Your vagina post baby can be quite concerning. Maybe you have recently had a baby and now you’re left wondering ‘what’s going on down there’. If you want to know whats normal, what’s not and where to find help then read on!

After the birth of my first baby, I was lucky not to have any pelvic concerns. Gradually, I returned to exercise and within a few months I was back into full triathlon training. Following the birth of my second child, I was keen to get back into exercise again. I started slowly with walking alone. As I gradually increased the distance, I started to feel some pelvic pain and a ‘heaviness’,  straight away I panicked! Within no time I had convinced myself that I had a prolapse. Boy was I was an emotional mess! As a physiotherapist and avid athlete, I was terrified by the possibility that I could have had a prolapse. I started thinking the worst. “I won’t be able to run again”. “I won’t be able to pick up my baby as she gets heavier”. “Maybe I won’t be able to have any more kids…”.  I googled “prolapse”. Let me tell you the news was not good. I was horrified by the stories that I had read! So many women had attempted to seek professional help without success. They are told things like “this is very common” and “there is nothing that can be done”. I continued to panic!…

Luckily I knew that Women’s health physiotherapists dealt with these issues. I booked an appointment the next day. Thankfully, I was reassured that my pelvic floor was healing well. I didn’t have any signs of prolapse and my pelvic floor strength was actually awesome. What I had realised though, is that the thought of having a prolapse was enough to send me into emotional turmoil. I started to wonder what it must be like for women who actually DO have concerns.

Over time I continued to study and went on to learn more and more about Womens health concerns post baby. There are a few common problems when it comes to postpartum pelvic health.

Women don’t know what’s normal

Women often understand that it will take some time to recover after having a baby, however there are common misconceptions when it comes to pelvic health post partum. Up to 1 in 3 women experience incontinence (unwanted bladder leakage) after having a baby. Whilst this is common, it is certainly NOT normal. Unfortunately, many women accept that they ‘pee themselves a little’ when they run/cough/sneeze/laugh etc.  Because there is this culture of acceptance – women don’t seek help. Incontinence is one of the biggest ‘warning signs’ of Pelvic Organ Prolapse (POP).

Prolapse is when one of the pelvic organs – the bladder, bowl or uterus starts to ‘fall’ from the vagina. Incontinence is a sign that there is something amiss within the ‘system’ that we understand as the core – the pelvic floor, diaphragm, multifidus and transverse abdominals. Other warning signs/symptoms of pelvic organ prolapse include:

  • A bulging sensation within the vagina
  • A heaviness within the vagina or pelvic region
  • Low back pain
  • A dragging sensation within the vagina

If you are experiencing these symptoms, please do not accept them as normal. Seek help!

Women don’t talk about whats going on down there!

Unfortunately, many women feel too embarrassed to talk about the pelvic concerns. Whether it be incontinence, pelvic pain, or prolapse. Many women don’t seek help, hoping that if they ignore the issues they will just go away. Whist it may seem confronting to “bare all” as a patient, it is important to remember that these health professionals see this everyday. Like they say “If you’ve seen one vagina, you’ve seen them all”. Ignoring the problem will not make it go away. The problem itself is likely to make you feel embarrassed, depressed and helpless. You need to get help, today!

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Often women are given poor advice!

Often, when women finally speak up and ask for help they are given poor advice, even by health professionals. Their doctors or gynaecologist tell them to ‘go away, and do some pelvic floor exercises’ But this is usually NOT the answer! When it comes to incontinence and prolapse weakness is not always the issue. Therefore ‘kegals’ may not help. There is so much more that can be causing the concern such as:

  • Poor posture
  • Poor lifting technique
  • Poor muscle ‘firing patterns’ – The ‘core’ may not be working well as a system, OR the core may not be working well with other muscles of the body. For example the glutes may not be working well with the core to manage particular tasks which can result in incontinence
  • Poor ‘recruitment’ or Over Activity of particular muscle groups.  For example women are often taught to ‘turn on the core’ when they exercise – which makes the pelivc floor fatigued and doesn’t allow the core to function as it was designed which ultimately results in incontinence.

To learn more about the core, and how it is designed to work click the article below

stop leaking when you run

Even when kegals are the answer, women often perform them incorrectly.

Whilst pelvic floor exercises might sound ‘easy’, it is essential that the muscle contraction is performed correctly. Did you know that on average 1 in 2 women do their pelvic floor exercises incorrectly!!  With poor technique the desirable results are not likely to be obtained. In some cases the problem is that the pelvic floor muscles are actually “too tight” or over active. In this circumstance doing even more pelvic floor exercises is NOT the answer! Some women actually need to ‘down train’ their pelvic floor and learn how to completely relax the muscles.

Women don’t know where to get help!

In many instances women fear that they will be told to stop exercise, and that they need to just ‘learn to live with the problem’.  In some instances therapists definitely recommend that women cease certain activities whilst they are rehabilitated, though they don’t need to give them up forever. Because women are often ill informed, they feel uncertain as to where to seek advice. A Womens Health Physiotherapist is best placed to treat pelvic health concerns – especially for conservative (ie. non surgical) management. A Womens Health Physiotherapist is able to conduct an internal pelvic assessment and can identify and treat:

  • If the pelvic floor muscles are contracting and relaxing effectively
  • If there is any specific areas of muscles weakness/tightness/overactivity
  • If the pelvic floor has adequate strength, endurance etc to exercise

Pelvic Healthy Physiotherapists can provide more than just ‘kegals’. They can offer ways to relax over active pelvic floor muscles, improve posture that is impacting on pelvic health concerns and also help to modify activities to reduce the impact that they have on the pelvic floor. For persistent problems devices, such as pessaries can be prescribed. These are just a few examples of how these therapists can help to improve your pelvic health.

Early intervention is key

If you have concerns with your female parts post baby, early intervention is likely to give you the best results. Putting off treatment will not help. In the postpartum period there is a ‘window of opportunity’ where elastic recoil can occur to help support your pelvic organs if you do the right things! If you do have concerns with your pelvic health, please consider seeing a Women’s Health Physiotherapist. I am yet to meet a woman who regrets that they did!

If you want more information about pelvic floor health read my guest blog post 7 Myths about your bits, that you need busted. 

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