Many women experience pelvic discomfort throughout pregnancy, but unfortunately, unlike other pregnancy symptoms, pelvic pain doesn’t always end with childbirth. In some cases, it can even worsen after delivery. Studies have found that 1 in 3 women continues to experience ongoing health issues post-birth.
Let's explore why pelvic pain occurs postpartum and what steps you can take to address it.
What Is Postpartum Pelvic Pain?
Postpartum pelvic pain is any type of pain or discomfort that occurs in the pelvic region in the weeks or months following childbirth. Postpartum pelvic pain can manifest in many different ways and for many different reasons.
What is the Pelvic Floor?
Some postpartum pelvic pain is related to the stress that is placed on the pelvic floor during pregnancy and delivery.
The pelvic floor is located between the pelvic bone and the tailbone. It is made up of the muscles that surround the pelvic organs, helping to control the functions of the bladder, bowel, and uterus.
During pregnancy and delivery, the pelvic floor muscles are stretched and strained. This can cause pelvic pain in the short and long term if not properly addressed.
Pelvic floor physical therapy during and after pregnancy can help to strengthen the pelvic floor muscles.
What Does Postpartum Pelvic Pain Feel Like?
Postpartum pelvic pain can manifest in many different ways. You might feel it at the vaginal opening, in the lower abdominal area, in the hips, or anywhere else in the pelvic region.
The pain might be dull and constant, or it may be sharp and concentrated in a specific spot. Any activity in the pelvic region, like sex or bowel movements, can make the pain worse.
Pelvic pain may be combined with other pelvic floor conditions, like bowel or urinary incontinence, but it is not typically associated with gastrointestinal distress. If you have discomfort in the pelvic region combined with gastrointestinal symptoms like excessive bloating, gas, nausea, or diarrhea, reach out to your healthcare provider.
Is It Normal To Have Pelvic Pain After Pregnancy?
Pelvic pain after birth is common. However, just because it is common doesn’t mean you have to suffer. If your postpartum pelvic pain is affecting your ability to care for your baby and yourself, reach out to a healthcare practitioner.
In addition, you can be proactive in managing pelvic postpartum by beginning to work with a pelvic floor physical therapist during pregnancy. Strengthening the muscles of the pelvic floor can help to manage pain and other related challenges, like urinary incontinence.
Why Does Postpartum Pelvic Pain Occur?
Pregnancy and childbirth put tremendous stress on a woman’s body, especially on the bones and soft tissue of the pelvis. Several different challenges can result from this:
- Perineal tears or vaginal tears: Tears of varying severity can occur during labor and delivery when the baby’s head comes through the vaginal opening. These tears can take several weeks to heal and cause tenderness, pain, and difficulty sitting comfortably after delivery.
- Diastasis recti: This is caused by the abdominal muscles separating during pregnancy. Abdominal muscles sometimes close on their own after delivery, but when they don’t it can cause pain in the lower abdomen and lower back. It can be hard to isolate this pain from other pelvic pain postpartum.
- Pelvic nerve pain: Also known as pudendal neuralgia, this type of pelvic pain is caused by compression of the pudendal nerve in the pelvis. This can happen during pregnancy or delivery. It can feel like there is shooting or burning pain, and can also cause tingling or numbing. The pain is typically worse when sitting and improves when standing or lying down.
- Muscle weakness: The pelvic and abdominal muscles experience tremendous stress and stretching during pregnancy and delivery which can cause weakness in the muscles and take time to heal. This is a very common cause of pain and discomfort.
- Pelvic organ prolapse: This is a condition in which one or more internal pelvic organs (bladder, uterus, or rectum) slip down from their normal positions due to weak pelvic floor muscles. Pelvic organ prolapse can cause feelings of pressure, heaviness, or bulging in the vaginal area.
- Pubic symphysis diastasis: In rare cases, the pubic bones can separate during labor or delivery and cause very severe pain.
How Long Will My Pelvis Hurt After Birth?
Postpartum pelvic pain can last for several months after delivery. For many women, it can continue until addressed by pelvic floor physical therapy or another treatment.
If your pain or symptoms are interfering with your daily life at any point during postpartum or beyond, talk to your healthcare practitioner about treatment options.
What Helps With Pelvic Pain After Birth?
There are some simple techniques that can support healing and help to relieve postpartum pelvic pain. Some strategies to try include the following:
Relaxation Techniques
Meditation, yoga, and other mindfulness activities can help to alleviate stress and tension throughout the body, including in the pelvic muscles.
Focus on Posture
The activities that come postpartum life - like lifting your baby and carseat, and breastfeeding for hours each day - aren’t exactly supportive of physical healing. While you can’t necessarily avoid these activities, you can bring awareness to your posture while doing them.
Try to bend down from the knees and engage your glute and leg muscles to reduce strain on the pelvis, abdomen, and back. If you are breastfeeding, try to feed in a supportive chair with a pillow behind your back. A nursing pillow can also help lift your baby up into a better position so that you don’t have to hunch over and strain your back.
Physical Therapy
Physical therapy can involve many different exercises that can help with recovering function of the pelvic floor, abdomen, lower back, and more. A physical therapist will assess your own unique situation and recommend exercises to help strengthen and stabilize your body to support the root cause of your postpartum pelvic pain.
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