What you might feel, and why
After a pregnancy loss, you might feel things in your body that no one warned you about. A tightness in your lower belly. A heaviness or pulling down low in your pelvis. A sense that something has shifted but you can’t quite explain what.
There’s no strong research on pelvic health after a pregnancy loss. Most of what we know comes from listening to women, or from studies on hormonal shifts and stress responses in the body. That doesn’t mean it’s not real. It just means it hasn’t been studied properly.
The pelvic area is sensitive to stress, hormones, and the way we hold ourselves through pain or grief. You may notice changes in how things feel, how your body moves, or how you go to the toilet. It doesn’t mean something is wrong. It just means your body is still responding.
There’s no checklist, but here are some of the ways women have described it:
Some women also notice pain if their pelvic floor muscles become tight or reactive. These muscles support the bladder, bowel, and uterus, and can hold tension in response to stress, trauma, or physical strain.
Higher levels of the stress hormone cortisol can also affect gut function. Some women experience constipation, loose bowels, or both. It’s not always easy to separate what’s physical and what’s emotional, and you don’t need to.
There’s no single answer. But small shifts can help you feel more at ease in your body:
If sex becomes painful after a pregnancy loss, it’s not something to ignore or push through. Pain is your body’s way of telling you something needs attention. It might be related to pelvic floor tension, but it could also be linked to hormones, vaginal dryness, infection, or something else entirely. And the longer it’s left unaddressed, the harder it can be to resolve.
If you’re leaking urine, even just a little, and it hasn’t improved with time, it’s worth getting it checked. Leaking isn’t something you have to just live with.
You can start with your GP or a women’s health physiotherapist. Both can help, and both are valid starting points. What matters is raising it early, so you can get the right kind of care.
Most of these changes settle over time. But if something feels like it’s getting worse, or just isn’t easing, you don’t have to wait. If something feels off, it’s valid to get it checked.
Abbott, J., Bowyer, L., Finn M. (2014) Obstetrics & Gynaecology: an evidenced based guide 2nd edition. Chatswood, NSW: Elselvier Churchill Livingstone.
Abbassi-Ghanavati, M., Greer, L. G., & Cunningham, F. G. (2009). Pregnancy and Laboratory Studies: A Reference Table for Clinicians. Obstetrics & Gynecology, 114(6), 1326-1331. https://doi.org/10.1097/AOG.0b013e3181c2bde8
Aguree, S., & Gernand, A. D. (2019). Plasma volume expansion across healthy pregnancy: a systematic review and meta-analysis of longitudinal studies. BMC Pregnancy and Childbirth, 19(1), 508. https://doi.org/10.1186/s12884-019-2619-6
Aldabe D, Ribeiro DC, Milosavljevic S, Bussey MD. Pregnancy-related pelvic girdle pain and its relationship with relaxin levels during pregnancy: a systematic review. European Spine Journal. 2012 Sep 1;21(9):1769-76.
Aldabe, D., Milosavljevic, S., & Bussey, M. D. (2012). Is pregnancy related pelvic girdle pain associated with altered kinematic, kinetic and motor control of the pelvis? A systematic review. Eur Spine J, 21(9), 1777-1787. https://doi.org/10.1007/s00586-012-2401-1
Arrue, M., Diez-Itza, I., Ibañez, L., Paredes, J., Murgiondo, A., & Sarasqueta, C. (2011). Factors involved in the persistence of stress urinary incontinence from pregnancy to 2years post partum. International Journal of Gynecology & Obstetrics, 115(3), 256-259. https://doi.org/https://doi.org/10.1016/j.ijgo.2011.07.024
Ashton-Miller, J. A., & DeLancey, J. O. L. (2009). On the Biomechanics of Vaginal Birth and Common Sequelae. 11, 163-176.
Association, A. P. (2021). Early Fetal Development. Retrieved 05/12/2022 from https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/early-fetal-development/#:~:text=Guideline%20to%20Progesterone%20Levels%20During,300%20ng%2Fml%20Third%20Trimester
Baddock, S. (2016). Physiological changes during the postnatal period. Nurse Key. https://nursekey.com/physiological-changes-during-the-postnatal-period/#:~:text=The%20uterus%20reduces%20in%20size,This%20process%20is%20termed%20involution.
