Pregnancy (and, in the case of a vaginal birth, the birth itself) put a lot of strain on your pelvic floor. In the first few days afterward, many women feel this primarily as a loose feeling in the lower pelvis. This soft feeling, which occurs especially when standing and walking, comes from the heavily stretched layers of your pelvic floor, which only shrink back and tighten up again over time.
Why does my pelvic floor have layers?
The pelvic floor is a dense tissue made up of layers of muscle, tendons and connective tissue. The pelvic floor muscles extend from your pubic bone (in the front) to your coccyx, which is an extension of your spine. Within this dense tissue, women have three openings with sphincters: the vagina, the urethra and the anus.
The pelvic floor has several functions: Firstly, it holds the organs in your abdominal cavity as a net and a double bottom. It also encloses your bladder and uterus, keeping them in the right place and preventing them from prolapse. It is also an important muscle for your continence, both for urine and stool. It also plays a role in orgasms and sexual intercourse and can, for example, increase sensitivity.
Incontinence after birth
The heavy strain on your pelvic floor during pregnancy and the stretching during birth can lead to you experiencing temporary mild or severe incontinence in the first few days afterwards. Many women also find it difficult to estimate when they need to pee at all in the beginning after giving birth because the pelvic floor is still very stretched and has to adjust to the new spatial conditions in your body. It can help in the beginning to go to the toilet regularly, even if you don't feel a strong urge to do so. You may also pass more flatulence after giving birth. In addition to the weak pelvic floor, this is also because your intestines are now filling up again after the pressure during birth and air is being pushed out.
The body's own recovery mechanisms usually help you regain control of your sphincter muscles relatively quickly. Your postpartum midwife will also start you on some careful pelvic floor exercises. Nevertheless, listen to yourself. If you feel that your incontinence is particularly severe or is even getting worse, contact your doctor to rule out a prolapsed bladder, for example.
If mild incontinence when sneezing or coughing persists even after a few weeks, don't worry too much at first: The pelvic floor muscles rely, among other things, on functioning abdominal muscles, which relieve the pelvic floor when strong pressure builds up, as is the case when sneezing and coughing. But your abdominal muscles need time and a little support to function properly again. These complex recovery mechanisms can take several months, give yourself and your body this time and, if at all possible, enough rest for it.
Orgasms after birth
The stretched pelvic floor not only affects your ability to hold urine and stool, but can also change how you feel during orgasm. You may initially feel an orgasm weaker than before birth or elsewhere - or you may have difficulty reaching climax at all. Don't worry, all of this is normal and has to do with your pelvic floor muscle, which you need for an orgasm. As you recover and by strengthening the muscle in a targeted manner, it will take on more tension again and orgasms will usually become stronger and more intense.
What does a stretched pelvic floor have to do with hemorrhoids?
Everyone in the world has hemorrhoids. Most of them are located in the rectum and ensure that your stool stays there unless you are sitting on the toilet. Due to the pressure of the baby during pregnancy and the pressure during a vaginal birth, some of these vessels can expand, sink and even turn inside out (these are the conditions that people mean when they say they have hemorrhoids).
There are several stages of hemorrhoids and they often go away on their own during the postpartum period. Light pelvic floor exercises can also help, ensuring that all organs move back into place. If you have severe pain when defecating or even bleed, fatty hemorrhoid ointments can improve the gliding of the stool (and thus reduce the straining when defecating, which has a positive effect on the regression of the hemorrhoids). Soft stools are just as helpful. If the symptoms persist or are really severe, it is best to talk to your postpartum midwife or gynecologist about suitable treatments. If necessary, they will also refer you to an appropriate specialist (proctology).
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Pelvic floor training
Your midwife will usually show you a few initial exercises to strengthen your pelvic floor while you are still in the postpartum period. In addition, statutory health insurance companies pay for postnatal exercise carried out by a midwife. This specifically trains the muscles of the pelvic floor and corresponding muscle groups in the stomach, back and legs.
A special and somewhat unique type of training is Cantienica®. The content taught in these postnatal courses works primarily with muscle groups that we cannot target individually, thus strengthening the muscles from the inside out.
