Perineum rehabilitation after childbirth is a standard practice in France, yet many Americans have never heard of it. The benefits of it are truly far-reaching!
I will be eternally indebted to France for perfectly-baked croissants, a bottle of Bordeaux … and a rehabilitated perineum. Say what??
Let me start at the beginning.
I don’t mean to insult your intelligence. Perhaps you know good and well what and where your perineum is. But to be perfectly honest, I didn’t. At least not until I was getting ready to deliver my first baby (I shared about my birth experiences a few months back if you’d like some background!)
But oh! Now I know, more than ever, what my perineum is and where it’s located. When you hear women talk about how delivering their children did a number on their “lady parts,” this is what they’re always referring to—the perineum. Though to be quite honest, the whole area below the belly button takes a major hit during pregnancy and childbirth, can I get an amen?
It’s funny how you don’t think about things like perineums until you become a mother. There’s a weird lingo to motherhood that seems like it can’t be taught (letdown, blowouts, engorged, cluster-feeding, wake time, perineum) And I learned what a perineum is only a few months before my daughter was born.
I was sitting in my French childbirth class hanging on to the instructor’s every word as she told us what needed to be packed in our hospital bags. Public hospitals are covered by the French government. I received excellent care, but I had to bring EVERYTHING, and they provided nothing. The packing list included the less-desirable toiletries needed in the event your delivery and recovery is especially difficult (read: a torn perineum).
Perineal Massage: A Means to Potentially Reduce Vaginal Tearing
Now, friends, this is where she launched into a discourse on perineal massage. Yes, it is exactly what it sounds like. Here is a great resource to learn more.
Ok, so are you intrigued? This is why this matters.
Some schools of thought teach that massage can help the perineal muscle become more flexible and tonic. This prepares it for the major stretching it will undergo when the baby is born, similar to a runner stretching before a big race. In some instances, perineal massage could help avoid a vaginal tear or episiotomy, so why not give it a try?
Perineal Re-Education: What’s the 411?
Well, I finally did pack my bag, and sure enough, my little baby was born not long after that. When the nurse came to discharge me, she handed me a folder with loads of papers stuffed inside, including the number of the midwife who would come and check on us postpartum (AMAZING), a script for birth control (hint hint, we don’t want to see you back here for at least a few years because we’re footing the bill) and, most notably, one on the very top that looked clinical and mysterious. It read:
Rééducation du perinée
Huh? What could that mean? All of the other papers made sense, but this one had me scratching my head. So, I turned to Google translate (again, not the most reputable source) Perineum re-education, to begin no earlier than six weeks postpartum. Oh heavens, what had I gotten myself into? Is this a postpartum underground cult?
I tucked the paper away into my folder, headed home with my newborn and not a clue what I was doing, and promptly forgot about it.
Six weeks later, I sat in my French OBGYN’s office for my postpartum visit, assuming I would get a quick check, a new bill of health, and be on my way. He looked over the top of his glasses at me and asked me (madame) if I was planning to do my perineum re-education. Come again? Oh right! The bizarre perineum thing. “Eh, not really,” I said, “I seem to be feeling well!” This was not the response that he was looking for, “Oh non madame, il faut, il faut.” (You must, you must!)
He gave me the name of a few pelvic floor PT’s in my neighborhood, and off I went on a new adventure. Fast forward, ten sessions of pelvic floor PT therapy later, and I felt REBORN. As good if not stronger than before I got pregnant. I worked with a pelvic floor PT for a handful of sessions that involved electromagnetic therapy to help wake those muscles down there and internal manual exercises with the help of a certified nurse-midwife.
God bless that French doctor who changed my life forever! I am grateful.
So, why does this matter?
If you had a vaginal birth, this matters. If you had a minor or severe vaginal tear, this ESPECIALLY matters. If you had a c-section or carried a baby, this matters. I am not a medical professional, but I have lived through the reality of acute injury in childbirth, and I know how important it is to rehabilitate afterward.
Imagine you’re an athlete who breaks a bone. Don’t you wait for the bone to heal and then do physical therapy to regain muscle strength and function? Why on earth wouldn’t we take the same approach when it comes to childbirth? Let’s say you have a severe vaginal tear in childbirth, and it heals, but it leaves you with painful sex or urine that leaks. If you do nothing to rehabilitate the perineum, these symptoms will ONLY get worse as you age and enter menopause. This does not have to be the case.
Journeying Across the Atlantic
When I had my second baby, this time on the other side of the Atlantic, there was no government-subsidized pelvic floor rehabilitation waiting for me. I found myself scrambling, battling some difficult postpartum symptoms, and not knowing where to turn. Thankfully one of our contributing writers for St. Louis Moms Blog told me about Legacy Physical Therapy. I asked my OB for a referral, and I was set up for my first appointment with a pelvic floor PT for the following week.
I will be eternally indebted to my PT at Legacy for helping me get back on track in just two short months. We did exercises in the clinic, and she armed me with exercises and supplies to use as well at home. We focused on posture tips, core strength, pelvic floor exercises, and scar tissue massage. My pain level was always her first concern, and she helped me reach a point where I was no longer experiencing pain, and nothing was leaking (hooray!).
If I may be so bold, mama, you are NOT destined for a lifetime of painful intercourse or leaking urine when you sneeze just because you had a baby. You deserve better!
Let’s take a lesson from the French. Even though we don’t have the luxury of mandated and covered pelvic floor rehabilitation, that shouldn’t stop you from getting the help you need! At your postpartum check-up, ask your OBGYN/Midwife for a referral to a pelvic physical therapist. Your perineum will thank you for it!
This blog post is sponsored by our partner Legacy Physical Therapy.