How to take care of your pelvic floor and core after birth

So your wondering how you should be taking care of your pelvic floor and your core now that you’ve given birth? That’s fantastic! There are so many things thwat you might have wished you knew about before you had a baby! The changes that happen in your girly bits may be one of them! What is going on with your post baby vagina exactly? Many women have pelvic concerns that they don’t speak about, because they are afraid that what they are experiencing is not normal.  IF you want to know how to take care of your core after baby, read on!

Bending down to lift your child you feel a dragging sensation in your vagina. Is it going to prolapse? Laughing with your friend in the cafe, you feel a bit of urine pass unexpectedly, you panic because you forgot to put your liner in this morning. Running after your toddler as they try to escape from you at the shopping centre, you feel a sharp pain in your abdomen. You want to stop to ease the pain, but know you can’t because she is getting close to the exit…. These are just some of the examples of how a woman’s pelvic floor issues can start to rule her life.

Lets face it, after babies your vagina might not feel quite the same, at least for a little while. Pelvic pain, incontinence, abdominal separation and prolapse are some of the common problems women experience after birth. Women can feel embarrassed, frustrated by pain, and sometimes helpless. Bending down, picking up heavy toddlers, running around after children, moving quickly in different directions are all things that mothers can’t help but do. Trying to modify your lifestyle to suit your pelvic health is very difficult with children. Taking control of your pelvic health and being able to do these activities with confidence can be life changing for some women. Especially those who want to participate in an active lifestyle.

See a Women’s Health Physio

Always my number one tip regarding your pelvic health is to see a qualified Women’s Health Physiotherapist that conducts INTERNAL EXAMINATIONS! Even if you have a trusted gynaecologist I would urge you to seek the help of a WHPT – their assessments and treatments are completely different to what your gynaecologist can offer. There is so much more to pelvic health than just doing pelvic floor exercises. In fact, many women have hypertonic or overactive PFM’s that can lead to pain and insufficient activation of the pelvic floor. Not only can a WHPT assess if you are doing your exercises correctly (which many women do not) they can offer a range of treatments and products that can assist you.

Get your bowels right

If you are having concerns with constipation, it is likely that you will be pushing and ‘bearing down’ through the pelvic floor, which can stretch the pelvic floor muscles. Avoid constipation by drinking plenty of water and eating a balanced diet with ample fruit and vegetables. Making sure you sit on the toilet properly to avoid excessive pushing will also help. Have your back relatively straight, leaning forward slightly, with your feet supported.

Don’t accept it!

Has your GP, midwife or even your gynaecologist told that your pelvic dysfunction (whatever it may be) is normal? WTF? Seriously!? Ummmmm NO, It is not normal for your insides to be on your outside!

It is not fair for you to have to live with pain, fear and embarrassment! Pelvic pain, incontinence, and prolapse are all common in the postnatal woman, but with the right intervention these issues are often reversible and very manageable. If your health professional tells you that your signs and symptoms are “normal” I strongly urge you to seek a second opinion! It has become so widely accepted that “a woman’s body will never be the same again after having babies” that these concerns get fobbed off. I agree, your body won’t be quite the same again. Nor will our bodies be the same as they were when we were in our teens, but that doesn’t mean we have to put up with it such problems. This takes me back to my first point. Please, see a Women’s Health physiotherapist.

Get a trainer you can trust

If you receive any form of personal training, group fitness etc, please make sure you have a trainer you can trust. Just because an exercise group claims to be designed for antenatal and/or postnatal women, this does not mean the trainer has specific qualifications. Your trainer/coach should screen each client for any postnatal concerns, and should be able to modify your exercise accordingly. At the very least they shouldunderstand when you inform them that you are unable to complete a particular exercise. If your trainer has not considered these things, it is unlikely that they understand how to keep you and your pelvic floor safe during exercise.

Part of trusting your PT or coach is also giving them the best detail you can regarding your pelvic health. You might not want to get into all the ‘nitty gritty’ detail with them, but you need to tell them what exercise/positions you are trying to avoid. After all, if they are unaware, they wont be able to guide you in the right direction. Not only will exercise be uncomfortable and possibly even painful, you could end up doing even more damage. Speaking openly about these issues will not only give you the most enjoyable and safe exercise experience, it also empowers women and breaks the ‘taboo’ which ultimately leads to better care.

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Don’t ‘grip’ your pelvic floor

Gripping, locking, bracing, switching on your core….It doesn’t matter what you call it. What matters is that you don’t overdo it! Excessive contraction on the ‘core’ is not helpful. In fact, it is likely to cause all sorts of problems like:

  • PFM fatigue – fatigued muscles will not contract effectively, and therefore not assist in protecting you.
  • You could be ‘bearing down’. The group of muscles we call your ‘core’ essentially work in a ‘pressure system’. If you overdo it, and recruit more than what is required you wont allow the muscles to work as they are designed to. This could mean you start to push down through the pelvic floor, even though you feel as though you are engaging your core effectively.
  • Poor breath control and synchronisation of movement.

Sort out those sniffles and sneezes!

If you suffer from persistent coughing or sneezing, your pelvic floor will be suffering from extra load. Seek appropriate medical advice and management, and avoid triggers where possible. You might not want to take daily medication, but you could at least avoid having fresh flowers in the living room, even though they look so beautiful! Less coughing and sneezing will help to protect your pelvic floor.

Fix your posture

Whilst baby is growing inside of us, we start to adapt different postures to make room for baby. Unfortunately, many women continue to carry these postural changes after baby. These changes can lead to instability within the ‘core’ which then ultimately lead to things like incontinence, pain and a ‘mummy tummy’ that wont go away because the diastasis has not had the opportunity to heal. To improve your posture ensure that you:

  • Stand with your weight spread evenly over the heels and balls of your feet.
  • Gently untuck your butt
  • Make sure that your ribs are positioned over your pelvis
  • Allow yourself the breathe into the belly and to the lower parts of your chest

Also, make sure that baby change tables/prams etc are positioned at a comfortable height.

Listen to your body

It is really important that you actually LISTEN to your body. If you are exercising, the moment you feel any leakage, any pelvic pain, and heaviness or dragging, or any abdominal pain you need to stop. These are all warning signs, and you need to LISTEN! Think of this as the same as when you lose your technique with an exercise at the gym. Your body is telling you that it is not quite strong enough to continue, and that injury could occur.

There will be some activities in your daily life that you can’t stop completely. For example, picking up children. However, modifying your exercise according to your pelvic health will help lessing the impact on your pelvic floor. Remember, just because you can’t do an exercise right now, it doesn’t mean that you won’t be able to do it in the future. If you listen to your body, and gradually progress as your pelvic health allows, you will be far better off than if you ignore them altogether.

Unfortunately women can be unaware of pelvic health and possible concerns postpartum, either because they have not received appropriate education, or because they are too nervous to talk openly about them with their health professionals. If you want to help empower other women to feel more in control, please share this post. Normalising conversation around these issues is an important step in helping to do so.

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