Woman’s Pelvic Health and Pregnancy

Woman’s Pelvic Health and Pregnancy

by Eva

Pelvic Health and Pregnancy – A friend of mine recently made the comment to me that she needed to start taking care of herself better because she wanted to have a baby soon.  She was concerned that if she didn’t take good care of herself before the baby, that she would have more pain and trouble after the baby.  This friend of mine is a wise woman to be thinking ahead about her post natal recovery!

So, I was thinking about this, and thought it might be worth a post.  I was someone who did not take care of myself before the babies came, …Oh, I was thin, and I ate a moderately healthy diet.  But I had horrible posture, and I had a couple minor back injuries that I never got PT for.  And core muscle strength?  What?! I didn’t even know what that meant!  After two babies, an episiotomy, and a really bad experience with a chiropractor, my body was a mess!  But at the time, I had no idea what to do about it.  It wasn’t until four years after my second child was born that I finally learned about the field of Pelvic Rehab and found out that my pain was actually treatable.  Now, over half a decade later, I’m still trying to repair my body from the damage that dangerous cocktail dealt me.  My pain was so bad at one point that I couldn’t walk without excruciating pain, and walking more than a half mile was completely out of the question.  And sex?  For a long time (like a couple years) our sex life relied primarily on pain medicine and alcohol…because otherwise there was no way I could get past the pain long enough to even consider spreading my legs.

So here’s some things I’ve learned on my journey…

Pelvic Health and Pregnancy Before the Pregnancy

  • If you don’t already understand what core muscle strength refers to, then do some reading about it.  Alternately, if you have a friend who is a young physical therapist (the older ones didn’t learn about it in school) or a friend who is a Pilates or physical trainer of some sort, they could probably give you an explanation as well.
  • If you have posture problems, fix them.  The best way I know to do this is to take a Pilates class.  Most posture problems have to do with how you engage your core muscles in your abdomen, and that’s what you’ll work on in Pilates.
  • Even if you don’t have posture problems, take a Pilates class.  Pay close attention to your form and to doing the exercises and the breathing correctly.  Make sure you know how these exercises are supposed to feel so that after the baby you know what you are aiming for.  Plus, if your muscles are in good shape before baby, they will probably won’t deteriorate as much due to the pregnancy.
  • Do some reading on pelvic floor muscles so you understand the importance of keeping those muscles in healthy working order.  A lot of people don’t know this, but the pelvic floor muscles do a lot to support the hips, so if they get stretched out or cut during delivery and you don’t do the work to fix them, you could end up with pain in your hips, knees, and/or ankles.  And pain in those places is confusing, because medical doctors try to treat the area where the pain exists…but in reality, they aren’t fixing the origin of the pain.
  • Learn to do kegels the right way.  If you aren’t sure you are doing them correctly, you could ask you ob-gyn or make a one-time visit to a women’s health pt.
  • If you already have any sort of lower back or hip pain, ask your ob-gyn to recommend a Women’s Health Physical Therapist to you.    Women’s Health PTs work primarily on the pelvic floor, hip, and lower back muscles.  If you have upper back pain, I would try a regular PT first, but if that doesn’t work, then go to a women’s health PT.  Remember that a lot of times the origin of the pain is not the same as the location of the pain.
  • Learn to sit correctly.  When you sit in a chair, sit with both feet flat on the floor.  Avoid crossing your legs above the knee, especially if you always tend to cross the same leg.  When you sit on the floor, sit criss-cross-applesauce.  Avoid sitting with both legs out to the same side as women tend to do when they wear dresses; and if you do have to sit this way frequently, be sure to change the direction that your legs are pointing periodically so the muscles on each of your body get stretched evenly.  Sitting on an exercise ball when at a desk or watching tv can also be a good habit to develop.

