Birth, Pregnancy, Prolapse

No, I Don’t Want to Hear Your Birth Horror Story

*Update*
*This post is in no way suggesting that women who suffered from traumatic births have no right to share their story, that is not my intention at all. Telling your story of a birth that didn’t turn out as planned can be incredibly healing. I’m merely suggesting that sharing stories with the motivation of inciting fear is not appropriate, and sharing traumatic birth stories may not be the best way to prepare a pregnant woman for birth*

What is it with women today?

We seem to glory in sharing horror stories about birth. As if you one-up each other in who had the worst experience.

Why do we describe birth as this horrifying experience you just have to ‘get through’ because the baby is ‘worth it’?

What if I told you, you could enjoy birth?

That you could look forward to it, and actually want to do it again?

I know I do! I cannot wait to get the opportunity to do it all again!

I was recently talking to a friend who is very pregnant with her first baby. She told me she is ‘terrified of labour’. It made me so sad. I just wanted to reach through my phone and hug her, and say ‘No, no, noooo! Please don’t be terrified!’.

I think a lot of the root of the fear with labour & birth stems from us being so disconnected from our bodies. Our health system has trained us to fear discomfort. Any time something feels off in pregnancy, we back off. We limit movement, we stop everything. Life comes to a screeching halt as we know it.

I just read an article titled The Scary Truth About Childbirth.  The title alone makes me stabby. To summarize, the article suggests that vaginal (and ‘natural’) birth is over-glorified and it’s injuring women in the form of pelvic floor (PF) injury, prolapse, tears and pelvis fractures. It uses words like ‘horrifying’ and suggests that the natural childbirth movement is to blame. It offers up un-helpful solutions such as get induced early, and have an epidural.

No.

No. No. NO.

NO!

While I believe the intention of the article was to educate women about the risks of vaginal childbirth, which are rarely discussed at length (true). It’s shock & awe, fear-mongering approach is everything that is wrong with medicalized birth today.

Inciting fear into pregnant women is not the way to help the situation. Suggesting MORE interventions is not the way to help the situation. Describing injuries that thousands (millions?) of women suffer from as ‘horrifying;, ‘humiliating’ and ’embarrassing’ is not the way to help the situation.

So what can we do?

Well, first, maybe let’s stop approaching birth as terrifying. Fear increases pelvic floor muscle tension, which in itself is a barrier to vaginal childbirth. The PF muscles have to relax and release, and stretch up to 2.5x their length in order for the baby to pass through. This is not possible if the woman is too scared to let them go. This can result in prolonged labour, prolonged pushing, and ‘failure to progress’. A label as failure to progress usually leads to more intervention, such as instrument assisted birth (forceps or vacuum), which greatly increases a woman’s risk for prolapse and/or tearing (or cutting, depending on the care provider).

Let’s think about this from a different perspective. The hormones needed for childbirth are the same hormones needed to acheive orgasm. Oxytocin is released naturally in the brain when having pleasurable intercourse, and is the same hormone that triggers the uterus to contract. Now, if you were having sex, and you were terrified of an orgasm, do you think you’d ever get there? Uh, nope. Highly unlikely. If you were terrified of having sex, would it feel good? Nope, it might even hurt. Same goes for childbirth.

All this fear mongering, is contributing to traumatic births, which contributes to more fear mongering, which just continues in a cycle.

Just STOP.

There is no benefit to making a pregnant woman fear labour and birth. Yes, there are risks. Yes, she should be aware of them and educated on her options. Yes, she should be made aware of potential outcomes of vaginal childbirth.

But we can do it without scaring the shit out of her! We can do better.

If you tell someone you’re planning on running a marathon, people don’t bombard you with stories of how their sisters mother in laws grandmother ran a marathon once and she had a heart attack in the middle and died. No, they congratulate you, and encourage you, and ask you how you’re training, and get excited! Why can’t we approach birth this way?

How about when you get on the topic of birth with a pregnant mama, you tell her she’s going to do great. You tell her that birth is amazing and it’s going to be one of the biggest accomplishments of her life. You tell her that it’s going to be like climbing a really tall, steep mountain, but the views along the way and at the top are the most breathtaking views you’ve ever seen.

Finally, let’s educate women how how best to prepare their body for birth. Like I mentioned, it’s like climbing a mountain, or running a marathon, except we don’t know how long it will be or how steep the climb, or what barriers we may face along the way. So let’s train for that. Let’s encourage women to move their bodies, nourish themselves (as best the can) and get their mind right for the journey ahead. Let’s teach them activities and movements they can do now that will help them later. Let’s get their bodies strong and capable, so when the time comes they are as well-prepared as they can be. Let’s teach them to have an open mind, and be educated about as many of the potential outcomes as possible so they’re prepared to go with the flow of whatever their body and baby presents. Let’s help them be okay with the unknown, not fear it. Let’s share positive birth stories, and help them trust that their bodies are capable of giving birth, and trust that their care providers will have mom & babies best interests at heart. Let’s encourage them to get in tune with their bodies, so they know how to listen to those primal urges that go along with the process.

