After experiencing my own difficulties post pregnancy, I felt I really had to post this blog to make women aware of ways they can protect and look after their bodies in general, even more so if you have had (or plan to have) children. I have called on Marie Fell- The Pilates Physio. to share her expertise in this widely neglected area. What I really love about Marie is her insight into the difficulties women face from pregnancy, due to her own difficult experiences. Her ethos of helping women regain body confidence and control fits very well with my values here at Guilt Free Health. This blog is a little more serious than most, but awareness of these issues is so important to empower women around the world to speak up and get support. There are big implications for women who exercise a lot and lift weights but do not actively take care of their pelvic floor.
Main issues to be aware of during and post-pregnancy
Marie says: “It’s important during pregnancy we keep active so that we are fit and can endure labour actively. No one wants to push a baby up and out lying flat on their back due to fatigue. Gravity positions such as a deep squat or four point kneeling are much better positions to give birth in if possible. It’s equally important we recognise the changes to our bodies in pregnancy and exercise safely to avoid over heating and over strain to muscles like our pelvic floor that are already being stretched and lengthened. So for example when you squat, activate your pelvic floor muscles in your squat and keep them lifted until you come out of the squat.
This can be experienced as leakage during and post-pregnancy. There are too types, stress incontinence (leaking when you cough/ laugh/ sneeze/jump etc) and ‘urge’ incontinence where you need to go to the toilet very often and sometimes cannot hold it in in time to get there. I had some scary episodes of incontinence post-birth and was just made to feel like I was over-reacting and it was ‘normal’. It seems to be widely accepted that women leak urine after having a baby, however my research shows this is not ‘normal’ and can be resolved with the right help. Don’t accept it as your ‘new norm’ just because you have had a baby.
Marie says: “This is where your recti abdominis muscle (the six pack one) widens to allow room for your growing baby. This is a completely natural process. However, it creates a weakness that needs to be corrected before returning to exercise.It is essential post-pregnancy that ladies work their core stabiliser muscles – their pelvic floor and their transverse abdominal muscles (your lower tummy muscles) to help close the gap safely by creating increased tension across their midline. Most recovery occurs in the first eight months, so it’s important new mums take the time out for them to exercise safely to encourage their gap to reduce. DO NOT do sit ups, planks, oblique work without first working locally on the core muscles first. So pounding it out at the gym, doing a HIIT workout or going for a run are not necessarily going to help you loose your mummy tummy. Seek advise from a women’ health physiotherapist if you are unsure.Ask someone to check your tummy muscles for you – some hospitals offer this service post baby for free.”
Pelvic Organ Prolapse:
Marie says: “For those who have never heard of prolapse its where due to weakness in your pelvic floor muscles your bladder, bowel or uterus walls can collapse down into your vaginal canal. You may feel or see a lump hanging down or bearing down and is often described as a heaviness felt in your vagina.” There are several stages of prolapse ranging from mild to severe. (This is one of the most hidden post-pregnancy issues faced by women). Symptoms of prolapse include a heavy feeling down below, incontinence, increase in discharge, constipation and not being able to insert tampons correctly.
Back pain can be caused by the weaknesses mentioned above as the pelvic floor is connected to the lower back and core.
How can you protect yourself?
Marie says: “Pelvic floor exercises. DO THEM, three times a day. It’s recommended we do x10 slow squeezes that we hold for 10 seconds and x10 fast squeezes, three times a day during and after pregnancy – FOREVER. This are massively important because…they will help prevent leakage (incontinence) and also they will help prevent pelvic organ prolapse.”
Who is most at risk of developing these problems post-pregnancy?
Marie Says: “All women who have had children have a degree of Diastasis Recti. Sometimes these do not fully resolve but most often they do. It is normal to have a 2 finger width gap post childbirth. Anything more you should seek advise.1 in 3 women who have had one or more children can experience vaginal prolapse, so quite a large proportion of the female population. You are more at risk if you are:
- suffer with a chronic cough (smokers)
- suffer with chronic constipation
- lift heavy weights such as in the gym
- work in a physically demanding job like stacking shelves
- lifting small children/moving elderly adults every day.
Prolapse can also affect ladies who have never had children if they regularly fall into one of the above categories.
Ladies who have a weak pelvic floor are more prone to back issues and continence problems during and after pregnancy. It is important we actively strengthen our pelvic floor muscles especially during pregnancy to avoid leakages and excessive back pain and also to help keep our pelvic organs lifted in our pelvic cavity but also its important we can relax these muscles to help in labour and avoid excessive tearing.
If we have weak core stability muscles and can not activate our lower tummy muscles in pregnancy we are also at risk post delivery of lower back pain as our tummy muscles have lengthened for nine months and leave our backs taking all the strain of the repetitive bending and lifting of a little one.”
What would be your best advice for helping women who may be facing these issues?
Marie says: “Practise your pelvic floor exercises EVERY DAY during and post pregnancy. Know why you are doing them. Get into the habit of making them part of your daily routine.Your lower back and pelvic organs will thank you for it. If you are struggling then get referred to a women’s health physiotherapist who has specialist training and knowledge in helping tailor exercise programmes to your pelvic needs. Don’t suffer in silence. You are not alone in this. Prolapse and Incontinence are common but not normal so do not “put up” with it either.”
I am so grateful to Marie for taking part in this blog. These issues are not talked about enough because there is so much shame around them and women DO suffer in silence or just accept it is a ‘normal’ part of having children. If you know there is something wrong do not be afraid to seek a second opinion. If you have been affected by any of these issues Marie has an amazing free resource called “THE 5 TIPS YOU NEED TO PREVENT PREGNANCY ACHES AND PAINS” on her website HERE.
She also has an online programme called Confident Core which is safe for pregnant and post natal ladies as the exercises are in pregnancy safe positions throughout. It is currently on offer for a hugely reduced price of £39. You can grab it HERE.
You are also welcome to contact me if you want to share your experiences privately at firstname.lastname@example.org.
Love Natasha x