Top 5 Frustrating Physical Postpartum Issues and How to Eliminate Them 

By Elizabeth Rogers, PT (Estimated reading time: 4 minutes) 

Congratulations on your new addition! As a new parent, there’s so much to learn – and quickly! If your body and mind aren’t quite caught up yet, don’t worry. These are some of the top issues our pelvic health physical therapists see in people who are postpartum, with some tips to help you get back on track (or know when it’s time to reach out to a pelvic health physical therapist for more guidance!). And please know: so much of this is normal! Your body just grew a human… these tips will show you how you can support yourself as your body heals. 

1. Constipation: I’m doing all the right things… drinking plenty of water, exercising, eating fiber, etc., and I’m still constipated. Help! 

• It’s all about balance. In this case a balance between fluid and fiber. 
• Slow down when eating. This may be obvious, but take time to really chew your food. New parents have so many demands on their time that sitting down to eat, much less having time to chew their food, can seem impossible. Taking the time you need to sit down for just a few minutes, properly chew your food, and, if possible, even a couple of deep breaths, can make a huge difference. We know it’s not easy… but each step in this direction can help. 
• Abdominal massage may be helpful to simply get your bowels moving things through the system again. And great news… some (not all) pelvic health physical therapists can teach you to do this yourself. 

2. Leaks: When I run/jump/sneeze/stand up I leak urine. My OB says to just give it time and it will improve. So far that hasn’t happened. Will it be like this forever? 

• Leakage, or incontinence, is super common. But honestly? It’s never normal. The not-so-great news? It won’t fix itself. In fact, ignoring this problem will just make it harder to eliminate. A recent study found that 92% of women who have urinary leakage at 12 weeks postpartum will still have leakage 5 years later if they don’t seek help. Ready for the good news? You don’t have to live with it, and pelvic health physical therapy will help. You’ll be able to get back to your life as you remember it! 
• Kegels alone are likely NOT the solution. 
• A skilled pelvic health physical therapist will work with you to find out if you’re able to contract and relax your pelvic floor musculature. If not, they’ll teach you how. 
• The next step is to evaluate your hip and abdominal strength. You need the muscles throughout your pelvic region to be strong and coordinated in order to prevent leakage with movement. 
• Once your pelvic health physical therapist has this info, they’ll teach you the right exercises for your specific leakage situation. There’s no one-size-fits-all solution, so you shouldn’t settle for a one-size-fits-all program. You’ll need an individualized program to help get you moving sans leakage! 

3. I feel weird pressure in my vagina and I’m not sure if I’m making it worse by doing upright exercise. 

• A pelvic health physical therapist can do a quick assessment to tell you if you can safely exercise upright or if you need to do some preparation before putting this kind of pressure through your pelvic floor. 
• Our pelvic floor muscles do a lot of heavy lifting, including holding our bladder and reproductive organs in place. Sometimes they need a little strengthening in order to do their job. 
• The good news is that it usually doesn’t take too much work to see a significant improvement in the pressure you feel when you’re upright. You’ll be walking/running/jumping with confidence in no time. 

4. My back is killing me from lifting my baby in and out of the crib. 

• The sooner we address this issue, the better. Your baby is only going to get heavier, so you need to build, strengthen and develop good lifting mechanics. 
• Try this… grab a small footstool and put it in front of the crib. Next time you lift the baby in or out, put one foot on the stool and lean into that leg for extra support. 
• Use a hip hinge and keep your back neutral. Not sure what we mean? A pelvic health physical therapist can teach you this back-saving technique and practice it with you until you do it perfectly! 

5. This feeding and pumping schedule is insane! How am I ever going to have time for myself again? 

• This is a challenge that many new parents face and addressing it will most likely be an ongoing practice. It starts with finding small ways to prioritize yourself and your health in daily life. We’ve found that postpartum people who work with pelvic health physical therapists are thrilled to not only have the support of a knowledgeable provider, they’re even happier to have an hour devoted to self-care each week. It makes it easier for them to begin to build self-care into their new routine as a parent. 

Again, congratulations on your new addition, and a huge kudos for taking the time to learn how to take care of you, too. Contact a pelvic health physical therapist to help you get back on track, stop further pain or frustration, and give yourself a few minutes each week, just for you. 

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