Birth is amazing, let’s remember that.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

If you’re pregnant and wondering where to start with getting over your fear of birth, here are a few suggestions, things that helped put me at ease:

Watch Birth Story: Ina May Gaskin & The Farm Midwives

Read Ina May’s Guide To Childbirth

Watch How to Have a Harmonized Childbirth

Read I Came Along, I Wrote A Song For You {The Birth Story Of Sparrow}

Watch Welcoming Theodore

Watch Waterbirth of Scarlett

Watch Birth of Sloane

i-dont-want-to-hear

Birth, pelvic health, postpartum, Prolapse

How I Healed my Prolapse (Part 3)

Continued from Part 1 & Part 2

After seeing Kristen, I felt so much better. I wasn’t worried about picking up and carrying Nugget around, I wasn’t worried about carrying laundry up from the basement or hauling in groceries. I was able to actually live my life.

I started doing the ab work Kristen suggested, and I was absolutely astounded at how effective they were! Who knew such tiny movements like lifting your foot off the ground could have such a dramatic effect. The first day I did the exercise for a total of 6 reps. I know, barely anything, but I wasn’t able to maintain proper technique after 6 so I stopped. The next day I was blown away by how sore I was. We went grocery shopping and I was waddling around like I was 9 months pregnant because my TA was so sore! It was a total lightbulb moment for me. It made me realize just how much your TA functions in supporting your pelvis and trunk through every day movements, like walking! It made me understand further how diastasis recti can influence your movement and why it is so important to keep it in check if you have one.

I did the PF progressions she suggested. I was surprised to hear she suggested going PF contractions with a full bladder, but if you think about it, that’s like an internal load on your PF, and it’s like adding plates to the barbell! I was able to get even more in tune with my body, and really feel how and when my PF was contracting and monitor the forces at work.

I went back to see Kristen a month after our initial appointment feeling great. I informed her that a lot of my symptoms had subsided and other were explainable by reasons besides prolapse. She laughed “well you can go home now!” she said, jokingly, but I probably could have. She reassesed my abs, alignment and PF. After she was all done she said “Well you’re boring! There isn’t much going on here! Your PF is strong and contracting reactively and is well coordinated with your TA. Your anterior wall is ‘stretchy’ but I wouldn’t say you have a prolapse!”

I wanted to cry, again. But this time tears of joy.

But I hesitated. I was worried. Nugget was my first baby and I definitely had plans of having more, and hopefully sooner rather than later. So I asked Kristen what to do. I was nervous another labour and birth would do even more damage. Should I come see her in pregnancy? How does she recommend labouring and pushing from the perspective of a PT? Can I prevent prolapse with future babies?

So many questions.

We had a lengthy discussion about labour, pushing and delivery. It was so nice to talk to someone openly about birth who was about the function and physiology of the female body, and she gave me tools to go into my next pregnancy & birth feeling strong and confident.

And that’s how I want you to feel. Strong & Confident

Not broken, or fragile, or sad or depressed.

Strong.

We are all strong, we just need to see it within ourselves.

Now if you have read this series of blogs, hoping for a how-to list of things to do to heal your prolapse, I am sorry that I didn’t deliver.

However, I will give you this one To Do.

Find a pelvic floor physiotherapist. A good one. One that supports your goals and lifestyle. Not all physios are as open and supportive as Kristen, and you don’t have to accept that. If your physio refuses to give you progressions, or only tells you your options are to swim and walk, never lift anything over 5lbs (that’s realistic) and never spread your feet wider than hip width, find a new physio. There are good ones out there. If you don’t leave your appointment feeling confident you know how to live your life without fear and anxiety, you need a new physio. They should support your goals, not crush them.

 

how-i-1

Birth, fitness, pelvic health, postpartum, Prolapse

How I Healed my Prolapse (Part 2)

Continued from this post.

Luckily, I was able to score a cancellation with Kristen, otherwise I would have to wait months agonizing over my broken body. I was able to get in to see her two days later.

Now, I have never met a physio I didn’t like (true story), but there was something about Kristen. We just clicked. Our personalities were totally in sync and we had the same values and beliefs. She started the session by reassuring me, she could tell I was nervous. She said she knew many, many women who had a similar diagnosis to mine, and who live complete and normal lives, that I shouldn’t let this hold me back.

She assessed my alignment, my musculature, had me squat and stand while feeling my back and sides to assess how my muscles engaged. She had me lay down and assessed my abs and glutes, and informed me that my transverse abs aren’t as strong or coordinated as I thought, but gave me exact steps how to correct them.

She then did an internal exam (which I describe for you here), which I was most worried about. You see, the physician who had diagnosed me with prolapse had informed me that my pelvic floor (PF) muscles were extremely weak. She had rated them 1.5 on a scale of 5. She described it as barely perceptible with no endurance. The problem I had with that assessment is she didn’t allow me to coordinate my contraction with my breath, it was more “aaaand GO! NOW!” and I was a bit caught off guard. When Kristen assessed my strength, she allowed me to exhale with the contraction and take my time. She almost laughed when I told her the doctor told me my PF was weak, she rated me at a 4 out of 5!

I left the appointment feeling so much better, relieved that my PF wasn’t weak, and looking forward to moving on with my life. I booked another appointment for a month out, just to follow up with the ab work she gave me and the PF progressions she had suggested. Kristen encouraged me to call her with any questions, and unlike some professionals you speak to, with her I knew she really meant it.

