#Postpartum Bladder Urinary Retention | Explore Tumblr Posts and Blogs

the-exercist · 2 years

Text

In honor of my daughter turning two months old today (Have you wondered where I've been? That's the big reason I'm so offline), here's my rendition of:

Things They Don't Tell You About Pregnancy, Labor, and Postpartum Life

Because we typically don't get to hear about a lot of the nitty gritty and, even as someone who took pain to educate herself beforehand, many of these things took me by surprise. Pregnant folk deserve to be prepared for the road ahead.

Pregnancy:

We start counting the age of a fetus at your last menstrual cycle, meaning that you are already two weeks pregnant on the day of conception

You will continue to get "period cramps" throughout pregnancy. This is because your uterus is expanding, and that muscle stretch does not feel good.

You may also experience round ligament pain, which is an incredibly sharp pain around your groin due to your ligaments stretching. I would get it if I moved too quickly or sneezed, and the pain would knock the wind out of me.

You are recommended against sleeping on your back while pregnant. In addition to being dangerous for the fetus, due to putting pressure on a major blood vessel, it can make you feel horribly nauseous and light headed. Get used to side sleeping.

Nasal congestion during pregnancy is a thing. Your nasal passages may constrict to the point that you have difficulty breathing during certain parts of the day.

You will be peeing frequently even before the fetus is large enough to press on your bladder. Since your body is producing extra blood, your kidneys have more to filter, so you will be visiting the bathroom way more often right from the start

Labor and Aftermath (C-section):

Cervical checks, where your doctor uses their fingers to measure how dilated you are, are very painful in the beginning but get easier as labor progresses.

You cannot actually induce labor. All of those old wives tricks, like curb walking or having sex, will only induce contractions. So engaging in them will likely only prolong your pain without making the baby come any sooner.

A side effect of the epidural is uncontrollable shaking. It hits right as the epidural wears off and can last for several hours, making it difficult to use your hands

You may not be physically able to pee after getting a c section. Your body loses the ability to control those muscles, leading to urinary retention that can last for a few hours or even a day or two. Even once you can pee again, your body may lose the sense of urinary urgency for a week or more, meaning you can't feel if you have to use the bathroom.

Congrats, you're still getting intense "period cramps." This time, it is your uterus contracting back to it's original size. The cramps get worse while breastfeeding.

IVs pump you so full of liquids that you may experience severe edema, aka foot swelling. This can last roughly two weeks and can reach the point that you can feel your feet sloshing around when you walk.

Postpartum:

Breastfeeding hurts. Your nipples may get torn up, but even so, the latch itself can feel like you are getting stabbed. For the first ~4 weeks, I had to take a deep breath, brace myself, and power through the sharp pain.

The "Let Down" also hurts/aches. This is when your milk releases and begins to flow. It may happen after the baby latches or randomly during the day and then your shirt is suddenly dripping wet. It feels like your boob muscles are stretching.

Lochia is your bloody discharge afterward. It can last for weeks, and it's worth wearing postpartum diapers to deal with it.

Keep taking your stool softeners even after you're all healed up. Breastfeeding can cause constipation.

You can get pregnant again right away, even if you haven't had your period yet. Breastfeeding will not reliably prevent it. Plan your birth control well before you're cleared for sex at six weeks.

Got a question? Want to share another odd tidbit? Add it here!

#pregnancy #birth #postpartum #baby #reproductive health

312 notes · View notes

carehospitals-india · 3 months

Text

Urinary Retention: Symptoms, Causes, Diagnosis and Treatment

Urinary retention refers to the inability to fully empty the bladder while urinating. It is a urological disorder that can greatly impact an individual’s quality of life if left unmanaged. Urinary retention can strike suddenly in acute cases presenting as a medical emergency, or manifest gradually as a chronic condition requiring ongoing care. This article explains what exactly urinary retention involves, its various causes, characteristic symptoms, methods of clinical diagnosis, and treatments to resolve it.

What is Urinary Retention? The bladder is a hollow muscular organ that collects urine produced by the kidneys until the body is ready to empty it. Urine itself is a waste fluid filtered from the bloodstream by the kidneys, comprising mainly excess water, salts, and nitrogenous by products like urea.

