A: After a vaginal birth, a new mother may experience discomfort in her genital area, particularly if she had an episiotomy or tearing, as well as hemorrhoids (one third of women after a vaginal delivery). She may also feel sharp lower back pain if her coccyx was displaced (10 percent of women). She may take longer to find sexual intercourse pleasurable again (20 percent of women who had stitches find intercourse painful three months after giving birth).
After a cesarean section, a new mother may experience discomfort as her digestive functions return to normal due to trapped gas. Her scar may itch and burn. Occasional pain and burning sensations can last for six to eight weeks. She will have to wait longer to start an exercise program (about ten weeks).
Q: How long should women wait between pregnancies? Why is this important?
A: again, this depends on the number of pregnancies you have already had, the type of birth you had, how tired you were, how well your body recovered (especially your pelvic floor tone). It is interesting to note that in primitive societies, babies are naturally spaced about every two years as their mothers breastfeed almost constantly for a year (the only way that breastfeeding works as a contraceptive). Obviously, the more fully recovered you are from your previous pregnancy, the better your next pregnancy will feel.
Q: Does having a baby mean that future incontinence is to be expected?
A: While it is true that one in three new mothers does experience some form of urinary or anal stress incontinence (leaking after a cough, a sneeze, a laugh or high impact such as a jump) in the weeks following childbirth, there is absolutely no reason to expect future problems with incontinence. Unfortunately, most women do not know enough about their pelvic floor. Before birth, we prepare our bodies to open up but we forget that closing up also requires effort. This process is essential to becoming a woman again as pelvic floor tone has a direct impact on the quality of sex.
During pregnancy, the weight of the uterus increases by twenty to thirty times. as it grows, the uterus pushes the bladder downward. Furthermore, the muscles and ligaments that normally hold up the reproductive and digestive organs are how weaker under the effects of relaxin. Childbirth will then stretch and distend these muscles, no matter how well a woman prepares for delivery - after a vaginal delivery, the pelvic floor looses about 50 percent of its tone. Episiotomies, tears and abnormal straining during the expulsion phase all add to the damage. If the pelvic floor muscles are not restored to their proper tone, the sphincters can no longer clamp down properly on the bladder (and in some cases on the anal) opening, causing leakage.
It is therefore essential to begin gentle pelvic floor toning exercises (described in my book) in the days after childbirth and to practice these for nine minutes a day for the first six weeks. Pelvic floor exercises are also very helpful in speeding the healing process after an episiotomy or tearing. Do not begin an exercise program until your pelvic floor has recovered its' tone.. Your health practitioner should check your pelvic floor tone at your postpartum check up. If they don't ask for it!