Pelvic dysfunctions are caused by a series of alterations that begin with the weakening of the fascial and muscular structures of the pelvic floor. These changes can occur throughout a woman's life but are primarily influenced by two main factors: pregnancy and menopause. Pregnancy, especially childbirth, has a significant impact on the anatomy and physiology of the pelvic structures.

Physical therapy aimed at perineal rehabilitation is essential to prevent and strengthen this often overlooked but crucial muscle for the well-being of new mothers.

Natural childbirth

Another particularly challenging moment is vaginal childbirth, which causes overstretching of the muscular and ligamentous structures of the perineum, potentially leading to their tearing.

It is estimated that:

• 23% of women experience pain during sexual intercourse 3 months after childbirth;
• 10% of women report pelvic pain in the period ranging from 3 to 18 months postpartum;
• il 3-10% delle donne riferisce episodi di incontinenza anale, ovvero l’incapacità di trattenere i gas o le feci;
• 24% of women experience urinary problems (especially stress urinary incontinence or during increases in abdominal pressure, such as coughing, sneezing, laughter, etc.);
• 32% of women experience some degree of urogenital prolapse, which is the descent of pelvic organs such as the bladder, uterus, vagina, rectum, and intestinal loops.

Numerous risk factors have been identified for perineal damage during childbirth, including:

• aver avuto più di una gravidanza;
• il parto operativo mediante l’applicazione del forcipe o della ventosa;
• la rotazione sacrale dell’occipite del feto;
• a particularly long expulsion period;
• l’analgesia epidurale;
• la presenza di lacerazioni perineali di III° grado;
• a too large baby (fetal macrosomia);
• l’episiotomia mediana.

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A cesarean section birth.

It's important to remember that the pelvic floor is completely connected to the abdominal muscles, diaphragm, and posture. A cesarean section involves all three structures.

Then there's the scar, which needs time; many women neglect it, thinking it should heal on its own.

Tutte le donne dovrebbero prendersi cura della propria cicatrice per evitare aderenze o tensione dei tessuti, oltre che, da un punto di vista neurologico ed emotivo, rientrare in contatto con una parte di sé che è stata lesa.

It seems like the abdominal wall comes out unscathed from a cesarean section, but no muscle likes to be crossed by a scar.

È necessario recuperare quanto prima la funzione addominale in particolare i muscoli profondi che hanno il compito di sostenere e contenere.

Stella Maris Glowinski

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