Beales D, Slater H, Palsson T, O’Sullivan P. Understanding and managing pelvic girdle pain from a person-centred biopsychosocial perspective. Musculoskelet Sci Pract. 2020 May 6:102152. doi: doi: 10.1016/j.msksp.2020
Beales D, Lutz A, Thompson J, Wand BM, O’Sullivan P. Disturbed body perception, reduced sleep, and kinesiophobia in subjects with pregnancy-related persistent lumbopelvic pain and moderate levels of disability: an exploratory study. Man Ther. 2016 Feb 1;21:69-75. doi: 10.1016/j.math.2015.04.016
Benjamin, D. R., Frawley, H. C., Shields, N., van de Water, A. T. M., & Taylor, N. F. (2019). Relationship between diastasis of the rectus abdominis muscle (DRAM) and musculoskeletal dysfunctions, pain and quality of life: a systematic review. Physiotherapy, 105(1), 24–34. https://doi.org/10.1016/j.physio.2018.07.002
Bjelland EK, Eberhard-Gran M, Nielsen CS, Eskild A. Age at menarche and pelvic girdle syndrome in pregnancy: a population study of 74 973 women. BJOG. 2011 Dec;118(13):1646-52. doi: 10.1111/j.1471- 0528.2011.03099.x
Bjelland EK, Owe KM, Stuge B, Vangen S, Eberhard-Gran M. Breastfeeding and pelvic girdle pain: a follow-up study of 10 603 women 18 months after delivery. BJOG:. 2015 Dec 1;122(13):1765-71. doi: 10.1111/1471-0528.13118
Björklund K, Nordström ML, Bergström S. Sonographic assessment of symphyseal joint distention during pregnancy and post partum with special reference to pelvic pain. Acta obstetricia et gynecologica Scandinavica. 1999 Jan 1;78(2):125-30..
Björklund K, Bergström S, Nordström ML, Ulmsten U. Symphyseal distention in relation to serum relaxin levels and pelvic pain in pregnancy. Acta obstetricia et gynecologica Scandinavica. 2000 Jan 1;79(4):269-75.
Blotta RM, Costa SD, Trindade EN, Meurer L, Maciel-Trindade MR. Collagen I and III in women with diastasis recti. Clinics. 2018;73. 10.6061/clinics/2018/e319 3.
Bo, K., et al. (2017). An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. Neurology and Urodynamics. 36:221–244. DOI 10.1002/nau.23107
Bo, K., Stuge, B., Hilde, G. (2019). Specific musculoskeletal adaptations in pregnancy: pelvic floor, pelvic girdle and low back pain: implications for physical activity and exercise. In: Rita-Santos-Rocha ed. Exercise and Sporting Activity During Pregnancy. 1st ed. DOI: 10.1007/978-3-319-91032-1. pp135-155
Ceprnja, D., Chipchase, L., Fahey, P., Liamputtong, P., & Gupta, A. (2021). Prevalence and Factors Associated with Pelvic Girdle Pain During Pregnancy in Australian Women: A Cross-Sectional Study. Spine, 46(14), 944-949. https://doi.org/10.1097/brs.0000000000003954
Chan, S. S., Cheung, R. Y., Yiu, K. W., Lee, L. L., & Chung, T. K. (2014). Pelvic floor biometry in Chinese primiparous women 1 year after delivery: a prospective observational study. Ultrasound Obstet Gynecol, 43(4), 466-474. https://doi.org/10. Thornton, M. J., & Lubowski, D. Z. (2006). Obstetric-induced incontinence: a black hole of preventable morbidity. Australian & New Zealand Journal of Obstetrics & Gynaecology, 46(6), 468-473. 1002/uog.13249
Chang, Y. M., El-Zaatari, M., & Kao, J. Y. (2014). Does stress induce bowel dysfunction?. Expert review of gastroenterology & hepatology, 8(6), 583–585. https://doi.org/10.1586/17474124.2014.911659
Chen MH, Hu CK, Chen PR, Chen YS, Sun JS, Chen MH. Dose-dependent regulation of cell proliferation and collagen degradation by estradiol on ligementum flavum. BMC Musculoskeletal Disord. 2014 Dec; 15(1):1-0. doi: 10.1186/1471-2474-15-238
Clinton, S. C., Newell, A., Downey, P. A., & Ferreira, K. (2017). Pelvic Girdle Pain in the Antepartum Population: Physical Therapy Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health From the Section on Women’s Health and the Orthopaedic Section of the American Physical Therapy Association. Journal of Women’s Health Physical Therapy, 41(2), 102-125. https://doi.org/10.1097/jwh.0000000000000081
Continence Foundation of Australia. Pelvic Floor Muscles. CFA https://www.continence.org.au/about-continence/continence-health/pelvic-floor
Continence Foundation of Australia. POP risk factors. CFA https://www.continence.org.au/who-it-affects/women/prolapse#whatarethecausesofprolapse
Corvino A, De Rosa D, Sbordone C, Nunziata A, Corvino F, Varelli C, Catalano O. Diastasis of rectus abdominis muscles: patterns of anatomical variation as demonstrated by ultrasound. Pol J Radiol. 2019; 84:e542. doi: 10.5114/pjr.2019.91303
Damen L et al. Pelvic pain during pregnancy is associated with asymmetric laxity of the sacroiliac joints. Acta Obstet Gynecol Scand. 2001; 80(11):1019–102
Damen L et al The prognostic value of asymmetric laxity of the sacroiliac joints in pregnancy-related pelvic pain. Spine 2002; 27(24):2820–2824 55.
