wellness

POP can occur at any stage of life from childbirth to menopause.  This guide will help you understand what pelvic organ prolapse is, why it happens, and most importantly, how to chart your full recovery. 

Pain or changes during sex after birth are common and often tied to pelvic floor tension or scar-tissue tightness—not a permanent problem. The medical term is dyspareunia, and it frequently improves with gentle postpartum pelvic floor exercises, breathwork, and time. Recovery is a system: when the pelvic floor relaxes and rebuilds, comfort and pleasure return. Persistent pain deserves a provider’s evaluation. Reclaiming your sexual energy and pleasure post-baby. Do you experience pain while having sex? Are you avoiding being intimate since giving birth because you’re afraid it will hurt or feel different? Have you just been doing it to keep things steady in your marriage (but don’t really enjoy it)? If you can relate to any of the above statements, I want you to know that you’re NOT ALONE! Fact: The medical term for feeling this is actually dyspareuniaand its diagnosis often qualifies you for pelvic PT. A leading cause of painful intercourse postpartum is pelvic floor spasm, a condition in which the muscles of the pelvic floor remain involuntarily contracted, making penetration uncomfortable or even impossible. According to a recent study conducted by PelvicCare, 1 in 3 women report pain during intercourse that actually worsened 2 or more years after delivering their last baby. This is a common side effect of childbirth and it often does not pass or go away on its own. But the good news is that it is very very treatable. Here at RM, we are committed to disrupting fear and pain cycles that restrict women's lives and your ability to thrive. Sexual intimacy, pleasure, and vitality are essential components to thriving in your life and marriage. So, TMI is not a thing here—we are bringing these conversations forward, educating you about what you’re experiencing in your body, and providing effective tools to help you head back between the sheets and have fun…even if it’s just for 5 minutes before your kids wake up and crash the party! Pelvic Floor Function 101, Sex + Tools To Get Your Groove Back: Time is on your side, not your doctor’s. The 6 or 8 week postpartum check up is not your defining moment and is often misleading. Your body is totally not healed, though you may no longer need medical attention. And, as for being ready for exercise and sex at that exact moment, that’s just not true for the vast majority of women. The reality is, it takes some vulnerability to look at your body after you give birth. You’re going to discover at first, a body that looks and feels very different than before. So, take your time—this is your body, your timeline, and when you feel ready to share yourself with your partner again, then it’s the right time for you. A Lesson in Anatomy + Recovery. Your pelvic floor muscles are a network of tissues, muscles, blood vessels, ligaments and tendons. Post-vaginal or cesarean birth, this well-calibrated network needs time to recover and a few tools to help come alive again. When these muscles become chronically tight or overactive—known as pelvic floor hypertonia—it can lead to persistent discomfort, difficulty with penetration, and even urinary urgency or constipation. This actually starts in other parts of your body—rolling out your feet, breathing and moving your ribcage, mobilizing your pelvis and back. When your body feels easeful, the pelvic floor muscles relax and move as well. When you are stressed and not breathing, the most common human response is to retain that tension in your pelvic floor, hips, back and jaw muscles. Pelvic floor tension is one of the most common causes for pain. It can feel a little confusing to have a weak and tight pelvic floor, but that is how muscles operate. When they are tight, they can’t engage and become weak, so surrounding muscles begin to tighten and overcompensate. For instance, your groin muscles and hip flexors will begin gripping to create stability in your pelvis when your central core and low-back waist are collapsing. Breath, soft foam rolling, and strengthening your transversus abdominal muscles all have exponential benefits when it comes to feeling your pelvic floor release and regain pleasurable sensation. Scar tissue adhesions from tearing along your perineum, a c-section or internal scarring that may not be visible to outside observation. Scar tissue sticks to things which creates asymmetry in the surrounding areas, most notably in the pelvic floor. When the pelvic floor can not glide and move, it gets really tight (like when you throw your back out and can’t stand up straight). This is why, penetration of any kind can feel excruciating—the muscles simply can’t relax and stretch the way they normally would. Scar tissue also leads to other pelvic dysfunction like incontinence, organ prolapse, and diastasis recti. Your pelvic floor is part of a system. It’s important to understand that your body is a system and that your pelvic floor is part of