Sex After Baby

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Sex.  This can be a scary thing for women who have had a cesarean birth, who have torn vaginally, or who have had an episiotomy (or some kind of traumatic birth...or even just birthed a baby).  For one, some women find it hard to look at their cesarean scar, think their vagina appearance has changed or have a difficult time letting their partner look at them postpartum because they have lost muscle tone, have a stretched out belly, stretch marks etc.  

The scar tissue from the cesarean delivery and vaginal delivery (with a 3rd/ 4th degree tear and episiotomy) is still healing at your 6 week check up and will continue to heal for 6-12+ months, even if you are released at your 6 weeks check up and were told your incision was healed.  

Remember, sex should not be painful, but if it is, it would be wise to see a pelvic floor physical therapist to assess your scar tissue (vaginal or abdominal) and see if it might be causing some of your pain.  Most OBGYNs and Midwives recommend waiting until after your 6 week appointment to start engaging in sex again.  If your doctor has cleared you for intercourse, it is fine to start. There are many factors during pregnancy and delivery that can cause pain with sex.  Remember, painful sex is common and not normal.  Speak with your doctor about your pain and see a pelvic floor physical therapist to help improve your symptoms.  A pelvic floor physical therapist can evaluate your pelvic floor muscles for tightness, poor coordination and assess your scar tissue (cesarean or vaginal) to help address your pain.

If you are experiencing pain with sex, here are some things you can try:

  1. Water-based lubricant

    Hormone fluctuations can decrease the amount of lubricant your body produces, especially if you are breastfeeding.  Trying a lubricant that is water based is likely to last longer.  Here are some options (In no particular order) :
    1. Slippery Stuff

    2. SYLK lubricants

    3. Good Clean Love lubricants

    4. YES lubricants

2. Longer foreplay with deep belly breathing

-It may take a little longer to increase your arousal.  Adding in some belly breathing with foreplay can help calm down the tissues and get them ready for the fun!

3. Switch it up!

-A position that used to be comfortable, may not be anymore.  Try a new position out and see if that does the trick.  For example, on your back might be uncomfortable, but on top might cause less discomfort.

If pain continues, please seek the help of a pelvic floor physical therapist and your healthcare provider.

Bladder Chat

Bladder, bladder...what's the matter?  

I once did a community talk with that title (Bladder, Bladder What's the Matter?) and I loved it!  Huge turnout which was eye opening to so many women that they were experiencing similar bladder symptoms to the women sitting next to them-no matter their age!

Urinary incontinence, leaking urine with exertion (coughing, sneezing, laughing, lifting, exercise etc), happens to 1 in 3 women.  If you are in a public place today, look around.  That is quite a few women dealing with some sort of leaking.  Some of those women have been dealing with it since childbirth because maybe they were told it was normal at the age.  Some developed it closer to menopause when tissues and hormones started to change.  And some, well, they have been peeing a little bit with exercise since they were teenagers.  OR, maybe some of you don't leak (yet), but are experiencing the "gotta go pee" feeling BEFORE you leave for exercise class, when you get to the gym, during the class (fear of leaking) and then after the session.  Your bladder is owning you.  You fear of leaking is taking over your day and maybe that's why you are only wearing black workout pants anymore. 

No matter when your leaking or frequent urgency began, know this, it is a COMMON thing that happens BUT it is NOT NORMAL.  

You mean I can be fixed?  Sure thing. 

First, if you are having the urgency and frequency, it is possible your pelvic floor muscles are contracting (tightening) and you will want to see a pelvic floor physical therapist to learn how to control and calm them down to decrease your symptoms and take back your control of your bladder.  Think about all the time your will save from running back and forth to the bathroom.  It's worth it!! 

Same goes for leaking urine.  Not all women with urinary incontinence are dealing with just weakened muscles.  A lot of the time, other things are going on, like an imbalance within the muscle tissues.  I see this a lot in postpartum and menopausal women.  The muscles are not communicating to each other correctly and some develop tightness and some are working how they are suppose to.  With seeing a pelvic floor physical therapist, you are able to bring your awareness to those muscles and learn how to control and coordinate them again.  

