I recently worked with a client who had fractured her tailbone (?!!!) during the vaginal delivery of her first baby. Of course it was a pretty traumatic experience and she was scared it would happen with the birth of her second. Our main focus to prevent this as much as possible was:
- (of course) to avoid lying on her back in labour … (more on why HERE).
- to prepare her pelvis mobility with Spinning Babies® techniques during pregnancy (discover how HERE.)
- to practice perineal massage (peri-what?! more info HERE.)
- to visit a Pelvic Floor Physio, to make sure her PF is healthy
In no way does all this guarantee you will not experience a tear or need an intervention but lets say you are definitely putting all the chances on your side to maybe prevent some complications.
Every time I have a chat with physiotherapist Hannemari de Jager from Jenni Davies’s team at Beaches Pelvic Physio we are both appalled by how many OBs do not recommend treatment to patients, even with a third stage tear or an episiotomy. A brief checkup, a peek ‘down-there’, and a battery of feeding and postpartum depression questions are pretty insufficient as postpartum care and not much focus is given to the pelvic floor muscles. If you lucky, you might get a leaflet from the hospital with the classic “red-traffic-light pelvic floor exercises” but that is about it.
The physical struggles after pregnancy and childbirth are very real and the need for pelvic floor rehabilitation is ABSOLUTELY CRITICAL. It should be compulsory and part of a proper treatment plan.
In France, women are offered 10 sessions with a physiotherapist or trained midwife and I was horrified that women in Australia are not offered that basic level of care.
Regardless of how we deliver (vaginal, caesarean, VBAC, …) pregnancy and childbirth inevitably take a toll on our bodies. Culturally, we’ve come to accept that once the baby is born, the focus should be on the baby. This paradigm makes any sort of additional maternal care seem like a luxury. But don’t jump this important stage that will enable you to avoid long-term problems such as incontinence, prolapse, pain during sex, etc.
Physiotherapist Hannemari de Jager says “There are always help out there with pelvic floor problems, wearing pads everyday shouldn’t be a cure or the norm for incontinence. Pelvic floor rehabilitation is imperative especially with safe return to exercise after having a baby. Please take care of your body!”
As a Doula, I actually suggest my clients see the PF physio EARLY during pregnancy to assess and correct any problem they might have long BEFORE the birth. It will also help their bodies support this major transformation during 9 months. It can prevent problems during labour and help with postpartum recovery.
As for any muscle in the body, we want it to be strong but flexible. Problems can occur when the pelvic floor muscles are weakened, stretched or too tight and most of us cannot actually identify what the problem might be so don’t go ahead doing strengthening exercises with your Kegels if you actually have hypertonic PF muscles, you will just make things worth! Visit your Pelvic Floor specialised Physio and build a treatment plan to ‘support’ your pregnancy and birth. This qualified professional will also help you identify the correct muscles to use.
To contact Hannemari & the Team at Beaches Pelvic Physio, visit https://www.beachespelvic.physio/
P.S. Did you know that your pelvic floor physio can also help on conditions like mastitis or blocked milk ducts? Teaching you the correct drainage techniques/massage and provide treatment with ultrasound therapy. It is very efficient!