What is my pelvic floor and why might it need to be “re-educated”?
The pelvic floor is a layer of muscles within the pelvis. Its functions include support of internal organs (bladder, bowels and womb), maintaining continence of both the bladder and the bowel, assisting in bladder emptying and sexual function.
It can be weakened by both pregnancy and childbirth, menopause, recurrent coughing, constipation/straining, lack of general fitness and neurological damage and the common conditions associated with pelvic floor weakness include incontinence, prolapses of bladder, bowel and womb and faecal incontinence.
Why do I need to worry about this if I’ve given birth, either vaginally or by c-section?
When you’re pregnant with the growing foetus inside your womb, the muscles are stretched significantly over a long period of time. Without muscle retraining, they will not necessarily spring back into place following childbirth (whether you gave birth vaginally or via c-section). Therefore, exercise is needed to shorten and tighten the muscles again, reducing your risk of the above conditions associated with a weakened pelvic floor.
Why have I never heard of this re-education where I am from?
Unfortunately, lack of education. This country is particularly poor at education in the ante natal period. People are handed leaflets within a pack of information regarding childbirth and pregnancy by their midwife but are not specifically trained or educated regarding the importance of this muscle.
Why is this so important?
Leakage of urine is a common and well-known problem for women following childbirth. It is known to affect 1 in 3 women.
The incidence of 3rd degree tears is as high as 1-9% of all vaginal deliveries, as recognised by the Royal College of Obstetrics and Gynaecology (RCOG). This could have a huge impact on a women’s continence, both bladder and bowel in the short and long term. It can also affect sexual relations due to pain. The incidence of faecal incontinence as a result of these tears is as high as 50%, but is not discussed as openly as urinary incontinence. Failure to manage these conditions at the time of injury could be detrimental to a women’s quality of life and many become socially isolated as a result.
The menopause can highlight problems with discomfort, leakage, pain and prolapse as a result of hormonal and vascular changes. These symptoms can be minimalized in the future with regular pelvic floor training immediately following childbirth and for life. Up to 30% of women who attend physiotherapy on their first session are not correctly performing a pelvic floor muscle contraction. It is vital that you know how to do this correctly for long term protection.
How common are these problems?
1 in 3 women suffer with Stress urinary incontinence
50% of women have some degree of prolapse
1 in 10 people suffer with some form of bowel problem
21.8% of women complain of pain with intercourse