Pregnancy, Prolapse

Pregnancy After Prolapse Series – Am I Ready?

This series of blog posts will follow my journey after healing my prolapse from my first birth, into my second pregnancy and beyond!

After I was diagnosed with my prolapse at 8 months postpartum with Nugget, I was devastated (you can read about that here). I thought my life was over and I wasn’t sure if I’d ever be prepared, physically, for another pregnancy and birth. I was terrified of picking up my baby out of the crib, never mind growing a second one!

Then I went to pelvic floor physiotherapy, and subsequently healed my prolapse. Then came rewiring my brain to actually accepting the thought that, maybe, I can have another baby. I mean, ever since I decided that kids were in the cards, I knew I wanted a lot of them! Like, 3 or even 4!

Before I was discharged from physio, I made sure to ask her thoughts on pregnancy, birth and postpartum. She had zero concerns with me getting pregnant again, gave me some great advice for labour and suggested I come back in for a check up at 6 weeks postpartum.

So, I had the go ahead from the professionals I trusted, but was I ready? Emotionally, I was SO ready. When I was pregnant with Nugget, my plan was to have him, then start trying for number 2 at 8 months postpartum, so they could be super close in age. Well, obviously, that didn’t happen. My husband wasn’t quite as antsy as I was to have babies right on top of each other, and I was still nervous about my body. I had felt betrayed and needed to learn to trust it again before taking on the challenge of pregnancy.

So I focused on getting strong. I started a new workout program, committed to working out every 2-3 days and for probably 2-3 months I stuck to it. I loved it. I was so happy with how my body felt, how my clothes fit, and how I felt in general. My body finally felt strong again. All of my muscles had blossomed, my core felt so supportive, and I was finally feeling like myself again.

I was ready. My body felt ready. My husband was ready.

It was time.

It took 9 months to conceive Nugget, so even though I was ready to start trying, I had absolutely no expectations for it to happen anytime soon. I was okay with that, prepared for a long road ahead.

Still, I did all the things. I peed on sticks. I took prenatal vitamins. I tracked my basal body temperature. I even tracked my mucous.

But even then, with perfect timing, most couples only have a chance of conception of 20% for any given cycle. Like I said, prepared for a long road.

We didn’t want to put our life on hold to have another baby, so we kept living it. We used the hot tub, we drank our fair share of wine, beer and coffee, we didn’t change our diet or exercise regimes. We just lived our lives.

I was so prepared for it take months to happen. After all, it had the first time, and nothing had changed in that department, as far as we knew, besides being a couple years older.

And then, two months in, it happened.

The line turned pink. The stick flashed ‘pregnant’.

Next thing we knew, we were preparing to be the parents of two under two.

{to be continued}

Pregnancy After Prolapse

 

fitness, pelvic health, postpartum, Pregnancy

Pregnancy is Temporary, but Your Choices Last Forever

Being avidly interested in perinatal fitness & a new mom myself, I come across a lot of advertising and social media posts about exercise in pregnancy and postpartum. I often find myself scrolling through the comments to see what the general consensus is on the latest (usually controversial) video or message is.

One comment that almost always crops up is:

“I did crossfit/ran marathons/did crunches/did what I always did when I was pregnant and my baby turned out perfectly fine”

And all I can think is you just don’t get it!

While there are definitely recommendations for exercise in pregnancy circled around maintaining baby’s health, Mom’s health is just as important!

(I know, groundbreaking stuff, right?)

When I (and many other well-educated fitness professionals) say maybe it isn’t the best idea to do crunches, or run long distances, or lift super heavy, I’m not saying this because I think you are putting your baby’s health at risk. I am saying these things because you are putting yourself, your body and your future function at risk!

Yes, you can powerlift (or sprint, or do jumping jacks, or whatever) when pregnant, and baby will probably be fine, and it might feel okay for you at the time, but should you? Probably not.

Something one of my idols in the fitness industry, Brianna Battles says regularly about exercise in pregnancy is:

Just because you CAN, doesn’t mean you SHOULD.
~Brianna Battles, Everyday Battles

It all circles back around to training with intention. When pregnant, a lot of women fear losing themselves when the baby comes (I know I did. I so did!) so they try to keep doing what they’ve always done and enjoyed through their pregnancy, as if to prove to themselves that they are the same! But, as much as you are the same, you are so not the same during (and after) pregnancy. You are growing a human! That is a big-freakin-deal! You need to respect that. You need to surrender yourself to the fact that as important your personal goals are, the priority should be keeping your body healthy and strong in this (so very short) chapter of your life.

