Thursday, November 12, 2015

three babies and my pelvic floor

This isn't a fairytale but there is a moral to the story.

Exactly eight months ago I was squatting in the hospital corridor after experiencing on-and-off early labour for a week. I distinctly remember grasping the handrail on the wall and sinking myself right down towards the floor; swaying, sighing, breathing baby down. This went on for hours and as midnight came around I thought to myself: "All this bearing down is going to wreak havoc on my pelvic floor".

Eight hours later I gave birth with the assistance of a vacuum - my first assisted birth - and the Obstetrician was just as shocked as I was when she announced that I hadn't torn (surprisingly the only time I have torn is during my second birth - in the water - these things you can never predict). Granted, I came out of the birth relatively unscathed and whilst the initial recovery was easy I have noticed that the long-term effects cannot be ignored; my core and pelvic floor is in need of strengthening and my sacrum is soft and sore - very sore. Of course, it's all related, especially now that my cycle has returned.

Most women believe that it takes six weeks to recover from a vaginal birth. In my opinion, it takes a lot longer (my GP agrees with me). At your six week check-up its not uncommon to still feel sore, swollen and stretched. And your pelvic floor? Personally, I find that if I lift anything too heavy in those first few weeks or if I'm on my feet for too long I experience a dragging feeling; it's uncomfortable and impossible to ignore. If this isn't a cue to put your legs up the wall and practise a few kegels I'm not sure what is.

Generally I find that women are eager to share stories about pregnancy, birth and breastfeeding but anything regarding the pelvic floor is shrouded in silence. When I was teaching pre-natal yoga classes I would bring the topic to the table most weeks and yet regardless of my enthusiasm for the subject most of my students were pained to talk about it. Why is that? My only guess is that the repercussions of a weakened pelvic floor are uncomfortable, embarrassing and stressful. Indeed, most women would rather deal with it later.

Please, don't wait till later.

I've never had any leakage issues but I am intent on maintaining the regular habit of pelvic floor exercises to hopefully prevent weakness and its associated symptoms in the future. I'm also passionate about normalising this issue for women - of all ages. We have to start talking about this and the conversation needs to be ongoing.

In my quest to prompt discussion, I agreed to trial and review the PeriCoach - the first training device, web portal and smartphone app to take the guesswork out of pelvic floor muscle training. It was invented in Australia and is now available to buy here as well as in the US and UK. It has been developed in conjunction with healthcare professionals, including women's health physiotherapists.

So how does it work? Yes, you insert it and yes, it's connected to your phone via bluetooth. Technology, hey?! The sensor on the device detects pelvic floor muscle activity and measures the strength of each contraction, prompting you to contract (squeeze!) correctly and effectively. If you are working with a health professional, the data reading can be accessed and tracked by them, too.

I keep my PeriCoach in my bedside drawer; a gentle reminder to use it every day. Personally I think the best thing about using the PeriCoach is learning where the muscles are and how to contract them - effective contractions are key to strengthening, toning and maintaining a strong and healthy pelvic floor. 


I'd love the open the discussion in the comments to hopefully normalise the issue of weakened pelvic floor. Feel free to comment anonymously if you wish.

Did you notice a distinct weakening of your pelvic floor after pregnancy and birth? Do you suffer from LBL and, if so, what are you doing about it? Are you keen to strengthen your pelvic floor but find it hard to incorporate exercises into your daily routine? 

This post is sponsored by PeriCoach. Thanks for supporting the brands that support Practising Simplicity.


23 COMMENTS

  1. I think more discussion about pelvic floors is so helpful.
    A few months after my first (vacuum assisted after 34 hours) birth, I didn't understand why every time I stood up I ached so much. Simple things like cooking, changing a nappy, waiting for the bus, were so painful. Walking was fine - anything involving standing - was not. It wasn't until I went to the doctor and asked that I even realised prolapse exists... Really - your insides can start falling out after a baby? Hmm. I wish someone in the hospital had mentioned that a large baby, a long birth, a vacuum assist all made it so much more likely.
    Two more large babies later I accept there'll probably be surgery down the line - but in the meantime I concentrate on my kegels and avoid too much standing! I'll definitely be looking into the peri-coach!
    Thank you for talking about it - it does seem a topic that's not mentioned!

