Postpartum Pelvic Pain: What You Need to Know

Giving birth takes a huge toll on the body, especially the pelvis. This means that giving birth has the potential to cause postpartum pelvic pain. The pelvis is the ring of bones at the bottom of your spine, which functions to stabilize muscles and protect organs.

When you have your hands full with a newborn, pain is the last thing you want to be dealing with, but it is a relatively common part of the postpartum healing process. The first six weeks postpartum are considered your “recovery period,” but everyone’s body heals at a different pace. It is normal for your body to need time to heal but you can proactively address pelvic pain instead of trying to wait it out. In this article, we will explore tips for preventing postpartum pelvic pain, potential causes, and how to manage pain when it emerges.

Symptoms of Postpartum Pelvic Pain

Some of the symptoms related to pelvic pain after childbirth are persistent pain in the pelvic area, hips, lower back, or pubic bone; difficulty walking or standing; and urinary or bowel issues. Factors such as type of delivery, the presence of complications, and the strength of the pelvis before childbirth will all influence which symptoms you experience. There are multiple possibilities for causes of pelvic pain, so a medical professional can help determine which one is contributing to your symptoms. The following section describes a few of the potential causes. 

Causes of Postpartum Pelvic Pain

Changes in the Pelvic Floor

Pregnancy and childbirth stretch and weaken pelvic floor muscles, which are connective tissues supporting pelvic organs like the bladder, rectum, and uterus. They serve to stabilize the spine and assist with continence. 

Pelvic Girdle Pain/Symphysis Pubis Dysfunction

Pelvic Girdle Pain (also known as Symphysis Pubis Dysfunction) happens when the ligaments that keep your pelvic bone aligned are too relaxed due to the hormone relaxin. While your body is supposed to produce relaxin before birth to allow for the baby to pass through, sometimes it produces too much, meaning your pelvic bones do not have the appropriate support and in turn, cause pain afterwards.  

Trauma from a vaginal delivery

There is, unfortunately, an association between vaginal delivery and ensuing urinary incontinence and pelvic organ prolapse. Pushing out a baby puts strain on the pelvic floor and weakens those muscles, leading to postpartum pelvic pain.

How to Prevent Postpartum Pelvic Pain

If you have yet to give birth, there are steps you can take to prevent or mitigate pelvic pain both during pregnancy and postpartum. These tips are not guaranteed to help you avoid pelvic pain altogether, but they may decrease the odds of experiencing it, or at least decrease the intensity of the pain you experience.   

Exercise your pelvic floor

Since pelvic pain is in part due to a weakened pelvic floor, working on strength building both before and after giving birth helps with postpartum recovery. Everyone’s body and postpartum challenges are unique to them, so it is best to do these under the guidance of a professional pelvic floor physical therapist. If that is not accessible to you, there are plenty of resources online that demonstrate some of these exercises. It is important to be aware of your body’s limitations and to stop if you experience an inordinate amount of discomfort or pain.      

Maintaining good posture

Though good posture is challenging to maintain when you have the weight of a pregnant belly pulling down, it will alleviate strain on the pelvic area. Good posture is also important postpartum, especially since early parenthood involves lots of lifting and bending.  

Move gently interspersed with rest

Staying active during pregnancy is vital to prepare your body for the strenuous nature of labor. Gentle forms of exercise like walking and stretching promote flexibility and blood flow without putting too much strain on the body. Equally important as exercise is to rest and avoid overexertion.

Wear comfortable footwear

Everything in the body is connected and affects other parts of the body. Even though your feet are not close to your pelvis, supportive shoes support spinal alignment and in doing so, reduces strain on the pelvis.

Use supportive devices

Maternity belly bands provide support for your belly and back can alleviate strain on your spine and pelvis.   

