As with most kinds of recovery, the road is a long and winding journey.
I had my son about three and a half years ago and I STILL have lingering issues from that perinatal time in my life. The seven hours of pushing, vacuum assisted delivery, and third degree tearing no doubt have a lot to do with where I am now. As you might imagine, I had persistent vaginal pain, for months. The intensity of it lessened over time, but I was never truly comfortable until I sought professional help.
I also had incontinence of all kinds: urinary, gas, fecal. Here’s a story of how I crapped myself, for those interested. Time also helped the severity of the incontinence, but it only got so much better.
But I couldn’t stand the constant heavy feeling in my vagina and the tight stinging and irritation of my perineum anymore. So at around eight months postpartum, I checked in to see a pelvic physical therapist (PT). (I may have gone sooner, but I didn’t have access to a pelvic PT until we moved to the D.C. area several months after giving birth.)
Consistency Is Key
For the first six months or so, I went to my PT somewhat regularly. I noticed quick improvements in my perineal scar. I learned a ton about my pelvic floor and what happened to it during pregnancy and delivery. My PT armed me with activities I can do at home to release my tight psoas and pelvic floor, and to massage my scar tissue. I felt less vaginal and vulvar pain. The vaginal heaviness went away. The incontinence wasn’t nearly as bad as it once was.
And then the realities of teaching and grad school threw a kink in my progress. I succumbed to the overwhelm of trying to finish my degree quickly. I crawled under a rock to write my dissertation and fulfill teaching duties. What little time I had left, I spent with my family. There was no mental or physical energy left for my pelvic rehab and self-care.
Besides, I had made “enough” progress to function normally, more or less. And I wasn’t in constant pain anymore. Plus, my grad school and teaching salary could only cover so many expenses. I stopped going to my clinic for a few months. Then I’d check in once every so often for “maintenance,” but I never really worked toward feeling 100% whole again.
After graduating this summer, I finally had a moment to check in with myself physically. I had aches and pains from spending most of my hours sitting at a computer typing. My body was stuck in fight-or-flight mode from the stress of meeting deadlines and worrying if I’d graduate. My muscles atrophied from not working out in the past half year, and I felt wobbly in my hips when I carried my son.
I also started leaking urine again when I jumped or laughed. Gas was harder to hold than a year ago. The tenderness in my vulva persisted.
I knew I had to rededicate myself to pelvic PT as well as my overall health.
Now that I’m not putting out fires everyday, I’m able to integrate pelvic floor care in my life with new resolve.
At first, I wasn’t sure I wanted to talk about why I’m still seeing a pelvic PT years after giving birth. I’ve been on my soapbox touting it as the best thing since slice bread. I didn’t want people to think that pelvic PT doesn’t work because, look, Yuka’s still going and it’s been years! My regression and lack of FULL return to my normal healthy self is on me.
In fact, below are the five top reasons why I’m still rehabbing my pelvic floor. I wish for this list to offer hope for postpartum mamas, even if the journey takes a little longer than expected.
ONE: I quit too soon
You know when the doctor prescribes to you antibiotics, you’re told to take it all even if you start to feel better? Well, quitting as I was getting better was kind of like the antibiotic situation. Going to pelvic PT with no doubt improved my symptoms and that progress gave me some permission to stop prematurely. Unlike the antibiotic situation, my pelvic floor didn’t become a super strain of bacteria resistant to Kegels. It just got weaker again.
TWO: I didn’t do my PT exercises regularly or consistently
I simply didn’t prioritize self-care for my pelvic floor. There’s no easy way around this fact. My family, work, and dissertation came first and I stretched myself thin to get everything done. Sound familiar?
In hind sight, taking 15 minutes a day to release my psoas or work on diaphragmatic breathing was totally doable. The internal PT exercises were a little more involved (time and energy wise), but doable nonetheless. Yes, I was busy. Yes, I had a an overloaded plate. But truth be told I didn’t have the right mindset around taking physical care of myself. That’s something I’m working through now, as I transition careers.
THREE: I had pelvic floor issues before I ever got pregnant
This one is a newer revelation. I recently learned that female athletes commonly have pelvic floor issues because they’re not taught how to properly breathe and engage their pelvic floor when training. I was a competitive athlete throughout high school and college (volleyball and squash) and I spent a lot of time squatting heavy weights and doing muscular conditioning including intense core workouts.
I didn’t know then that contracting my transverse abdominis or abs during inhalation while doing a crunch put undue pressure on my pelvic floor. Today, my breathing mechanics are off when I exercise! When doing heavy squats and deadlifts, I didn’t engage and lift my pelvic floor. I remember pushing it out. I also had a lot physical therapy in my sports clinic for misaligned hips, which may or may not have been due to the sports I played.
I also struggled with fertility. I have endometriosis. To get pregnant, I had a handful of surgeries, many intrauterine insemination (IUI), three rounds of IVF, medication that changed the tissue of my vagina and pelvis, and way too many transvaginal ultrasounds. It was a lot for my body to take. During that time, I noticed sex started to hurt, speculums and internal ultrasounds also hurt. My vulva started to get more red and irritated, and I’d clench my pelvic floor during medical exams. That bracing continued into pregnancy and postpartum.
As much as I want to think that the pregnancy and delivery caused my current pelvic issues, I definitely had problems beforehand. Delivery exacerbated them. But the silver lining is that those issues got me in to see someone who can help me get to the root of the problem.
FOUR:I want to feel like my best self NOW, and not settle for a lousy “new normal”
Need I say more?
FIVE: Some things just take time
I’m a results-oriented person. I’m also a little impatient with myself. I hate that it’s been too long since I’ve felt grounded in my body. I’m tempted to “grad school” my way to improvements, which means making an ambitious to-do list and attack! Then feeling bad about myself when progress is slow or stalls, and repeating the cycle from square one. With the help of my PT, I’m figuring out a balance between gettin’ it done and letting my body lead the way.
What did your postpartum healing journey look like? What got you over “the hump” if you struggled to get back to your normal?
**Medical disclaimer: This post is provided as information and resource only. This information should not be used as a substitute for professional diagnosis, treatment, or advice. Always seek the guidance of your physician or other qualified health care provider with any questions you may have regarding your postpartum care and conditions.