Urinary retention refers specifically to incomplete emptying of the bladder during urination. Acute urinary retention involves a sudden and rapidly progressing inability to urinate voluntarily despite having a full bladder. Chronic urinary retention causes gradual bladder overfilling over time due to inadequate voiding. Both acute and chronic urinary retention eventually cause distressing lower urinary tract symptoms.

What Causes Urinary Retention? Urinary retention stems from conditions affecting urine transport from the kidneys into the bladder (urinary storage) and/or passage of urine from the bladder out of the body (urinary voiding). Common reason for urinary retention include:

Prostate Enlargement The most frequent cause of chronic urinary retention in men over 50 is benign prostatic hyperplasia (BPH). As the prostate grows larger, it compresses the urethra impeding urine flow. Acute retention may occur if the enlarged gland completely blocks urine passage. Urethral Stricture Urethral scarring from injury, surgery or infection leads to narrowing (stricture). This creates resistance to the flow of urine. Bladder Muscle Failure Detrusor underactivity signifies weak bladder contractions failing to generate adequate pressure to void urine. It becomes more common with older age. Medications Drugs like antimuscarinics, antidepressants, antipsychotics, opioids, and alpha-blockers can hinder normal detrusor function leading to incomplete bladder emptying. Pregnancy & Childbirth Hormonal changes, uterine enlargement, and birth trauma involving pelvic muscles/ nerves increase postpartum urinary retention risk. What are the Symptoms of Urinary Retention? Chronic urinary retention progresses slowly, allowing the bladder to expand and often lacking obvious symptoms initially. Acute retention involves sudden onset of the inability to urinate and causes more intense symptoms.

Typical urinary retention symptoms include:

Difficulty starting urination Weak urine stream Straining or pushing to void Dribbling urine Prolonged urination time Frequent urination, especially at night Bladder pain Abdominal pain The feeling of incomplete bladder emptying Involuntary urine leakage between trips to the bathroom Diagnosis Doctors employ medical history review, physical examination, imaging tests and urodynamic studies to evaluate urinary retention. Here’s a comprehensive overview of the diagnostic process for urinary retention:

Medical History The doctor inquires about the patient’s symptoms, their onset and duration. Information concerning past medical issues, surgeries, childbirth trauma, medications taken etc. provide diagnostic clues. Physical Exam Abdominal palpation detects a distended bladder extended above the pubic bone, confirming significant urine retention. A digital rectal exam evaluates the size of an enlarged prostate. Neurological assessment identifies potential nerve damage to be the cause behind symptoms. Gynaecological examination screens for pelvic organ prolapse in females. Bladder Scan This noninvasive ultrasound test measures post-void residual urine volume. Urine amounts exceeding 100–200 mL signal abnormal emptying and urinary retention. Repeated scanning monitors retention severity over time. Urinalysis Microscopic urinalysis and urine culture detect infection which commonly accompanies retention. Blood in urine may indicate bladder stones or cancer. Imaging Tests Ultrasound and computed tomography visualise structural abnormalities like prostate enlargement, strictures, bladder stones, tumours obstructing urine flow through the urinary tract. Imaging also confirms enlarged bladder size due to urine backing up from any blockages. Cystoscopy A cystoscope (thin tube fitted with a camera) inserted in the urethra lets doctors directly see inside the lower urinary tract. This pinpoints strictures, obstruction by an enlarged prostate or bladder abnormalities causing retention. It also facilitates the removal of any bladder stones/ tumours detected. Urodynamic Testing Several tests evaluate bladder pressure and urine flow patterns during storage and release of urine. This assesses the coordination between bladder and sphincter muscles and the adequacy bladder contraction strength for proper voiding — key factors in urinary retention. How is Urinary Retention Treated? All urinary retention patients initially undergo bladder drainage to relieve symptoms and prevent kidney injury due to urine backup. Additional treatment focuses on the specific underlying cause.

