vaginal walls, to bothersome prolapse resulting in vaginal heaviness or bulge sensation.
FACT: Abdominal muscles commonly become weakened due to being overstretched during pregnancy. Some women may experience rectus abdominus diastasis which is a separation of the two sides of the abdominal muscle. This is a result of the ligaments becoming stretched and often heals spontaneously or with some guidance from a Physiotherapist.
We know these facts can sound scary, but don’t worry! There is plenty you can do to recover from these issues and help your postnatal body get to a healthier place.
The Long Term Effects of Pregnancy and Childbirth
The process of pregnancy and childbirth can cause a lot of changes, both physical and mental. Here are the changes you should look out for during postnatal care:
Mental Health Issues
When we think about the impact of pregnancy and birth on health, we often jump to the physical body. But pregnancy can have a big impact on a woman’s mental health too.
Postnatal depression, commonly referred to as postpartum depression, is the most common mental health condition that affects women after birth. In fact, postnatal depression affects 1 in 5 new mums in Australia, with symptoms that include low moods, difficulty with sleep, changes in appetite, and feelings of hopelessness.
It is not unusual for new parents to deal with feelings of overwhelm and tiredness, but it’s a much different thing when it enters depression territory. If you find these symptoms last for longer than two weeks following childbirth, you should reach out to a healthcare professional about postnatal depression.
Pregnancy and childbirth impact the physical body, too. Here are some more common postnatal complications that a pelvic health physiotherapist can assist with:
Incontinence issues are a common side effect from pregnancy. Urinary incontinence refers to issues with leaking urine and an inability to control the bladder. This is a complication that can happen with both natural and caesarean births, especially for those who may have had bladder issues before pregnancy. Incontinence issues can feel embarrassing, but they shouldn’t be! Pregnancy and childbirth have a lot of impact on the pelvic floor and pelvic organs. While reductions in muscle strength in the pelvic region can lead to incontinence, regular exercise guided by a physiotherapist can help to correct the issues.
Chronic Pain Issues
Chronic pain issues can also happen as a result of pregnancy and childbirth. The cause behind postpartum pain will differ depending on your specific medical issue, but in most cases, this kind of chronic pain is normally linked to joint, muscle, or bone related health issues in the pelvic region.
Vaginal births can lead to different pain related issues, often related to damage sustained during birth. This can include bone or joint pain in the hips/pelvis, muscle tears, nerve damage in the pelvic region, and more.
Again, depending on the nature of the issue, different treatment methods are needed. Treatments can include different strength training and physical activity exercises targeted to the pelvic region with a physiotherapist, or in extreme cases, medication and/or surgery.
Ab separation (also called rectus abdominis diastasis) is another common childbirth outcome that many first time mothers don’t know about. Sometimes during pregnancy, the growth of your developing baby can cause the outer layer of your abdominal muscles to separate. The weakening of this muscle and its separation will lead to poor abdominal and lower back control.
This is a result of the body making room for a growing baby. However, with the correct guided exercise program from a physiotherapist, this issue can be addressed.
How Will I Know If I Have Long-Term Postpartum Effects?
The only true way to know if you’re being impacted by postpartum health concerns is to reach out to a healthcare professional and ask! A postnatal physio appointment can be a great way to physically assess the body for issues. Here’s what you can expect if you go to one of these appointments.
What Happens at a Physiotherapy Postnatal Assessment
When attending a postnatal assessment with one of our pelvic health physiotherapists, there are four key areas that will be assessed: pelvic floor muscles, pelvic organs, the pelvic bones, and abdominal muscles.
Firstly, your physiotherapist will check the pelvic floor, mainly assessing muscle strength and stability. Along with assessing these pelvic muscles, they will also assess the pelvic organs for signs of prolapse, including the uterus, vagina, rectum, etc. Finally, an assessment will be done of the abdominal area, for signs of rectus abdominis diastasis.
After the completion of the assessment, we can then prescribe treatments as needed. In many cases, this will be a physiotherapy led program aimed at reducing any negative symptoms, and increasing strength and stability in affected areas through physical activity and strength training.
Healing with Weight-Bearing Exercises
Many of the different kinds of exercises patients do when healing from postnatal health issues will be different weight-bearing exercise routines. This is especially true for those treating bone health issues after birth in the pelvic region.
When people think of physical therapy or using exercise as recovery, they might picture non weight-bearing exercise, like the use of gym machines or endless hours of cardio. However, it is gentle weight-bearing exercises that will truly help, helping to build up healthy bones and strong muscles with less negative impact.
Please note that any higher intensity exercise should be avoided for the first 12 weeks post-birth, to prevent injury occurring. Your Physiotherapist will guide you with what exercise is appropriate for you, based on your assessment findings.