The next day I had a thought. She never gave me any limitations for movement or exercise? Everything I have ever read online about prolapse is a list of don’ts. So I sent her an email, and fully expected it to take a week or two to hear from her, if at all. A few days later, she phoned me at home. The first thing she said was, stop Googling. She doesn’t consider postpartum prolapse in the same category as post-menopausal prolapse because there is so much at play postpartum. Your body has so much healing to do, and especially if you are breastfeeding, that can take a really long time, and to be patient. She told me to not limit myself at all because I have a strong PF and to trust myself, use good form and breathing and listen to my body. She suggested I do what I would normally, ease back into things, and if something exacerbates my symptoms, to maybe back off a bit next time. She didn’t see the value in restricting a young mother like myself.

This was the best thing I could hear. Instantly vanished any fear I had about carrying Nugget around, about doing daily activities, going for long hikes, or getting back into weight lifting.

I was happy again.

~Stay tuned for my progress with the exercises Kristen gave me, and how our next visit went and what she told me~

how-i

Birth, pelvic health, Pregnancy

Hold Your Breath, Count to 10, Push Your Baby out, and Your Uterus too

Have you ever heard the term ‘Purple Pushing’?

I hadn’t either, until after I was diagnosed with a grade 2 cystocele (bladder prolapse) and a grade 1 uterine prolapse.

You read that right ladies, all that preaching I’ve been doing about being safe to prevent prolapse, well it didn’t save me.

And I’m about 99% sure I know exactly why.

Two and a half plus hours of ‘purple pushing’. Now the details of the pushing phase are a little foggy in my memory, probably due to the extreme fatigue I was hitting by that point. But I do remember on more than one occasion, grunting through a push and my midwife telling me to stop ‘pushing into my throat’… READ: shut up and bear down. Well when you bear down like that, you’re not only pushing your baby out, you’re pushing everything out. It’s really a matter of what gives first.

And you’re thinking ‘So what? Isn’t that what we’re supposed to do? That’s how it is in the movies, and on TV and in every birthing video ever

Nope. The research says otherwise. Actually, current UK & Canadian recommendations advise against directed pushing. Directed pushing is when the midwife or OB tells the woman when and how to push, usually at the beginning, middle and end of a contraction (that’s right, 3 full body, everything you’ve got pushes per 1 minute contraction) while they count to ten and you turn purple in the face (hence purple pushing).

I remember my midwife telling me 2 pushes per contraction wasn’t good enough. I remember thinking there was absolutely no way I had it in me to put that much effort in, 3 times, every couple of minutes. No wonder I was passing out between contractions by the time we transferred to the hospital. It just didn’t feel right. It felt forced, and painful, and wrong. Birth shouldn’t feel like you’re working against your body. It should feel like your body is doing this amazing thing and you’re kind of just along for the ride and helping out a little, which is what it had felt like for me up until that point!

The fact is that pushing like this not only is exhausting, it is not effective, it is damaging your body and sometimes can increase the risk for your baby to go into distress before they are out.

Boy can I speak to how exhausting it can be to push like that. It is essentially flexing every muscle in your body, while holding your breath, for 10 or so seconds, 2-3 times in a row, every 2-5 minutes. For those of you who’ve been through it, you feel me. For those of you who haven’t, imagine doing a 1 rep max squat, 3 times in a row. Not fun. This has also been found in the research, the effectiveness of the maternal muscles in contracting effectively to push out the baby is related to how frequently they are asked to contract. So if you contract 3 times per minute, rather than once, the muscle contraction gets progressively less effective, decreasing the efficiency of the push.

If a woman is allowed to push spontaneously when birthing (i.e. when she feels she needs to), it has been found that she instinctively pushes with the peak of the contract, once per contraction, thereby maximizing the efficiency of the push and making the most of the effort she is putting in voluntarily (if you can call it that). If you triple that effort, without any marked increase in effectiveness, it is possible the woman may become physically exhausted, before the baby is born, increasing the likelihood of an instrumental delivery.

This is exactly what happened to me. I was SO tired, and we intended on going to the hospital to use a vacuum to assist. So we took a break from ‘coached’ pushing, I was basically left to push voluntarily for about 10-15 minutes during the transfer, and I believe that, coupled with the moving around required to get to the hospital, helped Nugget get to the point where we didn’t need a vacuum after all.

I also believe that pushing like this is what has caused my prolapse. You see any time you bear down (think actively pushing out a poop, sorry if that’s too vivid for some, but I think we’re way past that if you’ve read this far!) you are putting pressure on your pelvic floor. The act of bearing down creates tension in the diaphragm, core muscles and directs all of the pressure created in your abdomen downwards, onto, you guessed it, your pelvic floor and all of those lovely organs sitting on top of it. So if you think, 3 pushes per contraction instead of one, thats 3x the amount of pressure placed on all of those muscles and organs. No wonder 50% of women who have given birth vaginally are estimated to have some degree of prolapse!

This act of holding your breath and pushing also increases the risk of harm to the baby. Let’s think about this logically: when you hold your breath, you are not taking in oxygen. Now, sitting on the couch doing nothing and holding your breath for 10 seconds probably isn’t a big deal. But when you’re literally flexing every muscle in your body and also you are the only source of oxygen for another human currently contained within your body, you are consuming oxygen at a much higher rate. And if there is less oxygen circulating in the mother, there is less oxygen getting delivered to the baby. There is even evidence that bearing down for more than 5 seconds can cause late-decelerations in the baby’s heart beat, often a precursor to an emergency c-section.