it. When you have pain and pressure in your vaginal wall that makes penetrative sex painful you are most likely dealing with a combination of the above conditions. Good news is, when you start treating the whole system, all of the symptoms begin to improve together! Where To Begin A pelvic physical therapist (not OT) that is specialized in manual and visceral manipulation. I look particularly for PT’s who are trained in the Jean Barral Method. They should talk you through everything, listen to your concerns, and be in communication throughout the session so that any internal or external treatments are consented to and you know what is being worked on, released, and realigned. Gentle postpartum recovery exercises that facilitate functional strengthening, but also integrate your emotional and mental health. For pelvic floor hypertonia and postpartum recovery, start with exercises that focus on releasing tension before strengthening, such as: Diaphragmatic breathing to encourage relaxation of the pelvic muscles. Pelvic tilts and bridges with a focus on slow, controlled movement. Soft tissue release with a therapy ball or gentle foam rolling around the hips and lower back. Mindful stretching to reduce tightness in the inner thighs and hip flexors. When you feel happy and relaxed, sex becomes more interesting and your body will respond more readily to the idea of intimacy and pleasure. Start in Phase 1, Week 1 of the RM App and discover your energy and creativity in all parts of your body and being. Be honest with yourself and your partner. Sexual intimacy is not solely defined by penetrative sex as one of my favorite clinical sexologists, Hani Avital, founder of Shelaah, shares in her work with women and couples. Sexual intimacy is about all of your sensual pleasure and senses being brought to life and stimulated together. Postpartum sexuality can become an awesome opportunity to awaken parts of your relationship that you never knew existed before. Something To Remember Sexuality evolves and matures decade over decade. Post-baby, you may feel exhausted and have zero libido or you may feel the opposite and want to jump on your partner the second you’re alone. All experiences and desires are normal and there is no right or wrong way to live into your sexuality—it will ebb and flow over a lifetime. But living with pain, restricting in shame, and silently suffering are formulas for total self-implosion. Breathe and relax. Your body is an incredible entity that is capable of healing, is powerful and resilient. Addressing pelvic floor spasm and hypertonia through breath, movement, and targeted therapy can restore your sexual wellness and confidence. Maturing within yourself, as motherhood often brings, can lead to you becoming more self-possessed, self-aware, and embodied, while experiencing greater pleasure and orgasms than you ever did before having kids. Get a mirror, take a look down there, and then let us know your questions. If you’re in need of a pelvic PT, send us a message and we’ll help you find one. Join our community and chat with other moms. Plus, it’s the month of love—what better time than to talk to your partner and let them know how you’re feeling. Honesty has a way of smoothing the path to intimacy more than anything else. Keep reading: Pelvic Organ Prolapse: Your Complete Guide Nurturing Intimacy Within Yourself Vaginal Birth Recovery: Tips and Secrets for Healing RM Heal — the Revolution Motherhood method Start your free trial with Revolution Motherhood →

A c-section is major abdominal surgery, so recovery has a few key differences from vaginal birth—but beyond the initial healing phase, the path back to strength is more similar than you’d expect. Safe c-section recovery centers on scar care, gentle reactivation of your deep core, and progressing only as your body and your provider allow. How to Prep, Plan & Heal Like a Badass After more than a decade of working with women and guiding their postpartum recoveries, there's not much I haven't seen. And the truth is, while there are some key differences between a c-section and vaginal birth, beyond the initial healing phase, there are more similarities than you might expect. However, those key differences are important and can make all the difference when it comes to planning the best outcome and making a full and active recovery. The initial weeks of postpartum recovery after a c-section require patience and intentional movement. Your body is healing from a major surgery, so focusing on gentle movement, breathwork, and core awareness will set the foundation for long-term healing. The 411 on C-Sections I’ll begin with the obvious, but often glossed-over fact: A c-section is major abdominal surgery. Your doctor cuts through your abdominal layers, muscle, fascial tissue, moves your intestines out of the way and then opens your uterus. It’s a lot for a body to recover from and if your experience was in any way unplanned or urgent, the psychological and emotional recovery can be just as intense as the physical. So, whether you are heading into a planned surgery or are looking