Catheterization Inserting a catheter tube through the urethra into the bladder allows complete drainage of retained urine. For acute retention, this is continued until normal urination is restored. Recurrent acute episodes may necessitate urinary retention treatment at home self-catheterization between bathroom trips. Medications In mild prostatic enlargement, alpha blockers (tamsulosin, alfuzosin) relax smooth muscles improving urine flow. Antibiotics treat underlying infections while anticholinergics like oxybutynin may help chronic retention cases by relaxing bladder muscles. Prostate Surgery For chronic urinary retention from benign prostatic hyperplasia unresponsive to drugs, minimally invasive transurethral resection (TURP) remains the cornerstone treatment. TURP surgically debulks excess prostate tissue pressing on the urethra using electrocautery. Other effective options include laser prostatectomy and prostate artery embolization. Urethral Surgery Urethral strictures require urethrotomy where surgeons make incisions into scar tissue widening the passageway. Complete excision of the structured area with end-to-end reconnection of healthy urethral ends (urethroplasty) may be needed for longer or recurrent strictures. Nerve Stimulation For retention from neurological impairment, sacral nerve stimulation electronically modulates nerve signals to improve bladder contraction and sphincter coordination. Creating an artificial sphincter around the urethra also helps with emptying the bladder. Bladder Surgery Detrusor muscle failure with severe bladder enlargement may require bladder reduction surgery, removing a portion of bladder wall to decrease capacity and allow complete emptying with weak contractions. Bladder augmentation surgery is an alternate option, using bowel segments to increase bladder volume in small contracted bladders.

Conclusion Urinary retention encompasses inability to fully empty the bladder leading to urine accumulating inside. Acute retention causes painful bladder distension and requires emergency treatment, while chronic cases progress more insidiously with gradual bladder enlargement.

Typical symptoms are straining to urinate, frequent/incomplete urination, weak stream and bladder pain. A palpable bladder, imaging tests and urodynamic studies facilitate diagnosis. Initial relief involves catheter drainage, followed by medications or surgery targeting causative factors. Prompt diagnosis and appropriate treatment is vital to avoid complications like recurrent infections, bladder damage and kidney problems.

