How to advocate for your pelvic health needs at the 6 week postpartum check up
It’s been 6 weeks since you delivered your baby and you are excited for your postpartum check up to see how things are healing and to make sure everything is on track. You may be hoping for clearance to resume activities like exercise and sexual activity (or you may not be feeling up to these activities and that is totally fine as well).
Your doctor or midwife will be checking several different aspects of your health at your postpartum check up including but not limited to: your uterus, cervix, and ovaries, tissue healing (cesarean incision/ scar or perineal tear), your mental and emotional health, your breasts, and your general health. This visit is crucial to ensuring you are healing well.
What this visit might not entail is a thorough assessment of your pelvic floor health, abdominal muscles and general orthopedic health. Therefore, it is important for you to know how to advocate for yourself if you feel like something isn’t quite right. Your muscles and joints went through many changes during pregnancy. Now, you are taking care of a baby which can require positions, movements and postures that can place new stresses on your body.
Below are all possible signs that indicate possible pelvic floor muscle issues, abdominal muscle issues or other musculoskeletal issues that warrant further assessment:
Urinary leakage with coughing, sneezing, laughing, daily activities, on the way to the bathroom, after you have finished emptying your bladder, or during any kind of exercise.
Stool leakage with coughing, sneezing, laughing, daily activities, on the way to the bathroom, after you have finished emptying your bladder, during any kind of exercise. (If this is occurring at ANY point postpartum, it needs to be brought to your providers attention).
Pelvic, vaginal, or rectal heaviness or “dragging” sensation with any activities
Seeing or feeling a bulge in the vagina
Abdominal separation AKA diastasis rectus abdominis
Lower back pain with movements, positions or exercises
Pubic bone pain
Tailbone pain
Pain with the pelvic exam or any sexual activities (usually not something you will notice until after your 6 week clearance from the doctor or midwife).
Pelvic soreness prevents you from being able to sit, stand, breast feed or sustain one position for longer periods of time (this could also be a sign of improper healing of the vaginal/perineal tissue, so definitely bring this to your provider’s attention.)
You can advocate for yourself in the following ways:
Ask lots of questions- as uncomfortable as it may feel to bring up issues related to your urinary, bowel or sexual health. Your provider is comfortable discussing these things with you and wants to know if you are suffering.
Write it Down- write your symptoms and questions down beforehand. Brain fog is a reality for some individuals during pregnancy AND postpartum so this can be a helpful practice.
Ask you provider to check your pelvic floor muscle strength and relaxation as well as to check for pelvic organ prolapse if you’re concerned about that.
Ask for a referral to a pelvic floor physical therapist and/or a urogynecologist- a doctor referral is not required for physical therapy in most states, but it never hurts to ask for one just in case.
Advocating for yourself at this time can be difficult. Brain fog, lack of sleep, and the tendency to minimize what your experiencing is common. But you can’t pour from an empty cup and your needs are extremely important. Please don’t hesitate to let your provider know if you are struggling in any way!