How can pelvic floor therapy help with cesarean births and VBACs?
April is Cesarean Awareness Month - Cesareans continue to account for around 32% of births in the United States, although in Montana it is below the national average at around 27%. The World Health Organization estimates it should be closer to 10-15%, and this is where better education and awareness is key!
We wanted to take the opportunity to talk about where pelvic floor physical therapy can be a resource for women who have had a belly birth. (There are different names that are used interchangeably: belly birth, c-section, cesarean birth).
First and foremost, every woman who has had a pregnancy and birth would most likely benefit from postpartum pelvic floor therapy. There are certainly differences in priorities between vaginal births and c-sections, but even with a planned cesarean, women have gone through a pregnancy with a lot of physical changes, and is now also recovering from a major abdominal surgery. Expert care can be highly valuable in managing scar tissue and healing, rehabbing abdominals after surgery, and potentially with the added complications of diastasis recti. Early intervention can also address mobility issues that come with abdominal surgery, including simply getting out of bed. Women who attempt a vaginal birth and eventually have a cesarean often have both abdominal and pelvic floor issues that can be uniquely addressed in pelvic floor therapy.
Another way pelvic floor therapy can support women who have had a cesarean is in future pregnancies. A growing number of women are opting for a VBAC, or vaginal birth after cesarean. The national average for VBACs is around 14% of births, and in Montana is around 20%. There are risk factors that need to be discussed on an individual basis, but many women are excellent candidates and simply have another c-section because that’s what their provider is most comfortable doing. If a woman is planning a VBAC, working on a prenatal program with a pelvic health therapist with expertise in perinatal or OB care can improve chances of a successful vaginal birth.
Key benefits of a prenatal pelvic therapy program include, again, addressing scar tissue mobility. It can improve coordination and control of pelvic floor, specifically to allow lengthening and relaxation during birth. It can help improve pelvic joint mobility and muscle control to manage pain through pregnancy and prepare for the physical demands of labor. In the third trimester, specific birth prep programs improve teaching pushing and breathing techniques, exercises and manual techniques to improve pelvic balance and mobility to optimize baby’s positioning and decrease risk of perineal tears. Women who participate in a prenatal program also often have a lesser need for ongoing care postpartum.
We believe women should know all the resources available to enhance recovery from a cesarean, as well as helping plan for a healthy pregnancy and birth after cesarean.