There are so many more factors at play in the perinatal period when it comes to exercise and fitness. Hormones influence your connective tissues. A growing uterus influences center of gravity, balance and movement patterns. Diastasis recti influences core function and strength. The weight of baby on the pelvic floor influences it’s ability to respond appropriately (hello, pee sneeze – not normal!). So we need to take all of these things (and more) into account when training in pregnancy.

Yes, we can program exercise along the same lines you are used to and enjoy, they just might look a little different. The how of exercise is often more important than the exercise itself. It’s about strategy rather than just do’s and don’ts. If you follow Brianna (mentioned above) Jennifer Cambpell of Mama Lion Strong & Healthy Habits Happy Moms, or Jessie Mundell, or Julie Wiebe or Katy Bowman, they all preach ‘ribs over hips’ and keeping your ribs, spine and pelvis neutral.

[Side note: I would be literally nowhere if it wasn’t for all I have learned from following these amazing women and for their trail blazing in this field]

So, can you complete a heavy overhead press while 30 weeks pregnant? Yes. Okay, but can you do it while maintaining your ribs over hips, without your diastasis bulging, and without holding your breath? No. Then that exercise isn’t the best choice for you in this chapter of your life. If you say you are just going to do it because it feels fine to you, my next question is why? What is the value of continuing to do an exercise that maybe isn’t the best for your body at this point? Is it because you think you should be able to do it? Is it because you’ve seen other pregnant women do it and you want to look ‘badass’ like they did? Is it because you’re afraid of looking like a weakling or a failure who didn’t have the guts to go for it? Take a look inside yourself, and analyze why you feel you need to do a specific exercise or program. Is it worth the risk? Spoiler alert: putting your glory ahead of your future function is not badass and doesn’t take guts. You know what takes guts? Putting yourself first. Saying no when someone challenges you. Looking within yourself and standing up for your own values. That’s badass. That takes guts. Going with the flow because everyone is doing it, that’s cowardly. Having the courage to stand out on your own is the pinnacle of strength.

Now I’m not saying you can never do your favourite not-so-ideal-in-pregnancy exercise again. That is definitely something you can return to. However, it’s something you need to work up to, and be mindful of how your body is functioning, and be ready to maybe take two steps forward and one (or two or three) steps back along the way. It’s about checking the ego, and respecting where your body is at during this very important period and allowing yourself to surrender to it. This chapter in your life is temporary. Eventually it will end, but the choices you make within it can have lasting consequences if you aren’t smart about it. In closing, I’d like to bring it back around to another quote from Brianna;

Pregnancy is temporary, Postpartum is forever.
~Brianna Battles, Everyday Battles

Try not to forget that, because your body won’t.

having-the-courage-to-stand-out-on-your-own-is-the-pinnacle-of-strength

fitness, pelvic health, Self Care

Painless Periods are Possible

I got my first period at age 11. I was devastated. My mom and all of my aunts and older cousins didn’t get theirs until they were 14 or older, so it wasn’t even on my radar, or my mothers for that matter. I didn’t know what to do, and I didn’t talk to my mom about it until she approached me about my stained underwear. The conversation pretty much went, here’s some pads, don’t go swimming, there’s tampons too, but you’re too young for those. Welcome to womanhood.

I don’t remember my first period to be painful, but I do remember pretty much every single one after that to be. Menstruation was so awful, I was pretty much incapacitated for at least one day a month, from age 11 until the time I was 17. And up until that point, the only thing that would help the pain was drugs, or sleep, or a heat pack. Well, who can sleep or use a heat pack during classes in highschool? As much as I wanted to stay home and sleep all day, my parents weren’t a fan of having me stay home just because of my period, I mean, women get it every month and go to work and function, I should too. That’s just how it is. It’s like a badge of honor to brag about how horrible your cramps are.

Then I went on the pill for 10 years (side note: !!!!) and forgot about it. I went to university, moved in with my boyfriend, got engaged, got married, bought a house, moved across the country, got a great career, and then it was time to make another human. So I went off the pill. And OH. MY. GOD. My ‘regular’ periods came back with a vengeance! It was like my body was getting revenge on me for pumping it full of artificial hormones for all of those years. And there it was, I was back to having debilitating periods again.

But… Why? If you think about it logically, why did human females evolve to be completely incapacitated by this perfectly normal human function? If we were ‘wild’ it would leave us extremely vulnerable very frequently. I’ve spoken to many, many women who have similar experience to me when it comes to their periods. I am not an anomaly.

