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How Do I Know If I Have Healed Postpartum?

On the surface, there may be other signs that you haven’t quite healed, as well. Your uterus six weeks after birth is still heavy and swollen. The belly muscles that expanded to accommodate that uterus are rejoining and knitting back together, even if you have experienced a vaginal birth. If you attempt vigorous exercise while this is still happening, you may be at risk of damaging the muscles further or prolonging the process. 

You may be unaware of this possibility because, against all logic, obstetricians, midwives and other medical professionals clear a majority of new moms for exercises without so much as an internal vaginal exam. Often, the only question asked at the six week check is “Have You stopped bleeding?” If the answer is “yes”, they put a little check mark next to your name and give you a thumbs up. 

The danger in this is twofold. First, they are not acknowledging the individual nature of recover and second, they are not examining the most maltreated parts of your body, the pelvic floor and the abdominal wall. These are critical areas and should be assessed for stretching, tightness, lack of mobility, stability, strength, lack of mobility, pain or other dysfunctions. Any type of prolonged issue here can lead to larger issues that can affect various aspects of your life, including, but not limited to, intimacy. 

It is my concern that women, armed with misinformation, may push their bodies to perform too quickly. Often, I treat patients for pain or injury postpartum, such as pelvic organ prolapse and diastasis recti, as a direct consequence. I see women who have suffered scarring in the perineum, the section of the skin that often tears near the vagina during birth and on the belly from c-sections that have received little to no treatment. Those scars can handicap crucial core muscles. Core muscles and the pelvic floor are not given a second thought in most cases. Other symptoms, such as incontinence, constipation and stiff, achy joints are common as well. 

You may be surprised to hear that I most often see these injuries, four, seven and even eighteen months after delivery. These moms then show back up with a whole host of issues in their 40’s and 50’s after failing your standard physical therapy for the injury that just keeps coming back. At eighteen months, in particular, many women are experiencing their second pregnancy or are wary of planning subsequent children because they never felt fully healed after their first. It saddens me to know that so many have this intuition, but not the validation from their doctors that they need to get help. 

Much of the time, the injuries I am describing are not actually results of the pregnancy or birth itself, but if engaging in activities they were cleared to resume but, in reality, were far from ready. The effects of leaving these issues unaddressed are long-lasting and not easily undone. 

By long-lasting, I do not mean that you find yourself sore a few years later. I do not mean that you may develop a twinge in your neck ten years down the road. When I say long-lasting I mean that you can find yourself dealing with intense side effects in the final days of your life. I mean that your symptoms can snowball into becoming a leading factor in your eventual death. 

In my personal practice, I have had patients  in their 80’s, 90’s and 100’s experiencing incontinence, confined to their wheelchairs and dealing with skin wounds all because they never rebuilt their core muscles after they gave birth in the first half of their lives. They are the worst case result of the misinformation you are being fed now. 

Unfortunately for those women, and you, the way postpartum women are treated as changed very little in the last century, though we have made great strides in technology. Now, we know the dangers of generalized care and have a full arsenal of tools that can facilitate whole-body healing. We can stop continued injury in its tracks, if only we know that we do, in fact, need it. The only hitch is that we need to be aware that it is possible in the first place. 

In France, it is standard practice for women to undergo specialized physical therapy to rehabilitate their pelvic floor and abdominal wall. This has come to pass because women in France advocated for themselves and the women that came after them. They saw their grandmothers, mothers and sisters in pain. They saw complications from post- birth injuries plague their loved ones into their elder years and become contributing factors in their eventual death. The women of France said no more. Today, we need to echo them. 

Excerpt From Dr. Allison Feldt’s Book Restore Your Body After Kids; The Secret o Avoid Peeing Your Pants And Achy Joints As You Age 


Allison Feldt

Body Motion Physical Therapy

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