for answers because you unexpectedly delivered via cesarean, I’m here to support you with my game-changing tips that will help you get the care you need from your medical team, understand what has happened to your body and learn how to design your personal recovery plan. Planned C-Section: Ask all the questions! If you know in advance that you’ll be delivering your baby via cesarean: Speak with you OB about the details regarding your surgery, where they perform the incision and how they close you post-operatively. Do they close you themselves or do they have someone else perform the closure? What materials do they use to close you (internal stitches and external). This will open the conversation and put you in the driver’s seat to make informed decisions and requests regarding the surgery itself. Previously delivered via c-section? If you’re experiencing pain, bumpiness or unevenness around your old scar, your surgeon can revise the scar tissue during your new c-section and restitch you for best abdominal healing and functional recovery. My Major Pro-Tip: Consider speaking with your OB about having a plastic surgeon in the operating room to close your incision. They are the best trained in the bizz to minimize scarring and stitch for optimal, functional recovery. Note: This can be a delicate conversation to have as it's outside of a physician's normal operating procedure—they may think it’s unnecessary. However, a great plastic surgeon can make a huge difference in your abdominal recovery and if you want to explore this option, you have the right to request it. An exceptional resource for the Plastic Surgeon route is Dr. Sophie Bartsich who has pioneered educational resources for women preparing for planned c-sections. D Post Operative: What to expect and what to do in those early days. Just like any other major surgery, expect a period of healing and rehabilitation, followed by targeted muscle re-education and integrative strength exercises. In the first few days post-surgery: While the incision is still healing, you will want to follow your doctor’s guidelines carefully. Keep it clean, rest as much as you can, and when you feel ready and able to begin standing and walking, go slowly. Expect some digestive discomfort, bloating and gas, as well as limitations to your ability to stand, sit, walk, and carry your newborn. In brief, you’ll need some help tending to your and your baby’s needs for a few weeks—be ready to ask for help! Emotional Check In: You will most likely feel grateful and frustrated having other people help tend to your baby’s needs. This conflicting emotional landscape is totally normal and it’s ok to want help, but also want to be the only person taking care of your baby. Buckle up! This tug will be with you for the rest of your life—welcome to motherhood. Accepting it will help you navigate your need for close intimacy with your sweet baby and space for yourself; year over year and decade over decade. Improve Healing In The First Weeks: Go slowly and listen to your body. The first effort you will make in recovering movement and sensation in your abdominal wall is…breathing. All pregnancies change the dynamics of your breath and hijack your diaphragm. Plus, newly post-op, you will instinctively want to curl around your incision, which can lead to compressing your already weakened core muscles and increase pelvic floor pressure. This mindful breathing video will improve circulation, relax the trunk muscles, and begin the recovery of your nuero-musclar connections (how your brain triggers specific muscles to move or not!). From these simple breath practices, you can begin to add some intentional and gentle muscle contractions through the rib cage, waist and Transversus Abs. Get more of my post-op recovery guidance in : The RM 4th Trimester Program (all on the RM APP) Scar Care: Reduce adhesions and improve your ab function Once your incision has healed and your doctor has given you the “green light” for some gentle movement, you can begin scar massage which will improve nerve regeneration, reduce swelling and adhesions, and increase blood flow (= quicker and better tissue healing), all of which leads to better overall function of your abdominal wall My Massage Hack: Take a little bit of your regular moisturizer and lightly massage your scar when you get out of the shower. Begin with gentle, circular fingertip movements, then, over several weeks, you can increase the pressure and begin moving up and down across the scar. There’s no doubt you’ll feel things—numbness, tingling, emotions…go slowly. About 60 seconds of tender, self-attention to feel, hear and be present in your recovery. STOP IF: You feel pain. That’s your guardrail to how deep you can go. You’ll be able to take a little more pressure for longer as you progress in your healing. If pain is ever persistent, sharp or just feels “off,” call your doctor and get it checked out. Pelvic PT: Yup, for a c-section…Depending on your healing and doctor’s clearance, around weeks 6-10 post-op, make an appointment with a Pelvic Floor specialized PT who practices