Day, J., & Goad, K. (2010). Recovery of the pelvic floor after pregnancy and childbirth. British Journal of Midwifery, 18(1), 51-53.
Deie M, Sakamaki Y, Sumen Y, Urabe Y, Ikuta Y. Anterior knee laxity in young women varies with their menstrual cycle. Int Orthop. 2002 Jun 1;26(3):154-6. doi: 10.1007/s00264-001-0326-0
Dietz, HP. Pelvic organ prolapse: a review. AJGP, 2015; 44(7). https://www.racgp.org.au/afp/2015/july/pelvic-organ-prolapse-a-review
Evans, S. (2015). Management of persistent pelvic pain in girls and women. Royal Australian College of General Practitioners. 44(7). https://www.racgp.org.au/afp/2015/july/management-of-persistent-pelvic-pain-in-girls-and
Estradiol (serum). (2010). Perinatology.com Reference Values During Pregnancy, . https://www.perinatology.com/Reference/Reference%20Ranges/Estradiol.htm
Fakari FR, Simbar M, Naz MS. The relationship between fear-avoidance beliefs and pain in pregnant women with pelvic girdle pain: A cross-sectional study. Int J Community Based Nurs Midwifery. 2018 Oct;6(4):305
Fernando M, Nilsson-Wikmar L, Olsson CB. Fear-avoidance beliefs: A predictor for postpartum lumbopelvic pain. Physiother Res Int. 2020 Oct;25(4):e1861. doi: 10.1002/pri.1861
Frawley, H., et al. (2021). An International Continence Society (ICS) report on the terminology for pelvic floor muscle assessment. Neurology and Urodynamics, 40:1217–1260. DOI: 10.1002/nau.24658
Gaurav, C. T., P. (2021). Physiology, Postpartum Changes. Retrieved 7/9/22 from https://www.ncbi.nlm.nih.gov/books/NBK555904/
Goom, T., Donnelly, G., & Brockwell, E. (2019). Returning to running postnatal – guidelines for medical, health and fitness professionals managing this population. https://doi.org/10.13140/RG.2.2.35256.90880/2
Gonzales, A. L., Barnes, K. L., Qualls, C. R., & Jeppson, P. C. (2021). Prevalence and Treatment of Postpartum Stress Urinary Incontinence: A Systematic Review. Female Pelvic Med Reconstr Surg, 27(1), e139-e145. https://doi.org/10.1097/SPV.0000000000000866
Hansen A, Jensen DV, Larsen E, Wilken-Jensen C, Petersen LK. Relaxin is not related to symptom-giving pelvic girdle relaxation in pregnant women. Acta obstetricia et gynecologica Scandinavica. 1996 Jan 1;75(3):245-9.
Haylen, B. T., et al. (2010). An International Urogynecological Association (IUGA)/International Continence Society (ICS) Joint Reports on the Terminology for Female Pelvic Floor Dysfunction. Neurology and Urodynamics, 21(1):5-26. doi: 10.1007/s00192-009-0976-9
Herbert, J. (2009). Pregnancy and childbirth: the effects on pelvic floor muscles: Stress incontinence can follow childbirth as pelvic floor muscles are damaged. In Nursing Times (Vol. 105, pp. 38-41).