I listen to Katy Bowman’s Podcast regularly and she has an episode where she discusses menstruation, and it was mind blowing. To summarize what she says, when your uterus sheds it’s lining (the endometrium), it leaves a wound, of sorts, and the lining combined with the bleeding of the wound, is the bloody discharge we know as a period. Well in modern society, our limited movement means that the organs and muscles within our pelvis do not get the ‘movement nutrition’ that they require, which results in limiting blood flow to those parts over time. This results in the impaired ability of our body to heal the wound associated with menstruation, resulting in severe pain and excessive bleeding, also known as menorrhagia.

So what can you do about it? Well if you ask the mainstream, take painkillers or go on the pill. Or just deal with it. If you ask Katy, or a lot of ‘healthy pelvis’ movers and shakers out there, movement is the answer. I know, it seems crazy. How on earth can movement affect my periods? Well it’s almost a ‘use it or lose it’ sort of thing. You have to move those muscles and organs around in the way your body was designed to move, in order to signal your vascular system that they require blood flow in order for them to function optimally. Your body is very efficient, and only sends the minimum blood flow required to keep your cells alive, but keeping them alive doesn’t necessarily help them function at their best. Your cells have to be active and demand blood and nutrients!

In modern society, we basically stand or sit all day. Some of us walk a bit. But very, very few of us squat or sit on the floor or use our legs to their full potential in their full range of motion. Our bodies have adapted to this limited range, and stopped sending adequate nutrition to the parts we don’t use, like our hips and our pelvis. I wonder if this has some influence on the skyrocketting rates of infertility and hip fractures or replacements? Now, this is totally just my own personal theory, with absolutely no scientific evidence, but something to think about!

So what did I do that helped me? First, went to pelvic floor physio. They helped me connect with my pelvic structures and learn how to move and activate them in ways that I hadn’t been. Second, in the midst of my prolapse diagnosis meltdown, I bought the Nutritious Movement for a Healthy Pelvis program from Nutritious Movement and started doing it immediately. I cannot describe how much I love this program. After just one day of doing the movements, I was sore in ways I didn’t even realize one could get sore, and felt so much more connected with my body, at a time when I felt like I was falling apart.

But I digress. I was surprised to find, two months after starting to incorporate my (new) PFPT exercises and the Nutritious Movement for a Healthy Pelvis program, I got my first postpartum period. I had heard horror stories from women about how the first postpartum period is the worst period ever. Like your body has saved up those 10 months (in my case) of periods to give you all at once. This was not the case for me! It was like the only reason I knew I was having a period, was I was bleeding. That was it. I mean, I was a little cranky, but other than that I felt great! I wasn’t buckled over in pain. I did not have to take one single pain pill. Not one! That is completely unheard of in my lifetime. Even when I was on the pill, I still had at least one day per period that I had to take at least 1 pain pill.

I really wish I had known this when I was a teen. If I could go back in time and tell myself what I know now, I could have saved myself so much pain and discomfort. I hope this information helps some of you better deal with your periods, and hopefully get to a pain free period like me!soup-salad

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

pelvic health, postpartum, Prolapse, Self Care

How I Healed my Prolapse (Part 1)

So I mentioned in previous posts that I was diagnosed with pelvic organ prolapse. This is a really common disorder in women, who have or have not had babies, though it is more common after vaginal childbirth.

I am sure mine was caused by 2+ hours of active, hard, hold your breath and bear down pushing, like I talked about in my post Hold Your Breath, Count to Ten, Push Your Baby Out and Your Uterus Too. Now, I’ll admit, I still struggle with my birth. It was not the birth I had planned for. It wasn’t perfect. It wasn’t the smooth, clean, athletic event in the way I had envisioned. That was all compounded 100x when I was diagnosed with prolapse.

After I left the doctors office who informed me my bladder and uterus had fallen, I cried.

You guys, I cried so hard. I couldn’t even make it to my vehicle in the parking lot. I was actively sobbing walking across pavement.

I couldn’t help it. I was thinking, how could I let this happen to myself? I knew better! (or at least I thought I did) I trusted my midwife and she let me down.

Listen, I know thoughts are illogical. But I was devastated. I felt broken. The doctor gave me absolutely no guidance as to whether or not I needed to alter my lifestyle. She told me my pelvic floor was super weak and basically told me I needed to do kegels, 10 x 10 seconds, twice a day. That’s it. I was terrified. I was scared to pick up my 21lb baby. Do you have any idea how awful it feels to be scared of picking up your infant when he needs you? I’m sure a lot of you do, and can agree, it’s fucking terrible.

I went home, drank some wine, and told my husband. We tried to move on with our lives, but it kept creeping up on me. My husband wanted me to go get tires put on some rims for my car. I had that gross, helpless, sinking feeling, as I told him he would have to put them into the car for me, since women with prolapse aren’t supposed to lift anything heavy (or so the internet told me).

