What is normal postpartum?



Nearly every day, women ask me about what is normal postpartum. These women are clients, friends, moms at the park, moms at my kids school, or family members. Some I have known for a long time, and others may start asking questions the first time they meet me. Once people find out what I do for work, they like to ask questions, and I do not mind answering. I love what I do, and I love educating women on being healthier and happier. Usually, these questions are paired with a comment like, “this might be T.M.I., but. . .”

So, let’s talk about what is normal postpartum.

This might be T.M.I., but it hurts when I have sex.

No, it is not normal to have pain with sexual acts. . . ever. The bottom line is intercourse should be pleasurable and enjoyable, if that is not what you are experiencing then there may be spasms in your pelvic floor muscles, your pelvic floor muscles may be contracting involuntarily prior to vaginal insertion, you may have scar tissue from a healed tear or episiotomy in childbirth, or a lack of lubrication may be causing vaginal dryness. The good news is that pelvic floor physical therapy can help, and the treatment should not be painful.

Last, but not least, anyone who tells you that you have to “just deal” with pain with intercourse postpartum (or any other time) is wrong. You deserve better

This may be T.M.I., but I leak when I jump on a trampoline.

No, this is not normal. Any urine that escapes your body when you are not prepared and ready on the toilet is incontinence. For approximately 6 weeks postpartum you may still be healing and recovering, but any (even just a drop or two) incontinence after 6 weeks postpartum should be treated. Most of the time, Kegels are not the answer. Most of the time underlying muscle spasms, tension, and contractions are making it impossible for your pelvic floor muscles to function properly to stop urine. It would be like trying to pick up a gallon of milk, but your bicep is permanently shortened so that your elbow is bent with your hand up by your shoulder. You need to straighten your elbow first. This is one of the many reasons that women need to be instructed on how to perform pelvic floor contractions correctly by an experienced practitioner who can feel both the contraction and relaxation occurring.

This may be T.M.I., but I feel weak all the time. Lifting my kids and taking care of my house is really hard.

This one is tough because lifting your kids and caring for your house is really hard, but the reason it is hard should never be based on your physical capability and strength. Growing your babies, delivering your babies, and caring for your babies is an amazing feat in itself and you are amazing. You deserve and should feel amazing. You should feel strong and capable. That weak feeling could be due specifically to pelvic floor dysfunction, rectus diastasis, moving your body with poor mechanics, or a combination of these factors. An evaluation is the best way to determine what needs to be addressed to help you feel strong and make it easier for you to care for yourself and your loved ones.