Perinatal and Post Partum Health
Pregnancy and delivery change the body!
Muscles, ligaments and connective tissues all have to stretch to accommodate the baby, making it harder for them to perform their roles as stabilizers. This can result in back or pelvic pain during pregnancy which can persist months after delivery. Common complaints are SI joint pain or instability/low back pain.
Incontinence is a common occurrence during and after pregnancy but it can be effectively treated with pelvic floor rehabilitation.
Diastasis Rectus Abdominis (DRA)
DRA which is also known as abdominal separation between the right and left rectus abdominis muscles, is very common in pregnant or postpartum women. The condition is caused by the stretching of the linea alba – white connective tissue that joins the recti at the midline. It often appears as a ridge down the midline of the abdomen between the sternum and the belly button. It becomes more prominent with straining and often disappears when the abdominal muscles relax.
Research has shown that DRA size diminishes in the early post-partum period but without treatment it will not change between 8 weeks and one year post partum. It is strongly recommended that all post partum women should be checked for abdominal and pelvic floor muscle function prior to returning to sport or exercise.
Pelvic Floor Weakness
After delivery, stretching and tearing of the pelvic floor tissue can lead to changes in pelvic floor muscle function. This can result in low back and/or pelvic girdle pain, incontinence, or pelvic organ prolapse where the bladder, rectum or uterus descend into the vagina. Real-time Ultrasound Imaging can be used to evaluate muscle function and an internal examination can be done after 6 weeks post partum to check for pelvic organ prolapse.
Many new moms find that intercourse in painful following the birth of their child. If this persists, it may be due to tight scarring that was caused by tearing during delivery or it may be due to tight pelvic floor muscles. Often when the deep pelvic floor is not working, the superficial muscles remain in a contracted position causing pain when attempts at intercourse are made. An internal examination can identify the root cause of the pain. Myofascial release techniques can help to restore normal function. Other causes of dyspareunia can include vestibulodynia/vulvodynia and vaginismus.