“When will I be back to normal after giving birth?” is a common question for pregnant women. And while the traditional answer is “at around the six-week checkup”, the world is now full of celebrities modelling bikinis within a couple of weeks, and mothers on forums saying they’re having sex mere days later. Women who aren’t joyfully trampolining by six weeks may feel they’ve failed to recover quickly enough.

The solution

Thank goodness for Janis M Miller’s research team at the School of Nursing at the University of Michigan. Their study of 68 women shows in glorious MRI detail the trauma that babies can inflict on a woman’s pelvic floor. The women, who had MRIs at seven weeks and again at eight months after delivery, were in a high-risk category having pushed for longer than was ideal or having needed forceps. But Miller was still surprised by the amount of damage done to the crucial levator ani muscle, which acts as a sling to support the vagina, bladder and bowel in the pelvis. Just over 40% had levator ani tears on the MRI scan – and in seven the muscle had come away from the pubic bone. A quarter of the women had fractures of their pubic bone.

Normally, these women would not have had an MRI scan, and their injuries would have remained invisible.

Miller says she isn’t advocating MRI scans for all new mothers, just acknowledging that standard recovery period – six weeks – won’t be true for everyone. Indeed, Miller found pubic bone fractures in some women had not healed by seven months. Women who, after three months still have pain in their pelvis, can’t contract their pelvic muscle (Kegel exercises) and find sex hurts them should see their doctor. “The levator ani muscle has to stretch three times its normal length in childbirth,” says Miller. “Our data shows a wide range of time for women to complete their healing after a very strenuous birth. Women are not given permission to have more time to recover after childbirth.”

How quickly you get over childbirth, of course, varies enormously. An Australian study of 204 women found high levels of exhaustion, back pain, urinary incontinence, sexual problems and perineal pain at six to seven months after giving birth. These physical problems increased the risk of depression in new mothers.

You might be lucky but if you’re struggling, it may be because you haven’t fully healed yet. If you don’t feel right, see your doctor – and don’t feel you’ve failed some mythical maternity test.