So why are we still holding on to the era of ‘we must actively push the baby out’? There are a lot of reasons. The medicalization of childbirth, where it is made to be the most convenient for the doctor, woman on her back, with an epidural working against gravity. Another is our bodies are no longer the bodies of ‘natural’ humans. We no longer hunt & gather, walk miles and miles each day, squat to forage and toilet. Our musculature is different than that of our ancestors due to the vastly different environment we live in. More often than not, we hold a lot of tension in our pelvic floor muscles, and those interfere with childbirth, especially when we are tense and scared of the event at hand. But if we were to take care of all of those variables, the fact is we wouldn’t have to actively push at all to give birth. Do you see elephants and lions and any other mammal that has a uterus holding their breath and grunting on those nature shows? No. 99% of the time the baby animals literally just fall out of the mother, after the uterus does all the work!

This is why we have to take care of ourselves in pregnancy, be educated about our rights and options, and choose healthcare providers that align with our goals and intentions. We have to be our own advocates and stand up (both literally and figuratively in this case) for what we know is right! We have to listen to our bodies, and I mean really listen. We have to get to know them in great detail, know every sensation, what is normal and what isn’t. That way when big events like this come along, we are prepared to work with our bodies instead of against them.

And above all, Squat!

Just keep squatting everyone.

makes-1

Birth, motherhood, pelvic health, postpartum

Don’t Put up With Leaking During Exercise

I’ve written a lot about my experience postpartum, and care I believe women should receive in the immediate postpartum period, but what about down the line?

What if you are 1, 2, 10 years out from your most recent birth?

What if I told you, once postpartum, always postpartum?

Growing a birthing a human fundamentally changes our bodies for the rest of our lives.

sneeze-and-pee

Do you relate? You would not believe how many women I’ve heard from who describe symptoms of pelvic floor (PF) dysfunction years after their last baby.

What do I mean by PF dysfunction?
Well there are varying degrees, but symptoms can include but are not limited to:

Peeing or leaking urine when you sneeze, jump, run, laugh or cough.
Feeling like you always have to pee, no matter how long it has been since you last went
Dribbling urine after you get up from the toilet.
Feeling like there is still urine in your bladder after you finished peeing.
Feeling like you have to bear down or push on your abdomen to fully empty your bladder.
Feeling like you have to push on your perineum in order to fully empty your bowel.
Pain in your perineum (the area between your vagina and your anus) with activity or prolonged standing.
Unexplained lower back pain.
Painful sex or decreased sexual pleasure.
Feeling as though the vagina is too tight or small for sexual penetration.
Feeling of laxity in the pelvic area.
Inability to consciously contract (or Kegel) or relax the pelvic floor .
Inability to distinguish between a bowel movement and passing wind.
Inability to control passing of wind or bowel contents.
Protrusion of internal organs out of the vaginal opening.

If you can relate to any (one, or more than one) of the symptoms listed above, it is possible you may be experiencing some degree of PFD.

mom-wet-pants

I know what you’re thinking; ‘But I’ve had babies, don’t all women just pee themselves after they have babies? Isn’t this normal?

The answer is a resounding NO!

If I could shout it from the rooftops, I would.

But what about all of those Poise, Always, and Depends commercials? They make it seem like it’s just something we have to accept.

mjaxmi1kmte3ytdmndfmotm2mtuy

Better buy some diapers, because you’re never going to keep your pee in again.

No.

No. No. No. No. No!

While urinary incontinence (one of the most frequent symptoms of PFD) is common it is not normal!

Some of you might now be saying “Well, that’s what I thought, and I told my doctor and he/she said ‘Just do your Kegels, you’ll be fine.

There seems to be a huge disconnect in the medical/obstetrical world when it comes to pelvic floor dysfunction. A lot of physicians and midwives seem to think that as long as your organs aren’t falling out, you’re doing okay.

This is not the case! There is help!

Can I get a Hallelujah?

So what can you do?

Do I really have to say it again?

I will. Because I can’t say it enough.

Pelvic Health, or Women’s Health Physiotherapy!

You’re thinking “But how? If my doctor doesn’t think anything is wrong, how can I get a referral?

Most Pelvic Health Physios don’t require a referral*!

Now you’re asking “How Do I find a physiotherapist?

Here is a list of websites that offer search within Canada to find local physiotherapists who specialize in women’s health and pelvic floor:
Pelvic Health Solutions
Pelvienne Wellness
Physio Can Help**

Once you’ve worked with a physio to determine where you are at, in addition you can work with a personal trainer who specializes in postnatal training to get your strength back! That’s what I am here for! I am now taking on a few clients to start building my personal training career and experience! Feel free to contact me for more information, either through this website, or on my Facebook page or Instagram page.

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And please, please, do not think you have to live with wet panties for the rest of your life!

*some benefits/insurance plans do require a physician’s referral to pay for the service
**General physiotherapist lookup – not specific to PF
Birth, fitness, Pregnancy, Uncategorized

What I Learned From my Labour & Birth

They say hindsight is 20/20.

