Your pelvic floor after a c-section
Many women are surprised to hear that you need to look after your pelvic floor after a c-section. They believe that, because the baby didn’t cross the vagina, their muscles did not stretch and get damaged. There are women that even think that a c-section will prevent pelvic floor dysfunction. This is not true. In fact, a c-section can debilitate the whole pelvic area as much if no more than a vaginal birth.
What is the pelvic floor?
Let’s start by knowing what and where is the pelvic floor. It is a group of muscles, nerves, connective tissue, bones and ligaments that are inside the pelvis. They all form a basket that holds your organs in place. Each of them has one or more functions and it needs to be a balance between them in order to get optimal function. Nerves take information from the brain to the muscles. Ligaments connect muscle to bone. And connective tissue surrounds and connects all the organs, muscle and bones.
When we are talking about pelvic floor we usually refer to the muscles. They can become weak, but you can also strengthen them with exercise like you would do with other muscles in the body.
Why would the pelvic floor muscles suffer from a c-section?
The first reason the pelvic floor muscles (PFM) get weak and overstretched is not the delivery, but the actual pregnancy. One of the PFM functions is to support the abdominal organs. During pregnancy, they carry an extra load with the weight of the baby, the enlarged womb, the placenta and the amniotic fluid. Some women will also experience constipation that could also add stress to the area. So, regardless what kind of birth you had, it is quite probable your PFM need a bit of extra care to get back to normal.
The second reason is that they too get damaged during the c-section birth. We may think that, during a vaginal birth, the baby going through the birth canal can damage the muscles by stretching them. Vaginal birth is also associated with episiotomies and tears. These create scar tissue and tightness around the vagina that can affect pelvic floor function. However, during a c-section, the doctor will cut and later sew several layers of fascia and organs. These cuts create an imbalance and debilitate the whole area. They also create scar tissue in the womb and other organs and muscles. Both things can create more problems in the pelvic floor that a vaginal birth.
However, there are still other two factors why you need to look after your pelvic floor after a c-section. Those two factors are age and lifestyle. The truth is that your pelvic floor can become weak only with age, regardless you had a baby or not. Women that have never been pregnant will experience pelvic floor dysfunction too as they age, especially, if they develop certain habits or neglect their shape. There are several habits that can damage the pelvic floor muscles, from sedentarism and bad posture to stress and high impact exercises.
How do I know if my pelvic floor muscles are all right?
Pelvic floor muscles that are strong and healthy
- support the abdominal organs like the vagina and womb, bladder and bowels. If you feel that there is something out of place in your pelvis, it would be better to go and have it checked.
- help prevent urinary and faecal incontinence. That means you don’t wet your pants when, for example, you are laughing, coughing or jumping.
- stabilize the whole pelvic area so it stays firm and your hips and legs don’t wobble.
- play a role in sexual function (yes, quality and quantity of your orgasm can be influenced by the state of your PFMs).
- and take part in the lymphatic action removing toxins from the area.
If you suspect that your PFMs are not working properly, you will need to talk to your doctor. Even though there are some things you can do yourself to test the muscles, ultimately you will probably have to visit a women’s health physiotherapist that can make an internal exam and assess the area.