5 Things You Weren’t Expecting Postpartum

I think I can speak for the majority of women when I make a bold statement and say there is a big gap in care for postpartum women here in North America. The female body changes drastically during pregnancy; the stretching of the core muscles, squishing of organs, and the addition of several pounds of extra pressure going down through the pelvic floor.

THEN:  We either push a baby out of the pelvic floor muscles during a vaginal delivery or undergo a major abdominal surgery in order to deliver our baby via cesarean section.

AFTERNo mention of postpartum rehabilitation.

Instead, rest is encouraged for 6 weeks at which time moms are discharged by their care provided and given the “all clear” to resume activity.

On one end of the spectrum, women often still experience unfamiliar symptoms that were not present before pregnancy. These symptoms leave them fearful of activity and for that reason, they avoid it. 

On the other end of the spectrum is the postpartum woman who feels great and ventures back to exercise quickly.  Unfortunately our fitness culture spotlights shedding baby weight and fitting back into our pre baby clothes ASAP. The result is that postpartum exercises often involves high intensity exercise that is  too much for the body.  This ‘Too much too soon’ mentality often leads to postpartum warning signs of  more serious issues if not addressed.  Leaking, vaginal pressure and heaviness, painful sex, back or pelvic pain and diastasis recti are all very common postpartum symptoms. 

“Why aren’t we told about this stuff?”

There are so many things I wish I would have known when I was pregnant with my first.  I understand the frustration and feeling completely unprepared for postpartum recovery.  I work with women in various stages of postpartum recovery and if I had them all together in one room, they would have A LOT of advice for moms-to-be. 

Here are the top 5 things moms want you to know about postpartum:

1.  You will likely pee your pants.

The pelvic floor is a very important group of muscles that ensure we don’t leak pee or poop. Because of the drastic changes during pregnancy and the trauma during delivery, these muscles don’t always do their job as well postpartum…hence the leaking.  Just like other muscles in the body, after an injury, muscles need time and gentle movement before working on strength.  The pelvic floor needs to be able to relax and also to tighten throughout the day to ensure we don’t leak. Kegels (pelvic floor tightening exercises) are often prescribed to address leaking. For some this helps, but for the many postpartum women who have tense pelvic floor muscles, kegels can perpetuate their symptoms.  

2.  Sex will most likely feel quite different.

It’s hard enough wrapping your head around being intimate for the first time postpartum, let alone dealing with ‘things feeling different.’ Many women report difficulty reaching climax postpartum along with less pleasure ‘down there’ due to lack of muscle tone. Others are surprised to feel that penetration is very painful for several months or even years postpartum. Both of these issues are very much tied to the pelvic floor muscles and you can imagine that when left unresolved, can be a major source of strain on a relationship.

3.  The organs in your pelvis will feel as though they have shifted.

If you feel any of the following symptoms:
  • vaginal heaviness or pressure
  • constipation and/or difficulty passing bowel movement
  • difficulty emptying your bladder fully
  • difficulty with tampon use
  • you see or feel a bulge down there

Then you are likely experiencing some degree of prolapse, meaning your uterus, bladder or rectum are not being supported as well as they need to be. Once again, our pelvic floor plays a very important role in the support of these organs and after all the extra weight from a pregnancy, plus the bearing down during delivery, these muscles may not be ‘holding up’ their end of the deal.

You may not feel the effects now, but over time…….

It could be that once you start increasing the intensity of your exercises, you notice these common symptoms

OR maybe it will be after a subsequent pregnancy and delivery due to compounding effects

OR it may take several years and maybe into menopause when the effects of hormonal changes bring symptoms that have been brewing just below the surface.

Don’t wait until you have symptoms!

Address these issues as soon as you experience them.

As symptoms progress, they become harder to address conservatively and may require surgical intervention.  Most of these women wish they could turn back the clock and address their symptoms when they first started happening.

4.  You will receive little to no guidance.

I was shocked when not one health care provider asked me about my physical symptoms postpartum or talk to me about:

  • What exercises are safe and recommended during pregnancy
  • My pelvic floor and what I could do to prepare these muscles to push out a baby
  • Symptoms that I can expect to experience postpartum and what I should do if they don’t resolve
  • What exercises I should start with postpartum and how quickly to progress.

Even as a physical therapist, I was not prepared for any of this. We learned very little in our physiotherapy education about the pelvic floor and postpartum changes.   It wasn’t until I had my own experience with leaking, pelvic pain so severe I could barely walk,  separated abdominal muscles which made my core feel weak PLUS a whole host of injuries that left me struggling to stay active, that I recognized I needed to seek out help.  I was feeling down and to be honest….. pretty frustrated.

Gap in care

My own experience was what drove me to further my pregnancy and postpartum knowledge. Now that I work to help women in the clinic who have stories similar to mine, I see how big this gap in care for postpartum women really is.

Ladies, I want you to know that your story doesn’t have to go as mine did.

In France, postpartum women are seen by a pelvic health physical therapist a number of times, for which the cost is covered by their medical system in an effort to provide proactive care.

In North America, unfortunately we just aren’t there yet.  

What can you do?

Find a pelvic health physical therapist

I would highly recommend finding a pelvic health physical therapist in your community and seeing them for an assessment during and after pregnancy.

I understand that this can be hard for some to access.  Getting to appointments with small kids at home can be nearly impossible. In an effort to provide accessible  guidance to all postpartum moms, I have created an online program which allows you to gain knowledge and empowerment in the early postpartum phase Learn how to re-connect with your pelvic floor and core muscles and then how to safely progress back to your favourite activities. 

Imagine learning about your pelvic floor and how it can support you again postpartum in the comfort of your own home so that you feel good not only with your activities but just in keeping up with your kids!

You totally can!

Click for a sneak peak at the Mommy Berries 6 week online program that is safe to start right after having a baby.

For tons of valuable information about pregnancy and postpartum, visit my website or follow me on Instagram, Pinterest and Facebook

Ready to rehabilitate your postpartum body?

Check out the 6 week program, From the Inside Out. Members gain access to the private Mommy Berries Facebook Community of other like-minded new moms working through the program together. You can find me there regularly answering questions and providing extra tips. 

Melissa Dessaulles

Melissa is a pelvic health physiotherapist at Wave Physiotherapy in Kelowna, BC. She is an active mom of 2 young kids. Her own experiences with post partum recovery have made her passionate about helping other moms.

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