Almost every mom-to-be has some worry about what can happen to their body after childbirth. While it’s natural for there to be some damage following delivery, most women do not experience adverse side effects. However, Dr. Ken Ostermann, OB/GYN and Urogynecologist with Marshfield Clinic Health System, said some women experience urogynecologic pelvic floor disorders, such as incontinence and uterine prolapse. Fortunately, there are preventive measures and treatment for these issues that may arise after childbirth.
Pelvic floor disorder and childbirth
One of the most common urogynecology problems as a result of childbirth and pregnancy are pelvic floor changes. Ostermann said this often happens because your body is enduring the stress of weight and mass pushing on your pelvic area.
“During childbirth, your pelvic muscles and tissues can be strained or torn, resulting in problems like incontinence and uterine prolapse that often stem from a weakened pelvic floor,” Ostermann said. “You can work on strengthening your pelvic floor before and during pregnancy to help reduce the chance of developing these issues.”
Ostermann recommends doing pelvic floor exercises at home like Kegels to make you less susceptible to injury. You also can continue doing them after pregnancy as part of your postpartum recovery process once your women’s health provider clears you for activity.
Incontinence and childbirth
A weakened pelvic floor can cause urinary incontinence – it’s why you’ll hear pregnant women and moms often talk about leaking a little when they sneeze. But, there’s another type of incontinence that can happen too. According to the American College of Obstetricians and Gynecologists, up to 10% of women also report fecal incontinence, which is the inability to control bowel movements. This can occur due to rectal sphincter injury during childbirth.
“If a tear happens in this area during delivery, it’s important to have an experienced provider properly repair it to reduce the chances of developing fecal incontinence later in life,” Ostermann said.
While Kegel exercises can be beneficial for both types of incontinence, there are a few additional actions you can take after delivery to help reduce the chances of fecal incontinence. Ostermann recommends maintaining a high-fiber diet, staying hydrated, and using a stool softener will help promote recovery without re-injuring the area. Your women’s health provider also may suggest other types of physical therapy or surgical and non-surgical interventions based on your needs.
“Incontinence isn’t anything to be embarrassed about,” Ostermann said. “Some women are hesitant to seek treatment, but our women’s health team has seen it all and only care about helping patients treat their conditions successfully.”
Uterine prolapse and childbirth
When pelvic floor muscles have stretched out and can’t provide stable support for the vagina and uterus after delivery, the uterus can slip down into the vagina, and sometimes protrude from the vaginal opening. While it may sound scary, mild uterine prolapse may not even require treatment.
However, if it’s causing you discomfort or concern, your women’s health provider may suggest a medical device called a pessary (to support the uterus) or minimally invasive pelvic floor surgery. Prolapse repair surgery is only recommended once you know you’re done having children.
The link between childbirth and urogynecology problems is something to be aware of, but not something to fear.
“We are here to help you navigate every aspect of pregnancy, birth and postpartum recovery with empathy and confidence,” Ostermann said.
Talk to your women’s health provider or primary provider if you have concerns.