Being a Women’s Health Physical Therapist has given me the privilege of working with a lot of post partum women. I have a profound respect for the body’s ability to birth a baby. It is a natural event that the body is designed to perform.
While birth is a natural function of the body, it is not designed to handle the effects of prolonged pushing or a baby that comes out in a less than ideal way. These conditions place excessive strain on the pelvis and vaginal tissues and create issues. Issues that a woman doesn’t have to just deal with for the rest of her life, but can get help with and fully recover. That is, when she gets help. Often times women are left to just deal with theses issues on their own and learn to just live with them. Many are convinced or made to believe it’s just a natural side effect of childbirth. But it doesn’t have to be this way!
A large majority of issues such as painful intercourse, incontinence, a pressure or falling out feeling in the vaginal area from organ prolapse, or just your body not feeling the same anymore, can all be helped by working with a women’s health physical therapist.
Helping Women Get the Help they Need!
Birthing professionals need to understand the effects a birth can have on a woman’s body and help them get the support they need to help their pelvis come back to it’s normal alignment and get their vaginal tissues released. This idea that birth is a natural function and we just spring right back to our pre-pregnancy state doesn’t always happen for all birthing women. The birthing professional needs to listen to the post partum woman and help them to understand that what they are experiencing in their body is an effect of birth and there is help.
Also understanding that when a birthing woman gets to a point in her labor where she feels like she doesn’t want to go on, it’s too much, or “just get this baby out of me now!” are all signs where the body can register the event as traumatic. When trauma occurs the tissues get stuck in the position she is in during the traumatic moment. The woman may not vocally say these words, it may just be a fleeting thought but those tissues respond accordingly. After the birth is over when you are reviewing the birth with the new mama, asking her if she got to that point of wanting things to stop or be done could give you an idea if any trauma effects may have occurred.
When we experience any traumatic event our body has three different options to protect itself. We can either choose to fight the event, try and flight from it or we just freeze. During labor, fighting and running away are not an option. The body’s only choice is to freeze, so the tissues get stuck in whatever position they are in at the time.
Usually this occurs during the pushing phase. When women are pushing their ischiums, or sit bones, are splayed out to the side, their sacrum is nutated, where the tailbone is farther away from the pubic bone, and their tissues are bearing down. A traumatic response can keep these tissues in this position well after the birth is over.
By listening to the tissues on an energetic level, one can feel what they still want to do. Helping a new mom tune into the effected area and realize that the birth is over can bring the tissues into a more neutral state.
When I assess post partum women’s tissues on an energetic level, many of them present with their bladder and uterine tissues still bearing down as if they are continuing to push a baby out. By just placing my index finger on the urethra and bladder and just listening to what that tissue wants to do, most of the time my finger gets pushed out of the vagina.
The great thing is, it’s easy to fix this problem. By having the woman bring her attention to the tissues I’m touching she can help them to realize the birth is over, that the tissues can stay up and inside. The tissues retract back up and in like a turtle pulling its head back into its shell.
Bringing the ischiums back into midline also helps to relax the pelvic floor tissues. Since the pelvic floor muscles attach to the sides of the ischiums, when they are splayed out and stuck there, the pelvic floor muscles can have too much stretch on them not allowing them to relax and contract fully. Sometimes one ischium gets more pressure than the other, creating an imbalance in the pelvis, especially when sitting. To learn more about pelvic trauma in birth, read this blog.
The vaginal tissues may need help releasing the effects of the baby turning it’s head to come out. Many times I can still feel the twisting effect on the pelvic floor tissues from this part of the birth. Soft tissue mobilization of the vaginal tissues can help restore normal function and contraction ability of the pelvic floor muscles. Read more here. Without this type of work regaining strength in the pelvic floor muscles can be like beating your head against a wall. The muscles need to be released in order to work properly. But in order to free up these tissues, any trauma that may be present in the tissues needs to be released first.
I had one mom I worked with who had seen another women’s health physical therapist for 12 sessions and she reported that after every internal session of massage with this PT, her pelvic floor area would ache and hurt afterwards. This is a sign that there is trauma in the tissues. When a tissue with tension in it doesn’t want to let go or release, there is trauma that needs to be addressed first. Also when a tissue reacts by hurting worse after a session, the body is trying to tell you it does not like that approach, something else needs to happen first. By listening to the tissues and sensing them you can tell when they are willing or unwilling to release. There is a different quality to the tissues when trauma is present.
Working with trauma in the tissues can be challenging, depending on the amount of trauma one has experienced. A lot of times with birth, just the act of bringing a woman’s awareness to the tissues, helping her breathe down into the affected area can help them to release. Also helping her go back to remembering herself before the moment of trauma and reconnecting to herself then can help release the tension and trauma in the tissues. This work needs to be extremely gentle and respectful. Forcing any tissues in the vaginal area is very counterproductive.
Helping new moms recover from the effects of birth needs to be a bigger priority in our country. In France, women get 8 physical therapy visits after giving birth. Getting moms the support and help they need to heal from the effects of trauma from birth and get their body and tissues back into their proper place should be available for every woman who has had a baby. I wish I could see every post partum woman just once to get her on the path to reclaiming her body and healing after birth.