A big factor in post-partum recovery is pelvic floor health. I'd heard rumblings about this from the wise moms I know on the internet, but I didn't really get how vital the pelvic floor is to overall health until after I had my baby. I'm not a doctor or health professional, but let me lay it on you in layman's terms: your pelvic floor is a band of muscles from your front to your back that supports and holds your junk in place: your bladder, vagina, and anus; basically, the big money. You don't want anything to go wrong with those guys, and the pelvic floor is the dandy little hammock that holds them all up.
During delivery, a lot of downwards force is exerted on your pelvic floor to get the baby out. Everyone's pelvic floor is a little different. Some ladies have naturally tighter ones, some have looser ones, but everyone's does a lot of work during a delivery. It varies by the type of delivery - vaginal or caesarean - but the pushing out of a baby is the most work your pelvic floor is ever gonna do.
So afterwards, it's super important that you get back on track at letting that bad girl recover and get stronger. In the United States, we do not place any importance on this, other than checking for organ prolapse at the 6 week post-partum visit. Organ prolapse is when the muscles are so overtaxed that they can't hold your organs in place, and the organs slip down a bit. When it's super extreme, they may even, um, come out of your body a bit. That has to be fixed with surgery.
But for most women, the amount of prolapse or weakness is much lower on the spectrum of pelvic floor issues. Even so, this can cause some significant quality-of-life issues for post-partum ladies: stress urinary incontinence (when you pee a little while sneezing, coughing, or laughing), pelvic pain (during sex, typically. sadface.), and a bunch of other stuff.
In our moms' and grandmas' days, this was just A Thing you had to live with, and everyone would talk about it behind closed doors (a lot like miscarriage and other "women's issues" that are impolite in normal society - basically, the issues I talk about all the damn time). But nowadays, you don't have to live with this forever at all. There is hope! There is light at the end of your tunnel! (Sorry.)
It's called Pelvic Physical Therapy and holy heck, I am a convert!
Not content with the idea that I would suffer from pelvic floor issues, I made an appointment with the Pelvic Health and Rehabilitation Center. My rad therapist Melinda did a thorough assessment (no significant prolapse for me, hooray!), and diagnosed the things I needed to work on. In my case, it was hip & pelvic pain due to a tight pelvic floor and diastatis rectus abdominis, or separation of the abdominal muscles.
Fortunately, none of my issues were very extreme. I had a pretty uncomplicated labor and birth. But if you had a difficult one and are experiencing these issues, please -- seek help! It doesn't have to be this way.
For example, even though my diastatis rectus abdominis wasn't too acute, it still meant at best, a poochy tummy, and at worst, that the other issues I was experiencing would have a harder time healing. When the abdominal muscles aren't doing their job, they sink down into your pelvic girdle, making less room for your other organs, meaning more prolapse, more squished bladder, more feeling like you have to pee all the time. So even though it may seem unrelated, getting strength in your abdominal muscles really helps!
The exercises I do are a mix of kegels (and learning how to do them correctly -- like you're riding up in an elevator and then holding them there), bird dogs, dead bugs, air squats, and pelvic floor drops. I actually have a tight pelvic floor after years of lifting, which in my case has meant no issues with stress urinary incontinence during pregnancy or after (yay!), but has meant that my pelvic muscles are tight and painful (eep!) So learning to relax has been a big thing for me. Also, I didn't use my abdominal muscles at all during pregnancy, so reengaging them and my glutes has been super important. The more you know!
So that's what I have to say about the pelvic floor. Seriously y'all, go see a pelvic floor therapist if you have any nagging (or severe, obvs) issues in your pelvic floor. Lower back, pubic, and hip pain -- these are issues that can be addressed, as well as the more obvious ones like stress urinary incontinence, pelvic pain, and prolapse.
The important thing is to just GO. I know this stuff can be embarrassing, but we've all lived in shame about our private parts for too damn long. Let's be healthy, whole, and strong from the inside out!