Luckily, the doctor had suggested I return to physio. She gave me a list with some suggestions, she said I could try and return to Michelle, but since I (apparently) didn’t have success with her, here are some other recommendations.

I liked Michelle, but there was something missing in our relationship. She didn’t seem all that comfortable guiding me back to the types of exercise I wanted to do. I wanted to lift heavy things, sprint, jump, and do the things I loved. She didn’t have much experience in that area, and to her credit she tried her best to guide me, but she didn’t give me much confidence.

I went over the list that the doctor gave me, and found one of the physio’s was based out of a sports medicine clinic. A light bulb went off, that’s exactly what I needed! I called the clinic, found out that Kristen had a cancellation in two days, and booked myself in!

~Stay tuned for my experience with Kristen, what I learned and how I healed myself, both physically and emotionally from my prolapse~

how-i-healed-my

pelvic health, postpartum, Self Care

Your Vagina Needs Therapy

It’s true.

I’ve said it time and time again. Maybe in nicer words, but I’ve said it. If you’ve had a baby (vaginal or otherwise), you need to see a physiotherapist (PT). And not for your back or your shoulder or your knee. For your vagina. More specifically, your pelvic floor (PF), or the muscles that surround your vagina and hold up your bladder, uterus and rectum. Those muscles that are *supposed* to stop you from leaking urine when you run, and are *supposed* to help you hold in a fart, and are *supposed* to relax and contract when you have sex and reach orgasm.

That’s what they are *supposed* to do.

I am putting *supposed* in between asterisks because they don’t always do these things, in all women. And that, my friend, is why your vagina needs therapy.

If you saw my previous post about PF dysfunction, and you are maybe having some issues, you’re maybe considering going to see a PF PT (first off, yay!). But maybe you’re nervous, ‘what exactly do they do at PF PT?’ you ask? Well that’s what I am here to tell you.

First off, most physio’s will have you fill out a questionnaire, so they can get a quick grip on your symptoms, your obstetrical history, and what your goals are. Most often the start off with an initial consultation, that is longer than your regular visits, so they can get to know you and do a thorough interview to assess where you are at. They want to know how many babies you’ve had, how you had them (vaginal or c-section), whether or not you’re currently having issues with leaking, discomfort with sex, and any pain or heaviness.

Then they will most likely assess your posture or alignment, movement patterns and sometimes feel the muscles on your back or sides while you move, like squatting up and down. They may also pay attention to your breathing while you move, or have you pick something up to see how you do it. They may even just assess your movement patterns without you even realizing, they are professionals and have a keen eye, and a lot of people move differently than they usually do when they know someone is watching! Then they will assess your abs, have you lay and lift your head and feel your belly to see if you have a diastasis recti (separated abs) and have you contract your transverse abs to see how well you are able to connect with them and how strong they are.

Then comes the fun part.

Okay maybe not fun, per-say, but the meat and potatoes of the visit, so to speak.

The Internal Exam.

This is probably what most women are nervous about, but I promise you, it is nothing compared to a pelvic exam by a doctor, a PAP or, hello, giving birth. I’ve been to two different PTs and both of them made me feel so comfortable, it didn’t feel awkward at all. They assess your tissues from the outside, get you to cough and bear down before they even touch you, then they touch the outside to see if there is any tension or tenderness anywhere. Then they insert a gloved, lubricated finger into the vagina and have you cough and bear down again to see if there is any prolapsing organs. Then they feel all of the muscles in your pelvic floor from the inside if your vagina, and assess them for tension or tenderness again. Then they have you do a pelvic floor contraction (or kegel) and assess how strong your muscles are and how coordinated they are with each other. They may also use their other hand to feel your abs to see if they are coordinating properly with your pelvic floor.

At this point it varies between PTs, but some may do some myofascial release, or scar tissue release or massage. Then most will work on teaching you how to do a PF contraction properly (if you don’t already, which most women don’t if they have been to PT before). Then they will work on improving your contraction, maybe positioning their hand in different orientations to assess how all of the different muscles are contracting. Depending on where you are at in your rehab, they may have you do some minor exercises (think lifting one leg up, or lifting your hips, no jumping jacks!) while laying on the table and assess how well your PF responds to the movement.

After that, they will conclude the internal,  and leave the room to give you a chance to get dressed. Then they will come back and discuss what they thought of everything, give you some exercises as homework and discuss whether or not you need to schedule another visit (or two, or more).

That’s it! It’s really not as bad as you may have thought (I hope!) but I promise you will leave with a whole new appreciation and understanding of your pelvic floor, and your body as a whole! The pelvic floor is an integral part of how your entire body functions, and supports some very important organs, I hope you plan to take care of it the same way you’d take care of any other muscle in your body if it were to go through a trauma like the PF does in bearing a child.

