When the pelvic floor functions normally it supports the pelvic organs, keeps us continent, and allows us to participate in the exercises we love doing. The pelvic floor is part of the global support system for the lower body and is interconnected with the larger muscles of the lower body.
Everyone has a pelvic floor, both women and men alike. The pelvic floor is a large sling like muscle that spans the underside of the pelvis supporting the pelvic organs. I often describe it as: 2 hands sitting under the pelvis, that rise and support when needed, and relax and let go at rest. For women specifically, the great news is that the pelvic floor is flexible and during a natural delivery stretches to 4-5 times its normal length! Sometimes, the pelvic floor might be slow to return back to its original state. It may need extra help for example with guided pelvic floor re-education and exercise from a women’s health physiotherapist.
The American College for Obstetrics and Gynecology (ACOG), released guidelines in 2018 for postnatal care. ACOG describe a comprehensive post-partum check, which includes an assessment of physical, social and psychological well-being. An important domain is the assessment of the pelvic floor, presence of incontinence and guidance provided on resumption of physical activity, with a referral to a Women’s Health physiotherapist/ physical therapist as standard. Addressing the physical recovery after birth is often overlooked or addressed with simplicity that prevents the full recovery and return to normal level of activity.
The fourth trimester, post partum period, should be addressed with the same level of attention as the former 3.
American College Obstetrics & Gynecology (ACOG) (2018) Optimizing Postpartum Care: Obstetrics and Gynecology VOL. 131, NO. 5, p140-150