0 notes

loanborder8 · 2 years

Text

Why Pelvic Floor Health Is Important To Your Pregnancy

make your vagina tighter The pelvic floor muscles unsurprisingly also play an important role after a birth — especially after a vaginal birth. In fact, giving birth vaginally is linked to a high rate of urinary leakage in the first few months after pregnancy, also called the postpartum period. This is true even for people who may not have had any issues with urinary leakage during their pregnancy. A strong pelvic floor helps you heal faster after birth by improving blood flow to your pelvic and genital areas and lowering the amount of swelling there. Don’t be discouraged if you don’t see results right away. According to the Mayo Clinic, Kegel exercises may take as long as a few months to have an effect on incontinence. You should feel like the muscles are squeezing together and lifting inside of the pelvis. Unlike other muscle groups in the body, you cannot show someone how to do a Kegel and it’s impossible to tell if a clothed person is doing a Kegel correctly. Urinary incontinence, fecal incontinence, and sexual dysfunction can all signal that your pelvic floor muscles need some attention. If exercising doesn't bring improvement, it might be a good idea to speak with your doctor or book a few sessions with a physical therapist. A hypertonic pelvic floor happens when the muscles are too tense and become difficult to relax, leading to pain, spasms, constipation, painful sex and a stronger urgency to pee. When the pelvic floor muscles are lax — too loose — urine leakage, an increase in urination frequency, pain and the feeling of urinary retention are common side effects. If you’ve tried and have trouble doing Kegel exercises, you may want to see a physical therapist who specializes in women’s health, specifically around strengthening the pelvic floor. Kelly Morales OB/GYN, we’re committed to helping women have the best pregnancies and healthiest babies possible. In 2019, UCSF surgeons implanted a new type of device that allowed a blind patient to see light and shapes. When this tiny implant receives signals from special video glasses worn by patients, it stimulates the eye's optic transmitters. UCSF is one of just a few hospitals in the U.S. that offer this procedure. So practicing quick contractions with coughing and sneezing will help to retrain your body and have less leakage by improving your muscle coordination. As our hormone levels naturally decline, it leads to vaginal dryness, thinning of the vaginal lining, and even pain during intercourse. A decrease in estrogen can lead to muscle loss, including in the pelvic floor. Exercising those muscles regularly is one way to stay on top of these natural changes. Like any group of muscles, it is in your own interest to keep them in good shape – so really everyone should be exercising their pelvic floor muscles from childhood through to old age. Pelvic Floor Exercises can help both men and women gain more control over bowel movements. If you think this might be the case, a Pelvic Floor Therapist can help you maximize your efforts. Also keep in mind that the releasing portion of a Kegel is just as crucial as the tightening—the clench and relax constitutes one Kegel. "Over-clenching can shorten the muscles of your pelvic floor and cause them to pull on your bladder and urethra," Stein says. This can increase your risk of leaking urine and actually make it more difficult to achieve orgasm during sex. Aim for 3 sets of 10 reps of Kegels per day—you can do them any time, anywhere, as no one can tell you're clenching and releasing. Another common type of pelvic floor problem is prolapse, which happens when the pelvic muscles and other supporting tissues become weak and cause the organs in the pelvis to drop out of place. If you try to contract muscles that are already tired, they won’t be able to respond. Your doctor can help you figure out if this applies to you. Both activities will result in stronger pelvic floor muscles, so increment either or both, until you reach 10 squeezes held at 10 seconds 3-6 times each day. It’s very important that you relax fully between each contraction and that you don’t hold your breath. Always spend the same amount of time or longer relaxing your muscles as you did contracting them. Before you start, get into a comfortable position so your body is relaxed. Most people prefer doing Kegel exercises when lying down on a bed or sitting in a chair. Once you’re familiar with the exercises, you should be able to do them in any position and in any place, such as standing and waiting in a line. A gynecologist named Dr. Arnold H. Kegel invented it in 1948. When done correctly, Kegel exercises can make your pelvic floor muscles better in shape and give them the ability to support pelvic organs like the bladder and uterus more efficiently. Keep reading to learn more about kegel exercises and Alpharetta pelvic floor rehabilitation. Pelvic floor physical therapy involves biofeedback and exercises to encourage relaxation and strengthening of the muscles of the lower pelvis. A physical therapist places biofeedback sensors on the vaginal wall to measure muscle tone and the strength of muscle contractions, which are then printed on a machine for you to see. After practicing your exercises at home, you can see your improvement on the machine the next time you visit the physical therapist. Place the ball of your right foot on the ball about 6-10 inches in front of you while balancing on your left foot. Inhale as you press your right foot into the ball, rolling from your medial arch to the front of your heel. Apply as much pressure as you can, to the point where you feel that hurts-so-good sensation. You will be treated with dignity, compassion, and respect as an individual. Pause 1-2 seconds at the top and return to the starting position. Your spine should be against the ground, with knees bent at a 90-degree angle, feet flat, and arms straight at your sides with palms facing down.

#how to make your vagina tighter #kegel balls

1 note · View note

advicetomoms-blog · 4 years

Text

Kegel Exercises to Make Birth Easier!

Kegel Exercises to Make Birth Easier! Among the exercises that facilitate birth **, kegel exercises are the only exercise that you can do at any moment, without needing anything. This exercise concentrates on the pelvic floor muscles, which will carry the most load during the birth process. Here are all the details from kegel's benefits to how it's done ** kegel exercises during pregnancy! **

What Do Pelvic Muscles Do?

Briefly, the pelvic muscles are the pelvic floor, or, in other words, the pelvic floor muscles, our muscles that hold the uterus, bladder and intestines. These muscles also prevent us from missing our urine when we cough or laugh. So, as you can see, when these muscles, which are the secret hero of our body and which are very useful for us, are strong, they can make sexual experience much more satisfying.

What is Kegel Exercise?

Kegel exercises, on the other hand, are exercises that help us train and strengthen this amazing muscle group. Moreover, with very little time and little effort! In fact, in an incomprehensible way when viewed from the outside… In other words, you can do these exercises whenever you can understand while drinking coffee, chatting, waiting for the subway, on the cash machine queue, during the safe, in traffic. You don't have to go to the gym, wear special clothes or even sweat. If you do these exercises 3 times a day for 5 minutes, you can see the benefits in both the short and long term.

What Are the Benefits of Kegel Exercises?