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    1. Thanks for sharing your story, Kirsty. One question: have you noticed a distinct decline in your pelvic floor strength after each subsequent baby? x

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  2. Great article Jodi!
    My situation is probably a bit unique but I thought I'd share anyway.
    I was born with Cystic Fibrosis (lung and digestive disease) and this causes me to cough (excessively) for hours and hours each day. This puts a lot of physical pressure on all my organs including my pelvic floor! I am 26 years old (I am not a mother yet) and I have quite a lot of trouble with LBL. It started when I was about 15 and since then it has really effected my everyday life and its something that isn't talked about - especially when associated with younger people. I have practised regular pelvic floor exercises but I do find it hard to get into a routine. I do worry about when i have children how I will cope, especially if it gets worse and because I have already been dealing with this issue for many years! Thanks for opening up the discussion Jodi XOX

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    1. Oh Alex, as if you didn't have enough to deal with! Thanks for sharing, lovely one x

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  3. I appreciate the open discussion of pelvic floor health. But want to clear up a few myths - pelvic floor isnt relative to a vaginal birth, ots relative to pregnancy but ALL women can have issues. Also in the interest of keeping pelvic floor health simple kegals are not always the answer http://mamasweat.blogspot.com.au/2010/05/pelvic-floor-party-kegels-are-not.html?m=1 our modern lifestyle of sitting and not squatting equals to many pelvic floor issues. As a doula I discuss alternatives to PFE and kegals with my clients. It concerns me that we are currently seeing high numbers of post-menopausal women undergoing radical surgeries often complete hysterectomies to assist pelvic floor dysfunctions.

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    1. HI Chrissy, thanks for your input. I'm all for regular squatting sessions to strengthen the glutes and, in turn, the sacrum/pelvic bowl. Cheers to that! I'm also well aware that many women who have cesareans do not realise that they need to be aware of maintaining a healthy pelvic floor (apparently this is one reason why Australia has the worst case of menopausal incontinence in the world!). So happy to be having this discussion x

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  4. Oh I just love your blog (seriously I scroll back through your posts so often because I find them so interesting and informative). I had baby number two almost 10 weeks ago amd although things are starting to go back to normal in the pelvic floor department I could probably do with a bit of extra help too! I used to do pilates 3 times a week which helped immensely... but with two little ones almost permanently attached to me pilates is all but a distant memory!

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    1. Pilates, with a very talented teacher, also made my pelvic floor much stronger. :)

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    2. Thank you, Malayka! I went to my first yogalates class last week and I must admit, the next day I noticed a distinct improvement in my lower back/pelvic floor x

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  5. Jodi! I literrally texted a girlfriend on monday : " I love women who aren't afraid to talk about vaginal prolapse!". Of course there was a reason for such a sexy text message. I am 22 weeks into my 2nd pregnancy and this baby seats much lower than number 1 did with kicks in my pubic area (which I truly don't love). I feel a lot of discomfort and just recently I started noticing leakages when sneezing hard. Oh Great!
    After my first pregnancy I worked with a midwife who showed me exercices to strengthen my pelvic. I kept telling myself I wasn't doing it enough...Anyways, I was talking about these issues last saturday with a friend of mind whom after listening carefully to me opened up telling me she had a vaginal prolapse with her 2nd pregnancy. She did not say so to freak me out and I was actually very thankful that she'd share her story with me. She just wanted me to be aware of something doctors somehow don't talk about. Which I understand, I'm not sure I would love my doctor to come up to me saying "let me tell you all about vaginal prolapse and the joys of it!" but it's good to be aware and my friend invited me to take actions such as wearing a pregnancy bell to help lift baby's weight so that it doesn't pressure my pelvic so much. I also happen to have a very bad sciatic pain so my doctor just referred me to a physical therapist and because I shared with her the leakage discomfort I am going through, she told me the therapist will be able to help me work on strengthening my pelvic....I agree it's rather rare to come across women willing to share such issues, it isn't the most sexy thing in the world but opening such discussion will help so many women, no doubt. Thanks for doing so. I am in the US and will check pericoach out, I will talk about it with my therapist on my first appointment next week. Thanks for speaking up! xx

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    1. Oh, baby kicks in the pelvis...I remember them well! I too wonder why midwives and OBs don't mention it more often as it seems to be more common than we think. I found support singlets/bands to be very beneficial in my pregnancy - they really helped to life my belly and eased the pressure on my pelvis. I highly recommend the Blanqi singlet (available from Queen Bee - ad on the sidebar - or if you're in the US I think you can buy direct from Blanqi) x

