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Birth-Related Pelvic Floor Trauma and Postpartum Mental Health

Birth-Related Pelvic Floor Trauma and Improving Mental Health Through Education

May is Mental Health Awareness Month. This post will specifically examine a way pelvic floor physical therapy can actually help maternal mental health. Lack of education on the pelvic floor during pregnancy can significantly affect postpartum mental health.

I can remember an Instagram post from Chrissy Teigen after she had her first baby that said something along the lines of – I knew the baby would come home in diapers, but I didn’t know I would too!

I work with expectant moms all the time, and often times, they feel like they have limited educational resources regarding what their body will go through during labor and delivery. Moms spend so much time during pregnancy prepping for how to take care of the baby (which they rightfully should), but typically not enough time learning to care for themselves.

Stressed mother-

Some may have never even heard of their pelvic floor until well into (or after) their pregnancy. Many can’t identify the muscles or coordinate their function. I can’t even tell you how many times I have heard, “I didn’t know pelvic floor physical therapy was a thing.” Awareness is definitely spreading through platforms like TikTok and Instagram, but we have a long way to go. Our goal at Renew PT is to give every pregnant mother access to a physical therapy evaluation!

Getting into the Research on Postpartum Mental Health

In an article in the latest Journal of Women’s Health Physical Therapy, the authors designed two studies that explored the effect on birth-related pelvic floor trauma and its sequelae (PFTS) and rates of perinatal mood and anxiety disorders in the first 12 weeks postpartum.  

Birth-related pelvic floor trauma includes perineal tears, episiotomy, levator ani avulsions (tearing part of the pelvic floor muscle away the from bone), and nerve damage. These may sound gruesome, but they are all very real possibilities in a vaginal birth. Imagine if you were pregnant and didn’t know there was a possibility of tearing your pelvic floor muscles. You can see how this would be extremely distressing if it happened!

In both studies, many participants reported a lack of prenatal pelvic floor education.  There were also strong associations between birth trauma to the pelvic floor and postpartum mental health. Those who had the greatest difference between their birth expectations vs. their birth reality had the strongest associations between their pelvic floor and psychological symptoms. Those who reported being more educated on the pelvic floor and its role in birth had fewer psychological symptoms. That is even if they had pelvic floor trauma. WOW!

Lack of Education: It Doesn’t Have To Be This Way!

The study participants mentioned wishing they had more pelvic floor education at prenatal appointments, pelvic floor protection during pushing, breathing strategies, and postpartum exercise guidance. Education is key. Pelvic floor education can reduce pelvic floor trauma during birth and help manage stress if trauma does occur.  We HIGHLY recommend meeting with a pelvic PT. We can provide an individualized assessment of your body as well as for birth prep education. Knowledge is power!

If you are pregnant, advocate for a pelvic PT referral. Call your local Pelvic PT and see if a referral is necessary. All US states have some form of direct access.


Johnson, Kimberley T. MS1; Williams, Paula G. PhD1; Hill, Audra J. MD2 The Importance of Information: Prenatal Education Surrounding Birth-Related Pelvic Floor Trauma Mitigates Symptom-Related Distress, Journal of Women’s Health Physical Therapy: April/June 2022 – Volume 36 – Issue 2 – p 62-72

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