The Postpartum Reset: Returning the Body to its Pre-Birth Position

Have you ever thought about what is actually happening to the structures that allow for baby’s passage during a vaginal birth? Today, we delve into the steps to take to create a postpartum reset in the body, which will help restore the body to its original pre-birth position and facilitate significant healing for your postpartum clients.

A vaginal birth causes extensive challenges to the tissues involved. After seeing thousands of postpartum clients and listening to their tissues, I have found several tissues that could use some assistance from bodyworkers to help them find their original position after birth.

The Impact of Pregnancy on the Body

Let’s think about what pregnancy does to the body. As the baby grows, the uterus expands up into the abdomen, and the small intestines are pushed up and out of the way. Usually, the small intestines end up posterior or superior to the uterus. The abdominal wall changes in pregnancy are more well known, with the linea alba stretching out to accommodate the expanding uterus. What about the pelvic structures? Have you thought about what happens to the pelvic structures when the baby’s head enters into the pelvic inlet?

The Impact of Baby’s Passage on the Body

Imagine if you can – the baby’s passage through the pelvis. As the head enters into the pelvic inlet, usually facing one direction, it needs to rotate in a corkscrew like manner to navigate through the pelvis to come out through the vaginal canal. As the head enters the inlet the bladder gets compressed to one side as the baby’s head rotates (ideally) to face the sacrum. The rectal tissues get compressed back with the baby’s head. As the baby moves through the pelvis the force of it’s movement pulls all the vaginal tissues down and out, including the bladder. The cervix widens to dilate, and imagine what the forces are on the uterosacral and cardinal ligaments of the uterus as the baby is born.

If you’ve ever witnessed a birth and were able to see the perineum and anal tissues as baby passes through you can see why I find so many knots in the anal sphincter during internal assessments. The amount of force and stretch on these tissues is phenomenal. As is the amount of downward pressure that occurs within the entire pelvic space.

All of this tissue expansion can’t happen without the pelvic bones widening for baby to come on out. Keep in mind the physiological motions the pelvic bones undergo during childbirth. Then, couple that with the position the birthing person is in when the baby is born. It always correlates to what you’ll find in the pelvic bones after birth, if you are looking for it. The ischium splay apart, and the sacrum goes into flexion. If one bone is blocked or at a mechanical advantage due to positioning, then one side will be more affected by the birth than the other.

What Can We Do to Reset the Body After Birth?

Considering the impact pregnancy and birth have on the body, as a pelvic health practitioner, we know we have our work cut out for us with most postpartum clients. Here are some guidelines on the steps you can use to help with a postpartum reset to get your clients back to feeling like themselves again.

Addressing the Pelvic Bones to Create a Postpartum Reset

First, we must start by addressing the pelvic bones to help bring them back to their original (pre-birth) position. I work with the pelvic bones through palpation and spring testing of the bones. I don’t treat positional differences; I only treat immobility. If one side moves well, the other side should too. Ensuring the sacrum is not in flexion is crucial. I always focus on the sacrum first and ensure it is in midline, then check that it can move easily in the sacroiliac joints. Once the sacrum is midline and mobile, then I bring my attention to rebalancing the iliums and ischiums and bringing them to the midline.

Working Intravaginally to Create a Postpartum Reset

As the pelvic bones are the foundation to which the pelvic floor muscles are attached, it’s important to ensure that this foundation is optimized after birth before doing intravaginal work. After addressing the pelvic bones, my attention turns inward to help the tissues intravaginally.

I begin by assessing the function of the pelvic floor muscles, and before treating them, I focus my attention on the bladder. Remembering the downward drag these structures experienced during birth, I not only want to reset the anterior structures to the midline but also encourage them to return up onto the shelf of the pubic bone. In addition, as the bladder sits right behind the pubocervical fascia in the anterior wall, I want to assess this fascia as well to see if the tissue is happy, meaning without any tension or tone. If it is, then this area should feel soft and saggy.

After, I address the position of the cervix. I can find the cervix anywhere after birth. My goal with my session is to release whatever structures need attention to get the cervix to be like a piñata again, where it can move 360 degrees around and move up and down as well. Ensuring this mobility will help eliminate deep thrusting pain with intercourse.

Remember the downward drag and consider its impact on the ligaments as well. Sometimes, the uterosacral ligaments need to be reset back into position, or consider tonifying them so they shorten again after childbirth. These steps can help lift the cervix into a more supported position.

By addressing the position of the bladder and cervix after birth and following the protocol I teach in my intravaginal section of the Holistic Treatment of the Postpartum Body course, you can instantly correct a high grade 2 prolapse if the structures are intact.

After addressing the organs internally, I like to bring my attention to the anal sphincter complex. This tissue got stretched and pushed down and out from the birth and needs support. After releasing the knots in the muscle, sometimes I feel this tissue needs a reset back up and in as well. It’s not about just jamming this tissue toward the head, but listening to the energy in the tissues and helping to shorten it back up and inside. Ensuring the ischiorectal fossa also has mobility up and inside is another component of resetting these tissues back into place after birth.

The Impact of a Postpartum Reset on the Body

There is so much to be done for our postpartum clients, and I am constantly amazed by the significant changes in pelvic floor function that can occur in just one session when we really listen to and honor the body. By addressing the areas I listed in this blog, by listening to the tissues, by clearing out any trauma response in the body that is ready to release, and by resetting the tissues back up and in, you can help get your clients the postpartum reset they desperately need to feel like themselves, again. What an incredible gift to be able to offer to a new family.

About the Author: Lynn Schulte is a Pelvic Health Therapist and the founder of the Institute for Birth Healing, a pelvic health continuing education organization that specializes in prenatal and postpartum care. For more information, go to https://instituteforbirthhealing.com