39 weeks
Me in early labour at 39 weeks pregnant!

I thoroughly believe that is true. Looking back at my labour and birth of nugget nearly 6 months out, there are a few things I would have done differently, if I had the chance. This doesn’t mean I regret anything. I did the best I could with the knowledge I had at the time, but I also believe that it’s smart to take every experience you have and try to learn something from it.

  1. I wouldn’t have pushed so early
    As soon as I felt the urge, I pushed. It felt good, so I kept doing it. Looking back now, I think I was just over excited and should have let my body and my uterus do more of the work before I started actively participating. Even when a woman is not actively pushing, your uterus is still working to bring baby down with each and every contraction. I would have focused more on ‘breathing baby down’ or breathing through contractions and allowing them to do their work and conserving my energy for the work of actively pushing later on.
  2. I would have squatted more during labor
    I honestly have absolutely no idea why I didn’t do this. Squatting during labour helps open the pelvis and relax the pelvic floor, allowing baby to come down more easily. I prepared by squatting throughout my pregnancy, I knew that squatting in labour was beneficial, but for some absurd reason it did not pop into my head once to squat during labour. I think maybe I had it in my head that squatting should be reserved for pushing, but even then I didn’t think of it.
  3. I would have paid better attention to my posture
    All day in early labour I was so keen. I stayed in alignment, made sure I was giving my baby the best passage through, until I got into the birth tub. For some reason as soon as I got in there, I sat back on my sacrum (re: slouched) and I believe that influenced nugget bumping into my pubic bone on his way out. I also started out pushing in this position, which when I think back was actually a terrible idea!
  4. I would have slept!!
    Man, I wish I had slept more in early labour. I woke up at 4:30 in the morning and stayed awake until 9 the next morning after he was born, with the exception of a few very short naps. I had it in my head that labour was going to be quick and didn’t let myself relax. I was also worried if I got too relaxed, labour wouldn’t start and I would have to be induced. Being induced terrified me, so that was always in the back of my mind.
  5. I would have paid closer attention to my body
    Going into labour I thought I was very body-aware. Now, thinking back, I don’t remember feeling the baby move down. I was shocked when my midwife told me how low he was because I didn’t feel it. I don’t remember feeling my contractions move him down until he was crowning. I don’t remember feeling my pelvic floor, whether it was relaxed or not. I would have put more mental effort into concentrating on how everything felt and how it was changing as I progressed.
  6. I would have seen a women’s health physiotherapist prenatal
    Now this isn’t essential, however I believe it would have dramatically helped me connect with my transverse abs and pelvic floor while I was pregnant to better prepare them for labour and postpartum. It probably would have also made me realize that I had a tight pelvic floor and allowed me to work on releasing that tension before I went into labour.
  7. I would have moved more in the later stages
    If I had known how much of a difference getting up and walking out to my car and contracting in those awkward positions would have made, I would have done it so much earlier! If I had known possibly hiking up and down the stairs even one time would have helped nugget sneak past my pubic bone and stop that excruciating pain I would have done it in a second. My midwife said later she thought about suggesting it, but didn’t think I would have been very receptive to the suggestion, which may or may not have been true.
  8. I wouldn’t have put so much pressure on myself
    As soon as my water broke, it was game on. I was raring to go. I’ve never been much of an endurance athlete and that was totally reflected that day. I wanted things to happen and I wanted them to happen NOW. I happened to be wearing my FitBit and I recorded nearly 60 stories of stairs walked that day! Looking back, instead of basically climbing a mountain worth of stairs, I should have rested, relaxed, and let my body do it’s thing.


I hope you can learn a bit from the things I would do differently if I had the chance. I’m hoping I will remember this when it comes time for nugget #2 and I can have the homebirth I dreamed of the first time around. I can only hope that my words and experience will help even one other woman takes steps towards having the birth that she hopes for, whatever that looks like.

 

what I learned

Birth, fitness, pelvic health, postpartum, Pregnancy, Self Care

Why the 6-week Clearance Isn’t Enough

So you’ve had your 6-week postpartum check-up with your doctor, OB or midwife. They say ‘All is good, you can resume exercise’. You think ‘Awesome! I’m going to go out for a run tomorrow!’. Then tomorrow comes, you start running, and you feel like a bowling ball is bouncing inside your vagina, you leak, or worse you lose control of your bladder or bowels.

No one wants this. Why didn’t they warn you?

You’re not alone. The fact is, it takes a lot longer than 6 weeks for your pelvic floor, abs and uterine ligaments to return to normal. I am 5 months postpartum and still only feel maybe 90% normal. I can’t tell you why doctors and midwives don’t talk about this, but I’m hoping by reading this you’ll have a little bit more insight into postpartum exercise.

I talked about relaxin and pregnancy before, but did you know relaxin influences you for up to 3 months postpartum? And other hormonal changes will influence the laxity and strength of muscles, tendons and ligaments as long as you are breastfeeding?

True Story, Bro.