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    2. looking at the Blanqi singlet r i g h t n o w , thank you Jodi!! it's better than looking at my fb feed and the Parisian terror :(
      Love
      B.
      www.happy-bandits.com

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  6. This is a great post. My story: my first birth, now 3 1/2 years ago was long, a posterior bub, 5hrs of pushing and an assisted vacuum delivery, bad tearing & episiotomy left me with my pelvic floor muscles feeling virtually non existent. The thing I struggled with mostly at this realisation was that no one had ever mentioned it being something that happens! I was prepared for sleepless nights, mastitis, cracked nipples... All those 'normal' things, yet I had never heard anyone talk about the damage that can be caused to a pelvic floor. A great women's health physio and lots of practicing and 'working out' made me feel mpre comfortable, not 'normal' (or pre child birth) but okay.
    A second baby born not quite 2 years later was an uncomfortable late pregnancy, lots of pressure down there, but a beautiful, healing water birth, tear and stitch free!
    My 'baby' is now almost 20 months and I'm booked in for a 'refresh' session next week back at the physio as I've felt uncomfortable, particularly after long busy days on my feet.
    When I had my first baby I was 23, young I suppose considered to many of the mums I've connected with, but I have made a real effort to be open about my experience with all mothers, simply because I want this to be a topic that Is up for discussion so that people are aware and not ashamed.
    Thanks Jodie, I love your blog, I discovered it this year and find it so inspirational.
    Reanna x

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    1. Thanks for your honesty, Reanna. And for your kind words about the blog - they mean the world x

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  7. Thank you so much for your post, Jodi. It is so important, as I can fully attest. Having had two babies only 19 months apart, by the time I hit peri-menopause I had a prolapsed uterus and prolapse of both vaginal walls. Surgery corrected all that, but I can only say: Do your kegels, ladies!

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  8. I had my first child at the very young age of 16. I didn't even breast feed because I thought it was gross ~ much less, do any kind of "female exercises"! My next 2 kids came in my late 20's. I was more knowledgeable, but still did not take the advise seriously. I am not in my late 30's (oh, yuck!!) and I have to be careful when I sneeze or I embarrass myself. I can no longer jump on a trampoline....and don't even think about tickling me! I wish I had taken better care of myself right after childbirth.

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    1. Self-care is so important. It's not too late, Amanda x

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  9. I had a long labour with my first - vaccum assisted and episiotomy. Absolutely no pelvic floor issues. Second baby 26months later, labour much shorter, an episiotomy and a 4kg baby left me with zero pelvic floor function. I was wearing adult nappies. Everytime I stood up it was like someone had tipped out a cup of water. This was straight after birth. They think I had nerve and muscle damage. Slowly my nerves seemed to have repaired, but during that time my muscles got weak. Over a year of physiotherapy at the hospital and pilates I am up to the stage at 2 and a half years postpartum that I am dry most of the time to except for running, jumping and sneezing. I have seen a urogynae and they offered me the tvt operation. At this stage I'm still deciding whether I want it and waiting for my toddler to be a bit more independent. They say you aren't allowed to lift more than 10kg (ever!) after the surgery. Decisions, decisions. ...

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    1. Best wishes with your recover and your decisions, Zoe. We go through a lot, us women, don't we...x

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  10. I had no idea this could even happen! My husband and I are going to try to have a baby after the first of the year and it's post like this of matters not normally discussed that I really need to read now! Thank you for sharing! =) Best wishes on your journey to recovery!

    Melanie | Toots + Dill

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  11. Late to the discussion!

    I just had my fourth baby 5 months ago. All of my boys have been big babies (4.1kg, 4.7kg, 4.5kg & 4.5kg) and even with second degree tearing after my second, I never had any issues with pelvic floor or LBL. Unfortunately, after birthing Atticus, I have been in a lot of pain in my lower back. I had all back pain while in labour and pushed for around 2 hours before he finally landed in his Daddy's hands, I think he may have been posterior. Now I have a near constant ache in my sacrum and hips. 2 weeks ago I woke up and couldn't even get off the bed. It was excruciating. Only now am I able to drive again and pick the baby up without help. And definitely issues with LBL, it's not horrible, but it's definitely there. I absolutely think my core is stuffed after carrying around such big bubs and not really working on that between pregnancy. I've learnt my lesson now, but truly this last pregnancy, birth and post party's has cemented for me that four kids is all my body can take. It's time to focus back on my health and get strong.

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