I’m going to let you in on a few mind-blowing, life-changing secrets about motherhood that no-one is talking about. Why? Because something I share could save your life, it could save your relationship, or at the very least it could save your sanity and self-worth.
No-one is talking about these topics because they are, sadly, still taboo. Which is ridiculous because at least every second mother (if not every mother) is silently suffering right this second! These secrets are what I call the 7 P’s of Motherhood, and fair warning, it’s not P-retty.
One more thing, I’m not a mother (yet). So what gives me the right to talk about motherhood? Well, it’s because I treat up to 20 mothers daily in my women’s health physiotherapy clinic. And, let me be honest,
I. SEE. EVERYTHING.
Much more than your obstetrician, your gynaecologist, your doctor/physician, your midwife, your doula, and really anyone else familiar with your lady bits, maybe even more than your partner or spouse!
The 1st ‘P’ stands for, you guessed it, PEE!
30–70% of women experience urinary incontinence
Why is nobody talking about the fact that 1 in 2 new mothers are accidentally peeing themselves? Or that 1 in 3 long-time mums are still leaking? I mean just look at the statistics — if you are having issues with incontinence, you are not alone!
Research shows that seeing a women’s health physiotherapist can cure incontinence in 80% of cases.
There are a few categories of urinary incontinence; the first being stress urinary incontinence, which is accidental leakage with a cough, sneeze, laugh, vomit, jump, run, exercise or during sex. This is usually an issue of poor coordination of the pelvic floor muscles prior to the stress-inducing activity.
Simply retraining your pelvic floor muscles can go a long way to reduce and even cure incontinence. I recommend doing a few sets of 5 pelvic floor coordination exercises daily to retrain your brain and muscles. The exercises go like this:
1. Take a deep breath in to relax your pelvic floor down.
2. As you breathe out squeeze and lift your pelvic floor muscles and hold them up and tight as you continue to breathe out.
3. Relax the muscles down as you breathe in and repeat 5 times.
Some imagery to help you visualise your pelvic floor muscles include:
- Imagine the way a pebble drops into a pond and the ripples it makes outward. Feel this as you breathe in. Then reverse this image as you breathe out.
- Imagine you are sitting on the toilet and want to stop the flow of your wee. These muscles that stop the flow are your pelvic floor muscles. But DO NOT do your exercises on the toilet — this is a place of relaxation of the pelvic floor muscles.
- Imagine there is a tampon in your vagina and you want to tighten around the tampon and pull it up towards your cervix.
You also want to retrain the fibres in the pelvic floor muscles that come on quickly, because sometimes coughs and sneezes come unexpectedly. You can retrain these by doing 10 quick lifts and drops in a row.
The second category is urge urinary incontinence, which happens when you are busting to go to the toilet and don’t make it in time and leak. For this type, you want to engage in urge suppression strategies which include:
1. Sitting down and taking a few relaxed deep breaths in
2. Applying pressure to the perineum with your hand or sitting on the corner of a couch or table
3. Tightening the toes or clenching the calves or both
4. Distraction techniques like crosswords/Sudoku or counting back from 100 by 7
Once the urge as passed, you can proceed calmly to the toilet to empty your bladder.
The 2nd ‘P’ is PROLAPSE
1 in 3 women have pelvic organ prolapse
After birth about 1 in 3 women experience prolapse of one or more of their pelvic organs. This is basically when the bladder, uterus and/or rectum sags down lower in the pelvis.
Women may experience a sensation of a “bulge” down there, or a dragging/heaviness sensation in their pelvis.
Some women may experience lower back pain or lower abdominal pain. These symptoms can worsen as the day goes on or if they go for long walks or carry heavy objects for long periods of time. Some women may experience bladder or bowel symptoms such as incomplete emptying or a slow, start-and-stop stream, or that their stream deviates to one side or sprays.
Women who have forceps or vacuum used in their birth have a much higher chance of having prolapse particularly of their bladder. The chances of having prolapse are higher with vaginal birth but not exclusive, as women who have had caesarean sections can also have prolapse but usually of their uterus.
Again, pelvic floor strengthening and coordination exercises can help here.
Pelvis floor exercises will help support pelvic organ prolapse
However, prolapse is not just an issue of the muscles, but an issue of the connective tissue, or fascia, holding these organs up. As a physiotherapist working in the area of women’s health, women who present to me with prolapse are fitted for a little support device called a pessary, which I insert vaginally to lift the organs up and back to their original position. If a woman is fitted with a pessary within the first 0–2 years post-birth and continues her pelvic floor exercise program, sometimes the prolapse can be reversed completely, which I think is really amazing!
The 3rd ‘P’ is POOCH
2 out of 3 women have abdominal separation
You know that dreaded lower belly pooch women get after birth, also known as abdominal separation, or DRAM (diastasis rectus abdominis muscle). Well, this one takes the cake (or makes you wish you never see cake again!), occurring in 2 out of 3 new mothers.
Now listen up mummies, doing intensive ab work can actually make this baby (belly) worse. For optimal health and function, abdominal exercises need to be done with core stability in mind.
Cue in… the glorious multi-talented pelvic floor muscles! And the muscle that keeps you breathing: the diaphragm!
The more efficient your diaphragmatic breath is, the more efficiently your abdominal muscles will work. Your deeper lower abdominal muscles, also known as transversus abdominis or TA, are also important for functional stability, and should engage with your pelvic floor. These muscles are like a corset that wrap around your belly and spine and help to tension the gap with activity.
The diaphragm, pelvic floor, transversus abdominis, and your deep back muscles, multifidus, together make up your core canister.
To find your diaphragm and engage it efficiently a Transversus Abdominis Assisted Thoraco Diaphragmatic (TATD) breath, as outlined by Ginger Garner, is encouraged.
1. Take a breath in to your belly to prepare.
2. As you breathe out gently tighten your lower tummy gently towards your spine. This will activate your transversus abdominis muscle.
3. Take a deep breath in and keep that lower tummy gently drawn in, and you will feel a deeper wider breath going into your lower ribs. This is your diaphragm engaging.
To get this amazing group of muscles working well, you must connect with them more intimately.
1. Take a deep and wide breath in to your lower ribcage to activate your diaphragm. You should feel your ribs expanding wide, without your chest rising too much.
2. As you breathe out, squeeze and lift your pelvic floor muscles and tighten your lower tummy below your belly-button in towards your spine to engage your transversus abdominis and multifidus.
- You should feel a corset-like zipping up and tightening feeling without your whole upper belly tensing.
- For some women, another cue to engage the transversus abdominis is to imagine the front two hip bones drawing together.
- Hold this pelvic floor and lower tummy contraction as you breathe out.
3. Relax and breathe in, and repeat.
To really get your mummy tummy under control, it is so important to activate these core canister muscles with functional exercise such as squats and wall push-ups, so that you can load the abdomen to create tension.
Want to know more about incontinence, prolapse and other secrets of motherhood, and how to overcome them?
I hosted a free weekly online training series called MOTHER NURTURE WEBINAR SERIES which you can get access to by clicking here: mothernurture
My first webinar was great, where I spoke about abdominal separation: what it is, the signs and symptoms, how to test for it, and most importantly how to recover from it holistically with advice about nutrition, alignment and exercise.
In the second webinar I spoke about urinary incontinence, the different types of accidental bladder leaks, why women leak, how to stop leaking and take back control of your bladder.
In my next blog I will cover the other 4 secrets of motherhood no-one tells you about.