BY LAURA BROTT, APRN
How Your Pelvic Floor Changes During Pregnancy
Having a baby can be such a beautiful time in your life, but it can also come with pelvic pain which can be attributed to changes in your pelvic floor.
Postpartum pelvic pain is a common issue that many women experience, and with the right support and care, it can be effectively managed, allowing new mothers to fully enjoy the precious moments with their newborns.
Where is your pelvic floor?
The levator ani muscles keep the pelvic organs in place, located between the tailbone and the pubic bone. These muscles help us maintain bladder, bowel, and reproductive function, acting as the foundation for your trunk and upper body. There are multiple nerves that run through the pelvic floor muscles, providing both function and sensation to those areas. Dysfunction of these muscles and/or nerves can lead to pain.
What are the main pelvic floor changes that occur after having a baby?
Postpartum pelvic floor dysfunction exists along a spectrum, with the muscles spanning from extremely loose to tight/spastic.
Relaxin is a hormone produced by the ovaries and placenta during pregnancy. It helps to loosen joints, muscles, and ligaments in the body. This allows the body to stretch and accommodate the growing uterus and baby. These relaxed joints, especially in the hips and low back, can cause a lot of instability in the pelvis.
Sometimes, the pelvic floor may tighten/spasm to provide stability for an otherwise unstable pelvis. The pelvic floor muscles may stretch and weaken because of the weight of the growing uterus and baby. Ultimately, both situations will lead to weakness and contribute to pelvic floor dysfunction and pain during and after pregnancy.
What are the main causes of pelvic pain postpartum?
The weight of pregnancy can hurt the pelvic muscles and nerves, causing pain during delivery and afterwards. Vaginal delivery, especially operative modes of delivery (ie vacuum or forceps), often causes stretch injuries to the pelvic floor. Perineal tearing during delivery is also common, and, depending on the degree of the tear, can lead to prolonged vulvar and vaginal pain.
What are the treatment options for postpartum pelvic pain?
A comprehensive evaluation by a pelvic pain specialist is the first step to resolving your pain. Different modalities can be used to manage pain, like the PRM Protocol for the pelvic floor muscles and nerves. Patients may also explore pelvic floor physical therapy, medications, and lifestyle modifications.