Herrmann, V., Scarpa, K., Palma, P. C., & Riccetto, C. Z. (2009). Stress urinary incontinence 3 years after pregnancy: correlation to mode of delivery and parity. Int Urogynecol J Pelvic Floor Dysfunct, 20(3), 281-288. https://doi.org/10.1007/s00192-008-0767-8
Hijaz, A., Sadeghi, Z., Byrne, L., Hou, J. C.-T., & Daneshgari, F. (2012). Advanced maternal age as a risk factor for stress urinary incontinence: a review of the literature. International Urogynecology Journal: Including Pelvic Floor Dysfunction, 23(4), 395-401.
Hill, M. A. (2022). Embryonic Development. Retrieved 5th December 2022 from https://embryology.med.unsw.edu.au/embryology/index.php/Embryonic_Development
Hongliang, Y., Pengfei, L., Cuiping, J., Jieqian, H., Ling, P., & Yumin, S. (2022). Pelvic floor function and morphological abnormalities in primiparas with postpartum symptomatic stress urinary incontinence based on the type of delivery: a 1:1 matched case-control study. In International Urogynecology Journal (Vol. 33, pp. 245-251). England: Springer.
Hu, Z., Li, M., Yao, L., Wang, Y., Wang, E., Yuan, J., Wang, F., Yang, K., Bian, Z., & Zhong, L. L. D. (2021). The level and prevalence of depression and anxiety among patients with different subtypes of irritable bowel syndrome: a network meta-analysis. BMC gastroenterology, 21(1), 23. https://doi.org/10.1186/s12876-020-01593-5
Iris, S., Yael, B., Zehava, Y., Ella, P., Hannah, G., Miriam, E., Lior, Y., David, Y., & Adi, Y. W. (2020). The impact of breastfeeding on pelvic floor recovery from pregnancy and labor. European Journal of Obstetrics & Gynecology and Reproductive Biology, 251, 98-105.
DeLancey, J. O., Trowbridge, E. R., Miller, J. M., Morgan, D. M., Guire, K., Fenner, D. E., Weadock, W. J., & Ashton-Miller, J. A. (2008). Stress urinary incontinence: relative importance of urethral support and urethral closure pressure. J Urol, 179(6), 2286-2290; discussion 2290. https://doi.org/10.1016/j.juro.2008.01.098
Dumoulin, C., Lemieux, M. C., Bourbonnais, D., Gravel, D., Bravo, G., & Morin, M. (2004). Physiotherapy for persistent postnatal stress urinary incontinence: a randomized controlled trial. Obstet Gynecol, 104(3), 504-510. https://doi.org/10.1097/01.AOG.0000135274.92416.62
Dumoulin, C., Martin, C., Elliott, V., Bourbonnais, D., Morin, M., Lemieux, M.-C., & Gauthier, R. (2013). Randomized controlled trial of physiotherapy for postpartum stress incontinence: 7-year follow-up. NEUROUROLOGY AND URODYNAMICS, 32(5), 449.
Incontinence Risk factors CFA https://www.continence.org.au/incontinence/understanding-incontinence
Jansson, M., Franzén, K., Tegerstedt, G., Hiyoshi, A., & Nilsson, K. (2021). Stress and urgency urinary incontinence one year after a first birth-prevalence and risk factors: A prospective cohort study. Acta Obstetricia et Gynecologica Scandinavica, 100(12), 2193-2201.
