Well everyone in the whole world is thrilled for Kate and William on the birth of their beautiful baby and so I decided to join the celebration and wish them well and offer a more practical gift than the usual booties and nappy service. I thought I’d revise the key things one must always do after one has delivered a baby into this world.
1. Pelvic floor exercises
It’s a given. Start early post-natally, do them gently and do them for every (damn) day for the rest of your life! You should feel lift and squeeze pressure, no pressure pushing down – called bearing down – if there is…stop trying to contract the muscles and see your local Continence and Women’s Health Physio for assessment and help in learning how to do them correctly. Initially start with a couple every hour for short holds (a couple of seconds) and build up the numbers and the length of hold continuing to breathe and performing them gently in the first weeks. Importantly, before you bend or lift or cough or sneeze- in fact any time there is an increase in intra-abdominal pressure – then first pull in your low tummy, then tighten your vagina and draw in your anus – then the bladder and pelvic floor is supported and there is a better chance of preventing prolapse and urinary leakage. This is called bracing or the knack.
2. Acute post-natal treatment
Immediately after the birth, there may be lots of swelling, pain and bruising so the RICE formula works just the same for your perineal region as any other injured part of your body.
Rest and recline (don’t receive visitor after visitor sitting for hours on your bottom in bed!)
Ice every couple of hours for the first 48 hours using a small icepack wrapped in a wettex or washer
Compression using firm supportive undies and perhaps SRC Recovery shorts
Elevation achieved by gently contracting your pelvic floor muscles to act like a muscle pump to help decrease the swelling.
3. Use the correct bladder (no elevation under the feet) and bowel positions to empty properly and prevent straining which causes excessive downward descent of the pelvic floor. Eat healthily-plenty of fruit and veggies, drink water, milk, decaf tea and coffee and have some soluble fibre (eg. Benefiber, Metamucil, Normafibe) in the first few weeks to ensure a soft easy-to-pass stool.
4. Gently pull in with your low tummy (the pubic hair region), stand and sit tall with good posture and seek help from a Continence and Women’s Health Physio if you have a separation of your abdominal muscles (called a Rectus Diastasis). Always brace your muscles and log roll through your side when getting in and out of bed.
Now I hope these pearls of wisdom help all those who had their babies today and I wish them all the best for the next few weeks, months and years with their precious bundles of joy….