Not feeling right in your pelvis after giving birth is extremely common and unfortunately ‘tolerated’ by a lot of women. I frequently hear stories of women who have been putting up with ‘not feeling right’ for years and they just didn’t know that they could get help. I see a lot of it in my clinic and wanted to share some of this knowledge with women who may be suffering. I’m going to be doing a series focusing on optimising recovery in this area. Today my aim is to give a voice to this subject, a place where you can start feeling listened to and each week I’m going to be providing more detailed tips on moving forward in your recovery.
What is pelvic pain?
Pelvic pain covers a very broad area – it is defined in many sources as pain within the lower abdomen or pelvis. It can be diffuse and cover a large area or it can be very focal. It can be intermittent or continuous, related to activities, positions or just generalised pain – you may experience pain on urination, pain on bowel movements or pain during sex (known in the medical world as dyspareunia). It could be dull or sharp or cramping or a sense of pressure. It can be sudden onset and acute or chronic long term – this latter described as Chronic Pelvic Pain (CPP). CPP is defined by the WHO as ‘noncylical pain lasting for more than 6 months which can lead to lower physical performance and quality of life in women.’ The Royal College of Obstetric Gynaecologists (RCOG) define CPP as ‘intermittent or constant pain in the lower abdomen or pelvis of a woman of at least 6 months in duration, not occurring exclusively with menstruation or intercourse, and not associated with pregnancy.’
Remember, pelvic pain which is acute and sudden in onset must be checked out as soon as possible from a medical perspective. This is not to be ignored. It’s important to rule out causes such as possible infections (e.g. peritonitis, appendicitis, urinary tract infection, pelvic inflammatory disease, infection resulting from surgery), ectopic pregnancies, miscarriage, torsion or rupture of ovarian cysts, constipation or bowel obstruction. It is also really important to see your gynaecologist if you are experiencing chronic pelvic pain to rule out any ovarian dysfunction, endometriosis, fibroids, painful bladder syndrome and to find out if possible what the source of your pain is.
What might you be feeling?
I am particularly interested in helping women who might have some pelvic pain but more importantly they just know that they have not felt right since having a child. Maybe you’ve been told that what you’re experiencing is ‘normal’ after having had a baby. But you know that what you feel doesn’t feel ‘normal’.
You’ve got discomfort in your pelvis and you know your pelvis just doesn’t feel right. Sex (if you’ve had the confidence to go there yet) doesn’t feel the same and is not comfortable. Your bowels don’t function as they did and you have to be very careful about what you eat. You had PGP in pregnancy and it’s a lot better than it was but still you can sense it is not quite the same as before getting pregnant. You don’t have the confidence to exercise but you really want to. You feel very cut off from your pelvic region, like it doesn’t belong to you and maybe you have a slight dragging sensation. Your bladder control is ok just as long as you don’t sneeze more than once. You’re exhausted and you know you’re eating too much sugar. You were told that things would improve after you stopped breastfeeding but now that you have you don’t feel hugely different. Individually, maybe these things don’t feel like a big thing but altogether, when you reflect, you know you don’t want this going forward.
Postpartum Pelvic Dysfunction
I have termed this ‘Postpartum Pelvic Dysfunction’ and believe that women need more support than they are currently getting for this. From my perspective, all of these symptoms are signs that your body is out of balance on several levels – physically, emotionally, hormonally and maybe even spiritually. Telling women to ignore their symptoms and to accept that what they are feeling is ‘normal,’ creates a disconnect and is disempowering. I want women to feel that they can start to reconnect with themselves and to find the support they need to make a full recovery.
A common message is that things will improve with time. Where there is definitely an element of truth to this, there is also the potential to fail women with this message by storing up problems for the future (in subsequent pregnancies or perimenopause and menopause). I repeatedly see women in my clinic who during their second or third pregnancy are experiencing much more discomfort than during their first as the issues in their body which were not fully resolved from their first pregnancy and now they have a lot less capacity for compensation and adaptation than they did in their first. And issues such as prolapse and incontinence in post-menopausal women and hormonal dysfunction in perimenopausal women can also be viewed as unresolved postpartum imbalance that has been held in check until such time as you loose the protective effects of oestrogen. There is power in the message that optimising our postpartum recovery can help us minimise future potential problems.
I want to hear from you
If any of this resonates with you then I would love to hear from you. Contact me to book a free 15 minute call to discuss your issues. And if you know of any women who you think fit this picture, then please send them this link. I’ll be writing plenty more about this in the weeks to come and providing tips going forward.
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Rebecca x