What is the pelvic floor?
Pregnancy and childbirth may lead to a weakening of the pelvic floor, i.e. all those muscles and ligaments constituting the pelvis and that support pelvis organs: uterus, bladder, up to the anorectal system.
Childbirth is a period during which the woman is subject to maximum effort in order to get the baby through and this may lead to an elongation of the pelvic floor muscle fibers and cause strains and lacerations, which lead to its weakening. Factors that may worsen the pelvic floor’s weakening are the baby’s weight or a precipitous labor.
It is important that all women who have given birth, especially those who have given birth spontaneously, undergo a clinical test to evaluate the potential impairment of the muscle-ligament apparatus of the pelvis and perineum and to determine if a specific rehabilitation programme is necessary.
Postpartum rehabilitation is crucial and needs to be addressed in particular to those women who are at risk, like those that have had more than one pregnancy or who have already experienced pelvic problems. It is also very important to prevent those conditions that weaken the pelvic floor. In fact, physiokinesis exercises, which act through muscle movements, and Kegel exercises, which are a series of contraction and relaxation movements of the pelvic floor muscles, are recommended to be performed on a regular basis during pregnancy.
What is the postpartum rehabilitation therapy to follow?
Postpartum and puerperium, that is the period of time that goes from delivery to when the female genital organs return to be normal, constitute an important time for the woman’s psycho-physical recovery and require an adequate programme.
Recommended rehabilitation therapy consists of physiokinesis exercises to be associated, if necessary, to electro-stimulation exercises; the more the woman is motivated, the shorter the rehabilitation time is. Usually, a cycle of exercises to be done once or twice weekly, is recommended.
Rehabilitation should be the first therapeutic attempt for women that experience a weakening of the pelvic floor which involves relaxation of the vagina and of the fascial component, in order to solve functional problems such as incontinence and urinary retention, that are the symptoms associated to the pelvis-perineum deficit. Only after trying rehabilitation associated to a pharmacological therapy, a surgical approach may be recommended.