manual, visceral manipulation. You can ask your doctor for a prescription and even if the PT is out of network, you may be able to receive some reimbursement from your insurance provider. Why + What to Expect: First, your pelvic floor PT should talk you through everything, from listening to your birth and health history, to telling you how they will touch and treat you. Internal work is very common and often very effective for aiding and accelerating c-section recovery. This is because your trunk muscles and pelvic floor muscles are all connected. When you undergo low abdominal surgery, the scar tissue can adhere to itself, other tissues, and even to organs—which often leads to tightness and feeling restricted across the groin and throughout your pelvic floor. A skilled Pelvic PT will release triggered or spasming pelvic floor muscles and re-mobilize internal and external fascial tissue. This will allow you to begin engaging your Transversus Abs (or TVA) and what I call ‘the pelvic corridor’ for a fully functional, strong pelvic floor and abdominal system. Generally, a few sessions with a great pelvic PT is enough. But, if you sustained other injuries while delivering (ie. tearing, organ prolapse, incontinence) you may need a longer course of treatment coupled with targeted exercises. Again, this should be an ongoing conversation with your PT so that you are aligned every step of the way. From Healing to Strength Training : How to start and how to stick with it Once you have been cleared by your physician and are feeling ready to begin exercising, it’s important to remember that your fitness needs and schedule are different in these initial months (and years!) postpartum. You'll want tools (like the RM Soft Foam Roller) to release tight muscles, flush out swelling + stiffness while reducing the physical impact of daily mom'ing on your body. Ab Exercises After Cesarean Not all core exercises are created equal after a c-section! The right approach to ab exercises after cesarean involves: Starting with breath-based core activation to prevent pressure buildup on the incision. Prioritizing deep core work over traditional ab exercises like sit-ups, which can strain healing tissue. Progressing movement intentionally to restore abdominal strength without overloading weak tissues. Focusing on breath and controlled movement first will help rebuild stability safely, making it easier to return to strength training without setbacks. One common concern post-c-section is umbilical hernia postpartum. A hernia can develop when weakened abdominal tissues allow a small bulge near the belly button to form. Some umbilical hernias postpartum resolve on their own with proper core rehab. If you notice persistent bulging, pressure, or discomfort, check with your doctor to determine if rehab or additional support is needed. Strengthening the deep core through breathwork and gradual ab exercises after cesarean can help prevent hernias from worsening. Mom Truth: Motherhood is hard on your body. Daily mom’ing left me tight and achy for years. This is why moving every day - even for 10 Min. - makes a huge difference in your recovery. Every time you take a deep breath, open up your shoulders or roll out your feet on the ball, you are reducing the build of stress and allowing your muscles to move better, heal faster and get stronger in the applied athleticism of your daily mom-life. Then, on days when you have a little more time, you do a longer sequence of deep core, glutes, upper body or back work. Your workouts should be progressive - meaning push you a little beyond what you can fully do comfortably. But, they should also teach you how to identify your edges so that you can push right up to your strength capacity (which changes daily) safely and with confidence. Emotional Check-In: It’s scary to have your body be so compromised, just when you need it to be strong and care for your baby. The fear and fatigue you feel is completely normal, but it doesn’t have to restrict you. Go slowly, listen to your body and your daily physical practice becomes the fear-disruption you need. Instead of all the “can’ts” you begin to focus on the “cans” as you feel and witness your incremental healing and increased strength every day. Birth is a powerful gateway to motherhood—the pull between anticipation, preparing for the unexpected, and letting go with resilience and a friendly pivot…it never stops. There is so much value in preparing your body, mind, and spirit for giving birth. But, when the moment arrives, both trust and surrender are needed—trusting yourself and your body, surrendering to a force that is much bigger than the confines of your physical body, and expecting that the unexpected will definitely occur. And, so, for whatever journey you have had or are about to embark upon, I’m so happy you’re here and am thrilled to guide and support you. Keep reading: Vaginal Birth Recovery: Tips and Secrets for Healing Building Muscle After Childbirth: Rebuilding Strength From Your Core Out RM Heal — the Revolution Motherhood method Start your free trial with Revolution Motherhood →