What to expect during pregnancy and after delivery
Pregnancy
Pelvic floor problems, also known as pelvic floor dysfunction (PFD), can affect anyone who is pregnant. These problems could be leaking urine (wee) or faeces (poo), unable to control wind, or a heavy sensation or bulge in the vagina. This can happen when the pelvic floor muscles are not working correctly. It is important to be aware of how pelvic floor problems occur and what you can do to reduce them.
During pregnancy, the pelvic floor muscles come under pressure from the extra weight of your growing baby, amniotic fluid, placenta, and the enlargement of the womb. This extra downward pressure and effect from pregnancy hormones (chemicals in the blood stream) causes stretching and tiring of the pelvic floor muscles. The stretching means your muscles do not do their jobs as well as usual.
Childbirth
During childbirth, your pelvic floor muscles will stretch for you to deliver your baby. Some women may sustain tearing of the perineum (the area between your vagina and back passage), and pelvic floor muscles which will take time to heal. This can affect how well the muscles work. The nerves that help make the pelvic floor muscles work well may be affected after birth, so you may feel you have a weak pelvic floor.
It is really important that the midwife or obstetrician (doctor) examines you after birth. You will be asked for your consent for the midwife or obstetrician to examine your vagina, perineum and anus (inside the back passage) to identify any tears and treat as necessary to avoid any further consequences. If you have a severe tear you will be followed up and referred to pelvic health physiotherapy as your risk of developing pelvic floor dysfunction will be higher.
Separated stomach muscles
It’s common for the 2 muscles that run down the middle of your stomach to separate during pregnancy. This is called diastasis recti, or divarication.
The amount of separation can vary. It happens because your growing womb (uterus) pushes the muscles apart, making them longer and weaker.
The separation between your stomach muscles will usually go back to normal by the time your baby is 8 weeks old.After you have had your baby, you can check the size of the separation with this simple technique:
- Lie on your back with your legs bent and your feet flat on the floor.
- Raise your shoulders off the floor slightly and look down at your tummy.
- Using the tips of your fingers, feel between the edges of the muscles, above and below your belly button. See how many fingers you can fit into the gap between your muscles.
Do this regularly to check that the gap is gradually getting smaller.
If the gap is still obvious 8 weeks after the birth, contact the GP as you may be at risk of back problems. Some women also have abdominal pain or discomfort.
The GP can refer you to a physiotherapist, who will give you some specific exercises to do.
Regular pelvic floor and deep stomach muscle exercises can help to reduce the size of the separation between your stomach muscles. It’s also important to stand up tall and be aware of your posture.
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