Treatments for Pelvic Pain

If you have already given birth and are experiencing postpartum pelvic pain, you have options for addressing it. The tips can still support your recovery if it is too late to prevent the pain. Additionally, you can take NSAIDs like acetaminophen, use a heating pad, get rest, and work with a pelvic floor physical therapist. Note that you should speak to your doctor as soon as possible about your concerns; they can give you specific guidance for the treatment options best suited to you    

The bottom line 

Understanding the potential causes, incorporating prevention strategies, and seeking appropriate treatment are the best ways to approach postpartum pelvic pain. Every person’s experience and body is unique, and healing timelines and trajectories will vary, which is why it is important to consult a qualified pelvic floor physical therapist and/or a sex therapist. Finally, though easier said than done, try to be patient with your body. It has just been through significant trauma and challenges, so health complications as a result are to be expected. By educating yourself and using available resources, you may feel more supported on the journey of postpartum recovery.     

Why Does It Hurt Down There? Here's How to Address Pelvic Pain

The pelvic floor muscles refers to the hammock-like musculature that supports your pelvic organs and therefore they are an essential part of executing bodily functions like ridding of stool and pee, and having sex. Like anything else in your body, they can weaken throughout the normal aging process leading to concerns like incontinence, or general pain and discomfort.

Differences between people assigned female versus male at birth

Everyone has a pelvic floor regardless of their gender or reproductive anatomy. Pelvic floor health has different implications depending on the type of anatomy it’s supporting. For people assigned female at birth (AFAB), the pelvic floor muscles support the uterus, bladder, and bowel, and the anus, vagina, and urethra all pass through this group of muscles. The pelvic floor is strongly involved in pregnancy and this is a common cause of pelvic floor dysfunction. For people assigned male at birth (AMAB), the pelvic floor muscles support the bladder and bowel, and the anus and urethra pass through them. Unfortunately, there is next to no research or information about transgender and intersex people and their pelvic floor health.

Common Pelvic Floor Concerns

Having pelvic muscles that are too weak or too tight can cause concern; the idea is to find a balance. Pelvic floor concerns might be the cause of additional problems but it can also be a symptom of conditions like endometriosis, pelvic inflammatory disease, and menstrual cycle cramping.

If untreated, pelvic floor imbalances can cause:

• Sexual dysfunction

  • Sexual dysfunction conditions relating to pelvic floor health include dyspareunia (AFAB people) and erectile dysfunction (AMAB people).  

• Pelvic pain

  • Pelvic floor dysfunction (PFD) is “the inability to correctly relax and coordinate your pelvic floor muscles to have a bowel movement.” It’s more commonly experienced by people assigned female at birth. Symptoms associated with it in addition to pain (usually exacerbated by sexual intercourse or certain movements) are incontinence, bloating and constipation, and lower back pain. 

• Bladder concerns

• If your pelvic muscles are too weak, you may struggle with a frequent urge to pee or an inability to hold in pee. This is often an aftereffect of pregnancy and giving birth. 

• Bowel problems

• Similar to bladder concerns, weak pelvic muscles sometimes struggle to hold in gas or poop, leading to bowel incontinence. On the other end, you might also experience constipation and straining pain when trying to poop. 

Options for Addressing Pelvic Floor Concerns

• Medication

  • Medication options will differ depending on the root cause of pelvic floor concerns. Hormonal based therapies like GnRH, Progestin, and oral contraceptives may be used to treat pelvic floor concerns associated with reproductive conditions such as endometriosis. For pain, over the counter medications like Tylenol can be used. If an infection is the source of pain, you may be prescribed antibiotics. Before starting any medication, discuss with your doctor to make sure it’s the right route for you and that it won’t cause adverse effects.   

• Relaxation techniques

• If your pelvic floor is too tense, you might want to try relaxation techniques such as diaphragmatic breathing and pelvic girdle stretches. 

• Physical therapy

• If your effort with pelvic floor exercises at home don’t work for you or if you’re just seeking professional guidance, physical therapy is a good option. 

• Pelvic floor exercises

• Kegels are the most well known pelvic floor exercise and they’re a great way to strengthen those muscles. Click through on the link above to get more details on how to properly do pelvic floor exercises.

Pelvic floor health is a buzzy topic on social media these days, especially on TikTok. We would caution you against taking any of that advice prior to speaking with a qualified health professional who knows you personally. If your pelvic floor concerns are causing mental distress, consider seeing a sex therapist. For those located in Illinois, reach out to Embrace Sexual Wellness to see if we’re a good fit for you.