Jean Hailes Website. 2020. Dyspareunia. https://www.jeanhailes.org.au/health-a-z/sex-sexual-health/painful-sex-dyspareunia#management-treatment
Jovkovic, B. (2021). EstriolBlood Test: High & Low Levels + Normal Range. SelfDecode. Retrieved 5th December 2022 from https://labs.selfdecode.com/blog/estriol-blood-test-high-low-levels-normal-range/
Jukic, A. M., Weinberg, C. R., Wilcox, A. J., & Baird, D. D. (2010). Effects of early pregnancy loss on hormone levels in the subsequent menstrual cycle. Gynecol Endocrinol, 26(12), 897-901. https://doi.org/10.3109/09513590.2010.487601
Keshwani N, Mathur S, McLean L. Relationship between interrectus distance and symptom severity in women with diastasis recti abdominis in the early postpartum period. Phys Ther. 2018 Mar ;98(3):182-90. doi: 10.1093/ptj/pzx117
King Edward Memorial Hospital. (2022). Pregnancy Loss: In the First 13 Weeks of Pregnancy. KEMH. https://www.kemh.health.wa.gov.au/~/media/HSPs/NMHS/Hospitals/WNHS/Documents/Patients-resources/Pregnancy-loss-in-the-first-13-weeks-of-pregnancy.pdf
Lahaie, M.-A., Amsel, R., Khalifé, S., Boyer, S., Faaborg-Andersen, M., & Binik, Y. M. (2015). Can Fear, Pain, and Muscle Tension Discriminate Vaginismus from Dyspareunia/Provoked Vestibulodynia? Implications for the New DSM-5 Diagnosis of Genito-Pelvic Pain/Penetration Disorder. Archives of Sexual Behavior: The Official Publication of the International Academy of Sex Research, 44(6), 1537–1550. https://doi.org/10.1007/s10508-014-0430-z
Press, J. Z., Klein, M. C., Kaczorowski, J., Liston, R. M., & von Dadelszen, P. (2007). Does cesarean section reduce postpartum urinary incontinence? A systematic review. Birth, 34(3), 228-237. https://doi.org/10.1111/j.1523-536X.2007.00175.x
Pipitone, F., Sadeghi, Z., & DeLancey, J. O. L. (2021). Urethral function and failure: A review of current knowledge of urethral closure mechanisms, how they vary, and how they are affected by life events. NEUROUROLOGY AND URODYNAMICS, 40(8), 1869.
Pirpiris, A., Shek, K. L., & Dietz, H. P. (2010). Urethral mobility and urinary incontinence. Ultrasound Obstet Gynecol, 36(4), 507-511. https://doi.org/10.1002/uog.7658
Pizzoferrato, A.-C., Fauconnier, A., Bader, G., de Tayrac, R., Fort, J., & Fritel, X. (2016). Is prenatal urethral descent a risk factor for urinary incontinence during pregnancy and the postpartum period? International Urogynecology Journal, 27(7), 1003-1011. https://doi.org/10.1007/s00192-015-2918-z
Nambiar, A. K., & Lucas, M. G. (2014). Pathophysiology of urinary incontinence. Surgery (Oxford), 32(6), 279-285.
Novo, R., Perez-Rios, M., Santiago-Pérez, M. I., Butler, H., Malvar, A., & Hervada, X. (2020). Prevalence and associated risk factors of urinary incontinence and dyspareunia during pregnancy and after delivery. European Journal of Obstetrics & Gynecology and Reproductive Biology, 245, 45-50.
Le Coutour, X. J., C. Beuscart, R. Renaud, R. (1984). Etude prospective chez 27 femmes [Effect of pregnancy and delivery on the function of the cervico-urethral closure. I. Prospective study of 27 women]. Journal of Gynecology and Obstetric Biology and Reproduction, 13(7), 771-774.
Leroy, L. d. S., Lúcio, A., & Lopes, M. H. B. d. M. (2016). Risk factors for postpartum urinary incontinence. In Revista da Escola de Enfermagem da USP (Vol. 50, pp. 200-207): Universidade de São Paulo, Escola de Enfermagem.
Lovejoy, D. A., Roem, J. L., Blomquist, J. L., Pandya, P. R., & Handa, V. L. (2019). Breastfeeding and pelvic floor disorders one to two decades after vaginal delivery. American Journal of Obstetrics and Gynecology, 221(4), 333-333.
LoMauro, A., & Aliverti, A. (2015). Respiratory physiology of pregnancy: Physiology masterclass. Breathe (Sheff), 11(4), 297-301. https://doi.org/10.1183/20734735.008615
Luo, D., Chen, L., Yu, X., Ma, L., Chen, W., Zhou, N., & Cai, W. (2017). Differences in urinary incontinence symptoms and pelvic floor structure changes during pregnancy between nulliparous and multiparous women. PEERJ, 5, e3615.
