Postpartum Gut Health and your Pelvic Floor

by Ellen Meisner, DPT

If you’ve been pregnant, or spent much time around a pregnant person, you have experienced first hand the tummy troubles that seem to stem from the pre and postnatal periods. But why is the gut turned upside down? Where does all the constipation and gas come from? Is it really just hormones? And most importantly, can you get relief??

The stomach and digestive organs are not immune to the physical and physiological changes during and after pregnancy! Hormones can be a cause of morning sickness during pregnancy, and they can impact your gut mobility too! But hormones are not the only reason your intestines can be “out of sorts” postpartum.

Watch this quick video for an overview of pre/postnatal gut health.

During pregnancy and throughout the time a woman lactates, hormones can impact the mobility of the smooth muscle around your gastrointestinal tract. The smooth muscle that contracts to propel food through the system becomes more relaxed, which slows down the movement of food through the intestines, slowing digestion and delaying elimination from the body. When food stays in the intestines longer more water is absorbed, contributing to that pesky constipation pregnant women experience.

Another change in the gastrointestinal tract is compression. As the uterus expands and baby grows, the structures of the gut are actually pushed into a different position in the abdominal cavity, not to mentioned pressed and squeezed, making it more difficult for that relaxed musculature to push things through, and even creating kinks where things might get “stuck”, including gas.

These changes can lead to symptoms of constipation, bloating, increased gas, or abdominal cramping during pregnancy as well as after delivery. When the baby comes out, your intestines are left to fill the void that was prior filled by your uterus. As the uterus shrinks back down, the guts rapidly fall back into place – but not necessarily the same place they were before. Persistent laxity in the abdominal wall, especially in the presence of diastasis recti, can further contribute to symptoms.

Whether symptoms are coming from gut transit slowdown, laxity, a growing uterus, or organ rearrangment, pelvic physical therapy can help! Pelvic floor therapists can provide a lot of education to help you get your guts working properly again, help with bowel movements and constipation, and help you restore abdominal wall support. In particular, a specialized technique called visceral mobilization can help soothe the intestines back into place and back into proper function, reducing pain and helping you feel normal again. (Book with Ellen to try out visceral mobilization!)

Some women are concerned about fecal incontinence after delivery. This can be related to changes in stool consistency, your strategy for stool elimination, scar tissue from a perineal tear or epesiotomy, or other pelvic floor dysfunction.

It is very important for the digestive tract to work efficiently in order to have a healthy pelvic floor! Many people believe their pelvic floor is weak during or after pregnancy, but sometimes it is related to the gut. In cases of increased bloating or constipation, the pelvic floor has to work harder to support the organs under higher pressures, causing fatigue or excess tension, which can contribute to pain and incontinence.

If you can relate to any of these things or have more questions about gastrointestinal health and the pelvic floor during and after pregnancy, give us a call and come in for a visit!

In the meantime…here are some tips!

  • Throughout the day, use gentle diaphragmatic or belly breaths to stimulate intestinal motility and move food through the system. The motion of the diaphragtm and abdomen massage the intestines, stimulating peristalsis and more regular bowel movements.

  • When sitting down for a bowel movement, relax the abdomen and try to use a belly breath to help create space for stool to move out of the body. Focus on relaxing the pelvic floor and anal opening to allow passage, vs forcefully pushing stool out. (pro tip, this is the best time to “practice push” for labor!)

  • If you are feeling abdominal cramping, gas, bloating, or constipation, try gentle abdominal massage, regular walks, and gentle movements like cat/cow and happy baby get things moving!

  • Get in touch with your pelvic floor and deep abdominals! Can you relax? Can you contract? Do your pelvic floor and deep abs feel hyperactive and tense throughout the day or do they feel completely lost to you? Come see us – we’ll help you find them 😉

Book with Dr. Ellen or another SHEFit DPT here!