Pelvic floor

The pelvic floor muscles form the lower closure of the pelvis. The pelvic floor is a functional whole of muscle tissue and support tissue. Its function is to support the abdominal organs (including uterine bladder and intestine), but also to close and open the urethra and anus.

The malfunctioning of the pelvic floor can lead to complaints. It may be that the muscle is weakened or too tense. It is important that the pelvic floor does the right thing at the right time. If the muscle tenses too slowly or too cramped, problems arise with the retention or passing of urine and/or stools.

CHILDBIRTH

During childbirth, the pelvic floor is stretched considerably to allow the baby to pass through. Not only the muscle and connective tissue are stretched, but also the nerve structures. You notice this by a heavy and quickly tired feeling around the vagina and/or anus. Recovery of the pelvic floor muscle, but especially of the nerve tissue, takes time and rest. The damage to the pelvic floor during childbirth depends on a number of factors: the duration of the pushing, the size and position of the baby and whether or not there was an artificial delivery.

AFTER BIRTH

The first days after delivery, both the pelvis and the pelvic floor need rest to recover. Try to lie down a lot, alternating with short walks around the house and sitting for a while. Standing still for a long time is unwise. It is important not to overload the pelvic floor by exercising your pelvic floor too quickly and fanatically. There is still plenty of time for that. In addition, adjust your physical load so that you give your pelvic floor the chance to recover. It is not wise to perform strenuous activities in the first weeks after delivery. It is better not to do things that require you to exert force. The pelvic floor has not yet recovered sufficiently to absorb the increase in abdominal pressure during this type of activity.

EXERCISES

Any woman who has just given birth would do well to pay attention to her pelvic floor muscles. The advice is to do a kind of 'mini-exercises' during the maternity period. It is then only about getting feeling in the pelvic floor area again, the strength comes later. Make a gentle retraction of the vagina and anus and concentrate on the feeling of letting go.

If your pelvic floor sensation has returned after the maternity period and the swelling has reduced, you can intensify the exercises. You can then try to pull in the pelvic floor more forcefully (but not to the maximum) while you breathe in slowly. Try to hold this for 3-8 seconds. While doing this, pay close attention to the feeling of letting go. You can actually practice in any body position; lying, sitting, hands kneeling or standing. Consciously try to do the exercises 2 to 5 times a day with 5 to 15 repetitions.

You will notice that after a few weeks the holding of urine and stools will go well again. If this is not the case, you can ask the pelvic physiotherapist for advice. The pelvic physiotherapist checks the condition of your pelvic floor muscle and teaches you (again) to use your pelvic floor correctly and gives you tailor-made exercises. You could discuss this with the midwife during a possible follow-up check. Proper recovery and use of your pelvic floor help prevent complaints in the future.

COMPLAINTS

Common pelvic floor complaints:

  • Accidental loss of urine during exercise.
  • Rapidly occurring urge to urinate that is difficult to suppress, with or without loss of urine.
  • Difficulty stopping winds and/or stools.
  • Difficulty passing stools (constipation).
  • Prolapse of bladder, uterus, or rectum.
  • Pain and/or a feeling of heaviness in the lower abdomen, vagina and/or anus
  • Pain during sex

WHEN MORE RISK?

Women who have had a “heavy birth” are more likely to get (mild) pelvic floor complaints. It is often wise to make an appointment at the consultation hour of a pelvic floor physiotherapist. You will then receive information and advice to allow your pelvic floor to recover properly and to prevent any future complaints.

What do we mean by a “heavy birth”?

  • Long pressing
  • Birth weight > 8 pounds
  • Total or subtotal rupture
  • Artificial redemption (vacuum or forceps)

PHYSIOTHERAPY

Inquire at PUUR geboortecentrum for good physiotherapists specialized in the pelvic floor.