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 marriage, 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.
I’ve already covered the first 3 P’s here: Pee, Prolapse, Pooch
The 4th ‘P’ stands for POOP
There’s no way women are going to be talking about pooping their pants after birth, but guess what? About 1 in 8 women are experiencing faecal incontinence. And it’s usually due to anal sphincter injury during birth. If you had a 3rd or 4th degree perineal tear, you have a higher chance of poor bowel control after birth. This might be difficulty controlling wind, faecal staining or all out faecal incontinence.
If this is you, you need to be doing anal sphincter strengthening exercises. The external anal sphincter forms part of your pelvic floor muscles so doing your pelvic floor exercises with an anal cue will help. I recommend starting with 5 repetitions of 5 second holds, and doing 3 sets of these daily.
I hosted free live online training which was be all about birth tears and trauma.
I had 2 special guests joining me: Professor of Obstetrics & Gynaecology Hans Peter Dietz, who spoke about levator avulsion aka pelvic floor tears and Professor of Colorectal Surgery Marc Gladman who spoke about OASIs aka perineal tears (2nd, 3rd, 4th degree tears)
The 5th ‘P’ is PILES
A lot of women develop piles, or haemorrhoids, during pregnancy, mainly because the growing uterus puts pressure on the pelvic veins, causing the veins below your uterus to enlarge. There is a massive increase in a hormone called progesterone whilst pregnant, which can also cause veins to swell, and also contributes to constipation. Because of the increased constipation, many women strain to empty their bowels, which can cause or aggravate haemorrhoids. And some women develop haemorrhoids from pushing too hard from their back passage during birth.
It is so important to empty the bowels in a safe and healthy manner to minimise aggravation of piles, without straining. The best way to do this is a squat position. If you live in the western world, this isn’t the norm and the toilets these days actually encourage straining. My advice: invest in a sturdy stool like the Squatty Potty, or get some old phone books or some yoga blocks and use this as foot support to elevate your knees so that they are above your hips.
Have your legs wide, then lean forwards and rest your forearms on your thighs. Take a deep breath in and really allow your belly to expand and bulge out, and then do a gentle push to empty your bowels as you breathe out. This position allows the pelvic floor muscles that wrap around your rectum to completely relax so that the bowel motion can come out easily.
Paying attention to your nutrition is important too. Don’t get so busy with baby that you forget to eat and drink. Drink about 6–8 cups of fluid — this can be water, tea, soup — but always have healing beverages. Try not to have too much coffee — because this can mess with your hormones and dehydrate you too. Eat plenty of fibre-rich foods such vegetables and seeds.
The 6th ‘P’ is PAIN
The amount of women I see with pelvic and sexual pain after birth is insane. The statistics are unclear but recent research estimates post-partum dyspareunia (painful sex) at 45% — 70% of mothers. There are a myriad of reasons for this, but definitely one of the biggest reasons is scar tissue. This could be from perineal tearing, vaginal tearing, episiotomies and caesarean scars.
Scar tissue can be nasty if not smoothed out, as it doesn’t line up straight, but rather all jagged and criss-crossy. Once the scar has healed, grab some coconut oil and gently massage across the scar in perpendicular strokes to smooth out the tissue. Do this for any and all scars in the pelvic region.
Bonus tip: to reduce your risk of perineal tearing, massage your perineum from 32 weeks into your pregnancy on a nightly basis to make the tissue more pliable and ready for stretch.
Another reason for painful sex can be from the hormonal changes that occur if you are breastfeeding or pumping. When you lactate, the body produces less oestrogen, which lowers your libido and can make the vaginal walls dry. I recommend the good old all-purpose coconut oil because it is rich in vitamin E which helps support healthy oestrogen production. Apply coconut oil to your vulva and inside your vagina using a clean finger, every night before bed. And if you are having intercourse with your husband, use lots of coconut oil as a lubricant.
The other reason sex can be painful is due to pelvic floor muscle overactivity. Sometimes due to pain of birth, or due to scar tissue, or prolapse, or a painful experience with sexual intercourse, the muscles in your pelvic floor can go into spasm and tighten up. If you were having painful sex before pregnancy, this is likely the root cause. I recommend seeing a women’s health physiotherapist or physical therapist that specialises in pelvic & sexual pain, as she can use physiotherapy techniques to release the muscles and retrain them to relax during sex.
There are many other reasons why sex may be painful such as birth trauma, psychological issues such as post-partum depression or stress, hormonal dysfunctions, sleep difficulties, nerve damage, prolapse, pudendal neuralgia and others. It is best to see a women’s health physiotherapist / physical therapist, as she is best trained to advise you on your treatment plan, and can recommend any other team members. This brings me to the final ‘P’.
The 7th ‘P’ is Post-Natal Depression and Postpartum Post-Traumatic Stress Disorder
If talking about physical health is taboo, mental health is a whole other ball (mind?) game. Let’s get real for a moment — 1 in 7 mothers develop post-natal depression and 1 in 10 fathers develop post-natal depression. Wow! Mind-blown. I don’t know about you but from within my close friends and family, I know at least 7 mothers and 10 fathers, and hardly any of them have disclosed PND.
And listen to this! Up to a third of women describe their births as traumatic — luckily most quickly overcome this but 1 in 16 meet the diagnostic criteria for postpartum post-traumatic stress disorder. This means these women are having flashbacks and nightmares about their birth, physical reactions like heart palpitations, nausea, faintness when seeing a hospital or hearing about birth — to the point that these mothers will avoid driving past or visiting hospitals, baby showers or other pregnant women. They often feel alone, unheard, isolated, anxious, afraid, loss of control and a lot of guilt.
Working in women’s health I feel like PND and P-PTSD is almost every second patient, and a lot of it comes down to what is going on in their body in that time. Most of my mums are depressed or traumatised because they have prolapse, or incontinence, or pain because of their birth experience. And because no-one is talking about these topics, they feel like they are alone. They were never told that this could happen so they didn’t have the chance to mentally prepare for these changes in their body. The most common phrase I hear in my clinic is “Why didn’t anybody tell me?” And it breaks my heart every time!
If you are suffering from PND or P-PTSD it is important to seek help from an experienced psychologist who specialises in postpartum mental health. If you are experiencing PND or P-PTSD due to physical changes in your body, also see a women’s health physiotherapist / physical therapist so that she can help you overcome these issues. Having a team of therapists to help you will allow you to heal faster and cope better.
I am on a mission to break down the barriers of silence, and I need your help to do this! It is important for every woman to share her story and to reach out to other women for support. We need to educate, inspire and empower each other so that we are able to lead healthier lives — physically healthier, emotionally healthier and spiritually healthier. I will leave you with a favourite quote of mine: “Alone we are strong. Together we are stronger!”