Let’s look at this logically though. Even if we take the scientific mumbo jumbo out. Your uterus was just huge (relatively speaking), then within the span of 6 weeks (or less) it shrank back down to the size of a pear. All of those ligaments, tendons and muscles that were holding that giant uterus up for 9 or so months have been stretched and loosened to accommodate it. They are going to take time to get back to where they were before. Here’s some perspective, if you had your leg in a cast for 9 months, then got the cast cut off, do you think you could go out and run a marathon 6 weeks later? Doubtful. Why do we treat all those very stressed ligaments inside our abdomen and pelvis any different? They’ve gone through massive changes and we need to respect that. We need to slowly and gently start adding exercises back in to allow those structures time to re-adapt back to their former glory.

Think of your pelvic floor like a trampoline. Now imagine a 400lb sumo wrestler sitting on that trampoline. That’s what your pelvic floor is like at the end of your pregnancy. Trying desperately just to keep everything up. Now imagine that sumo wrestler sitting there for a few months. How stretched would that trampoline be?

Ya, let that visual sink in for a moment.

We want that PF to bounce like trampoline, and be taught enough to resist the pressure of the organs it’s holding up (uterus, bladder, bowels) but flex with breath and impact. If you were trying to fix that stretched out trampoline, and someone kept jumping on it while you were working, it wouldn’t be very effective, would it? This is how it works with your PF and impact postpartum.

So what do I mean by ‘impact’?

I mean jumping, skipping, running, jogging, box jumps, jumping jacks, basically anything where there’s a period of time where both of your feet are off the floor, no matter how short the period of time is. Yes, even if it is a split second. Yes, even if you land gently.

Now, this isn’t to say you can never do these things again. This is definitely something you can work your way back to eventually. But you have to take your time, be careful and do it right. If you want your body to be functional well into old age, it’s important to take care of it now. If you want to have more children and want your body to support those pregnancies well, it’s important to respect this postpartum period and recover appropriately.

So the next question is how?

Well first, go see a Pelvic Health Physio (do I sound like a broken record yet?). Then work with a personal trainer who specializes in postpartum (like me, soon!) or purchase a program that is designed for postpartum women, like Birth2FitMum.

The most important thing, though, is to be mindful of your body. If things don’t feel right, don’t do them! Let go of your ego, and just be proud of where you are at currently. Just because you aren’t in the same place you were months ago, doesn’t mean you are broken, it’s all part of the journey! You grew a human! Go You!

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While I am in the process of obtaining my PT certification with prenatal/postpartum specialization, I’m not quite there yet. Even then, I won’t be able to help everyone, but I don’t want that to hold you back from reaching your goals. My lovely friend Lorraine Scapens over at Pregnancy Exercise has most generously offered to give my readers a 10% discount on her programs that I used when pregnant and still use postpartum; Fit2BirthMum & Birth2FitMum as well as her other programs Super Fit Mum & No More Mummy Tummy Challenge. Simply enter the discount code ‘HMHB‘ at checkout to get your 10% off!

Birth, fitness, pelvic health, postpartum, Self Care

My Core & Floor – The Never Ending Saga

I am so thankful I was lucky enough to learn about diastasis recti (DR) and how it relates to pregnancy early on in my pregnancy. So many women I talked to had no idea what this is, how it develops and how it affects their lives going forward. Even some OB/GYNs are poorly informed on what DR is and what it means for their patients. One of my good friends was telling me about the coning in her belly while she was doing crunches in her 3rd trimester and how her OB just told her ‘oh that’s normal, don’t worry about it’ so she didn’t think anything of it and just pushed the coning down while she continued doing crunches! What her OB SHOULD have said was, this is DR, this is what it means, these are the exercise you should not be doing as they will aggravate it and make it worse.

DR is the separation of the abdominal muscles to accommodate the growing uterus, and it happens to up to 66% of women when pregnant. In order to heal this separation, you first need to reconnect with your deep core muscles, the transverse abdominus (TA) and your pelvic floor (PF) and re-learn how to engage them appropriately.

I had a DR at the end of my pregnancy, even though I worked to prevent it. Looking back now, I think poor posture was to blame, but we all know hindsight is 20/20. At birth my separation was about 2 1/2 finger widths at the widest. I was lucky in that simply following my training program, Birth2FitMum, I was able to heal it within 6 weeks. However, once I began seeing my pelvic health physiotherapist (PHP) I realized that it was probably my over-active TA that helped more than I realized. The problem was, even though my TA healed my DR quickly, they further delayed the healing of my poor stretched out PF.

See, the core muscles work in symphony, and when one component is over or under-active, it throws the whole system out of whack. Julie Wiebe does an excellent job of explaining this in her video here. I love her model of the piston system of the core muscles. I experienced the issues she discussed in this video. I was tensing my PF in hopes of counteracting my strong abs. Before visiting my PHP I found Julie’s program The Pelvic Floor Piston: Foundation for Fitness extremely helpful. I’ve since learned through visiting my PHP that I hold a lot of my tension in my core, through holding in my abs and PF and taking short small breaths (because you can’t really hold your diaphragm taught and stay alive!). I’ve been learning how to allow my abs and PF to relax and how to take bigger breaths, and it’s still a work in progress 2 months later. It seems once I get one issue sorted out, another pops up, and after visiting my family doctor today, it seems I am on my way to the pelvic floor clinic in my city.