Let's come to the benefits of this miracle exercise: Strong pelvic floor muscles can reduce many symptoms from pregnancy and postpartum hemorrhoids to urine and stool incontinence.It can prevent episiotomy, that is, incision or rupture during labor.It has been observed that the vagina of women who do kegel exercises regularly during pregnancy is more easily regained after the baby goes out.Stretching and strengthening the pelvic muscles with kegel exercises can increase the pleasure you will get from sexuality after birth.

How To Do The Kegel Exercise?

Fix the pelvic floor floor muscles located around the vagina and anus.Try to stop the flow of urine while going to the toilet to make sure you find the right muscles. If you can stop, you have found the right muscles. After that, you will do this exercise with these muscles. (Making it a habit of keeping urine and doing kegel exercise while there is a need to urinate, this is just a way of determination and awareness for the beginning.)After fixing the pelvis muscles, empty the bladder and thoroughly muscle the pelvis base muscles in a sitting or standing position. Increase intentional retention time up to 10 seconds. Drop it slowly and repeat. You can do it 20 times 3 times.When doing Kegel, remember that you need to focus your attention only on the pelvic muscles. If you feel that your butt or hip muscles are contracting, you are unable to properly work your pelvic muscles.

What Should Be Considered While Doing Kegel Exercises?

Performing kegel exercises while urinating or when the bladder is full weakens the muscles rather than strengthening them. It causes the urine bag not to be completely emptied. This increases the risk of urinary tract infections. Doing abdominal, thigh and hip muscles while doing Kegel exercises. This may further impair the elasticity of the pelvic floor muscles. Finally, don't hold your breath. Continue breathing regularly and relax. Just focus on contracting the muscles around the vagina and breech. Read the full article

#KegelExercises #pregnancy #sport

1 note · View note

partnersinpelvichealth-blog · 4 years

Photo

What is Pelvic Rehabilitation?

Pelvic floor rehabilitation helps in reducing pain in the joints of pelvic area. These exercises also helps in restoring the functions of the pelvic muscles.

Pelvic rehabilitation is versatile and can address several conditions, including:

Chronic pelvic pain

Constipation and fecal incontinence

Urinary incontinence and retention

Overactive bladder

Spasms of the pelvic floor muscle

Muscle weakness and relaxation of the pelvic floor

Postpartum muscle weakness

Uncomfortable intercourse (dyspareunia)

#Chronic pelvic pain #incontinence #pelvic floor muscle #dyspareunia

0 notes

ownerwhale0-blog · 5 years

Text

What to Know About Pregnancy, Childbirth, and Your Pelvic Floor

If you’re pregnant, you might feel like people are constantly telling you how much the entire experience is going to suck or hurt or change your body forever. Or maybe people aren’t telling you that all the time, but you can’t imagine how that wouldn’t be the result.

It’s true that pregnancy and childbirth can bring about some major physical changes. The focus is often on external ones (ahem, a growing belly). But one of the biggest pregnancy and childbirth changes impacts an area that’s impossible to see from the outside: the pelvic floor. We won’t lie to you, pregnancy and childbirth can definitely do a number on this area. But for some people, a little thing called pelvic floor physical therapy may be able to help.

Here’s the truth about pregnancy, childbirth, your pelvic floor, and pelvic floor physical therapy.

Your pelvic floor anatomy

We can’t blame you if you’re like, “Excuse me, the anatomy of my what, now?” In general, people don’t talk about pelvic floors often, even in pregnancy and childbirth conversations.

“The pelvic floor is essentially a group of muscles integrated together to create a support structure for the intra-abdominal organs,” Angela Bianco, M.D., a maternal-fetal medicine specialist and associate professor of obstetrics, gynecology, and reproductive services at the Icahn School of Medicine at Mount Sinai, tells SELF.

These muscles work like a hammock to brace organs such as the uterus, bladder, and rectum. In doing so, the pelvic floor promotes healthy bowel and bladder control along with comfort during things like penetrative sex. If something goes wrong with your pelvic floor, it can mess with your ability to pee or poop normally, with your sex life, and with your general function in that region.

