Start doing some gentle, slow pelvic floor contractions as soon as it’s comfortable (day 1-3 post delivery, depending on the labour). Start when lying down (easiest position to activate without having to work against gravity). Once you can do some squeezes well, and feel the difference when you relax you pelvic floor, then progress to more difficult positions: sitting, standing, walking and then bending over/squatting (in that order).
Lying down regularly to take your body weight’s pressure off your pelvic floor will aid comfort and recovery. Aim to rest lying down for at least 30mins, 3 times a day for the first few weeks, while the bleeding is settling down.
After pregnancy, our pelvic floor muscles have “amnesia”, they lose the “knack” of knowing when to automatically turn on. This is partly due to the weight of the baby during late stage pregnancy, so even women who have a planned Caesar, are likely to exhibit some symptoms of pelvic floor weakness.
This is especially true for vaginal deliveries, particularly if the labour has involved tearing or damage to the pelvic floor, or required the use of forceps, ventouse or episiotomy.
Try to “pre-engage” pelvic floor when you move, especially standing up from a chair, (or sitting down), picking up your baby, bending over (to pick something off floor), walking, go up/down stairs, laughing, coughing or sneezing, or do any movement that feels uncomfortable for your back/groin, or when you are aware you normally “leak a little”. A great regular practice time is when you have finished in the toilet.
Your pelvic floor should return to normal a few months after birth, but this doesn’t naturally happen just with the passage of time. Strength and endurance, just like with any other muscle, requires training, and weakness or injury can cause symptoms. Sadly, many women are uncomfortable talking about this, don’t seek help, or don’t realise that it’s possible to return to normal.
When we say “normal pelvic floor” we mean:
> No “stress incontinence” - leaking of urine (or faeces) when laughing,
coughing, sneezing, jumping, running, hopping or playing sport.
> No “urge incontinence” – suddenly needing to go, without much warning
> Pre-pregnancy sexual experience (painfree, normal sensation, and ability to
climax as previously)
Pelvic Floor Info : www.pelvicfloorfirst.org.au has some great info!
Please be wary that some women have issues with an overactive pelvic floor, and difficulty relaxing it. These women should see a pelvic floor physio for further advice, and not attempt these types of exercises until they have “the go ahead” from their physio. (Symptoms of PF overactivity include pain with sexual intercourse or during a gynaelogical exam, tailbone pain with sitting, generalised pelvic pain, or pain when doing a poo.)