Peri & Postpartum Health

During pregnancy and delivery there are both predictable and unpredictable physical changes that can occur in your body.

The hormone relaxin is secreted to help to loosen the ligaments so that the pelvic girdle can allow for growth and delivery of the baby. This is a normal response in pregnancy, but can lead to pelvic girdle pain in some women.

As your abdomen expands, the muscles in the area stretch and the fascia (tissue connecting the muscles) has to accommodate the growing baby. If the fascia is overloaded and tears the rectus abdominus muscle can separate. This is called a rectus diastasis. If you have a diastasis your ability to stabilize your spine and transfer load effectively may be altered.

As your baby grows he/she will increase your intra-abdominal pressure and may change your breathing pattern and put increased pressure on your pelvic floor and bladder. You may also experience pressure in your rib cage and associated middle back pain.

When you deliver your baby vaginally, you will have some stretching and sometimes tearing of your pelvic floor muscles and the joints and ligaments in this area. It is also possible for you to develop pressure on your nerves that control the pelvic floor area during delivery. If you have to have an episiotomy or stitching you will have some scarring in your pelvic floor muscles. It is possible to also have some separation of the pelvis at the front joint (known as the pubic symphysis).

If your delivery is done via C-section, you will have an abdominal incision across the fascia at the front of your body that can cause changes in muscle function and scarring.

All of these changes can eventually lead to low back pain, incontinence, pelvic organ prolapse, thoracic spine and shoulder girdle pain and eventually neck pain. Often during and after pregnancy women lose the normal function of their deep abdominal, back and pelvic floor muscles. This loss of normal function can lead to many other compensatory problems if it is not addressed.

Although the post partum period is busy and it is difficult to find time to take care of your own body when you have a new child in your life, it is important to take care of your body after pregnancy. Taking care of your body now should improve any pain and dysfunction that you are having currently and should help to prevent future damage that can occur because of the compensation strategies you will develop if you haven't recovered normal muscle function.

It is postulated that the long term problems associated with post pregnancy compensation strategies include: incontinence, prolapse, hip arthritis, degeneration of the lower lumbar spine and neck and back pain.

Cara Humphreys, one of the senior therapists at Kamloops Physiotherapy has developed a special interest in treating women who are pregnant or recently post-partum. Cara has taken advanced courses in pelvic girdle and thoracic spine dysfunction during and after pregnancy, ultrasound imaging to assist with retraining post childbirth, internal pelvic floor assessment (if needed for urinary incontinence or pelvic organ prolapse) and advanced techniques for pain management and motor retraining.