What Every New Mom Should Know About Pelvic Floor Dysfunction
A woman's body goes through a lot of changes during pregnancy. It amazes me just how many changes occur during the 40 weeks of gestation. When I was pregnant with my first child, I didn't even think about the changes I would experience after delivery. From night sweats to extreme back pain, I was rather surprised about all the postpartum issues I did not know about. During this pregnancy, I have been doing a lot more reading on prevention of postpartum complications. Through my reading, I have learned about a disorder that is rarely discussed and often misdiagnosed called pelvic floor dysfunction.
What is the pelvic floor?
The pelvic floor is the group of multi-layer muscles that forms the bottom of your torso. The bony structures include the sits bones (ischium bones), pubic bone, and tail bone. The pelvic floor muscles span from between the pubic and tail bone to both sides of your sits bones, making a sling on the bottom of your body. This muscular layer supports the entire weight of your body.
What are the major functions of the pelvic floor?
The pelvic muscle is the same type of skeletal tissue that is found in the bicep and quadricep, which means that when you tighten and relax the muscle they will do just that. Most people do not realize that they have control over the muscle. The muscle is made up of 3 layers: ?
- Sexual muscular layer – this layer helps with sexual responses and is full of blood vessels?
- Sphincter muscular layer – the muscles in this layer form the sphincter, a round muscle that closes off the urethra (the tube that goes from the bladder and carries out urine), the vagina, and the rectum?
- Supportive layer – the layer deep within the pelvis that helps to keep the bladder, uterus, and bowels in the right position
What is pelvic floor dysfunction?
Pelvic floor dysfunction is a condition in which the muscles of the pelvic floor are tight or weak. A person may experience pelvic pain or decreased sensitivity. The most common conditions of postpartum pelvic floor dysfunction are urinary incontinence, anal incontinence and pelvic organ prolapse. Several research studies have shown that the actual pregnancy, not the birthing processes, is thought to cause the condition. However, other studies have concluded that the trauma is caused during the birthing process.
How common is pelvic floor dysfunction?
Recent research shows that around 3 months postpartum 33% of moms experience urinary incontinence and 20% experience fecal incontinence.
What happens to the pelvic floor during a vaginal delivery?
As your baby comes down the birth canal, it stretches and elongates the pelvic floor muscle. Sometimes there can be trauma because of the stretching. Also, if the baby is too big to come through the birth canal, the pelvic floor muscle will tear to allow the baby to come through. Other times an episiotomy is necessary to help assist the baby through the pelvis, which can create trauma to the pelvic floor. During an episiotomy, the main tendon of the pelvic floor that helps to give it stability can be disrupted.
What is the likelihood that I will have pelvic floor dysfunction following birth?
There has been a lot of research in this area of postpartum pelvic floor dysfunction. Most studies have concluded that a pregnant woman’s general health may influence the likelihood of developing incontinence.
Risk Factors for Developing Postpartum Pelvic Floor Dysfunction
1. A study by Rasummen et al in 1997 suggested that woman who are obese before and during pregnancy may have a slight increase for postpartum stress urinary incontinence. In other studies not specifically related to pregnancy, there has been a definite link demonstrated between obesity and pelvic floor dysfunction (Kapoor and Freeman, 2008).
2. A research study by Chiarelli and Campbell in 1997 concluded that women with a chronic cough during pregnancy could have four times the risk of developing incontinence.
3. Initial strength of the pelvic floor muscles also influences the development of incontinence during pregnancy (Morkved et al, 2003).
4. The risk is increased the more times a woman gives birth.
What are the symptoms of a weak pelvic floor?
- Leakage from a cough or sneeze (urinary or fecal incontinence)
- Poor sexual arousal?
- Urge incontinence (when you feel as if you have to go to the bathroom but cannot hold it back)
How is it treated?
Treatment of pelvic floor dysfunction is dependent on how severe the symptoms and the damage to the muscles. Generally, treatment includes behavioral changes, such as learning how to relax the muscles in the pelvic floor. Physical therapy and biofeedback is a treatment option in where an individual learns how to relax and coordinate the movement of pelvic floor muscles with Kegel exercises. In more severe cases, surgery may be necessary.
If you are experiencing any of the symptoms of pelvic floor dysfunction it is important to seek out medical advice. Typically the condition requires specialized medical care.
What post-natal symptoms surprised you the most after delivery of your baby?