It's no secret that giving birth is a superhuman feat.
And while you'd think you'd deserve an easy few weeks after months spent growing a real, living human being inside you, it's common for your body to be left feeling far from perfect as you recover instead.
And that's okay! Some discomfort is to be expected [1].
However, being in pain isn't something that should stick around, and it's important to pay attention to your body.
For some women, the postpartum period may come with pelvic pain — with variations in the cause including pelvic girdle, pubic symphysis or sacroiliac joint pain [2].
We've done the research on what to look out for and what you can do to help get your body back on track.
What causes pelvic pain after pregnancy?
When you're going through pregnancy, labour or vaginal delivery, it's a bit of a rollercoaster for your pelvic floor muscles.
These muscles, which are key for supporting the uterus, bladder and bowel, can get stretched, bruised, inflamed or even torn.
For some, this strain means pelvic pain is a feature of their pre-childbirth experience, with symptoms often clearing up not long after labour [3].
For others, the pain can continue, or even first appear, postpartum.
While there's still some uncertainty about the exact cause of postpartum pelvic pain, during pregnancy, your body has spent all this time adjusting to fitting a growing baby inside of you, causing your pelvic joints and pelvic ligaments to loosen and stretch.
These changes can take varying times to recover from and can lead to abnormal wear or use, resulting in pain.
This pain is often related to the wear and inflammation of the pubic symphysis or sacroiliac joint (the joints where your spine meets your pelvis), but injury can also occur during the delivery of your baby [2].
Women with a history of lower back pain or pelvic pain, including in a previous pregnancy, tend to have a higher likelihood of experiencing postpartum pelvic girdle pain or sacroilitis joint pain [2].
If you had high levels of pain during your pregnancy you're also more susceptible to the pain post-bub too, with pain intensity and disability recognised as risk factors for persisting pain after delivery [4].
Other factors that can play a role in postpartum pelvic pain include physically strenuous work during pregnancy, fatigue, poor posture and lack of exercise pre-birth.
What does postpartum pelvic pain feel like?
Pelvic pain isn't going to feel exactly the same for everyone but broadly relates to pain experienced below the belly button and above your legs [5].
For some, it could present as a dull ache, while others may experience more of a sharp, stabbing pain.
The severity can also range broadly from mild to severe, with the pain known to sometimes radiate down towards the thigh [6].
With pelvic muscle pain, having sex or using tampons might also be less than a pleasant experience, and difficulty walking, pain when standing on one leg and pain when lifting anything heavier than your baby could be a part of your experience [6].
Where does pelvic floor dysfunction come into this?
Yep, there are more ways your pelvic floor could be impacted postpartum. The miracle of childbirth, hey?
Pelvic floor dysfunction encompasses a range of symptoms that indicate your pelvic muscles aren't working how they're supposed to. Pain can be included in this but isn't the only symptom.
Common symptoms include urinary incontinence (that is, accidental leaking and the loss of bladder control), straining when urinating, constipation, pain or even pelvic organ prolapse.
Basically, prolapse occurs when the muscles are working so inefficiently that they're unable to properly support the internal pelvic organs, and they drop to sit lower than they should [8].
Prolapse is often recognised as feelings of heaviness, pain or bulging in the vagina [8]
The range of pelvic floor dysfunction is broad, and some women may not have very obvious symptoms — although uterine prolapse is more serious, and without treatment, can put pressure on other pelvic organs, and interfere with your sex life [9].
It's important that if you're experiencing any of these symptoms, you get the all-clear from a qualified health professional.
In the interim, wearing sanitary pads or Kin's Soothing Padsicles (which have a built-in ice pack to soothe your most vulnerable bits) can help provide comfort and catch that leakage.
Why does pelvic pain occur while running?
So you've finally finished months of restricted activity, and the urge to jump back into your pre-bub exercise routine is growing by the day.
It's only natural that after a sustained period of having to take it easy (either because you knew you should or because those swollen ankles weren't letting you get anywhere fast anyway), there can be a real urge to hit the pavement and get back to the exercises you enjoyed previously, like going to the gym or for a run.
While running is safe after childbirth — after an appropriate recovery period advised by your doctor or OB-GYN — it's not uncommon for women to experience some discomfort when they first get back out there.
And yep, you may find your bladder doesn't hold up quite like it used to.
With your pelvic muscles and core weakened after the impressive feat they've just displayed, a high-intensity exercise like running can put a strain on your already sensitive muscles, loosened ligaments, and joints [10].
For this reason, it's usually advised that you work up to an exercise like running and instead consider building back into your workout with more gentle practices like yoga or walking.
Don't rush this step — it takes around 3-4 months postpartum for the pelvic floor muscles to recover from the stretching needed for a vaginal delivery. The marathons can wait.
With the right preparation and build-up, which can include a specific exercise plan from a relevant health professional, pelvic pain shouldn't be expected.
Listen to the signs of your body telling you to pull back.
If you're experiencing persistent pelvic pain while running, get checked out by your doctor.
How long does postpartum pelvic pain last?
While it can be frustrating, bouncing back from pregnancy doesn't happen overnight. In fact, some experts even believe the postpartum period lasts as long as 6 months [11].
However, by the time you're ready for your postnatal check (about 6-8 weeks after delivery), you're likely well on the way to recovery from the delivery [11].
If you're dealing with pelvic pain postpartum, in particular, research indicates it's uncommon for symptoms to stick around for longer than 4 months [12].
The bad news is that pelvic pain can be tricky to break down in terms of specific causes or forms, so there can be a bit of a gap in the data about just what a standard recovery looks like.
What's most important is keeping your OB-GYN or doctor across your symptoms and pain levels to ensure your post-pregnancy recovery is coming along.
How to treat postpartum pelvic pain
There's no denying it's pretty incredible women's bodies are bouncing back after childbirth, with many of the aches and pains, fatigue and hormonal changes sorting themselves out fairly quickly.
Unfortunately, diagnosing specific causes of pelvic pain can be tricky, even for medical professionals, and finding the right pain management can be a very individual thing.
For many women, pelvic pain will clear up with time, but that's not always going to be the case.
If you're experiencing pain, or finding your daily activities are being impacted, the best thing you can do is get checked out by your doctor or OB-GYN.
From here, you'll likely be able to get a referral to a pelvic floor physical therapist — a.k.a the best friend of the pelvic muscles.
Through pelvic floor physical therapy, you'll work with a specialist to restore your strength and get a better insight into what's causing your specific pain and what can be done to fix it.
Warmth can also be helpful with pelvic pain, so a bath is often a great way to manage the pain. Having a bath after giving birth isn't allowed for the first few weeks, so Kin's Sitz Bath is a great alternative to soothe any painful areas and reduce swelling.
Strengthen your pelvic floor
Finding the right method of strengthening these muscles is something a pelvic floor physical therapist can guide you through, and, again, an individual assessment with a physiotherapist with insights into postpartum exercise is advised to make sure you're targeting the right areas and not going to do more damage.
Strengthening your pelvic floor is a key part of postpartum recovery, and isn't something that should be ignored.
For those not yet in the postpartum phase, now is the time to get a head start.
First up though, it's important to correctly identify your pelvic floor muscles before you move into regular exercises, as it's surprisingly common to actually be activating the wrong parts [13].
A common pelvic floor exercise is Kegels, which involves tensing and squeezing your pelvic floor muscles for a few seconds at a time.
Learning to activate your deep abdominal muscles can also help with your recovery [14].
Photo credit: Kin / Unsplash + Justin Heap
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