The new normal for new moms?

Mothers know that once you have a baby, your body changes. One common sentiment is that your bladder and bowel control will never be the same; from now on, whenever you laugh, sneeze or cough, you’ll likely “leak” a little.

Amanda Jensen had heard this from friends, and it was one of the changes she was concerned about when it came time to deliver her daughter last October.

During delivery, Jensen suffered a third-degree tear, which is a laceration through the perineal muscles and muscle layer that surrounds the anal canal. A fourth-degree tear is the most severe tear a woman can have, so while Jensen wasn’t in the worst position possible, her tear was still considered serious.

“Healing from a third-degree tear can take longer than from a first- or second-degree tear and may cause discomfort or pain with sitting, bowel movements and/or intercourse. Lifting, such as when lifting a newborn, may cause pressure or discomfort in the perineal area, as well,” says Angela Fishman, a physical therapist who specializes in pelvic floor rehabilitation at Outpatient Rehabilitation Services at Advocate Lutheran General Hospital in Park Ridge, Ill., who treated Jensen.

Following delivery, Jensen’s physician referred her to the Women’s Pelvic Health Rehabilitation program at Lutheran General to help heal the tear and minimize discomfort. If a tear is left untreated, it can put patients at risk for possible complications such as pain with intercourse, experiencing bowel urgency, difficulty controlling gas or loss of solid stool.

“I had never done PT before, so I didn’t know what to expect. I didn’t know that this type of PT was even an option,” says Jensen. “My physical therapist provided me with a lot of education on pelvic floor rehabilitation. I really appreciated it because I had no idea there was a fix for the pain I felt.”

Jensen met with Fishman a few days after her baby was born. Fishman talked with Jensen about the sites of pain, when she was experiencing discomfort and about her bladder control. She then led Jensen through a series of exercises to test which muscles needed to be addressed in therapy.

“If something looked incorrect, she would fix it,” says Jensen. “If I wasn’t coordinated enough to do all the movements in a particular exercise, she would modify it for me.”

Jensen left with several exercises to practice at home. She had two follow-up appointments to check her progress and was given different exercises to continue strengthening her muscles in addition to learning how to protect her pelvic floor.

“Pelvic floor rehabilitation is more for teaching the patient how to protect her pelvic floor than it is for healing the tear; however, doing gentle pelvic floor exercises during the healing process may assist in healing through changes in local blood flow,” says Fishman. “We also try to empower women to be able to know what to watch for, how to protect their pelvic floor, know what to do to prevent problems and know where to find assistance, if needed. “

Three treatments were enough for Jensen to feel “back to normal.” Her tear has healed, and she’s regained control of her bladder. She still does her PT exercises once a week for maintenance, but the issues surrounding the pelvic floor that plague so many new mothers are no longer obstacles for Jensen. She’s grateful that her physician referred her to physical therapy. Without the referral, she says she would never have asked the doctor what could be done for the tear or other issues.

“It sounds silly to go for PT for muscles we don’t really see or are so small we don’t realize they’re there, but they have such a huge impact on the body,” says Jensen. “You don’t have to go through life with pee coming out every time you sneeze. That doesn’t have to be your new normal.”