What are the impacts of childbirth on the pelvic floor?

Pregnancy is a wonderful time in the life of would-be mothers. Unfortunately, the physiological changes that come with pregnancy as well as the trauma that results from delivery all have a detrimental effect on the pelvic floor.(1)

During vaginal delivery, pelvic floor muscles are stretched, and possibly torn, by the head of the baby, leading to pelvic floor dysfunction. Studies suggest that aside from pelvic floor muscle weakness brought about by the trauma of giving birth, any tears that heal will not be as strong as the original fascia.(2) These were seen to lead to pelvic floor dysfunction symptoms.

To counter these unwanted symptoms, pelvic floor rehabilitation has been recommended after pregnancy to prevent urinary incontinence.(3) Thus, strengthening the pelvic floor muscles, that were already weakened after delivery, is of paramount importance to prevent pelvic floor dysfunction symptoms and ailments.

 

What is a pelvic floor rehabilitation?

Improving the strength and control of pelvic floor muscles to attain normal function is the goal behind rehabilitation. Overloading, specificity, and reversibility are the main aspects behind an effective pelvic floor muscle training regimen.(4)

Overload refers to the amount of stress applied to muscles beyond what was previously experienced. Improvement in muscle performance is seen up to the point when fatigue sets in the muscle

The concept of specificity states that the muscle performs activities that resemble the required functional movement. Kegel exercises have long been seen as the only exercise that matches the criteria for specificity and enhances pelvic floor muscle function.

Lastly, reversibility signifies that the advantages gained from exercising the pelvic floor muscles are reversible if the exercise routine is not maintained. Thus, a sustained exercise regimen of the pelvic floor is necessary to continue achieving symptom relief.

 

What can happen without a pelvic floor rehabilitation after childbirth?

The weakening of pelvic floor muscles as a result of childbirth is seen as the cause of symptoms associated with pelvic floor dysfunction. The symptoms include stress urinary incontinence, problems with controlling bowel movement, perineal pain, pelvic pain, and pelvic organ prolapse in the postpartum period or in the later years. In the absence of pelvic floor muscle training, weakness of the involved muscles may last up to a year in most women.(4) This highlights the importance of pelvic floor rehabilitation in postpartum women.

 

When is it possible to start pelvic floor training after childbirth?

Given the traumatic effects childbirth has towards pelvic floor muscles, pelvic floor muscle training requires proper scheduling, not at the earliest time but after the pelvic organs have satisfactorily recovered. Multiple studies have shown that the best time to start pelvic floor training for urinary incontinence or anal incontinence is at 6 weeks postpartum.(6) Training within 1 month postpartum is not recommended. The training regimen requires commitment not only in regularly sticking with exercise sessions, but also in properly executing each Kegel exercise.



What are the best pelvic floor exercises to get a faster postnatal recovery?

Pelvic floor muscle training provides the necessary rehabilitation towards the non-invasive prevention and treatment of pelvic floor dysfunction. Training revolves around Kegel exercises, which when done properly, decreases swelling, promotes blood flow to pelvic organs, and allows faster healing.(7)

The key to properly executing Kegel exercises is by identifying the target muscles. As if trying to prevent midstream urination, bowel movement or passing gas without the contraction of the glutes, abs, or inner thigh muscles without any upward body movement.(8)

Perifit provides a comprehensive approach thanks to a dedicated program focused on postnatal recovery, and a biofeedback device that will ensure that you properly train your pelvic floor. Obtenez des résultats rapides et permanent with Perifit.

 

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References:

1 Durnea CM, Khashan AS, Kenny LC, Durnea UA, Dornan JC, O'Sullivan SM, et al. What is to blame for postnatal pelvic floor dysfunction in primiparous women-Pre-pregnancy or intrapartum risk factors? European journal of obstetrics, gynecology, and reproductive biology. 2017;214:36-43.

2Kapoor, D.S., Freeman, R.M. Pregnancy, childbirth and urinary incontinence. In: Haslam, J., Laycock, J. (eds)Therapeutic Management of Incontinence and Pelvic Pain.London: Springer-Verlag. 2008.

3 Hall B, Woodward S. Pelvic floor muscle training for urinary incontinence postpartum. British journal of nursing (Mark Allen Publishing). 2015;24(11):576-9.

4 Elenskaia K, Thakar R, Sultan A, Scheer I, Beggs A. The effect of pregnancy and childbirth on pelvic floor muscle function2011. 1421-7 p.

5 Laycock J. Concepts of Neuromuscular Rehabilitation and Pelvic Floor Muscle Training. In: Baussler K, Shussler B, Burgio KL, Moore KH, Norton PA, Stanton S, editors. Pelvic Floor Re-education. 2nd edition. London: Springer; 2008.

6 Deffieux X, Vieillefosse S, Billecocq S, Battut A, Nizard J, Coulm B, et al. [Postpartum pelvic floor muscle training and abdominal rehabilitation: Guidelines]. Journal de gynecologie, obstetrique et biologie de la reproduction. 2015;44(10):1141-6.

7 Women’s and Men’s Health Physiotherapy Team. Your recovery after childbirth. Physiotherapy, exercises and advice. 2016. Version 2.

8 Kegel exercises: A how-to guide for women. (2018). Retrieved from https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/kegel-exercises/art-20045283