5 Tips on healing after birth
I’m Josie, I’m a pelvic health Physiotherapist and have been for over 7 years. You may not know what a pelvic health physiotherapist does or why we are able to give specialist advice on healing after having a baby so I’m here to tell you all about it.
Pelvic health physiotherapy is an umbrella term which encompasses lots of individual strands. It covers the assessment and treatment of conditions affecting the pelvic floor and surrounding muscles, including:
Pregnancy-related discomfort and birth preparation
Postnatal recovery, including abdominal muscle separation and pelvic floor weakness
Bowel problems including constipation, leakage, or straining
Bladder issues such as urgency, frequency, leakage, or difficulty emptying
Pelvic pain (including pain with sitting, exercise, or daily activities)
Pain with sex or difficulty using tampons
Pelvic organ prolapse
We treat any woman at any stage of her life, although most commonly those during pregnancy, after the birth of the child and during peri or post menopause.
The appointment
During the assessment we gain really important insight into your life by asking detailed questions about you, including how much you drink, when you go to the toilet and how it feels, how you birthed your baby (if appropriate), what forms of movement/exercise you do regularly and also lots more detail about how your symptoms impact you day to day. This gives us a really good idea of whats wrong and means we are already thinking about things we need to check during the physical assessment.
Assessment of movement, posture, abdominal muscles and general strength are all important aspects of a postnatal check. We will ask you to move whilst we watch, we will ask you to show us your tummy and feel for a muscle separation and c-section scar (where appropriate), we will ask you to perform some simple pilates based movements and find out where your baseline is. If you’re keen for more information then have a look at ‘what to expect’ at an appointment.
The internal pelvic floor exam
This isn’t for everyone and isn’t appropriate for everyone but we will (generally) always talk about it during the session. You can say no, you can say yes then change your mind half way through or you can opt in the following appointment. We want you to feel comfortable and therefore talk in detail what it involves before asking your consent.
There are some really good reasons to why we offer an internal pelvic floor examination.
We want to know if you are squeezing and relaxing correctly. 25-50% of women are not using the correct technique.
We base your exercise programme on how strong your muscles are now, so it’s individual for you.
We can check for scars and scar tissue to see if this is causing pain/tightness/discomfort.
Touching the muscle can help it function better by you feeling where to squeeze.
Checking for pelvic organ prolapse if this is something you describe or want to find out about.
Mostly, it’s about gaining more information on how best to help you with your symptoms.
Myth busting
There is so much information to sift through that I thought it would be good to share some common misinformation.
Leaking is normal after having a baby or getting older: It’s not normal to have incontinence, it’s very common, but not normal.
You will just have to put up with it: This is completely untrue, there are a variety of things that can help with all of the above symptoms.
The pelvic floor will get stronger if I do lots of yoga or pilates: Yes, some other types of exercise can help strengthen around the pelvic floor but it won’t replace the ‘kegel’.
I just need to squeeze more: It’s not all about the squeeze. Relaxing your pelvic floor is just important as squeezing it so it is important to do both.
Gadgets will help get stronger, quicker: Not always. Gadgets including visual or pressure biofeedback, muscle stimulators, vaginal weights and others can be used as an adjunct. A simple ‘kegel’ is absolutely enough.
Pelvic floor exercises are the answer to my problems: Not often, there is an array of other things that can all have an impact in improving your symptoms.
My 5 tips
Constipation. It can make symptoms feel worse and one of the first things pelvic health physios will ask about. Things that can help with constipation are increasing fluids, increasing dietry fiber and simple regular exercises like walking. If you have trouble emptying your bowel after birth, try sitting on the toilet with your feet on a small stool and leaning forwards. Breathe into your tummy rather than pushing down and give your perineum support by holding toilet paper gently against your stitches.
Listen to your body, increase slowly and gradually. Your body has been through so much and it needs time to heal and recover. Making conscious steps to do a little more each day will help you to regain strength and feel better. This could mean being active around the house in the first few days like walking to the bathroom, making a cup of tea or fetching a new outfit for baby. It does not mean hoovering, lifting heavy bundles of clothes or walking to the shops and back.
Start pelvic floor exercises as soon as you are able. Before you are pregnant, whilst pregnant or after birth; the sooner you begin the better. Imagine you are trying to stop yourself from passing wind and gently squeeze the back passage closed for a few seconds. Breathe as normal, don’t hold your breath. Repeat the squeeze a few times until your muscles are tired or you can’t get a good squeeze. Repeat this sequence 3 times a day for 3-6 months, yes that’s how long it will take of regular input.
Bounce back isn’t realistic. If you have a private chef, a doula, a nanny, a personal trainer and overnight help with your baby then you’re more likely to have the energy to recover well and feel rested enough to build up exercise to strengthen quickly. For the majority of us, it looks more like taking each day as it comes. Don’t compare yourself to anyone and taking small steps to doing more is the sensible way through recovery.
See a pelvic/womens health physiotherapist for a postnatal assessment. We are best placed to help you with the symptoms you are experiencing. A Mummy MOT is a really great full body assessment and will give a detailed insight into how your body is recovering.
If you want to find out more, I often share tips and information on my social media pages or you can look at my website for more detail.