What Men Should Know About Pregnancy, Postpartum, and the Pelvic Floor

A woman’s body changes rapidly during pregnancy and continues to change in the postpartum period. These changes can affect the pelvic floor in different ways. This is a quick guide for men about what may be happening in regard to the pelvic floor during pregnancy and the postpartum period.

First, let’s talk about the pelvic floor. The pelvic floor consists of muscles that sit in the bottom of the pelvis like a sling. The muscles attach to the pubic bone in the front and the tail bone in the back. These muscles are not specific to women alone, men have these muscles too! The muscles of the pelvic floor function in multiple ways:

  1. They provide support to the pelvic and abdominal organs;
  2. They help to maintain normal urination and defecation; and
  3. They are involved in sexual function.

Now that we know what these muscles do, let’s talk about the changes that can occur. During pregnancy, the biggest and most obvious change is that a fetus is growing in the uterus. On average a woman’s weight gain is approximately 30 pounds: the fetus weighs approximately 7.5 pounds, the placenta about 1.5 pounds, and the uterus approximately 2 pounds.  The increases in fluid, blood volume, and breast tissue make up the rest. As you can see, there is at least an extra 10-13 pounds in the pelvic cavity by the end of pregnancy. With this increased weight comes an increase in pressure pushing down into the pelvis and onto the muscles of the pelvic floor. This weight on the pelvic floor muscle can lead to overstretching of the muscles, which means that they cannot contract correctly and may become weak and dysfunctional. Women will often experience urinary incontinence (involuntary loss of urine) and sometimes fecal incontinence (involuntary loss of stool or gas) when the muscles weaken. Another possibility is a pelvic organ prolapse. The pelvic floor muscles help to support the pelvic organs; however, when they are overstretched or weak, the pelvic organs can begin to shift and drop lower in the pelvis.

During labor and delivery, the pelvic floor muscles are exposed to more trauma with a vaginal delivery. There is a possibility that the muscles may become even more stretched and possibly torn during delivery. This can also lead to urinary and fecal incontinence and pelvic organ prolapse in the postpartum phase. Another symptom that a woman may experience during this phase is a pelvic floor muscle spasm. A spasm may be the muscles response to overstretching during delivery. A muscle spasm may prevent the muscles from contracting like they should. Intercourse and sexual function may also be affected in the postpartum phase. Weakness of the pelvic floor muscles may result in sensation changes for a woman because her muscles are not able to contract and create pressure around her partner. If tearing or an episiotomy occurred during birth, the scar tissue that formed may not stretch easily which can cause pain with penile penetration.  Muscle spasms can also cause pain during intercourse which may make a woman hesitant to participate in sexual encounters.

The pelvic floor muscles are important for several different reasons and can be affected by pregnancy. To help with muscle weakness, a woman may be able to use the Joy ON Kehel. This biofeedback device is used to help her perform pelvic floor muscle strengthening utilizing games and an exercise log to keep track of her progress. There are also several massage settings that can help to stimulate the muscle contractions or can help to decrease a muscle spasm and tissue soreness. The Kehel is reasonably priced and can be purchased on Amazon.

If pain with intercourse, prolapse, or incontinence continues to be a problem, encourage your partner to discuss this with her physician or see a pelvic health physical therapist. If you have questions please contact us at [email protected].

Lola Rosenbaum

Doctor of Physical Therapy

Elizabeth Bell

Clinical Specialist in Women’s Health

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