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This week’s edition of the Sunday Mail Body and Soul supplement on Baby had lots of interesting articles on ‘Budget tips for new mums’, ‘How to face your birth fears’ and ‘Labour tips for Dads’, but I would also like to add in the very important subject of the pelvic floor. Damien Kelly mentioned that an exercise called the ‘Clams‘ was useful in strengthening the pelvic floor but I think it would be handy to mention pelvic floor dysfunction such as prolapse, bladder or bowel incontinence, pelvic pain or sexual dysfunction in the article on ‘Boost your post baby body’. I know for a fact that women are hungry for information on these subjects and don’t want us to gloss over these very important topics.
So to add to this article there are some important things to remember.
1. Exercise in side lying, four point kneeling, sitting or standing when pregnant after 20 weeks avoiding supine lying (on your back). This takes the pressure of an increasingly heavy baby and uterus off the major vessels (the aorta and vena cava) which can lead to a decrease in blood pressure for the mother and therefore a drop in blood and oxygen to the developing foetus.
2. During and immediately post pregnancy do pelvic floor friendly exercising – that is, be mindful of your pelvic floor integrity and of the downward forces on your pelvic floor- counterbalance those forces by contracting your pelvic floor muscles first. (Sometimes your deep abdominal muscles -Transversus Abdominis- can assist).This is called ‘bracing’ or ‘the knack’. Pelvic floor friendly exercising also means if you have a birth injury such as levator avulsion being assessed by a pelvic health physio to see the impact of for example running, sit ups or double leg lifts is useful. Responding immediately to any “yukky’ feelings in the vagina (downward descent) by modifying the exercise is important.
So for some women who have developed prolapse following a vaginal delivery – maybe with their first baby, or even during the current pregnancy, doing a full side plank or a ‘bump shift’ as described in the article, would create too much force down the vagina making their prolapse worse, or may exacerbate a separation of their abdominal muscles called a Rectus Diastasis.
Pelvic floor friendly exercises in pregnancy include seated cycling, walking on a treadmill, exercising while sitting on a Swiss ball, side-lying exercises and 4 point kneeling exercises.
3. The research tells us that doing pelvic floor exercises during your pregnancy will decrease the risk of developing stress urinary incontinence following a vaginal delivery. So doing 20-30 pelvic floor exercises every day and incorporating them into all facets of your day will increase the chances of a positive pelvic floor outcome following your delivery. And of course the big message is to continue with this pelvic floor muscle training and bracing for life!
4. Using the correct posture for emptying your bladder and your bowel is not just for pregnancy and post-partum, but for the rest of your life. Straining at stool, for some women using poor techniques, can be like delivering a little baby every day. So adopting the correct posture and using the correct dynamics with the abdominal muscles will help prevent worsening any vaginal wall relaxation.
Well I could go on forever. But if in doubt as to what to do – do yourself a favour and seek an appointment with a Pelvic Health Physiotherapist and they will guide you through any considerations with exercise and be able to treat any pelvic floor dysfunction after your birth.