It has struck me in recent weeks how many women book appointments in the clinic and almost apologise for the fact that they are wanting an assessment having had a “normal vaginal delivery".
With this comes the implication that they are somehow undeserving of the right to seek help through what is a critical period in terms of long-term wellbeing and pelvic function.
It begs the question “what is “normal” post-natal recovery?”
And why don’t all women automatically assume the right to be assessed by a specialist Physiotherapist in pelvic/women's health?
Evidence supports the fact that delivering a baby vaginally takes its toll on the pelvic floor muscles. DeLancey* described how the muscles are stretched, on average, during the 2nd (pushing) stage of labour to 3.25 times the resting length, with the greatest risk of injury to these muscles being as a result of the use of forceps.
He also reports on evidence suggesting that the nerves to the anal sphincter undergo maximum strain during this stage of delivery.
If we were to sustain this degree of damage to other skeletal muscles in the body, would we then feel the need to apologise for seeking expert help?
The answer is clearly no, we would not.
The reason that many women fail to realise they need help is the fact that they are unaware of the potential damage done during delivery. This may be because many post-natal women do not demonstrate bladder or bowel symptoms and assume that the pelvic floor is sufficiently strong, whilst the new and demanding role of motherhood takes over.
It may not be until many years later, following subsequent pregnancies or the onset of the peri-menopause, that symptoms creep out of the shadows, as the body’s ability to mask any potential pelvic floor weakness subsides as hormonal changes occur.
We know that there is a significant association with damage sustained during vaginal delivery and the development of pelvic organ prolapse years later.
So returning to the questions posed at the start of this blog. There is no such thing as “normal” or “abnormal” post-natal recovery, it is simply “recovery”. As such, regardless of whether you have had a vaginal or caesarean delivery, all women deserve and indeed should be assessed by a specialist pelvic Physiotherapist.
This should be done to assess, counsel and support them through this final, critical stage in the transition from pregnancy to childbirth and through the postnatal period. Many women so often feel a sense of abandonment once the baby has been born, with their own health and wellbeing taking a back seat to that of the baby when the two should be viewed in tandem?
Surely specialist support during the postnatal recovery for the mum is crucial to the success of her settling into her role as a mother?
As a specialist pelvic Physiotherapist, I assess the pelvic girdle complex both internally and externally. I educate and reassure you on what normal bladder and bowel function is, and what may be abnormal and require additional help. I teaching appropriate abdominal muscle rehabilitation and supervised safe return to exercise reduces the risk of future prolapse or pelvic floor dysfunction.
For support in regaining your confidence both physically and mentally so that you can embrace the postnatal period, please arrange a free consultation call here.
*Book reference: Ashton-Miller, J.A and DeLancey J. (2007) Functional Anatomy of the Female Pelvic Floor. Annals of the New York Academy of Sciences, 1101, pp266-296