Unfortunately, I won’t be able to get in for another 3+ months. In the meantime, I will continue doing my exercises prescribed by my PHP, the pelvic floor piston exercises, as well as a few other exercise I’ve found help me personally connect with my PF and breath. One of my favourites that I’ve been doing since I was pregnant is just sitting in a squat. And no, I don’t mean those awful hover squats like you’re trying not to sit on a public toilet. More like you’re squatting in the forest having a pee. I relax, and it really helps me feel my breath through my pelvic floor. If you are having a hard time understanding how your breath and your PF are connected, try this. I also like to flow through cat-cow poses while controlling my breath and PF contractions. I think the reason these exercises work for me is because it takes my TA out of the equation, because they always want to kick in and take over.

I’m hoping I can re-learn how to use my core effectively before it comes time to work on nugget #2, and I think I am on the right track. However, some days I just feel like I am missing a piece of the puzzle, and I’m hoping the pelvic floor clinic can help me with that. I encourage you, if you feel like something just ‘isn’t right’ to go to your doctor, or find a PHP near you to help you sort things out. Don’t be discouraged if it takes time, and multiple tries to figure out what’s going on and how to fix it. You don’t have to just deal with a dysfunctional body because you had a baby!

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While I am in the process of obtaining my PT certification with prenatal/postpartum specialization, I’m not quite there yet. Even then, I won’t be able to help everyone, but I don’t want that to hold you back from reaching your goals. My lovely friend Lorraine Scapens over at Pregnancy Exercise has most generously offered to give my readers a 10% discount on her programs that I used when pregnant and still use postpartum; Fit2BirthMum & Birth2FitMum as well as her other programs Super Fit Mum & No More Mummy Tummy Challenge. Simply enter the discount code ‘HMHB‘ at checkout to get your 10% off!

Birth, motherhood

What do you mean you didn’t get an epidural?

 

I am at that age, 29 years old. The majority of my friends are trying to get pregnant, pregnant or just recently had a baby or two. So, as women do, we talk. A lot of the currently pregnant or recently pregnant women have asked me about my labour and delivery. I shared my story, as I did here, but they wanted to know how. So here are the ins and outs of how I managed an unmedicated birth.

Now I am not by any means suggesting I did it the ‘right’ way. Or that these strategies will work for you. It was just really important for ME to try my best to have an unmedicated birth, ideally at home. If you chose to schedule a c-section, or get an epidural the second the first contraction hits, or give birth in the forest with deer and bunnies, the more power to you! As long as it is what is right for you and your baby.

I remember my close friend getting pregnant a few years ago. Well before I had even considered the idea of having a baby. She was telling me all about how she was planning to have an unmedicated birth and all the preparation she was doing.

I thought she was absolutely insane.

I was fresh off a labour and delivery placement in nursing school and seeing what those women went through made me cringe at the thought of feeling aaaallllll of that.

Then I got pregnant and my perspective completely changed. All of a sudden it wasn’t about me, it was about this child, and what I felt would be best to bring him into this world. I did research, watched documentaries, found a midwife, fell in LOVE with Ina May Gaskin and watched Birth Story: Ina May Gaskin & The Farm Midwives over and over and even made my husband watch it too.

I think having the right mindset was key. You have to believe you can do it in order to be able to. I’ve been an athlete in one form or another my whole life so that was something I could relate to. I decided to approach labour like an athletic event, like a marathon or climbing a mountain. I tailored my workouts at the end to be like labour training. I’d do one minute on, one minute off of different exercises to prepare myself mentally for the work of continuous contractions every two minutes. I used positive self-talk and told myself over and over again that I can do this. One of the biggest things that I found helped me was doing some research on Hypnobirthing and watching relaxation videos.

When the time came for me to actually be in labour I was excited! I was not scared at all, I saw it as a goal for me to challenge, not as something I needed to survive. I felt every contraction as work towards my baby coming earthside. I knew the stronger the contractions the sooner I’d get to meet my baby, so as they got stronger and closer together, I got more energized and excited. I felt like I was working with my body, not against it. Allowing it to do the work it needed to do.

When my midwife arrived in the middle of the night and checked me, she was so surprised to find I was already 7cm dilated, as I was still smiling and chatting in between contractions. I watched an entire season of friends and laughed and joked.

Now, don’t get me wrong, it wasn’t all sunshine and lollipops and rainbows. Pushing was, let’s just say, not the funnest thing I’ve ever done. At first it was great, it felt like a relief to finally be able to push with the contractions. I felt like I was actively doing something to help my baby arrive.

That was until my pubic bone began to separate.

That’s where the real work, the mental grit, came into play. It was hard. It was the hardest thing I’ve ever done. This part of my labour was all a bit of a blur, but my husband tells me there was a lot of screaming and swearing and definitely a few F-bombs were dropped. This is where I think being a homebirth made the difference between me staying with my unmedicated plan, versus taking something for the pain. It simply wasn’t an option. I didn’t think about it, it wasn’t offered, it wasn’t an issue. It wasn’t until I was 2 1/2 hours into pushing and just physically and mentally exhausted that the idea of maybe trying to go to the hospital for some help was even brought up.

Once we got to the hospital, we tried to use the gas, but for whatever reason we couldn’t get it to work. And at that point, I wasn’t even having the same pain that I was having at home. Baby’s head had slipped past my pubic bone and we were in the home stretch, so we didn’t even worry about it.

