What is it with being pregnant? The moment people find out you’re going to be a mother then everyone and their uncle wants to tell you what to do… or more specifically what not to do. And it doesn’t end once you deliver your baby. If anything, it gets worse. It feels like everyone has an opinion on what you must not do, what you can not eat and what you definitely can not drink. The very moment when you are about to become responsible for another human seems to be the very moment that everyone else seems to think you can’t function without their unsolicited and often unwelcome advice.
I wouldn’t mind but so much of the advice I received, especially while pregnant, had absolutely nothing to do with careful scientific researched evidence. If this rings true for you then I really recommend Emily Oster’s no nonsense book "Expecting Better" which has no advice for pregnant women but is a wealth of information about hazard and risk - with evidence cited - which aims to help you to make informed choices about you and your baby’s health while pregnant. Exercise and movement during pregnancy and in the post-natal years, (yes, I do mean years!) is complicated. Pregnancy and childbirth are hard on your body and it’s really important to recognise this. That said, the normal rules about movement and health apply to mums just as they do to the rest of us. The human body is made to move and research continually tells us that being sedentary is one of the most dangerous habits you can cultivate. More to the point most mothers do not have the luxury of avoiding many activities they are supposedly forbidden to perform. I've yet to find a mum who doesn't have to lift weights (what else is a baby in their carseat?) perform squats (grab a nappy from the bottom of the pram) or perform lunges (push that pram up the hill to the GP's surgery). Parenting is rarely a sedentary job. My favourite thing about the modern postnatal exercise course I attended recently - taught by the inspiring Jenny Burrell was her insistence that we support mothers to move in the way they need to rather than continually restricting their activities. Of course there are movements which have the potential to cause injury and should be treated with extreme caution in the months following delivery. Both running and sit-ups tend to spring to my mind. But rather than telling women to avoid these movements with no follow up we should be explaining the risks, supporting them to listen to their body and guiding them in a safe return to movement. I don't know about you but the moment someone tells me I can't do something I have a burning desire to do it. Right there and then - In front of them with a cheeky grin on my face. (It's entirely possible that you are more mature than me and if so, I applaud you). In my experience women are less likely to listen to their own body and so take unnecessary risks when they are getting unhelpful direction from people who haven't bothered to check their facts. Instead of telling women what they can’t do lets start giving them the information about potential hazards but then take our lead from them. Asking what they need to do, what they would like to do. Asking them what feels right and of course what doesn’t feel right and most importantly listening to what they say. Otherwise we deserve to see them doing exactly what we advised against with a cheeky grin on their face.
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For many Londoners the summer of 2012 was marked out by the arrival of the Olympics but for me this sporting event was overshadowed by the day that I tied my landlady's mother-in-law to a chair, shaved her and then covered her in electrodes. I moved flat not long after. Surprisingly theses events aren't linked - at least not in the way you might imagine. For my Physiotherapy honours project I was lucky enough to work on a neuro physiotherapy project using a robot arm designed for stroke rehabilitation. It was a great project but unfortunately we needed participants who were slightly older than the average student. Take it from me, you don't find many old age pensioners hanging about in the university cafe! In desperation I sweet talked my Dad, my mates mum and of course my landlady's mother-in-law into taking part. The participants all had to play an hour of specialist computer games using the robot arm. Since we were measuring muscle activity in the legs during trunk restraint (a common therapy technique in stroke rehabilitation) we had to strap our subjects to a chair and shave their legs before sticking electrodes onto their skin. I think they all quite enjoyed the experience ... well most of it. Perhaps not the being shaved part ... but we did give them some good biscuits so I think they forgave us.
