How to Restore Your Pelvic Floor After Baby

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Taryn Watson - FitRight Women's Health physio

Women need to rebuild from the inside out after having a baby. All too often as women and mothers, we neglect our own health and wellbeing. I experienced pelvic floor issues after the birth of my kids that I regretfully ignored!  I invited women’s health physiotherapist Taryn Watson from FitRight Physio and FitRight HQ to write a guest blog post on this topic.

6 Week Health Check

It’s common practice to go and see a health professional at approximately six weeks after giving birth. Typically an obstetrician, a midwife or a GP. The purpose of this consult is generally to ensure you’re medically well, and to get the ‘all clear’ for return to normal activity – whether that be lifting toddlers, driving, sex, sport or all of the above!

It is time that the word got out there – being medically well at 6 weeks postnatal is great.  However, this check-up does not necessarily mean that your body is ready for the vigour of loaded or impact exercise like Boot Camp or running.

Women’s Health Physio Check Up

It is very important to have a check up with a Women’s Health & Continence (WH&C) Physiotherapist after having a baby. Ideally at 6-8 weeks postnatal, around the time when you have your medical check up. It can be earlier than this, with an external screen of your pelvic floor. Just be aware that a more comprehensive pelvic floor and prolapse assessment, done with a vaginal examination, needs to wait until after 6 weeks postnatal.

If these early weeks and months are too hectic, then it can be later, but ideally it would be before you get back into higher level physical exercise, or before you get pregnant again.

As your physiotherapist in hospital (if you’re lucky enough to have access to one) should tell you, physical activity in the first 6 weeks or so should be limited to pelvic floor exercises, gentle stretches and body weight or low load resistance exercises.  You can gradually return to 30-60 minutes of low impact cardio exercise like walking too. For further information refer to Postnatal Rehab – The First Six Weeks. Click here for more information including educational videos.

Assessment

At a postnatal WH&C Physiotherapist appointment, a physiotherapist will go through a number of questions about your:

  • pregnancy and birth,
  • medical history,
  • bladder and bowel function,
  • muscle and joint function,
  • exercise history and
  • exercise goals Exercise after baby and restoring your pelvic floor

Pelvic Floor Muscle Assessment

The physiotherapist will then assess your pelvic floor muscles, which is important even if you have had a caesarean section delivery. You may be thinking – aren’t internal examinations over and done with now that the baby is born?! But it doesn’t necessarily have to be done via a vaginal examination.

Screening Test

A screening test can be done with an ultrasound of your lower tummy.  The ultra-sound will show the physiotherapist how well you can elevate and relax those muscles.  The patient, can see this on the screen too, which is great for feedback and learning. A vaginal examination however, is the gold standard.  Considerably more information can be gained such as pelvic floor muscle strength, tone and the presence of pain or a vaginal prolapse. This more thorough examination is even more highly recommended if you have any symptoms of pelvic floor dysfunction, such as bladder or bowel incontinence, a feeling of vaginal heaviness, or any pain in the vaginal area.

Rectus Abdominis Diastasis

Your abdominal muscles will also be assessed for Rectus Abdominis Diastasis (RAD). To determine whether or not your ‘six pack muscles’ and the connective tissue in the mid line have returned to normal after pregnancy.  This stretching apart of the two belly muscles is completely normal if you carry a baby to full term. But did you know that natural healing only occurs in the first 8 weeks? If the tissue in the midline isn’t back to being thick and strong by that stage, you will need to do specific exercises to rectify it.

Musculoskeletal Assessment

This will depend on any specific muscle or joint symptoms, and also will depend on your exercise goals and aims. A physio will often assess posture, strength and the ability to do certain movements and exercises with good technique. Common movements that would be tested are sit ups, bridging (both legs or single leg), squats, getting up from a chair (both legs or single legs), double leg raises or planks.

