November 2014 is Pelvic Floor Month at Fit for Birth. What??? and why???
I’ve become aware that most women (a) don’t know how to activate their pelvic floor/core muscles correctly (b) may have an idea of how to do it but aren’t doing it properly (c) have weakness in their pelvic floors after pregnancy, regardless of how they give birth, which needs correct exercising to bring back to health (d) have pelvic floor damage due to the birth, caused by things like epidurals which lead to forceps/vacuum, prolonged pushing in second stage, unsuitable birth positions like lying on their tailbone, unnecessary episiotomy etc.
My concern is that women aren’t taught how to do their exercises correctly and how to protect their core area in everyday life, and that after their baby is born, they neglect this area until they either have a major problem, like leaking or wetting pants or having to race to the toilet urgently, or having sex hurts, or their belly sags so much that they have terrible backache. At that point they may see a women’s health physio, but most women put up with symptoms sometimes for years. If they become pregnant again, their symptoms will get worse and make the problem harder to fix.
Why aren’t our birthing women receiving the education they deserve? Isn’t their health and sex life worth it?
Here’s how I see the situation. Feel free to correct me if I’m wrong.
The Sunshine Coast Private Hospital in Buderim have physios who aim to see all new mums before discharge. At this visit they might ask if your pelvic floor feels OK and how your stitches are if you had a tear or cut. They may check your tummy muscle separation, which I’m not sure is easy to do a few days after birth, particularly for caesarean births. They may recommend certain exercises, and give you a booklet containing exercises and information. I wonder how many mothers ever open that book, or do the exercises within as often and as well as they need to.
All these women see their obstetrician for a postnatal check 6-8 weeks after the birth, and most tell me that their ob just asks how their pelvic floor is, if their stitches are healed, and not much more. What a missed opportunity!!
Women birthing at Nambour Hospital may see a physio before discharge, but many women are missed, especially with the short amount of time they spend in hospital. Again I doubt that a woman faced with taking her new baby home is attending to what the physio is telling her, and even if they’re given exercises to do at home, I doubt that many of them do them, or do them properly.
Nambour Hospital have a great program called FAB ie. Fit after Birth, run by women’s health physiotherapists. Did you know that? From what the women tell me, a lot of them don’t even know about the program (even if they’re given information on leaving hospital, they’re so busy and distracted at home that they don’t read it). They’re also busy so don’t get around to booking their class. Others of them might know about it, but think they don’t need it or don’t have time to go back to Nambour. (I wonder would they go if the program was offered in places like Noosa or Cooroy?)
Apparently women who don’t give birth at Nambour Hospital can also access FAB if they get a GP’s referral, but who knows about that? A lot of women don’t even know about the free Child Health new mum’s groups which are fabulous.
Women birthing at Nambour Hospital usually have their postnatal check at 6-8 weeks with a GP, who probably only asks basic questions and may not do a thorough check of pelvic care. They only address this area if the woman specifically asks, at which stage the woman would benefit from a referral to a physio. I don’t think this happens very often, because postnatal women are tired, focussed on the baby, and not always sure what is normal at this stage.
The consequence? I believe that many women like you are experiencing some form of pelvic damage or at least weakness due to their pregnancy and/or birth, and aren’t aware of how to rehabilitate with exercise, or where to go for help, or when to go for help. What a huge amount of dis-ease we must have in our community, and a huge expenditure to fix problems which could have been avoided.
What can we do about this? Our pelvic floors deserve more love.
I can’t fix the system single-handedly, but what I can do is to invite you to attend Fit for Birth’s classes during the month of November. I’ll teach you how to locate and exercise your pelvic floor and core muscles correctly. We’ll talk about what’s normal and what’s not. I’ll refer you to a physio with expertise in this area so that you can receive the care and education you need. Class will give you time to focus on this area without the distractions of daily life, even if you bring your baby with you. What a great opportunity. Ask your friends how their pelvic floor is, and bring them along to class too. Let’s make a difference, one pelvis at a time!!