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Urinary incontinence and pelvic organ prolapse are the most significant negative outcomes of childbirth. Vaginal delivery is linked to a high rate of postpartum urinary issues, as well as incontinence of stool and flatulence.
Prolapse, which may not occur until years after childbirth, has unpleasant consequences. Urinary incontinence associated with a bladder prolapse (cystocele) can be bothersome. A rectal prolapse (rectocele) can cause constipation, incomplete bowel movements or an inability to hold gas or stool, and sexual dysfunction.
Supportive pelvic muscles and tissues can weaken during pregnancy and are strained during childbirth. Varying levels of perineal injury, such as tears or an episiotomy, are factors.
Nerve damage that impacts pelvic organ support also may occur.
Pelvic-perineal dysfunctions are the most common diseases in women after pregnancy. By one estimate, 35 percent of new mothers experience urinary incontinence following childbirth, and 20 percent of first-time moms experience severe pelvic floor muscle injury after a normal pregnancy and delivery.
Urinary and fecal incontinence are common symptoms of postpartum pelvic floor issues in the near term. Many women regain strength in their pelvic floor muscles within two months.
Pelvic pain may persist for months or years postpartum.
Symptoms of pelvic organ prolapse can emerge years later.
Doing Kegel exercises correctly will help strengthen your pelvic floor muscles. To do this exercise, you squeeze the muscles you use to control the flow of urine, and hold for up to 10 seconds, then release. Aim to do at least three sets of ten repetitions a day.
Pelvic rehabilitation therapy may be recommended by your gynecologist. The muscles and tissues of the pelvic floor, which support your bladder, bowel and uterus, can be strengthened, lessening your symptoms. Tight pelvic floor muscles can lead to inflamed tissue and nerves, contributing to chronic vulvar pain, burning or itching, or pain during bowel movements.
A pelvic floor physical therapist can evaluate these muscles and determine whether they're at the root of your symptoms.
When should I make an appointment with a specialist?
Postpartum pelvic floor issues can sap the energy you need to care for your newborn. See your gynecologist when symptoms impact your quality of life. A subspecialist known as a urogynecologist has expertise in treating complex pelvic issues. The Women’s Medicine Collaborative has specialists who can help.