Pelvic floor dysfunction with pregnancy and after childbirth

During pregnancy the hormone relaxin helps to relax stabilizing ligaments around your pelvis.  This helps to ease the passing of your baby through the birth canal. In some cases, these relaxed ligaments don't return to their normal  pre-pregnancy properties.  If they don't, this can leave you with pelvic ligament laxity and instability.

Why are my pelvic ligaments important?

Your pelvic ligaments are important in controlling your movements.  Weak pelvic ligaments can cause your pelvic floor muscles to contract continuously against an unstable base. These contracting muscles that are continuously in spasm will generate pain.  Loading through these unstable joints, whether with walking, lifting or moving,  can also increase the stress on your other core muscles in your hips and your back.

What are risk factors for pelvic floor problems?

There are many scientific studies discussing reducing the risk of pelvic floor dysfunction after a natural vaginal delivery, especially if assistance had to be used (i.e. episiotomy, forceps). The American College of Obstetricians and Gynecologists stated: “severe perineal lacerations… are more commonly associated with increased risk of pelvic floor injury, fecal and urinary incontinence, pain and sexual dysfunction with symptoms that may persist or be present many years after giving birth.”

Stress urinary incontinence and pelvic organ prolapse are strongly associated with having a vaginal childbirth and with multiple births.  Contributing factors are likely mechanical and neurovascular injury to the pelvic floor during childbirth.

What if I have pelvic pain but I didn't have a traumatic delivery?

Pelvic pain after childbirth isn't uncommon.  If your pelvic floor pain lingers beyond the normal healing time frame of 6-8 weeks and no known source is found, then injured, sprained or weak ligaments and instability of the pelvis should be considered.