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    Do you know enough about your pelvic floor?

    Do you know enough about your Pelvic Floor? Are you wondering why sex is not quite the same and will it EVER get better. You can find out why. There is a reason. During childbirth, whether the delivery was easy, or if you had an extended second stage where you had to push hard for ages and ages, had a big baby eg over 8 pounds (kilos),if you needed an episiotomy, with or without the doctor needing to use forceps, suction etc. Even
    with a ceasarian delivery that was or wasn't planned, your pelvic floor, called the "perineum" has changed.
    The muscles of the perineum have undergone lots of stretching, your hormones have been preparing during pregnancy by making your pelvic girdle looser, muscles and other soft tissues more pliable to allow your baby to makes its way out through the perineum.
    Nerves called the "pudendal nerves" have also stretched and lengthened. As a result things ARE different "down there". This is one of the reasons that you have your 6th weekly check up with your Obstetrician or Midwife. They will often make you cough and that is to see if your pelvic floor muscles are strong enough, usually against the force of a cough. If not, they might refer you to a Woman's Health Practitioner, like a Physiotherapist trained in teaching how to regain the strength of your Pelvic Floor muscles. With retraining, strengthening and co-ordinated functional use of these PF muscles.
    I use Real Time Ultrasound, rather like the machines that your Obstetrician sent you off to see what developmental stage your baby was at 4 months, except we want to be able to evaluate your contraction of the pelvic floor muscles.
    With strengthening comes an increase in blood supply to assist healing of the perineum postpartum, activation of these muscles assist in continence and gradually the slowly pudendal nerves recover. So, it takes time for your pelvic floor to recover enough strength and response for you to start enjoying intercourse again. Gentle perineal massage techniques and gentle foreplay to enable both you and your partner to regain confidence that there is a "light at the end of the tunnel". Also, use a good quality lubricant that your chemist might recommend.
    Also, as time goes by and you both are not so tired, things will get better.

    Article by Linda Chee Physiotherapy and Pilates Studio

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