Your Health

Pelvic health: Pregnancy, postpartum and beyond

Courtesy of Michelle Reynolds
Kim Gladfelter shows a patient how to avoid pelvic health dysfunction with physical therapy that focuses on the pelvis, corresponding muscles, bones and soft-tissue structures.

During pregnancy and the postpartum period, women’s bodies undergo many changes. When a problem arises as a result, there is a misconception that it is normal and you just have to accept it. But ignoring the matter can cause long-term problems that affect quality of life in years to come.

Common problems include leaking urine when you cough, sneeze or exercise; pelvic pain with intercourse; pain at the incision site of a C-section; and diastasis recti (abdominal separation with bulging).

Women are often too embarrassed to discuss these problems and may suffer in silence. Many women finally get to the point where the pain or discomfort becomes so life altering that they seek out help. When you finally discuss the pain with the proper specialist, you are put at ease and often wish you had sought out help sooner.

To determine whether you need help, ask yourself the following questions.

• Are you having trouble losing the baby weight?

• Are you experiencing embarrassing moments of leakage?

• Are you fearful of admitting to pain with sex?

• Are you wondering if you can fix your pelvic floor years after childbirth?

These are problems that many women experience, and though they are all common symptoms, they are not normal.

Pelvic floor physical therapy

Pregnancy doesn’t have to lead to a weak or dysfunctional pelvic floor that results in pain or leakage. When your body does not heal on its own properly, pelvic floor physical therapy can help. This is such a common need that many countries standardly provide pelvic floor therapy in the postpartum period.

Pelvic floor health is a sub-specialty of physical therapy. It is physical therapy to restore the pelvic region to a more functional and/or less painful state. Pelvic health physical therapists receive specialized training in the evaluation and treatment of pain and dysfunction related to the pelvis and corresponding muscles, bones and soft-tissue structures. Pelvic health physical therapists treat women and men with pelvic floor dysfunction.

Pelvic floor physical therapists help to alleviate pelvic pain and/or weakness that may cause leakage of urine or bowel. Additionally, they will educate you on how to build awareness in what you are doing in your daily life that may be making such problems worse. Women at various times are likely to experience some pelvic floor problems, which should be addressed by a specialist to stop the symptoms from getting worse. Even children/adolescents can experience issues with their pelvic floor, such as bedwetting and pain with tampon use.

I’m often asked when an exam can be done in the postpartum period. For vaginal deliveries, it is six weeks postpartum, whereas with C-sections, eight to 12 weeks is ideal. However, you may choose to undergo evaluation sooner, because you can still be educated in ways that can help prior to the postpartum timetable.


Everyone encounters different postpartum problems. But some of the telltale signs of an issue postpartum include:

• Infections, including bladder, kidney or uterine

• Discomfort or pain during sex

• Vaginal discharge

• Fecal or urinary incontinence

• Pain in the perineal area (between the rectum and the vagina)

• Constipation and hemorrhoids

• Difficulty regaining your pre-pregnancy shape

• Blocked milk ducts, which can lead to infection


Your physical therapist will do an evaluation, build your awareness for how you can help change strategies contributing to the problems and discuss the progression for a treatment plan. It is also the time to discuss what your goals are so that the program can be tailored to your needs. The great part is that there are many strategies you can learn to easily manage at home without a lot of time.

At PhysioFit Physical Therapy and Wellness, we help women to take control of their bodies so that they can feel strong, confident and empowered. Women don’t need the added stress about pelvic floor pain, leakage or getting hurt while trying to get into shape. We can help you get back to the exercise and activities you love.

PhysioFit is scheduled to host a Women’s Health: Pregnancy, Postpartum & Beyond Workshop Thursday. For details, call 887-6046.

Kim Gladfelter is owner, physical therapist and Pilates instructor at PhysioFit Physical Therapy and Wellness, 1000 Fremont Ave., Los Altos. For more information, visit

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