I think about that robot arm a lot when I'm teaching Keegals. The biggest complaint from my clients is that Keegals are dull and they just don't have time to squeeze them (sorry, not sorry) into their busy lives. Neuro physiotherapists as a group are very good at considering how to make therapy and exercise fun. This is because many of their patients have life-long conditions and they will be expected to do these exercises for years after they have said goodbye to their therapist. That's why they developed a robot arm for patients to play with. If exercises aren't engaging and don't feel useful to the patient then they won't get done and the initial therapy session was a waste of everyone’s time. For some reason we don't seem to take the same approach to pelvic and core rehabilitation. Us post natal professionals cheerfully tell women to squeeze their pelvic floors three times a day - usually in those crazy intense newborn weeks when mums are struggling to find time to even wee and then we look confused and disappointed when the mums report that, er, hmmm ummm, they might perhaps have missed a few exercises or more honestly just plain forgotten to do them even once since their last appointment. Newborn babies might be cute but wow do they suck up your time and attention. It's not surprising that the majority of mums I meet struggle to find time or headspace to do the mind-numbingly boring exercise program carelessly given to them with their discharge notes. Pelvic health is important but that doesn’t mean it has to be boring. If we expect women to make core strengthening part of their lives long term than we have to be more creative about how we teach it. That’s why I love my Egyptian Dance classes. They combine the deep down important education about pelvic floor activation with the joy of moving to beautiful music and embracing your perfect post baby body. And before you say it, Yes! your post-baby body is perfect whatever instagram might be making you feel. Egyptian dance celebrates women’s bodies whatever battle scars they bear and at a time when many women feel their most vulnerable it can help mothers feel beautiful while also gently healing their stretched abdominal muscles. Just like the neuro physios and their robot arm taught me - If you enjoy performing an exercise then you are more likely to introduce it into your daily life and get long-lasting benefit from it. I’ve not met many people who don’t enjoy a boogie so why not harness that joy to benefit your core strengthening? Oh and if you were wondering, my landlady realised that because of the Olympics she would be able to rent out our flat for a good wedge more so she politely asked us to move out. In fairness she did give us 6 months notice, a great reference for our cat and press-ganged her mum-in-law into taking part in my honours project. So the two events were linked but I bet that wasn't how you imagined it. I’m not sure quite when I became a Molo - a member of The Motherload- but it’s one of my favorite online communities. It’s an unashamed sweary, no-holds-barred space for mums to share their triumphs and fantastically horrific lows with a community of equally sweary but awesomely supportive mothers. This is the place where you can share the horror of taking your two year old for an emergency wild wee in the grounds of a national trust house only to discover they are depositing more expected. If you leak through your breastpads less than five minutes into a meeting with a mortgage advisor then The Motherload is the place to share your embarrassment and be comforted by other Molos equally embarrassing tales of woe. Molos unveil the whole of motherhood to one another in all it’s gory glory. They frequently share their worst moments and in doing so become the best - raising up mums who are struggling, who have lost themselves in babyland and who might otherwise feel that they are the only ones falling behind. (spoiler alert. We all feel like we are the ones falling behind and helps to know we aren’t)
A regular feature on the page are tales from mums who have been let down by their down belows. I find the stories of unreliable pelvic floors both heartening and depressing in equal measure. I love and applaud the women who step up to giggle - and invite us to giggle - at the horrors of having your teenage son witness you slipping in a post-sneeze puddle or the tales of trampoline terror. Incontinence is a problem that is associated with sky high levels of shame and loss of dignity. You would be hard pushed to find a mum who hasn’t experienced some form of incontinence, if only in the first few days or weeks after birth although you might be harder pushed to find one who would admit this to you. So seeing mums laughing together and standing up to the embarrassment of incontinence is bloody brilliant. It is definitely time that women lost the shame associated with their stressed pelvic floors. The thing that brings me down is the way that many mums treat this incontinence as a normal even necessary part of motherhood. They swap recommendations for pads and commiserate on the burdens us mums must bear. Rarely, I see a recommendation for physiotherapy but not as often as one for trusty Tena Lady. Mums tell each other that its OK (it really is) we’ve all been there (we so have) and that it’s normal (Eeeeek! No! Stop right there! It’s really not). Recommendations for pads don’t help women long term. It’s great to lose the shame associated with leaking but please don’t ditch the long-term ambition to lose the leaking. Pelvic floor rehabilitation has an impressive body of evidence to show that it works for the vast majority of clients. While it is true that some women may suffer a pelvic injury which will never fully heal this is relatively rare and there is no reason for the majority of Mums to resign themselves to a lifelong challenge of avoiding trampolines, suppressing sneezes and paying for pads. So, next time you hear a Molo tell their tale of leaking while laughing in a management meeting or of struggling to contain a fart at a funeral then please, honor their honesty, share your story if you fancy but please for the love of all gorgeous confident mums don’t pass them off with a pad recommendation at least not without also mentioning physiotherapy. Because leaking might be common but it’s really not normal. Physio will cost less than pads in the longterm and the confidence of being able to sneeze and squeeze simultaneously is priceless. |
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July 2019
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