Action Plan

Then a plan of attack will be put in place as to the best way to achieve your exercise goals. In this way, it is a very individual approach to postnatal exercise. There is no ‘recipe’ to achieve a certain level of activity at a certain number of months postnatal. I can’t tell you how many times I hear ‘but I waited until 3 months before I did sit ups, so I should have been fine!’ We can never assume that one woman’s muscle activation, hormonal changes, and birth trauma are the same as the next woman’s.  We’re all individual!

A Gradual Return to Exercise

Think of returning to exercise like building a house. If you don’t first build strong foundations, you will very likely have issues building your house on top of it. Therefore, spend the first weeks or months after giving birth preparing your ‘foundations’ or your ‘core’.

When your joints, muscles and pelvic organ support have been assessed, you can work together to plan a graduated return to higher intensity and loaded exercise. Ideally the physiotherapist would liaise with your personal trainer or coach to formulate this plan.

Exercise after having a baby

The plan may be anywhere between 6 weeks and 12 months + after childbirth.  It all depends on how you present at the initial assessment and how quickly you progress. Even when you graduate to higher level exercise it is still so important for all women to incorporate pelvic floor and deep abdominal exercises into their routines. Pelvic floor and deep abdominal exercises keep your foundations strong!

Don’t Leave it Too Long

“There is nothing that makes me sadder than when a woman comes to see me months or years after giving birth, and tells me that she’s been suffering with symptoms like prolapse or incontinence or pain ever since the birth but was told this was ‘just something she needed to put up with’ ”

Many women assume symptoms will just get better over time, or they make a guess at readiness for exercise. At FitRight, the message is all about empowering women to be proactive, rather than reactive with their pelvic floor health. Have your postnatal assessment done with a Women’s Health Physiotherapist FIRST.  Then you can build your return to exercise (and daily life!) on strong foundations.

About Taryn WatsonTaryn Watson - Women's Health Physio

Taryn is a Women’s Health & Continence physiotherapist with a passion for providing pelvic floor friendly exercise options in the community.

In 2013 Taryn completed her Masters in Continence & Women’s Health Physiotherapy at Curtin University. Her master’s research project was on the incidence of stress incontinence (the leakage of urine with exertion) in women who attend gyms to exercise. The results of this study were that a staggering 50% of the women surveyed reported that they suffered from this incontinence.  The enormity of these results lead to Taryn establishing FitRight.

Through FitRight, Taryn originally created a chain of physio-led fitness classes for women, and then in 2021 she partnered with Jess Hextall to open FitRight HQ – a centre for Women’s Health & Exercise in the Applecross Village in Western Australia. Their team now includes the following

  • multiple Women’s Health Physios
  • Musculoskeletal Physios
  • Women’s Health General Practitioner’s
  • a Sexologist and
  • FitRight HQ share their space with a team of Lactation Consultants

Taryn is passionate about assisting women through the childbearing years and treating women with prolapse, incontinence and other forms of pelvic floor dysfunction.

Nicole Cassey

written by

Nicole Cassey

Nicole Cassey, Mum to Jacob and Emily, founder and general dog’s body at Bubbaroo. Nicole was inspired to create Bubbaroo and Australia’s first swaddle after the personal experience she had with her first child, Jacob.

Nicole explains "It is such a steep learning curve becoming a parent. Getting to know the baby you created and finding your groove as a parent. You sometimes feel like you need to become a detective to try to interpret your baby's cues, personality, cries and behaviour. This is my passion to help parents on their journey, especially new parents as they transition to parenthood."

Nicole has a passion for sharing knowledge and community, regularly organising and presenting at various expectant parent and sleep workshops. Nicole ensures she is up to date with the latest evidence-based safe sleep and health research. Bubbaroo collaborates with experts in their field that share similar values and philosophies and have a passion for helping and supporting parents and expectant parents.

Nicole’s attention to detail with the creation of her premium quality baby, toddler and child sleepwear is exceptional. Nicole has been committed to ensure that Bubbaroo is not just a mass market brand producing products, Nicole’s focus is on helping your baby sleep safely in products that stand the test of time.

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