MacArthur, C., Wilson, D., Herbison, P., Lancashire, R. J., Hagen, S., Toozs-Hobson, P., Dean, N., & Glazener, C. (2016). Urinary incontinence persisting after childbirth: extent, delivery history, and effects in a 12-year longitudinal cohort study. Bjog, 123(6), 1022-1029. https://doi.org/10.1111/1471-0528.13395
Mantle, J., Haslam, J., Barton, S. Physiotherapy in Obstetrics and Gynaecology 2nd edition. London: Butterworth- Heineman; 200
Mens JM, Pool-Goudzwaard A, Stam HJ. Mobility of the pelvic joints in pregnancy-related lumbopelvic pain: a systematic review. Obstetrical & gynecological survey. 2009 Mar 1;64(3):200-8.
Miscarriage Australia. (2022). What is a miscarriage. Miscarriage Australia: Melbourne. https://miscarriageaustralia.com.au/understanding-miscarriage/what-is-miscarriage/
Miscarriage Australia. (2022). Types of Miscarriage. Miscarriage Australia: Melbourne. https://miscarriageaustralia.com.au/understanding-miscarriage/types-of-miscarriage/
Morino S, Ishihara M, Umezaki F, Hatanaka H, Yamashita M, Aoyama T. Pelvic alignment changes during the perinatal period. PloS one. 2019 Oct 10;14(10):e0223776.
Moossdorff-Steinhauser, H. F. A., Berghmans, B. C. M., Spaanderman, M. E. A., & Bols, E. M. J. (2021). Prevalence, incidence and bothersomeness of urinary incontinence between 6 weeks and 1 year post-partum: a systematic review and meta-analysis. International Urogynecology Journal, 32(7), 1675-1693.
NICE 2021, Pelvic floor dysfunction: prevention and non-surgical management. NICE.
https://www.nice.org.uk/guidance/ng210
Park SK, Stefanyshyn DJ, Loitz-Ramage B, Hart DA, Ronsky JL. Changing hormone levels during the menstrual cycle affect knee laxity and stiffness in healthy female subjects. Am J Sports Med. 2009 Mar; 37(3): 588-98. doi: 10.1177/0363546508326713
Pandit, M., DeLancey, J. O., Ashton-Miller, J. A., Iyengar, J., Blaivas, M., & Perucchini, D. (2000). Quantification of intramuscular nerves within the female striated urogenital sphincter muscle. Obstetrics and gynecology, 95(6 Pt 1), 797–800. https://doi.org/10.1016/s0029-7844(00)00825-5
Press, J. Z., Klein, M. C., Kaczorowski, J., Liston, R. M., & von Dadelszen, P. (2007). Does cesarean section reduce postpartum urinary incontinence? A systematic review. Birth, 34(3), 228-237. https://doi.org/10.1111/j.1523-536X.2007.00175.x
Rajavuori, A., Repo, J. P., Häkkinen, A., Palonen, P., Multanen, J., & Aukee, P. (2022). Maternal risk factors of urinary incontinence during pregnancy and postpartum: A prospective cohort study. European Journal of Obstetrics & Gynecology and Reproductive Biology: X, 13.
Resende, A. P., Petricelli, C. D., Bernardes, B. T., Alexandre, S. M., Nakamura, M. U., & Zanetti, M. R. (2012). Electromyographic evaluation of pelvic floor muscles in pregnant and nonpregnant women. Int Urogynecol J, 23(8), 1041-1045. https://doi.org/10.1007/s00192-012-1702-6
Resnik, R., Lockwood, C., Moore, T., Copel, J., Siler, J. (2019). Creasy and Resnik’s Maternal-Fetal Medicine: Principles and Practice. Elsevier.