Don’t neglect the pelvic floor!

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.

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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
fitness, motherhood, pelvic health, Self Care

No Time for Exercise? Start Here to Restore your Core

The number one reason mom’s don’t exercise is they don’t (think they) have time. They are busy with baby (or babies/kids) and next thing they know the day is over. Well there are things you can do in your everyday activity that can help restore function without adding ‘exercise’ to your to do list.

  1. Get off the couch
    Duh, right? Well I don’t mean get up and exercise, I mean sit on the floor! Couches and chairs are designed to keep us comfortable, even in positions that our body is not supposed to be in for extended periods of time. So, get off the couch and get onto the floor. When the kiddos are playing and you are checking emails or drinking your coffee, sit on the floor. Just the act of getting up and down off the floor forces your body to move in ways that begin to strengthen your core stability system. There is no ‘right’ or ‘wrong’ way to sit on the floor. The fact is if you are on the floor, you won’t be able to stay in the same position for long, due to discomfort, and this is a good thing! Keep moving, even when you are resting!
  2. Stop using your back to lift
    Now, you might think you already do this. But you probably only take this into consideration when lifting heavy objects. Take a day, and be conscious of your body position and mechanics every time you lift ANYTHING. I’m talking, the baby, the laundry, that dirty spoon off the floor. Anything. Are you rounding your low back with straight legs? Most likely at least some of the time you are, without even realizing it. Make a conscious effort to avoid this. Whether it is hinging at the hips or squatting down, do whatever it takes to avoid rounding your low back in order to get down to lift anything up. This includes lifting the baby out of the crib! If you are too short to get baby out of the crib without rounding, then get a step stool so you can hinge at the hips to get over the rail.
  3. Exhale when you lift
    Lifting things is strenuous, which is why you shouldn’t use your back to do it, like I mentioned already. But learning to exhale as you lift anything, is the first step to engaging your core properly. Next time you have to pick up baby, think about blowing air out and lifting your pelvic floor and engaging your transverse abs (like your bracing for a punch to the gut) before you lift.
  4. Stop sucking it in
    As your reading this, are you holding in your belly? Maybe. You might do this all the time without even realizing it. I do. A lot. I am trying my best to stop, but it’s habit that has been engrained in me for years, and it’s going to take longer than a few months to stop. When you hold your tummy in, it increases your intrabdominal pressure and forces your core muscles to work overtime. In my case, this led to my pelvic floor becoming tight and spastic in order to compensate for my sucked in tummy! As I wrote this paragraph I had to think to release my tummy 3x! It’s so hard to break habits that have become subconscious!
  5. Carry your baby
    And I don’t mean in a wrap or in their carseat. I mean actually carry them, in your arms. What do you think is working in order to keep you upright while you’re holding 10-20lbs of wiggly baby? Your core! This is a natural, healthy way of building core strength. How do you think people got around with their babies before cars? They carried them! I can tell you, after a good hour or so of carrying Nugget around my whole upper body is burning and my core can definitely feel the work! And it’s not like you need to go out and find opportunities to carry your babe, I carry Nugget around the house while I tidy up. One hand for picking up mess, the other for carrying babe. Then I switch. Just like floor sitting, you can’t hold a baby in the same position for long before both your arms, and the baby get tired of it. The bonus of this is it is also extremely good for baby’s development to be held. The constant movement helps them build core strength and helps them meet milestones faster. Haven’t you ever noticed your baby immediately calms down the second you start carrying them around? This is because they need the movement too! Win-win!
  6. Let baby be your guide
    This one only really applies if baby is old enough to be somewhat mobile, but even once they are doing tummy time consistently you can model them. Babies instictively move functionally. Try to mimic their motions exactly, not skipping steps to make it easier. A lot of ‘prescribed’ core exercises are movements your baby does naturally!
  7. Walk instead of driving
    Next time you have an errand to run within 5km of your house, get out the stroller and walk there to do it! It will definitely take a little longer, but it will be like killing two birds with one stone – exercise and an errand. I routinely walk to the post office, or the bank, or the pharmacy and I feel so much better after I’m done! Plus, Nugget usually falls asleep in the stroller, so add a nap to the stack of things getting accomplished – because we all know a nap is a solid accomplishment!


Becoming healthier doesn’t always have to mean spending an hour a day at the gym, sometimes we can find ways to squeeze activity into everyday life. If you are able to start incorporating some of these changes into your daily life, your core and floor will thank you!

7 ways to Restore your Core without Exercise