That thing called the Pelvic Floor - Part 2

In part 1 of our discussion about the Pelvic Floor, we talked about the anatomy and what exactly the Pelvic Floor is. We discussed its role and detailed what could happen if you have weakness or injury to the pelvic floor, and I gave you suggestions on what to do to strengthen it. So if you haven't read Part 1 yet, you can catch it here.

In part 2 of this blog, we'll go into more detail about what to do in those first few days after having baby, how to heal the pelvic floor post-delivery, and when you can recommence exercise. 

What to do in those first few days after having baby:

After you have had a vaginal delivery, your body is tired, your pelvic floor muscles have been stretched and you need to do one very important thing...REST! 2-3 days of full rest is extremely important to help your body begin the recovery and healing process. Some bruising and slight tearing or laceration to the vagina and surrounding tissues can be pretty normal. You will most likely feel quite stiff in the lower back and pelvis, and very unstable in the abdomen. 

If you have had a c-section, of course, you will be exhausted and you'll have to deal with recovery from major abdominal surgery, look after your scar, and really take it extremely easy for a few weeks, getting help lifting baby in and out of the cot and general help around the house. BUT, you still need to focus on Pelvic Floor recovery as, during Pregnancy, your muscles were put under significant pressure. 

How to heal the pelvic floor post-delivery:

Like any form of injury, you would use the RICE principal: Rest Ice Compression Exercise.

R: Rest - As already highlighted, please rest for a couple of days immediately after birth. Lying on your side or back is best to take pressure off the pelvic floor and perineum. 

I: Ice - If you feel you have some bruising and swelling, it can be really soothing to use a wrapped up, disposable ice pack down below a few times a day. Ask your medical practitioner if it's ok to take some ibuprofen too, to also help with reducing swelling and discomfort.

C: Compression - a gentle and soothing pressure can come from some thick & very unsexy maternity pads, with proper Bridget Jones-esque massive knickers. Think the bigger the better here.

E: Exercise - gentle holding and releasing of the Pelvic Floor as described in Part 1, will help to restore strength to the muscles, but will also bring fresh oxygen and healing to the area too. Pelvic floor exercises after the first 24 hours after birth are recommended. Even a few days after your birth, you can start to do some basic yoga.  Positions like Cat-Cow will be wonderful for the back and the pelvic floor. Also starting to activate your deep core muscles (Transversus Abdominis -TA) is important for healing and for strength after you've had your baby. We focus on this muscle a lot in our Pregnancy Yoga classes and in the NurtureMamas Online Own Your Birth Program, and the 5 Week PostNatal Recovery Program.

You can start to activate your deep core muscles by coming down onto the hands and the knees, drawing in on the lower tummy muscles (TA) as if you are lifting your belly towards your spine, hold for 10 seconds while breathing normally, and release again. 

In those first few days after a vaginal delivery, sometimes it can be stingy when going to the loo - so what I have found very useful and soothing is pouring water down below using a water bottle while peeing. 

When you need to 'open your bowels' for the first time after having baby, let's face it, you are terrified. Supporting your perineum with some form of a pad or compress can give you some confidence here. A good diet with lots of water, high-quality fibre and magic linseeds will help enormously. 

When can I return to exercise? 

A question I get a lot is...when can I come back to yoga and other exercise? Returning to exercise all has to do with how you are feeling and depends on the strength and integrity of your pelvic floor. Another consideration may be how fit you were during your pregnancy, which will obviously allow for a faster return to exercise. Within the first 6 weeks, walking, pelvic floor exercises 3 times a day, and gentle yoga are all suitable activities. Exercising will do wonders for your mental health too. Swimming is also fabulous for recovery, once you have stopped bleeding. 

Returning to your more vigorous exercise routine would be appropriate for most people after a 12-15 week period. However, if you have any incontinence during this vigorous exercise, you should stop. You can return to your pelvic floor strengthening routine and a more gentle form of exercise. If your problem persists after 12 weeks, you will need to go to see a women's health physiotherapist. 

Please go to a Physio or your consultant obstetrician without delay if you are experiencing regular incontinence, a feeling of heaviness, fullness or that something is inside your vaginal canal, or simply if you just don't feel like yourself after a few weeks. 

I cover an in-depth pelvic floor 'bootcamp' in The Club, our monthly membership programmed, designed to inform, support and empower you to enjoy your pregnancy & have a KICK A*S Birth! I only open it twice a year, so make sure to get on the waitlist to get a notification when it opens next! Don't miss out.

xxx Helen xxx

_{Helen Plass is a Pre & Postnatal Fitness Specialist, and Yoga Instructor, working with women and their birthing partners to achieve a comfortable, healthy & happy journey into Pregnancy, birth and Motherhood. She is known for her very practical & non-judgmental approach to pregnancy and the crazy times of motherhood. Check out all her communication at NurtureMamas.com, and if you are in Ireland, her local business MumandBaby.ie}