Rive, M. Average fetal length and weight chart. Baby Center. Retrieved 5th Decemebr 2022 from https://www.babycenter.com.au/a1004000/average-fetal-length-and-weight-chart
Royal Womens Hospital – Pregnancy Related Carpal Tunnel Syndrome fact sheet https://www.thewomens.org.au/images/uploads/fact-sheets/Pregnancy-related-carpal-tunnel-210319.pdf
Sanghavi, M., Rutherford, J. (2014). Cardiovascular Physiology of Pregnancy. Circulation, 130(12), 1003-1008. https://doi.org/https://doi.org/10.1161/CIRCULATIONAHA.114.009029
Sanozidis, A., Mikos, T., Assimakopoulos, E., Athanasiadis, A., Tantanassis, T., Tarlatzis, B. C., & Papameletiou, V. (2018). Changes in levator hiatus dimensions during pregnancy and after delivery in nulliparas: a prospective cohort study using 3D transperineal ultrasound. J Matern Fetal Neonatal Med, 31(11), 1505-1512. https://doi.org/10.1080/14767058.2017.1319926
Schock, H., Zeleniuch-Jacquotte, A., Lundin, E., Grankvist, K., Lakso, H., Idahl, A., Lehtinen, M., Surcel, H. M., & Fortner, R. T. (2016). Hormone concentrations throughout uncomplicated pregnancies: a longitudinal study. BMC Pregnancy Childbirth, 16(1), 146. https://doi.org/10.1186/s12884-016-0937-5
Segal, N. A., Boyer, E. R., Teran-Yengle, P., Glass, N. A., Hillstrom, H. J., & Yack, H. J. (2013). Pregnancy leads to lasting changes in foot structure. American journal of physical medicine & rehabilitation, 92(3), 232–240. https://doi.org/10.1097/PHM.0b013e31827443a9
Segal, N. A., & Chu, S. R. (2015). Musculoskeletal Anatomic, Gait, and Balance Changes in Pregnancy and Risk for Falls. Musculoskeletal Health in Pregnancy and Postpartum, 1–18. https://doi.org/10.1007/978-3-319-14319-4_1
Shek, K. L., Kruger, J., & Dietz, H. P. (2012). The effect of pregnancy on hiatal dimensions and urethral mobility: an observational study. Int Urogynecol J, 23(11), 1561-1567. https://doi.org/10.1007/s00192-012-1795-y
Shek, K. L., Pirpiris, A., & Dietz, H. P. (2010). Does levator avulsion increase urethral mobility? European Journal of Obstetrics & Gynecology and Reproductive Biology, 153(2), 215-219. https://doi.org/https://doi.org/10.1016/j.ejogrb.2010.07.036
Shi, Q., Wen, L., Zhao, B., Huang, S., & Liu, D. (2021). The Association of Hiatal Dimensions and Urethral Mobility With Stress Urinary Incontinence. Journal of Ultrasound in Medicine, 41.
Shultz SJ, Sander TC, Kirk SE, Perrin DH. Sex differences in knee joint laxity change across the female menstrual cycle. J Sports Med Phys Fitness. 2005 Dec;45(4):594.
Soldin, O. P., Guo, T., Weiderpass, E., Tractenberg, R. E., Hilakivi-Clarke, L., & Soldin, S. J. (2005). Steroid hormone levels in pregnancy and 1 year postpartum using isotope dilution tandem mass spectrometry. Fertil Steril, 84(3), 701-710. https://doi.org/10.1016/j.fertnstert.2005.02.045
Soma-Pillay, P., Nelson-Piercy, C., Tolppanen, H., & Mebazaa, A. (2016). Physiological changes in pregnancy. Cardiovasc J Afr, 27(2), 89-94. https://doi.org/10.5830/cvja-2016-021
Sperstad JB, Tennfjord MK, Hilde G, Ellstrom-Engh M, Bo K. Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain, Br J Sports Med. 2016 Sep; 50, 1092 – 1096. doi: 10.1136/bjsports-2016-096065
Snyder, K., Peterson, J., & Bargstadt-Wilson, K. (2021). “No One Told Me About This Part”: What Breastfeeding Women Want and Need to Support Their Physical Health. Journal of Women’s Health Physical Therapy, 45(2), 51-56.
Stær-Jensen, J., Siafarikas, F., Hilde, G., Benth, J. Š., Bø, K., & Engh, M. E. (2015/01/01/2015). Postpartum Recovery of Levator Hiatus and Bladder Neck Mobility in Relation to Pregnancy. Obstetrics and gynecology, United States.
Stothers, L., & Friedman, B. (2011). Risk Factors for the Development of Stress Urinary Incontinence in Women. Current Urology Reports, 12(5), 363. https://doi.org/10.1007/s11934-011-0215-z
Sultan, A. H., et al. An International Urogynecological Association (IUGA)/ International Continence Society (ICS) joint report on the terminology for female anorectal dysfunction. Int Urogynecol J. DOI 10.1007/s00192-016-3140-3
Svabik, K., Shek, K., & Dietz, H. (2009). How much does the levator hiatus have to stretch during childbirth? , 116(12), 1657-1662.
