I have postpartum pain. Can pelvic floor therapy help?

Question

Hello doctor,

I gave birth four months ago. It was a vacuum-assisted delivery with a third-degree episiotomy. I had a very bad postpartum experience because of the complications, but I have improved now. But I still have pain down there, especially when I am standing for a long time, and I feel pressure and pain too.

Moreover, when I sit on the toilet seat, I feel pain when I try to contract the muscles when I pee. Will this pain go by on its own over time, or do I need to get pelvic floor physiotherapy? I do have scar tissue inside there.

I do feel more pressure near the butthole. Also, I am having discharge (white to yellowish) from the vagina continuously for the last three months. I am not sure if it is normal after birth or not, as there is no infection.

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Based on what you have experienced, it is very common to continue experiencing some discomfort several months after a vacuum-assisted delivery with a third-degree tear and episiotomy. These types of injuries involve deeper layers of tissue and muscle, especially affecting the pelvic floor and areas near the anal sphincter, which can take longer to heal.

Ongoing pain, especially when standing for long periods or when straining muscles during urination, as well as a sensation of pressure near the anus, indicates persistent pelvic floor tension or weakness. The presence of internal scar tissue can also contribute to localized discomfort or pain during movement or muscle engagement.

Given that you are four months postpartum and still experiencing pain and pressure, it is wise to consult a pelvic floor physiotherapist. Pelvic floor therapy can help improve muscle coordination, reduce pain, and promote healing, especially when scar tissue or muscle trauma is involved.

The discharge you mentioned, which is white to yellowish and has continued for three months, is part of the normal postpartum healing process, especially if there are no signs of infection, such as foul odor, itching, or fever. However, persistent discharge should still be evaluated to rule out bacterial vaginosis or other underlying issues, even in the absence of overt infection.

Overall, while some healing can continue with time, your symptoms suggest that professional pelvic floor therapy would be helpful and likely beneficial for your recovery.

I hope this helps.

Feel free to reach out at any time. I am always here to help.

Thank you.