Pregnancy comes with a number of changes that happen to a woman’s body. Women can experience backaches, headaches, acne trouble and more. One area of the body that can have lingering effects after birth is the pelvic floor.

According to the Cleveland Clinic, the pelvic floor is a combination of muscles supporting the important organs in your pelvis like your bladder and reproductive organs. Maybe you’ve heard that after giving birth, it’s normal to pee when you cough, sneeze or laugh. It’s not. When you start to have pain or persistent issues, you may be referred to a pelvic floor physical therapist.  These therapists are working to change the narrative that women should ignore or live with issues with their pelvic floor that don’t feel right.

What Are Symptoms of Pelvic Floor Dysfunction?

Pelvic floor physical therapist, Abigail Mandelblatt says the pelvic floor plays a really big role in proper bladder, bowel and sexual functions. Those muscles also support your baby as it grows in the womb. Women have a high risk of pelvic floor dysfunction after giving birth. That high risk could also be associated with underlying issues that you may not have previously noticed. Pregnancy and delivery can worsen these problems. That’s why Mandelblatt suggests including a pelvic floor physical therapy visit in your pregnancy care.

“I highly recommend at least one prenatal visit and at least one postpartum visit, even if you are not symptomatic,” Mandelblatt advised.

One major sign of pelvic floor issues is experiencing pressure at the pelvic area. That could be a sign of prolapse. Prolapse means an organ is loose or has shifted, which can cause pain or discomfort. Women who have given birth are particularly susceptible to this. Other clear signs of pelvic floor dysfunction include urinary leakage, bowel leakage, constipation, painful bowel movements or painful sexual intercourse.

Starting Pelvic Floor Therapy While Pregnant

Once you’ve decided to meet with a pelvic floor physical therapist you’ll likely be guided through several exercises. However, these are usually not one-size-fits-all sessions. Mandelblatt says your initial pelvic floor care visit will start with a discussion over any issues you may have.

“If you’re pregnant and already noticing any leakage or any pain even if it’s orthopedic pain, all of that affects how your pelvis functions and can affect how the pelvic floor functions,” Mandelblatt explained.

Whatever pain you are experiencing will help determine your physical therapist’s treatment plan.

Exercises recommended may include Kegels. This popular practice requires tightening and releasing your muscles to help build strength. There is also trigger point therapy. This exercise involves either internally or externally apply pressure to trigger points in your body.

The therapy session will also cover your diet, amount of exercise and preparing for labor.

Postpartum Pelvic Floor Issues

Since giving birth to your child, you may notice some discomfort or changes with your bladder or bowels. Or you may have experienced some trauma during delivery. According to Mandelblatt, one of the most common complications to happen during childbirth is tearing.

“If you did have a perineal tear, that definitely warrants a visit to a pelvic floor therapist,” Mandelblatt advised.

There is a special therapy called a scar massage to help heal those tears. This care comes after you have received post birth care and clearance from your doctor. It’s also important to note that your gynecologist is the one who will help with your medical diagnosis. But there are some conditions that pelvic floor physical therapists can treat in conjunction with treatment from a gynecologist.

As far as healing goes Mandelblatt says, “it depends on that person’s complaint and how long it’s been going on.” Some patients may only need a few sessions, while others could take up to a year to recover.