Symptoms of pelvic floor dysfunction

Among other causes, pregnancy and childbirth can lead to pelvic floor dysfunction, the broader term for a collection of conditions known as pelvic floor disorders. Pelvic floor disorders crop up when muscles or connective tissues of your pelvic area weaken or are injured, according to the National Institutes of Health.

Urinary incontinence (when pee dribbles out of you during everyday activities such as walking, laughing, or coughing) is a common pelvic floor disorder, according to the Mayo Clinic. Then there’s fecal incontinence, or leaking stool. Pelvic floor dysfunction can also manifest as difficulty fully emptying your bladder (this is known as urinary retention) or rectum (the rudeness that is constipation). Or you could experience painful sex as a sign of pelvic floor problems.

Severe pelvic floor dysfunction can even lead to pelvic organ prolapse, which is when structures such as the bladder droop and press into or out of the vagina. In this case, you might see a bulge protruding from your vagina, feel like something is coming out of there, or notice an aching or “full” feeling, according to the American College of Obstetricians and Gynecologists (ACOG). Pelvic organ prolapse can also lead to those pee, poop, and sexual health problems we mentioned above.

So, how exactly can pregnancy and childbirth bring about pelvic floor dysfunction? Let’s get to it.

Pregnancy and your pelvic floor

Being pregnant can loosen up the muscles and connective tissues such as ligaments that need to work well for good pelvic floor function. (Ligaments are a type of tissue that helps organs stay put.)

This loosening effect is thanks to hormones that increase when you have a baby on the way, like progesterone, estrogen, and one literally called relaxin. “These hormones can act to soften the ligaments so that the muscles may not be as tightly interconnected together,” says Dr. Bianco. The point of this loosening is to eventually allow a baby to pass through the birth canal more easily.

Then there’s that growing belly part. As your uterus expands and you gain weight, more pressure bears down on your pelvic floor, which can contribute to a loss of support, Dr. Bianco says.

Childbirth and your pelvic floor

As you’ve probably surmised, birthing a baby vaginally can definitely impact your pelvic floor. To sum it up: “You have a giant head going through a small vagina,” Lisa Dabney, M.D., director of urogynecology and pelvic reconstructive surgery in the department of obstetrics and gynecology at Mount Sinai, tells SELF.

Of course, the rest of the baby’s body passes through too. But, typically, the head will go first. In the process, pelvic floor muscles get shoved out of the way and sometimes tear. While doctors can usually repair such lacerations with surgery when necessary, it will take some time for your pelvic floor to recover (and sometimes it’s just a bit different forever). There may also be damage to the nerves that govern pelvic floor muscles and organs.

All of this can lead to postpartum issues like pain during sex, urinary or fecal retention, and urinary or fecal incontinence. (According to ACOG, childbirth is actually the most common cause of fecal incontinence.) Having a heavy baby who weighs more than 9 or 10 pounds may increase the risk of these problems, Roger Lefevre, M.D., director of Beth Israel Deaconess Medical Center’s female pelvic medicine and reconstructive surgery division, tells SELF.

You might be wondering about how having a cesarean section (C-section) would influence your odds of winding up with pelvic floor dysfunction. Having a C-section does appear to be linked with a significantly lower risk of pelvic floor disorders, but it doesn’t mitigate this risk entirely because you still have all of the factors from the pregnancy itself, Dr. Bianco explains. A C-section is still a major abdominal surgery that comes with its own intense healing process even if it doesn’t harm your pelvic floor in any big way.

When to check in with a doctor

The advice on when to talk to your doctor about your pelvic floor can change a bit depending on if you’re pregnant or postpartum.

If you’re pregnant: Routine pregnancy check-ups are a great time to discuss how your pelvic floor seems to be functioning. It might help to ask your doctor exactly what kinds of pregnancy and postpartum pelvic floor symptoms you should expect. That way, you’ll have a more personalized framework for when to get in touch with your doctor about any concerns.

If you’re postpartum: ACOG recommends having at least one comprehensive check-up four to six weeks after giving birth. (Ideally, that would be the start of a consistent, ongoing postpartum care relationship between you and your doctor, not just a one-time visit, ACOG says.) That’s the perfect opportunity to tell your doctor how things are feeling, ask if your pelvic floor function seems on track, and ask when to let them know if your symptoms are still persisting.

