Best to start at the beginning. Learning how to do those pesky pelvic floor (kegels named after Dr Kegel) exercises while you are pregnant is a good idea. Even if you only do it once or twice to find out what the fuss is all about.
After you have had your baby, you will definitely want to do them. For various reasons:
- Your labour was not great, again for various reasons. And now your pelvic floor is not doing its job very well.
- Having a baby in winter may give you a cold, and coughing so soon after having a baby, can give you a ‘leaky’ bladder
- Discovering exercise again, especially little tiny jumps may give you more than you bargained for. Buying new underwear is a short-term answer.
- You may have had an episiotomy or forceps or ventouse, or any combination thereof; and you will find that these interventions will definitely affect your pelvic floor musculature. You will get it back, eventually. But you will have to work at it.
- Prolonged labour in Second Stage, pushing too hard on your back, big babies over 4 kilos, dehydration, can all exert pressure, to the point a pelvic floor loses its initial tone to support the internal organs of bladder, uterus and bowel. The rectus abdominus muscle (the big verticle muscle from base of sternum to top of pubic bone) can come under fire as well, and separate to a degree that further retards a woman’s good recovery after birth.
Degrees of leakiness:
- ‘leaky’ bladder or occasional incontinence
- bladder prolapse
Unrestrained pushing can do damage
Once labour is underway, it’s mostly too difficult to pause and guard the pelvic floor, as a woman is often exhorted to push with energetic force, which can over-strain the pelvic floor muscular structure.
- Unrestrained pushing during second stage of labour can damage a woman’s pelvic floor.
- Prolonged pushing (generally accepted as more than 2 hours) can also strain the pelvic floor.
- Unco-ordinated pushing can do the same, and often results in the labouring mother becoming quickly fatigued and worn out.
- If the mother-to-be could be encouraged to gently breathe her baby out as opposed to more forcefully push her baby out, labour could be an effortless and joyful process; and this kind of damage would happen much less.
How to recover and regain your tone afterwards
Recovery can be set back as baby’s needs tend to be priority number one. But a new mother quickly realises she has to expend some solid effort to help herself recover, because if there’s some damage, unfortunately, it doesn’t tend to ‘fix itself’ without attention.
She will need to set aside time to care for herself;
- do pelvic floor exercises
- and possibly (depending on the state of her pelvic floor) – attend a specialised clinic or clinician, such as a ‘Women’s Physio’ in order to heal and repair her pelvic floor and restore her bladder tone.
Take care with some activities
The downsides are:
- having to guard against coughing, laughing, doing star jumps at the gym or skipping (my two personal must not do faves!)
- Yes it does take work and there’s plenty of good information and resources out there to help you with re-educating your body and keeping it all in good shape again.
- And yes, restoring your pelvic floor does bring your body back to full recovery, and gives you confidence that you are YOU again!
– it’s important to work the pelvic floor properly –
Pelvic floor exercises
Pelvic floor exercises commonly consist of pulling up the pelvic floor, holding and letting go again. The variations of this exercise are all effective. However, invariably the gluteal muscles are activated, effectively side-lining the pelvic floor musculature itself, and giving a sense of tightening but not sufficiently effective for a good recovery. Read on for a more effective method of tightening and toning your pregnant floor, for that next pregnancy, to run for the bus all of a sudden, or to run for the fun of it, and to not wet yourself when busting for a wee!
Breathing in and relaxing your pelvic floor is important to isolate the pelvic floor properly. The breath out then ensures that you are lifting up the pelvic floor first before the bigger and more dominant muscles of the gluteals get activated. Practise this exercise in the car at traffic lights, in bed, sitting at your desk, watching TV, or some other regular time.
- Breathe in – and as you do, relax your pelvic floor (let your tummy gently fall out!).
- Breathe out – and as you, lift up your pelvic floor as much as you can. Continue to breath and hold for a count of 5-6.
- Repeat for a few rounds.
This exercise and breath combo is often the opposite of what most women are taught re pelvic floor tone. However, it is effective and works.