The pelvic floor is a group of muscles and ligaments (tough bands of tissue that connect bones) in your lower abdomen (belly). These muscles and ligaments form a bowl-shaped network between the hip bones, pubic bones and tailbone that hold the bladder, bowel (large intestine), vagina and other organs in place.
Muscles in the pelvic floor help stabilize your core, protecting your pelvic organs when you cough or lift. The pelvic floor also helps control your bladder and bowel, helps with vaginal contractions during sex and supports vaginal delivery.
Physical and hormonal changes during pregnancy and childbirth can stretch or damage the muscles, tissues and nerves in the vagina and pelvis, causing pelvic floor disorders. Read about the pelvic floor conditions we treat.
Our specialists at the Pregnancy Pelvic Floor Wellness Clinic will tailor a treatment plan to meet your unique needs. We begin with a thorough evaluation to understand the symptoms you’re experiencing, and you may have specialized diagnostic testing, such as 3D ultrasound.
We also discuss your goals for treatment, including future pregnancy plans, and review possible treatment options. We work closely with you to provide effective, long-lasting treatments that meet your specific goals.
Our team usually recommends nonsurgical treatments to start your care, and you may benefit from one or more treatments, including:
Antibiotic medications, if needed, to treat infection
Medications to treat urinary and fecal incontinence (bladder and bowel control)
Pelvic floor physical therapy to relieve pain and improve pelvic muscle strength and control
Trigger point injections to relieve vaginal pain
Vaginal creams or ointments for wound healing
Vaginal device (pessary) fitting in the office to manage pelvic organ prolapse or activity-related urinary leaks
Vaginal, laparoscopic and robotic-assisted surgery for reconstruction and repair of pelvic organ prolapse and fistulas, and to treat urinary and fecal incontinence
Pelvic floor physical therapy is a specialized type of physical therapy that targets muscles in the pelvic floor. This minimally invasive treatment option can strengthen pelvic muscles and help them relax, which helps relieve pain and other symptoms of pelvic conditions. Pelvic floor exercises and other therapies help stabilize your core and improve your control over urination, bowel movements and sexual function.
Research supports the effectiveness of pelvic floor physical therapy as a primary treatment for many pelvic conditions, including pelvic pain, painful intercourse, pelvic organ prolapse, and urinary and fecal incontinence.
Our specialized pelvic floor physical therapists provide you with education about pelvic floor health. We work with you one-on-one using therapies and techniques such as:
Exercises to strengthen or relax the pelvic floor muscles
Biofeedback to show you how to control your pelvic floor muscles
Electrical stimulation to help strengthen muscles
Manual therapy to help release muscle tension
Your perineum, the tissue between your vagina and anus, may be sore after delivery, particularly if you had vaginal tearing or your doctor performed an episiotomy. An episiotomy is an incision (cut) through the perineum during childbirth that may help prevent vaginal tearing.
Our specialists recommend keeping the area clean and dry. These self-care instructions can help reduce pain and swelling:
Ice packs: Apply ice packs wrapped in a soft cloth to your perineum. Ice is most helpful and soothing during the first several days after your delivery. Use the ice for no more than 20 minutes at a time.
Squirt bottle: Fill a squirt bottle with warm water to spray on your perineum while urinating or after toileting to clean the area. A gentle warm water spray can help minimize irritation and keep the area clean.
Sitz baths: Take short sitz baths (warm, shallow baths) 2 to 4 times each day.
Witch hazel: Place cotton pads soaked in witch hazel in the refrigerator and use them several times per day to cool the perineum. Throw each pad away after one use.
Pain management: Take over-the-counter pain medications, such as acetaminophen (Tylenol®) or ibuprofen (Advil®), as recommended by your doctor. Limit narcotic pain medications, if possible, because they can cause constipation.
No straining: Keep your bowel moving with a stool softener and/or a laxative, as directed by your doctor, to avoid straining during bowel movements.
If your symptoms worsen or you’re concerned about them, call your doctor’s office.
A sitz bath is a warm, shallow bath that cleanses the perineum. All you need is a small amount of warm water in a bathtub or clean shallow basin. You can buy plastic kits that fit over your toilet seat at many stores and pharmacies.
The warm water increases blood flow to promote faster healing and helps relieve itching, irritation and minor pain. Epsom salt and other additives don’t provide additional benefits and aren’t necessary for your sitz baths. But if you prefer to use Epsom salt, add a ½ teaspoon to every 1 gallon of water.
Sitz bath recommendations:
Soak for about 10 minutes.
Gently pat yourself dry with a soft towel or cloth. Don’t rub or scrub the perineum because that can cause pain or irritation.
Take two to four sitz baths each day until the area is fully healed.
If you experience pain, itching or swelling, immediately stop taking sitz baths and contact your doctor.