Honestly, it can be pretty confusing to know what’s normal when it comes to your postpartum pelvic floor situation, especially if you’re mainly dealing with urinary incontinence. A little bit of transient urinary incontinence when you’re postpartum is very common, Dr. Bianco says. Once your body is no longer exposed to the added weight of a baby in utero and that muscle-loosening hormone cocktail, pelvic issues usually improve, Dr. Bianco explains.

This can take anywhere from a few days to a few weeks or months, or longer than that for some people, Tanaka J. Dune, M.D., a urogynecologist at Weill Cornell Medicine and NewYork-Presbyterian Hospital, tells SELF. “I try to reassure postpartum women about the changes that can occur and not to fret if recovery is not right away,” Dr. Dune says. If you’re still having symptoms related to pelvic floor dysfunction 12 weeks after giving birth, check in with your doctor.

Whether you’re pregnant or postpartum: See your doctor whenever you’re really concerned that something you’re experiencing isn’t normal. We know that seeing a doctor is much easier for some people than it is for others and that so many factors can lower the odds of receiving compassionate, competent health care. This is especially true when it comes to people with vaginas, and even more so if you belong to multiple marginalized groups, like being a woman of color with a low income. While this is an unfortunate and frustrating reality, the important thing to keep in mind is that you deserve competent, empathetic care if something is off. We're about to go into some treatment options for pelvic floor disorders, and we know they may not be accessible for all. If these don't seem doable for you, know that getting care wherever and whenever you can is still better than nothing. This is one of those situations when it makes sense to seek the most trustworthy medical advice you can.

The science behind pelvic floor physical therapy

Pelvic floor physical therapy is a way of trying to strengthen the area to alleviate symptoms under the guidance of a physical therapist who specializes in pelvic floor disorders. Just like you’d go to physical therapy if you tore your ACL, you might consider seeing a licensed physical therapist trained in certain techniques that some research suggests may help rehab your pelvic floor. This might sound really weird, but some experts believe pelvic floor physical therapy to be helpful in certain cases. In fact, pelvic floor physical therapy is commonly prescribed for newly postpartum parents in France, where it’s known as la rééducation périnéale.

A pelvic floor physical therapist might teach a person how to properly do Kegels (relaxing and tightening the pelvic floor muscles), go over proper posture so the pelvic floor muscles might work in a more coordinated fashion with the rest of the body, teach deep breathing work that attempts to stimulate the pelvic floor, and more, says Dr. Dune.

That's not to say pelvic floor physical therapy is guaranteed to fix pelvic floor dysfunction. The research on the efficacy of pelvic floor physical therapy is somewhat promising but not yet robust enough to claim it's definitely an effective treatment.

For instance, a July 2014 review in Cochrane Database of Systematic Reviews looked at 13 trials on 1,164 women with urinary incontinence. Some received pelvic floor muscle training (PFMT, like Kegels) in addition to other treatments such as bladder training or anti-incontinence drugs, and others received only other treatments without pelvic floor muscle training. The review concluded that there wasn't enough high-quality evidence to say how much (if at all) PFMT helped with urinary incontinence or quality of life in those who had it.

But a 2015 meta-analysis in the International Urogynecology Journal, which examined 13 studies with 2,340 patients experiencing pelvic organ prolapse, found that those who got PFMT experienced fewer and less severe symptoms than people serving as controls. And a 2018 review in Clinical Interventions in Aging looked at 24 studies analyzing how PFMT affected 2,394 women with urinary incontinence, finding that it led to significant improvement in their quality of life compared with control groups.

Basically, there's a lot more research to be done here before anyone can definitively say that pelvic floor physical therapy is the answer to pelvic floor dysfunction. But ACOG's practice bulletins on both pelvic organ prolapse and urinary incontinence do mention that the pelvic muscle exercises typically included in this type of therapy may be recommended for these types of issues. It's worth knowing what these types of appointments would involve if you were to seek them out.

