ONE OF THE MOST COMMON QUESTIONS WE'RE ASKED AS DOULAS IS HOW TO PHYSICALLY PREPARE FOR PREGNANCY, BIRTH, AND RECOVER POSTPARTUM. JOIN US ON THE BLOG TODAY WITH STACEY HENDRICKS, A CINCINNATI PELVIC FLOOR PHYSICAL THERAPIST AT ELEVATE PHYSICAL THERAPY, TO ANSWER SOME OF YOUR BURNING QUESTIONS. WANT MORE OF STACEY? JOIN US FOR OUR JUNE MIX+MINGLE, A SOCIAL EVENT FOR EXPECTANT FAMILIES. STACEY IS OUR FEATURED GUEST TO ANSWER YOUR QUESTIONS! SPACE IS LIMITED, REGISTER NOW.
Is there anything I can be doing now to prepare my body for giving birth?
First, follow the ACOG recommendation for getting 150 minutes of moderate exercise per week being sure to incorporate regular core and pelvic floor strengthening into your routine. Giving birth can be as intense as running a marathon (or two!) so staying physically fit will make labor feel easier. Regular physical activity also helps to prepare your baby for the stress of labor.
Second, be sure you practice getting into and maintaining your ideal laboring positions such as a supported squat or on hands and knees. This may require that you work on your flexibility and muscle endurance.
Lastly, understand that a healthy pelvic floor is strong AND flexible. Kegeling is great for improving strength, but you must also focus on relaxing and lengthening your pelvic floor. This can be practiced while having your daily bowel movement. There is also some research to support performing perineal massage daily after 35 weeks gestation to improve pelvic floor relaxation and flexibility and to reduce risk of tearing.
I keep hearing about doing Kegel exercises during pregnancy. How often should I be doing Kegels, and how do I know if I'm doing them right?
Strengthening needs are unique to each individual, but a general rule of thumb is that you should be able to hold a firm pelvic floor contraction for 10 sec while breathing normally and be able to repeat this 10 times in a row without fatiguing.
You can assess your strength yourself by inserting your finger 1 inch into the vagina and practice trying to close around your finger and pull it in toward your pubic bone. If done correctly you should feel your muscles close circumferentially around your finger and feel like your finger is being pulled further inside. When you release the contraction, the muscles should smoothly and quickly let go. If your muscles do not release quickly or completely, you should not do any Kegels until you master full relaxation of the muscles.
If you are still unsure what you are feeling on yourself, a pelvic health physical therapist can assess this for you and provide you with a individualized program to maximize the function (strength and relaxation) of your pelvic floor muscles.
I've always been physically active. I can't imagine not being able to exercise for 6 weeks after birth. Is there anything I can be doing during those 6 weeks? What about after my doctor says it's OK to exercise, is there anything I need to avoid?
Due the size of the uterus by the end of pregnancy, women develop altered breathing patterns and altered core/postural muscle activation patterns. After giving birth, these muscle imbalances contribute to pelvic floor dysfunctions and persistent core muscle dysfunctions like diastasis recti.
Simple exercises that focus on improving breathing patterns and deep core activation (pelvic floor and transverse abdominis) are safe to do immediately after childbirth and will actually improve your readiness to return to regular exercise once you are cleared by your OB.
Once cleared to initiate exercise, start with short duration and low intensity and gradually increase your level of effort. Your body has just gone through significant transformation, and it will need time to return to your pre-pregnancy level of fitness. If you experience any bladder/bowel leakage, vaginal pressure, back pain, or abdominal strain sensation while exercising, reduce the intensity of the exercise. These symptoms suggest that you are overloading your inner core and pelvic floor beyond their current capacity and putting yourself at risk for pelvic floor, spine, or other injury.
I've had a cesarean. My body just doesn't feel the same, and my incision site is still painful. What can I do to help my body heal?
Gentle massage can be performed around the incision as it is healing, and once it is closed, the scar can be massaged to improve its mobility and reduce nerve sensitivity. Diaphragmatic breathing and gentle stretching can also improve scar mobility and pain. A pelvic health physical therapist can teach you how to safely do all of these things before or after your Cesarean delivery.
I tore during my birth and had stitches. I'm really nervous about having sex again. Will it hurt? If it does, is there anything I can do to make it better?
Every woman’s experience with sex after delivery is unique. The good news is that if there is pain, this can be treated! Some women who are breastfeeding may have some vaginal dryness and discomfort due to hormone changes. Other women may have some pain with intercourse due to muscle tension, nerve sensitivity, or scar tissue. If you do have pain, understand that this is not normal and your OB and pelvic health physical therapist can help you to determine the source of your symptoms and the best treatment approach.
STACEY HENDRICKS, PT, DPT, WCS
Board Certified Women's Health Specialist in Pregnancy, Postpartum, Female Pelvic Health
Stacey Hendricks is a doctor of physical therapy and founder of Elevate Physical Therapy. She is the only board-certified Women’s Health Clinical Specialist within a 90 mile radius of Cincinnati, treating conditions such as urinary incontinence, pelvic pain, sexual dysfunction, and bowel and bladder dysfunction.
Learn more from Stacey at our June Mix+Mingle. Registration is complimentary; space is limited to 10 couples.