Thom, D. H., & Rortveit, G. (2010). Prevalence of postpartum urinary incontinence: a systematic review. Acta Obstetricia et Gynecologica Scandinavica, 89(12), 1511-1522.
Toozs-Hobson, P., Balmforth, J., Cardozo, L. et al. The effect of mode of delivery on pelvic floor functional anatomy. Int Urogynecol J 19, 407–416 (2008). https://doi.org/10.1007/s00192-007-0455-0
Uzelpasaci, E., Çinar, G. N., Baran, E., Gürşen, C., Nakip, G., Ozgul, S., Beksac, K., Unal, C., Orgul, G., Beksac, A. T., Akbayrak, T., & Beksac, M. S. (2021). Trimester-based changes in urogenital symptoms and their impact on the quality of life in pregnant women: A preliminary report. Curr Urol, 15(3), 167-171. https://doi.org/10.1097/cu9.0000000000000021
Van Geelen, H., Ostergard, D., & Sand, P. (2018). A review of the impact of pregnancy and childbirth on pelvic floor function as assessed by objective measurement techniques. International Urogynecology Journal, 29(3), 327-338. https://doi.org/10.1007/s00192-017-3540-z
Van Veelen, G. A., Schweitzer, K. J., van Hoogenhuijze, N. E., & van der Vaart, C. H. (2015). Association between levator hiatal dimensions on ultrasound during first pregnancy and mode of delivery. Ultrasound in Obstetrics and Gynaecology, 45(3), 333
Vico Pardo, F. J., López Del Amo, A., Pardo Rios, M., Gijon-Nogueron, G., & Yuste, C. C. (2018). Changes in foot posture during pregnancy and their relation with musculoskeletal pain: A longitudinal cohort study. Women and birth : journal of the Australian College of Midwives, 31(2), e84–e88. https://doi.org/10.1016/j.wombi.2017.08.114
Viktrup, L., Rortveit, G., & Lose, G. (2006). Risk of Stress Urinary Incontinence Twelve Years After the First Pregnancy and Delivery. Obstetrics & Gynecology, 108(2), 248-254.
Vleeming, A., Albert, H. B., Ostgaard, H. C., Sturesson, B., & Stuge, B. (2008). European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J, 17(6), 794-819. https://doi.org/10.1007/s00586-008-0602-4
Vollyhaug, I., van Gruting, I., van Delft, K., Sultan, A. H., & Thakar, R. (2017). Is bladder neck and urethral mobility associated with urinary incontinence and mode of delivery 4 years after childbirth? , 36(5), 1403-1410.
Wand BM, Elliott RL, Sawyer AE, Spence R, Beales DJ, O’Sullivan PB, Smith AJ, Gibson W. Disrupted body-image and pregnancy-related lumbopelvic pain. A preliminary investigation. Musculoskelet Sci Pract. 2017 Aug 1;30:49-55. doi: 10.1016/j.msksp.2017.05.003
Wang, K., Xu, X., Jia, G., & Jiang, H. (2020). Risk Factors for Postpartum Stress Urinary Incontinence: a Systematic Review and Meta-analysis. Reproductive Sciences, 27(12), 2129-2145. https://link.springer.com/article/10.1007/s43032-020-00254-y
Wesnes, S., & Lose, G. (2013). Preventing urinary incontinence during pregnancy and postpartum: A review. International Urogynecology Journal, 24. https://doi.org/10.1007/s00192-012-2017-3
Woodley, S. J., Lawrenson, P., Boyle, R., Cody, J. D., Mørkved, S., Kernohan, A., & Hay-Smith, E. J. C. (2020). Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews(5). https://doi.org/10.1002/14651858.CD007471.pub4
Yoo, H., Shin, D., & Song, C. (2015). Changes in the spinal curvature, degree of pain, balance ability, and gait ability according to pregnancy period in pregnant and nonpregnant women. Journal of physical therapy science, 27(1), 279–284. https://doi.org/10.1589/jpts.27.279
Need Immediate Help?
If you or someone you know is struggling during the postnatal period, it’s crucial to remember that immediate help is available. Here are steps and resources you can turn to:
In Urgent Situations:
Support Services:
Remember, you are not alone, and reaching out for help is a step toward healing. Your well-being is important, and support is just a phone call away.