A Closer Look At Pelvic Floor Issues in Postpartum

While leakage, hemorrhoids, pain with sex, and more can be common during postpartum, it doesn’t mean these pelvic floor issues are normal.

After ten months of growing your baby, the labor and delivery process, and the necessary care of a newborn, it can feel like your body is more of a vessel and supplier for someone else than something that belongs to you.

Taking on the role of a mother is transformative. It walks along the narrow tightrope of beautiful and fulfilling, and challenging and overwhelming. The potential addition of pain, discomfort, communication difficulties with a partner, or feelings of shame or isolation into the mix quickly adds a physical and mental load that makes balancing on that tightrope nearly impossible. 

It’s not just about your pelvic floor

Even under the smoothest conditions, the body undergoes enormous stress and strain to grow and deliver a human life. Sue Croft, a leader in pelvic floor therapy, says, “the pelvic floor muscles are like the first responders” to stress and trauma.

The nervous system – our sympathetic (‘fight or flight’) and parasympathetic (‘rest and digest’) responses profoundly impact healing. Full transparency, when I work with women postpartum, it’s never just the pelvis. Postpartum healing is and should be a whole-body experience. 

The pelvis is our anchor, and the work is to build a foundation for lifelong body literacy and develop the ability to create space for healing.

DANA SOLOMON

I observe the woman in front of me: her body language, effect, how she talks, moves, and holds her body. When she tells me that she “feels fine,” I take a closer look at what the nervous system cues exude.

Is she social and engaged?

Frantic or overwhelmed?

Agitated or frozen?

Numb and aloof?

These nervous system responses can shift along a continuum throughout one’s day.

However, when we explore where someone’s body typically lives, and how that connects to her pelvis, and more importantly, her symptoms, we can better understand how a new mother is genuinely doing.

Common pelvic floor issues in postpartum

Here’s the thing about postpartum that no one shares: it’s more than two weeks or two years; it’s your life post-childbirth.

So, when symptoms come up such as leakage, back or pelvic pain, constipation, hemorrhoids, or pain during sex, there’s no need to live another moment succumbing to the idea of “this is what it is.” 

Pelvic floor therapy has become the front line of conservative therapeutic interventions for pelvic-related issues. There is overwhelming research to show that common symptoms generations of women have accepted as “normal” are able to be alleviated. 

The most common pelvic floor issues include

  • Feeling like you have to go to the bathroom all the time
  • Urinary leakage with coughing, sneezing, jumping, or other quick movements
  • Leakage (#1 or #2) with urgency
  • Incontinence
  • Constipation
  • Painful sex or an inability to have penetrative sex
  • Pelvic Organ Prolapse
  • Pain involving the lower back, pubic bone, hips, SI joint, groin, and abdomen
  • Postpartum recovery

How a pelvic floor OT/PT can help you

In addition to addressing the common pelvic floor issues in postpartum listed above, a Pelvic Floor Therapist can help you heal beyond your physical symptoms.

  • Nervous system regulation
  • Improve body awareness
  • Manage pain and symptoms
  • Provide education
  • Understand your anatomy
  • Recommend tools and products
  • Adapt to emotional, mental, and physical changes
  • Return to exercise and other activities that bring you joy
  • Perform infant care tasks with ease
  • Achieve optimal positioning for your back, core, and pelvic floor
  • Regain strength and function
  • Feel confident 

What a pelvic floor OT/PT might recommend

If you feel like a pelvic floor therapist would help your postpartum recovery, here’s a sampling of what they might recommend depending on the symptoms and issues you’re experiencing.

  • Pelvic floor exercises to do at home
  • Massage of other parts of the body
  • Trigger point massage to the pelvic floor to release muscle tension
  • Stretching and yoga
  • Strength-building exercises
  • Nutrition and lifestyle considerations
  • Postural training and teaching proper body mechanics
  • Mindfulness and breathing techniques
  • Pain management strategies 

You are worthy of pelvic floor care

You are allowed to be a mother and still be a human being. You are worthy of the same love, care, and nurture as your baby. 

Above all, you are worthy of living in a body that functions as expected and feels good so that you can be the best mom and woman you can be. This is why every woman deserves support that enables her to walk along that tightrope of motherhood with more ease. 

More resources for postpartum recovery


Dana Solomon
Dana Solomon

OTR/L, Certified Yoga Instructor

Dana Solomon, OTR/L, is a licensed occupational therapist, 200-hour registered yoga instructor specializing in restorative yoga and traumatic brain-injury informed yoga, and founder of Functional Wellness, LLC. She spent years working as an occupational therapist in Inpatient Rehabilitation and Early Intervention, where she gained her foundations in family-centered care and a deep connection with a multi-system approach to treatment.

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