Being a new mum is a pretty amazing experience. It’s also a steep learning curve because babies don’t come with a ‘how to look after your new baby’ guidebook!
Many women say that there is a lot of helpful information available during pregnancy but not quite so much that after their baby is born.
So it’s often easy to ignore any concerns you may have about your own health and to cross your fingers in the hope things will get better.
There are lots of websites with some great information but there are some things that aren’t often mentioned.
Here are some very common problems that all new mums need to be aware of but may not have been told about – followed by some simple solutions!
I have a feeling that something is bulging into my vagina and that ‘everything is going to fall out.’
Carrying a baby around for 9 months and then having a natural delivery weakens the pelvic floor muscles and the ligaments. These ligaments and muscles usually hold your bladder, bowel and womb in a well supported position. Pushing for a long time during the second stage of delivery or if you had a large baby also puts this area under strain.
‘My baby is 2 months old now and although we’re both exhausted we wanted to get our sex life back to normal. The problem is sex really hurts.’
Around 78% of women have usually resumed sex three months after delivery. It may feel a little ‘different’ at first until your muscles regain their tone but it shouldn’t be painful. There are a few reasons why sex can hurt;
– Low hormone levels in the vaginal tissue. It’s oestrogen that keeps your vagina well lubricated and supple. Sometimes this hormone is at a low level due to breast-feeding and the absence of periods. You can develop the symptoms of vaginal dryness many women experience during menopause. This can make sex very uncomfortable.
– Painful scar tissue. If you have had a forceps delivery or a longer tear the area will take longer to heal. Sometimes scar tissue can be excessively sensitive to stretching or pressure.
– Tension in your pelvic floor muscles. This spasm can occur as a response to pain because of the two problems above. The muscles can become tense in anticipation. It may be that you can get so far but then full penetration becomes impossible as the muscles tighten and levels of pain increase.
‘I have vaginal wind! I didn’t think it was possible but since my baby was born I have times when I hear and feel wind escaping from my vagina. It’s a very weird feeling.’
This is a more common problem that you would think. It’s not really known how many women experience this symptom because it’s embarrassing so we don’t talk about it. It could be a bit of a conversation stopper if you brought it up at your mother and toddler group!
Air moves naturally in and out of the vagina. After having a baby more air is likely to move in and become trapped because of weak vaginal walls and lack of pelvic floor muscle tone. There is no good evidence to support any specific treatment but pelvic floor exercises can be very effective and some women find a ring pessary helpful.
It is uncommon to have bowel wind passing into the vagina but if you have any concerns that this may be happening then speak to your GP.
‘I’m really struggling to control my bladder and bowel. When I need to wee I have to rush to the toilet and I leak when I cough or sneeze. It’s also really hard to control wind- I’ve had some really dreadful moments when I’ve hoped people thought I had a windy baby!’
You should be able to regain good bladder and bowel control and not experience ongoing background problems for years. Bladder leaks, bowel weakness and difficulty controlling wind may become worse with future pregnancies.
Simple solution one
We can have just one solution that may be the answer to prolapse, bladder,bowel and vaginal wind problems – doing our pelvic floor exercises!
We could save ourselves years of misery, embarrassment, reduced self -confidence and poor sensation during sex. We could also reduce the risk of having to have prolapse and incontinence surgery.
Why don’t we do them? I think we see them as a chore and something to prevent us becoming ‘leaky old ladies’. We don’t associate doing these exercises with our femininity and sexuality.
So here is the simple way to start doing pelvic floor exercise after delivery;
- The first few days: your pelvic floor area is bruised and sore possibly with a few stitches in place. Try and gently tighten your pelvic floor muscles whilst sitting or lying.
6 contractions 3-4 times a day is enough to help reduce swelling. It may be difficult for your brain to even be able to ‘find’ these muscles! Just keep trying.
- After a 4-6 weeks: progress your exercises slowly by tightening your pelvic floor muscles and holding for 5 seconds, repeating this 5 times then doing 5 faster contractions. Repeat this routine 4 times a day.
For further information about assessing your own pelvic floor muscles spend a few minutes watching this video tutorial.
Don’t do the internal examination described in the video until your vaginal tissue is completely healed.
Simple solution two
Accept that you’re not a superwoman. It takes time to recover from being pregnant for 9 months and bringing a baby into the world!
- Allow yourself periods of rest in those first few weeks to give your pelvic floor chance to recover.
- Short walks are great but avoid long distance hikes and lifting more than the weight of your baby. Be aware of any dragging or heavy feelings down below and rest if you feel these sensations building up.
It’s great to see family and friends but show them where the kettle and teabags are kept – and remember your house doesn’t have to look like a set in the ideal homes exhibition!
- Don’t forget to eat and drink. It sounds crazy but you can become so wrapped up in your babies routine you can forget about yourself. Lack of fluids and a poor diet causes constipation and straining, which is not recommended at any time, but especially not in those first few weeks after delivery.
Simple solution three
Remember it’s good pelvic floor muscle strength that will help your sensation during sex to improve. If you have any scar tissue use a lubricant such as YES and don’t ‘go for gold’ first time. Sometimes it takes a few gentle attempts before full penetration is comfortable. If you have ongoing problems with pain see your GP. Make some time to spend with your partner. Many women struggle with their body image and resuming sex can be a bit of a daunting prospect. Expect things to feel different for a while. It takes time for muscles to strengthen and for nerve endings to recover.
Simple solution four
If you feel your progress is slow and you need guidance in how to progress your pelvic floor exercises seek referral to a specialist physiotherapist.
Some women find using biofeedback and electrical stimulation devices very helpful. These types of pelvic floor rehabilitation devices can activate weaker muscles and help you to progress your exercise routine.
If you want professional advice speak to your GP who should be able to refer you to a specialist women’s health physiotherapist or a continence nurse advisor.
de Smit Medical has been working alongside Chartered Physiotherapist, Jane Appleyard to create a blog for advice and thoughts on a range of topics relating to the pelvic floor. Return to our blog for more articles and videos.
Jane Appleyard has over 30 years' experience as a Chartered Physiotherapist and specialises in pelvic health. You can read Jane's bio here.