Pelvic disorders common to pregnancy and childbirth

As mothers well know, incredible changes happen to a woman’s body before, during and after childbirth. As a result more than one condition might affect her pelvic muscles. For instance, hormonal changes cause soft tissues and joints to become hypermobile, or excessively loose, in order to allow a baby’s head to pass through during a vaginal birth. If misalignments result, pain may occur in the back, sacroiliac and pubic areas and eventually become chronic. In most pregnancies, some stretching and tearing of delicate tissues in the rectal area is also inevitable. If anal sphincter tears do occur, however, 50% of the women who have surgical repairs still report trouble with bowel control or urinary incontinence. Other problems include prolapse (the collapse of an organ such as cervix, uterus, bladder or bowel), and urinary or fecal incontinence which sometimes reoccur later even if the symptoms disappear right after childbirth.

Does physical therapy help?

Physical therapy is often prescribed for correcting joint misalignments that may contribute to persistent pain. Our treatments include myofascial release and/or electrical modalities to help the healing of stressed and torn soft tissues as well as re-education and strengthening of the trunk muscles (for postural support) and the pelvic floor muscles (to help control prolapse or incontinence) in tandem with dietary changes and medication if necessary. This type of combination therapy has proven to be quite successful. As the National Association for Incontinence points out, “a loss of bladder control should not be considered an ‘inevitable’ cost of motherhood” (for more information go to www.nafc.org).

A randomized trial published in a 2004 issue of Obstetrics and Gynecology cited results validating the efficacy of physical therapy for patients with persistent postnatal urinary incontinence. According to Chantale Dumoulin, PhD, PT, “Recent experimental data suggest that deep abdominal exercises may be used to improve the effect of a pelvic floor muscle rehabilitation program.”

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