Urinary incontinence is common after childbirth. Kegel exercises are an excellent way to strengthen pelvic floor muscles and prevent urinary incontinence.
If you had a C-section, you should wait until your incision heals to have sex. Your doctor will check the wound before clearing you to increase your activity level.
Diastasis recti
While a small degree of abdominal separation is common in women during and following pregnancy, it can cause pain and weakness. It is caused by excessive inner-abdominal pressure due to the growing uterus pushing on the abdominal wall and pregnancy hormones softening connective tissue. This causes the two sides of the ab muscles to separate, creating a gap in the midline known as the linea alba. The condition is most common in the second and third trimester of pregnancy. In some cases, the diastasis can become permanent and lead to hernias and abdominal pain.
While the condition can heal naturally, it is important to do some abdominal exercises to retrain your core muscles and strengthen your abdomen. A physical therapist can help you with this. However, it is not always covered by insurance and may be too costly for some people. In severe cases of abdominal separation, some women may need to wear a support brace to prevent hernias and pain.
To diagnose the problem, your doctor or physical therapist will perform a gentle examination of your abdominal muscles and check for a gap between the two sides of the rectus abdominis muscle. The gap should be no more than two finger widths wide. A gap that is larger than this can indicate a more severe case of the condition, and it requires further treatment.
Pelvic floor dysfunction
Pelvic floor dysfunction, or PFD, can develop after pregnancy and childbirth, regardless of how the baby is delivered. It causes bladder problems, sex dysfunction and pain in the area. It can also lead to other conditions, such as a prolapsed coccyx (tailbone) or a herniated lumbar disc.
The pelvic floor muscles support several of your internal organs, including the bladder and uterus in women and the prostate in men. They can also provide support to your lower back and pelvis. But during pregnancy, the muscles may become strained or damaged during vaginal or cesarean section delivery. This can lead to urinary tract or anal problems, including leaking urine or incontinence, pelvic pain or a herniated sac in the lower spine (coccyx fracture).
Some of these issues can be corrected with physical therapy or medication. Your doctor may prescribe a pessary, muscle relaxants or a procedure that relieves entrapped nerves in the area, such as sacral nerve stimulation. In more severe cases, your doctor may recommend surgery.
If your symptoms aren’t resolving, contact your gynecologist or urogynecologist. They can perform a variety of tests to diagnose the issue and determine the best treatment. They will ask about your past medical history, your bowel movements and your experience with childbirth. They may also ask about whether you have any other underlying health conditions or problems, such as diabetes or neurological disorders like Parkinson’s disease.
Postpartum hemorrhage
Less than 10% of births result in excessive 产后 修复 bleeding, but when it does occur, it can be very serious. PPH can be caused by the uterus failing to contract after delivery or the loss of blood vessels that supply the placenta. If left untreated, it can cause shock and be life-threatening.
PPH is usually diagnosed with visual and physical examinations, lab tests and a review of your birth history. Your healthcare provider may also use a blood-soaked pad or sponge to estimate how much you’ve lost. Depending on your symptoms, your healthcare provider may give you medications like oxytocin to help your uterus contract and reduce the risk of complications such as anal laceration or uterine rupture.
In addition to giving you IV fluids and medication, your doctor might use a device called a Bakri balloon to create pressure against the walls of your uterus and encourage blood clotting. If the bleeding is severe, your doctor might need to perform surgery to remove the placenta or a surgical procedure called dilation and curettage (D&C) to repair any tears in the uterus. In rare cases, if the bleeding is still not controlled, your doctor might need to remove your uterus, or hysterectomy, as a last resort. Hemorrhage is the leading obstetric complication and the second leading cause of maternal death in the United States.
C-section scar
During pregnancy, the abdominal wall expands to accommodate your growing baby and uterus. When a C-section is necessary, the scar that marks the site of your incision can become stretched and floppy. Eventually, this can cause the scar to become discolored and uneven.
Most C-section scars fade and become lighter or more closely match your skin color over time. However, sometimes your body goes into overdrive during the healing process and develops a thicker, raised scar known as a hypertrophic scar. This type of scar stays within the boundaries of your original incision and doesn’t extend beyond it, but it can be uncomfortable and itchy.
In more serious cases, your body may form a more dangerous scar called a keloid. This type of scar can be more pronounced and is often darker than the rest of your skin. Keloid scars can be more painful and itchy than other types of scars, but they are not generally life threatening.
If you have a hypertrophic or keloid scar, talk to your doctor about treatment options. They can suggest over-the-counter silicone sheets or pads that hydrate the scar and soften it, which may help minimize its appearance. They can also recommend physical therapy, which has been shown to be effective at minimizing C-section scars. Finally, they can advise you to use sunscreen when exposing the area to sunlight, as sun exposure can make scar tissue darker over time.