Pelvic floor physical therapy appointments

So let's say you decide to see a pelvic floor physical therapist. They will usually take a full medical history from you and ask about your symptoms, Dr. Dune says. At some point, they may want to do an internal pelvic floor exam and internal manual therapy directly on your pelvic floor. This doesn’t necessarily need to be during your first appointment. The goal is to only get started on that part of your evaluation when you’re comfortable with it, and any medical professional who tries to pressure you into it is not the right person for you. You can also ask to have a second person in the room.

During the actual exam, your physical therapist will typically insert a gloved finger into your vagina or rectum and ask you to clench your pelvic floor muscles. Depending on what’s going on with your body, this may or may not be painful, Dr. Dune says.

Internal muscle tone is something you can try to evaluate by yourself. If you insert a finger into your vagina, tighten your muscles as if you’re holding in your pee, then let go, you should feel the muscles contract and move up and down, according to the U.S. National Library of Medicine. But you’ll only know your own baseline, Dr. Dune says, while a therapist is more likely to recognize where you fall in the overall anatomical standard.

Plus, a therapist will likely evaluate how some of your other body parts are working, too. “The pelvic floor isn’t isolated—it’s impacted by the hips, low back, knees, and other joints,” says Dr. Dune. “It’s important to get evaluated for bigger picture issues to know for sure what’s going on.”

If your physical therapist thinks you could benefit from a stronger pelvic floor, they will likely come up with a game plan to possibly help you retrain those muscles to contract and loosen appropriately. Then, you will typically start regular appointments to work on your pelvic floor muscles while your therapist tracks your progress.

Many people have appointments once to twice a week over a period of six to 12 weeks. It is generally accepted that some people will start to see differences within four to six weeks, Dr. Dune says. “Like any muscle in the body, retraining the pelvic floor muscles takes time, but it is…often very successful,” she says.

But unfortunately, pelvic therapy isn't a guaranteed success, and even when it might help with pelvic floor issues, you'll probably need to put in a fair amount of work. If you’re curious about checking in with a pelvic floor therapist anyway, you can touch base with your ob/gyn to see what they think and if they have recommendations. You can also visit the American Physical Therapy Association’s (APTA) Women’s Health website and plug in your zip code. It might help to search specifically for physical therapists who have APTAs Certificate of Achievement in Pelvic Health Physical Therapy (CAPP) or Women’s Health Clinical Specialist (WCS) certification. And here’s some information about how to choose the right physical therapist for you.

For some people, pelvic floor physical therapy may help sufficiently with pelvic floor problems. For others, surgery might be necessary to correct issues like pelvic floor organ prolapse.

Preventive pelvic floor physical therapy

Some people decide to see a pelvic floor physical therapist while they’re pregnant instead of waiting until after giving birth. It’s essentially a way of trying to learn how strong your pelvic floor is and possibly get some tips for maintaining that strength throughout pregnancy and childbirth. This can be worthwhile for some people, Dr. LeFevre says.

However, pelvic floor physical therapy is definitely not a requirement during pregnancy. What’s more, it can be a luxury when it comes to both time and money. It will typically be harder to get pelvic floor physical therapy covered by insurance if you’re going preemptively rather than if you’re actually diagnosed with pelvic floor dysfunction, Dr. Dune says. When paying out of pocket, a session may cost between $150 to over $300, she notes, though this can vary based on your location and the specific practice. Even if you do get your session partially covered, you may still be on the hook for a co-pay. Plus, there’s all the time involved with actually going to these appointments.

Also, getting pelvic floor physical therapy while you’re pregnant is kind of like dealing with a moving target. “It might be more effective to wait until you don’t have the ongoing effects of pregnancy,” Dr. Bianco says.

If you want a quick and easy check on how your pelvic floor is doing while you’re pregnant, ask your ob/gyn if they can feel your muscles while you do a Kegel, Dr. Dabney says. See if they have any tips for keeping your pelvic floor strong during pregnancy, like the proper way to do Kegels if you’re not quite sure about your form.

It might be that your pelvic floor is totally fine and any symptoms you’re experiencing—hello, leaky bladder—are just par for the pregnancy course. But if you and your doctor have reason to think you might actually have pelvic floor dysfunction, they can help you identify any next steps to strengthen this important part of your body.

Source: https://www.self.com/story/pregnancy-childbirth-pelvic-floor

0 notes