Pelvic Health After Delivery

  • Here’s a fun fact.  In France, pelvic floor rehab (aka Women’s Health PT) is an expected part of postpartum recovery for all women.  It’s so common, in fact, that their public health care system pays for it!  Ah!  I want our congressmen to care that much about my vagina!  Here’s another fun fact, most French women stay sexually active well into their 70s.  Husbands, did you hear that?  So make sure your wife gets some v-jay-jay rehab after that baby is born!  Women, ask your ob-gyn to recommend a therapist for you.
  • If you already know how to do kegels (because you are confident you were doing them correctly before the baby) then start doing them again.
  • But!  If your kegels hurt…AT ALL go to a women’s health PT immediately.  Sometimes the muscles tighten up in such a way that tightening them more in kegels causes more pain and more problems.  A WHPT will give you a funky curvy dildo looking thing and will teach you how to use it stretch out those ultra tight muscles.  But, you can use the dildo thing wrong and cause yourself more problems, so please go to a PT rather than experimenting on your own.
  • If intercourse is painful in any way, go to your ob-gyn.  There are things like pelvic organ prolapse that can be serious problems that need specialized attention.
  • If you are having problems with controlling your urine flow, or if peeing just doesn’t feel quite the same as it did before the baby, this is a pelvic floor issue and you can get help to correct it.
  • If you are experiencing hip, leg, foot, or lower back pain after the baby or within a year or two of the baby that you did not experience prenatal, go to a WHPT.  Even if you think something other than the birth caused the pain, there could be issues with your pelvic area muscles that are making it worse than it would otherwise be.
  • Read about diastasis recti.  This is vertical separation of the abdominal muscles that is very common.  Sometimes it heals itself and sometimes it doesn’t.  You can do a quick test at home to figure out if you are experiencing this, and you might even find some exercises on youtube that would help you correct it.  But!  Like with the kegels, if your exercises cause you pain, or if you aren’t positive you are doing them correctly, GO TO YOUR WHPT!  Also, be aware that doing exercises like crunches can make diastasis recti worse, so don’t do them until you know your diastasis is cleared up!
  • Once you’ve gotten specific concerns addressed with your ob-gyn and/or whpt, then take a Pilates class.  Yoga and other exercise classes are also good, but I would start with the Pilates to make sure those core muscles are functioning correctly before moving on to anything more complex.  Your core muscles are called CORE for a reason.  They support everything else your body does.  So if they aren’t working, who knows what kinds of fun injuries and pain you could end up with.
  • And no matter what, stay active!  Get yourself a Jawbone or a pedometer or something.  Make sure you are getting your 10,000 steps in as often as possible.  This can be hard with a new baby, I know!  But it is crucial that you don’t let yourself turn into a vegetable between now and the time your kids get on the school but for the first time.


Some Thoughts for Husbands concerning Women’s Pelvic Health and Pregnancy

  • Husbands, I don’t know if you’ve ever noticed this, but some women have a tendency to be self-sacrificial (to the point of stupidity) for the sake of their families.  They will ignore the pain and put off caring for themselves because they think that in doing so they are doing everyone else a favor.  This, of course, is bullshit.  If a woman can’t walk or can’t fuck or can’t laugh without peeing her pants, she isn’t doing anyone any favors.  So, as a loving, caring husband, do her (and yourself) a favor and make sure she gets her post-partum issues addressed as quickly as possible.  And make sure she has the freedom to leave the baby frequently enough to both take care of herself both physically and emotionally.
  • Also, here’s a note about semantics.  Sometimes, interestingly enough, women don’t describe the discomfort they experience due to pelvic muscle problems as “pain.”  Sometimes they’ll say things like “I feel like my body is twisted” or “my hips don’t seem to be rotating correctly” or “I’m not walking right.”  And plus, since these are women who have just given birth to a small human, their definitions of “pain” are sometimes a bit warped. If your wife seems uncomfortable, even if she declares she isn’t in that much pain, make sure she makes caring for herself a priority.  Just because it isn’t pain now, doesn’t mean it won’t become pain later.


Some Extra Reading on Women’s Pelvic Health and Pregnancy

So, those are some things that I’ve learned.  I wish I’d known this stuff years ago.  It would have saved me so much pain and frustration.  Bottom line.  KNOW YOUR BODY.  You only get one copy of it, and it has to last your whole life.  And plus, don’t you want to be like one of those French women, still getting laid all the time in you 70s?  Yeah!  That’s what I’m talking about.  :O)





5.00 avg. rating (95% score) - 4 votes
3 replies
  1. Mokey
    Mokey says:

    Doc. Eva, that was great. Thank you for sharing your knowledge. I love your proactive thinking.

  2. Emmy Sue
    Emmy Sue says:

    Thank you, Eva! I’ll probably be pregnant with our second child within the year, and it’s really important to me that I’m strong for it, I was pretty strong during my first pregnancy, but I broke my tailbone during delivery, which caused me months of excruciating pain, including during sex. I’m glad to say that I’m almost completely recovered from it, but I am concerned that it may happen again next time around, and I want to be very strong and prepared so that I can recover again if it does! I’ll be putting all of your suggestions in my bag of tricks! I appreciate your knowledge! 🙂

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