Growing up, it’s much more common to hear the cliche “words of wisdom” when it comes to becoming a new mother. We hear things like, “get ready for no sleep” or “it’ll be hard but you’ll love every minute of it”. One thing that many more women are less prepared for are the changes their bodies go through both during pregnancy and after.
- Sex may be painful after delivery.Women often get a clean bill of health at their 6 week follow up with their OB-Gyn or midwife and attempt to have sex only to find that it uncomfortable or downright painful.
This is true even for women who undergo a cesarean section. The pelvic floor muscles experience pressure and stretch with the latter stages of pregnancy and labor, and often tear during delivery. This can lead to pain that can last even beyond the 6 weeks typically allotted for healing. Breastfeeding also leads to decreased estrogen levels in the body which can lead to vaginal dryness which is another factor leading to discomfort during intercourse.
There are a few ways to work through this condition depending on the severity of the pain. First and foremost is to only return to sexual activity when you truly feel ready. Trying to push through the pain can lead to tension in the muscles and can prolong healing time, eventually becoming a chronic issue. Take your time, and move at a pace that feels good to you.
Second, utilize safe, water based lubricant to assist with dryness. Last, if the pain becomes worse, or has not improved within 6 months, ask your physician to refer you to a pelvic floor physical therapist. The physical therapist can assist in managing scar tissue, and rehabilitate the pelvic floor muscles.
- You may experience Pelvic Organ Prolapse (POP). Pelvic organ prolapse is a condition characterized by a sensation of pressure in the pelvis or vagina. It will often feel as though the pelvic organs have become heavy, or as though they are falling out of the body.
This is caused by tearing and weakening of the pelvic floor muscles themselves, or to the ligaments suspending the organs. Prolonged pushing during labor and delivery (pushing for longer than two and half hours), tearing of the pelvic floor during delivery, and delivery of a large baby are all factors that can lead to prolapse. Women who are on their second, third, or more births are at higher risk for POP to occur.
Women who have undergone C-Section can also experience POP in some cases, especially if they pushed during labor prior to undergoing C-section. Sit ups, crunches, and heavy lifting should be avoided, as this can lead to worsening of the prolapse. Moderate cases of POP are fixable with specific pelvic floor strengthening exercises (Kegels), and use of kegel exercise weights.
It is beneficial to see a pelvic floor physical therapist for instruction in a safe progression of exercises. Severe cases of pelvic organ prolapse may require surgery.
- You might start leaking urine when you cough, sneeze, laugh, or jump. The pelvic floor muscles can weaken during pregnancy and after delivery, which decreases support of the bladder neck and urethra, where urine exits the body.
When you add exertion to this situation with a sneeze, a cough, or a good workout, the pelvic floor muscles can’t withstand the force and it results in bladder leakage. The good news, is that this, like prolapse, is fixable with Kegels to strengthen the pelvic floor muscles and does not require going under the knife in the majority of cases.
Hopefully you’ve learned a thing or two about how a woman’s body changes after pregnancy and by no means is this meant to scare you but the more women know about what to expect from their bodies, the better prepared you’ll be!