Common But Not Normal - 5 Things to Watch for Postpartum

Whether you've had a baby 6 weeks ago or 6 years ago, being pregnant and giving birth (no matter if it's vaginal or c-section) causes internal structural changes in your body. Some of these changes require repair, but unfortunately go undiagnosed and untreated even though they cause pain or negatively affect your quality of life. Why does this happen? Because too often, people (even doctors!) dismiss these changes, don't know enough about postpartum healing, and even worse, call them "normal." 

My friends, I am here to tell you that just because a side effect of pregnancy and birth is common does not mean that it is normal. In other words, you do not have to "just accept" that you now leak urine when you sneeze. There are ways to heal! Read on to learn five common -- but not normal! -- problems that can occur after having a baby, and what you can do about them. 

Leaking urine. Your pelvic floor muscles are responsible for many, many things in your body, one of which is helping to allow and prevent the flow of urine when you pee. If your pelvic floor is weakened, which happens often as a result of both pregnancy and/or childbirth, it can cause issues with incontinence. The good news is that this is often very treatable, even without surgery. To learn more and get the best treatment for pelvic floor problems, visit a physical therapist who specializes in pelvic floor work.

Anxiety and/or depression. Yes, it's fairly normal to feel more worrisome after having a baby. It's also normal to have a few brief moments of feeling down or sad. What's not normal is if either of those feelings starts to take over, intrude on your day-to-day well being, and interfere with your normal functioning. That could be sign of a postpartum mood disorder and require that you get help and treatment as soon as possible. Start with your OB or primary care doctor to discuss your symptoms and talk about treatment. They may refer you to a specialist for additional treatment. 

Tummy pooch. No, I'm not talking about the extra 10 or so pounds you're carrying around from pregnancy. If you see a pooch where your stomach once was, you may be experiencing what is called diastasis recti, and while it is very common, it is also very treatable -- and it's important that you do treat it! Diastasis is a separation of the abdominal muscles. While this happens naturally during pregnancy to accommodate your growing baby, the muscles can remain separated after birth, which can cause pain and problems, including weakened core strength/instability, back pain, pelvic pain, posture problems (which can cause pain and muscle imbalance), pelvic floor problems, constipation, and hernia. The best way to treat diastasis recti is to first have it diagnosed by a professional -- all people after birth should have it checked whether you notice a problem or not. Then, seek a professional who is trained in diastasis repair to carefully guide you to healing, like a physical therapist or postpartum doula. Belly wrapping or belly binding after birth also can help heal diastasis recti. Seek out professional advice and guidance for binding in a way that is safe and promotes the optimal healing. 

Pelvic (crotch) pain. If you have mild to severe pain around your public bone or "crotch" area, you may be dealing with pubic symphysis disorder/diastasis. This is when there is a separation of the pubic bones, which are normally joined together. Depending on the amount of separation you have, you will experience varying levels of pain and discomfort when participating in routine physical activities, including walking. This condition requires diagnosis and treatment by a physical therapist, who will likely order an xray, MRI, or CT scan to determine the level of separation which will inform how you need to be treated. 

Painful sex. Painful sex after giving birth is common, and yet, it's not normal. Sex after birth should not hurt. There could be a handful of reasons why sex after birth hurts, but the most common are lack of lubrication and scar tissue. Lack of lubrication is typical when you're breastfeeding and when your hormones are in flux after birth. It's generally temporary and is easy to fix: buy and use lube! There are many brands out of lubrication out there -- experiment to see what works best for you. The other reason sex can hurt after birth is due to scar tissue. If you tore during birth, even a little, sex may be painful. The more severe your tearing, the more likely you will experience pain with sex. If you believe that your scar tissue is contributing to pain in and out of the bedroom, see a professional for help in healing. A holistic pelvic floor specialist, a physical therapist who specializes in pelvic floor work, or a STREAM (scar tissue remediation education and management) practitioner. 

Resources

Kimberly Ann Johnson. The Fourth Trimester. 2017.

STREAM. https://www.scartissueremediation.com/stream  

Parents. Diastasis Recti: The Postpartum Body Problem No One Talks About. 

Physiopedia. Pubic Symphysis Dysfunction.