Giving birth puts the body under serious trauma, so much so researchers from the University of Michigan find their potential injuries are comparable to athletes. The findings are the first to uncover the real damage women experience after childbirth, which may inspire new childbirth strategies and treatment.

"Women with pelvic injuries often feel like something isn't right, but they don't understand why and can't get answers from physicians," said Janis Miller, associate professor at the University of Michigan School of Nursing, in a press release. "A woman may have bladder problems, and in some cases prolapse of organs if the pelvic muscles are not functioning well enough to hold them in place." Miller and a team of midwives, radiologists, and obstetricians used magnetic resonance imaging (MRI) to scan pregnant women at risk for pelvic muscle tears in order to see what kind of damage they faced after birth.

Because childbirth can result in severe injury, similar to endurance athletes, it made researchers think MRIs could be routine for mothers with injuries in order to assess damage. Researchers found one-quarter of the women scanned for the study had fluid in the pubic bone marrow or sustained fractures similar to a sports-related stress fracture. Excess fluid in the muscle indicates a muscle strain injury, and it was found among third-thirds of the women; 41 percent had pelvic muscle tears so severe the muscle was partially or fully detached from the pubic bone.

"If an athlete sustained a similar injury in the field, she'd be in an MRI machine in an instant," Miller said. "We have this thing where we tell women, 'Well, you're six weeks postpartum and now we don't need to see you — you'll be fine.' But not all women feel fine after six weeks nor are ready to go back to work, and they aren't crazy." Up to 15 percent of women end up with pelvic injuries that don't heal, and if they do heal, it can take eight months or longer. During birth, the pelvic bones adjust to make room for the baby's delivery.

The pelvis is made up of four separate bones attached together with a web of muscles, nerves, and ligaments, all softened by a hormone called relaxin to prepare for childbirth. According to the Women's Health Foundation, the change in pelvic bones can lead to back pain, loss of balance, and stress on the pelvic floor muscles. Normally, doctors will recommend women practice strengthening their pelvic floor muscles with kegels, a type of exercise that involves tightening and relaxing the muscles repeatedly. Miller hopes the MRI scans will lead to a lesser focus on kegels and more focus on treating injuries like a doctor would an athlete.

"We're not saying that every woman who gives birth needs an MRI nor that women should not do Kegel exercises," Miller said. "A key point is that if a woman is sensing that she has delayed recovery or unusual symptoms of discomfort or feels she just can't Kegel anymore, she should see a specialist."