I truly believe that the key’s to making it through were having a midwife and attempting a homebirth. I was so much more relaxed, I knew my midwife very well by the time it came to deliver so I was very comfortable around her. I went into it with the right mindset and a positive attitude. Even though women tried to discourage me with comments like ‘oh just you wait’ and ‘the pain is real’ I wasn’t phased. I knew I could do it, and I did.

Birth, fitness, pelvic health, Pregnancy, Self Care

Pregnancy Fitness – How I did it

In previous posts I mentioned that I maintained working out throughout my pregnancy. Now let me preface this by saying I am not a doctor, midwife, physiotherapist or personal trainer (working on this one!) and I am simply explaining what I did, what worked for me and how I felt doing it. Before I got pregnancy  I was working out regularly, lifting (relatively) heavy weights and doing some high intensity workouts.

Most women experience a dip in stamina in the first trimester, and I was no exception. Even though I only had minor morning sickness I definitely had the fatigue, all I wanted to do was sleep. And I did. Because why not? I was smart enough to realize that come 8 or so months from then I wouldn’t be able to sleep all day, so I did! In addition to magnificent, glorious, magical sleep (can you tell I am writing this post-baby, with a 2 month old who still enjoys multiple night wakings?) I continued on my merry way working out the way I normally do. I lifted weights 1-3x per week, depending on my work schedule, and walked 25-60 minutes with the Big Brown Dog 4-6 days a week. I did not do traditional “cardio”, mostly because I fucking hate running. Hate. Despise. Loathe. I tried it once last year in preparation for the Tough Mudder. I managed to scrounge out a few 8km runs and deluded myself into believing I found the ‘runners high’ but nothing stuck.

I digress.

The moral of the story is until about 14 weeks, nothing changed. I worked out normally, lifting ‘heavy’, walking. Living life. Somewhere around the beginning of the 2nd trimester I decided to purchase the Fit2Birth Mum program from pregnancyexcercise.co.nz. I cannot say enough good things about this program. It felt exactly as hard as it should, I ended my work outs sweaty, but I never felt overworked or out of breath. The best part of her program is the owner, Lorraine Scapens, also hosts a Facebook group for each program and answers questions from users about their specific needs in a timely and friendly fashion.

In addition to the Fit2Birth program I continued my weight lifting, progressively lowering my weights as the weeks went by. For some perspective I started deadlifting and squatting approximately 150lbs, and my final weight lifting session was somewhere around 34 weeks and I was lifting about 65lbs, read: less than half my normal, but probably way too heavy for some other women. I also focussed on maximizing the strength and flexibility of my pelvic floor. I did many stationary squats (think peeing in the forest) as this has many benefits for pregnant ladies, which I will get into in it’s very own post later on down the road.

Now for the benefits, at least from my perspective.

As mentioned previously, around 9 weeks or so, I made a lengthy journey across the country to share the good news with my family in person. This included many hours sitting awkwardly in an airplane. I think it’s no coincidence that this is also when I started experiencing sacral-iliac joint pain. I thought this was the end of the world as I knew it. Working out keeps me sane. I knew a lot of women start having SI joint pain, and they are hooped. No more workout. No more walking. No more functioning. Done. So I snuck down to my nice little basement gym and did the easiest workout I could muster, and prayed and went to bed. The next morning before I got up, I was so paranoid that the soreness from my workout would be the death of my in addition to my newfound SI pain. I got up. I was sore. But no SI pain? Magic!

Well if you think about it, SI joint pain is usually born from a poor interaction of the sacrum and the ilium, two bones on the back half of your pelvis. Relaxin allows the ligaments holding the two bones together to loosen, allowing the bones rub painfully. One would think, strengthening the muscles around these bones would help hold them in place properly, decreasing the amount of pain. This was certainly true for me. This carried on throughout my pregnancy, every time I got lazy and didn’t work out for a while, my hips would get sore, I would work out, the pain would go away.

I also believe working out helped Nugget be in the perfect position for birth from early on. At my 20 week ultrasound his head was so low in my pelvis the tech had to all by smash my bladder in order to see it well enough to take measurements. This was true again for my follow up ultrasounds at 24 and 34 weeks. As soon as I knew that he was head down, I squatted until I could squat no more! Squatting is a functional movement. Back in the day (re:100+ years ago) humans used to squat regularly. Think hunting/gathering/child rearing/harvesting fields etc. Our bodies were designed to squat! It makes so much more sense physiologically than bending at the hips. We are so much stronger in a squat! Also, squatting helps open up the pelvic bones and lengthen the pelvic floor to allow the baby’s head to descent into the pelvis and make it less likely to flip. I’ll explore and share my love for the squat in it own post later on, as I could go on forever!

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While I am in the process of obtaining my PT certification with prenatal/postpartum specialization, I’m not quite there yet. Even then, I won’t be able to help everyone, but I don’t want that to hold you back from reaching your goals. My lovely friend Lorraine Scapens over at Pregnancy Exercise has most generously offered to give my readers a 10% discount on her programs that I used when pregnant and still use postpartum; Fit2BirthMum & Birth2FitMum as well as her other programs Super Fit Mum & No More Mummy Tummy Challenge. Simply enter the discount code ‘HMHB‘ at checkout to get your 10% off!