Pelvic Floor Care
I was lucky enough to share a hot beverage or two with the knowledgeable and all-round lovely Emilie Haynes, owner of Full Moon Physio. We talked about all things pelvic floor for pregnancy and beyond. And I ate cake.
My main objective of the meeting was to discuss what symptoms require seeing a pelvic floor specialist physio. One of the first topics that we discussed though is that in France, ALL birthing people have prescriptions given to them for 10 sessions of pelvic floor physiotherapy and another 10 for abdominal muscle rehabilitation. If after those sessions, it is considered that more work needs to be done, birthing people go to their doctor and simply get another prescription. It sounds amazing that they place so much importance on this and it begs the question as to why France places such importance on core strength and other countries generally don’t. Like many of these things, you pay a little for it now, or you pay big time for it later and when pelvic floor issues are so predominant in birthing people and cause such issues later on in life. To look at this coldly and practically, it’s better for the government to pay a little for preventative and healing care now than to pay for the issues that come about when these issues haven’t been treated for decades, but sometimes just a few years later.
As I talk with Emilie, a kind and clearly compassionate physiotherapist, it’s clear that a pelvic floor specialist really should be part of every pregnant and postpartum person’s care community. In pregnancy, she can determine how strong your pelvic floor is, how to get it in tip-top shape ready for labour and birth. A strong pelvic floor can decrease the pushing stage of labour by as much as 30 minutes and reduce the likelihood of tearing and what I consider best of all, she can give you real pain management and reduction techniques. Having this kind of care prior to labour can also reduce the likelihood of tearing. As we discuss the fear-tension-pain cycle, along with techniques for helping to open the pelvis for birth, what I never realised before is that a pelvic floor specialist can give the kind of preparation that no other antenatal class can. A plan, customised to your body for preparing your mind and physical self for pregnancy and birth while also investigating if there are any underlying issues that need addressing. And trust me, with today’s desk culture, there seem to be many.
As we talk about care going forward into the postpartum phase, Emilie points out that GPs and OBs do not routinely do an internal check-up for birthing people at their six-week check-up and yet a third of women experience pelvic floor prolapse, even more on subsequent births. What I personally find most worrying about this is that some people display no symptoms and yet the effects of prolonged prolapse are pretty unsavoury, I mean, are we happy to accept the need for Tenalady as we age? But more than that, our pelvic floor is a pretty main part of our core. We’ll never truly be strong if our pelvic floors aren’t. Pelvic weakness can be the cause of back pain, incontinence, pain in the vulva, pain with sex, inability to orgasm and loss of sleep (like we need any more of that with a baby or toddler, or indeed at any part of our lives. I do wonder if those symptoms were so frequently experienced by men (men can get POP but it isn’t as common), there would absolutely be government paid assessment and treatment as standard based on the activities (in a female body, this would be childbirth) that are most likely to cause it. The damned patriarchy. By booking in to see a pelvic floor specialising physio for after the 6-week check, you can get assessed for prolapse and get the best advice on healing.
And talking of healing… Here in the Comox Valley, our cesarean rates are pretty high at 42%. Pelvic floor physios can give you key information on how to best care for your scar to get optimal healing. Again, this isn’t something that GPs and OBs typically do, yet without adequate care, scars can heal lopsided, with tension and/or with complete loss of sensation if massage techniques and manipulation of the area is not undertaken. A pelvic floor physiotherapist can help you with this and the releasing of pelvic floor muscles that were straining with the weight of pregnancy that struggle to release without vaginal delivery. Seeing someone as soon as possible is the key to the best and fastest outcomes.
Towards the end of the conversation, we run through some of the times when people should seek out specialist care. There’s the obvious pain-related symptoms of pelvic pain, but also any back pain at any point in your back for postpartum women, hip pain, incontinence (no matter how minor), a feeling of bulging in the vagina, frequent urination, the feeling of not being able to empty your bladder. I asked Emilie for what she’d consider being the least known reasons to need to see a physio and she enlightens me, because I honestly had no idea, that queefing is a sign you need to see someone. Yes, the sudden release of air from the vagina that exits with enough volume to notice the sound is a sign that you should see a pelvic floor physio! We’re not talking about inverted yoga poses here but when we’re naturally moving about in our days. Now you know. Another is the mom pouch. Honestly, I just thought I naturally stored weight there but the mom pouch is an indication that the lower abdominal muscles are weak. Whenever there is a weakness in your core muscles, this spells trouble for your posture, back pain and susceptibility for injuries. We need to look after our core!
We finish up our drinks and honestly, my mind is blown that a few therapy sessions can treat so much and if caught early, or even before birth, with the earliest care plan you really can achieve an easier, shorter birth and postpartum recovery. My lasting titbit of info is that the pelvic floor doesn’t fully close until around 6-8 months postpartum and that relaxin production is still pumping through your body for as long as you breast/chestfeeding, even if you are full-term nursing. We definitely need to care for those potentially wobbly joints!
I know that many mothers and other identifying birthing people tend to put their needs last on the list but really, your physical health is not something you should ignore. At the very, very least, you should see a physio after birth because there may well become a time when you can’t enjoy precious time with your children because your core is failing you. Want to go jump on the trampoline anyone?
Full Moon Physio has clinics in Cumberland and Comox. They specialize in pelvic floor physiotherapy; from pregnancy and postpartum concerns to pelvic pain or sexual dysfunction and everything in-between. They are growing and in search of more specialised physiotherapists to join their team. If you are certified and looking to join the community, please reach out to them to apply.
https://www.fullmoonphysio.ca/
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