So...this holiday season while spending time with people you love, why not ask a group of gals (maybe over some wine :) ) who has bladder issues going on and what they have done to improve them.  Maybe even suggest, you know what, this year, let's take back our health and improve these bothersome symptoms by seeing a pelvic floor PT :).

 

What You Need To Know About Pelvic Health

As women, we live in this one body, yet, we still have a difficult time bringing awareness to the pelvic floor muscles and learning how to contract and relax these muscles. This is a topic that surprisingly, not a lot of women are well educated on. I love addressing the pelvic floor muscles, their roles in our health and how they can change with pregnancy and birth.  

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The pelvic floor muscles offer many functions to our bodies: they are supportive to our organs, they help pump/ circulate fluid in as we breathe in and out, they aide in sexual function, they control opening and closing of our openings and stabilize our SI joint, pelvis, hip joints and lumbosacral joints. The muscles run from the front of the pelvis at the pubic bone, to the sits bones and attach to the SI/ tailbone area.  When functioning properly, the pelvic floor muscles should fire prior to movement of lifting children, laundry, jogging, grabbing a glass of water etc. So it is important to continue to focus on your pelvic floor muscles through all phases of life.

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Your "core" is made up of your diaphragm, pelvic floor muscles, transversus abdominus and your mulitidus muscles in your low back.  So, as you can see, doing abdominal exercises for your "6-pack" muscles, will not target the true core. 

With life, we generally create habits.  Even within our bodies, we tend to do things the same way most of the time.  For example, we tend to carry our children or purse on the same side of our body.  This can create compensations to certain tissues and joints, especially during pregnancy and postpartum.  For instance, during pregnancy we may stand with our bum tucked under, our abdominals stretched and tightness in our backs to hold us up with our growing belly/ uterus.  After birth, our bodies stay in a similar posture, with weakened tissue and we start moving throughout the day making new compensations with carrying an infant or a toddler.   Seeing a pelvic floor physical therapist can help you fire and re-train your core the proper way to improve your core support during pregnancy and postpartum. 

One day, I hope it becomes a natural thing for a women to be seen at least once during her pregnancy and then get an automatic referral to a pelvic floor physical therapist postpartum to check on how the pelvic floor is functioning prior to beginning an exercise routine.  I believe many women would benefit on a prenatal visit with a pelvic floor physical therapist, to figure out how to make their pelvic floor muscles function properly and then what posture and body mechanics would be beneficial to avoid to promote a healthy pelvic floor.  Then postpartum, addressing women's pelvic floor strength, endurance, coordination and any areas related to pelvic floor dysfunction, diastasis recti or scarring from cesarean birth or perineal tearing.  I think so many women are doing too much too soon instead of giving their bodies enough time to heal postpartum prior to jumping back on the exercise train.  Remember, it took your body 9 months to grow that baby (ies), so give it grace with healing.  You will be glad your took your time and were smart with your healing and exercise, instead of rushing back into things.  

What Happens During a Cesarean Birth?

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This is an area that as women, even those of us who have HAD a cesarean birth,  we know little about.  Cesarean births can be planned or unplanned.  Planned are scheduled ahead of time and unplanned can happen after pushing for long periods, or when needing to deliver baby quickly, like in my first delivery.  There are lots of different reasons for an unplanned cesarean.  

During the cesarean delivery, the doctor makes an incision into your skin, through your fat cells, connective tissue and into the abdominal cavity.

The abdominal muscles are spread apart and the bladder is moved so the doctor can get to the uterus.  An incision is made into the uterus and the baby is guided out.  After the placenta is removed, then the uterus is stitched up, the bladder is put back, the connective tissue and abdominals, and then the skin is stitched up.  A lot of layers of sutures within the tissues so scar tissue develops as you heal.

Please note, your abdominal muscles are not cut through during a cesarean birth, but your connective tissue is.  This is important to understand why we need recovery programs after birth, not just “sit ups” and running as soon as we feel like it.  

 

"I had a csection, so why do I need to heal my pelvic floor?"

Google Image

Google Image

This is a question I seem to get quite often. "I had a csection, so why do I need to heal my pelvic floor?"

During pregnancy, your pelvic floor muscles are compromised and stretched with weight of growing baby and uterus.  This can cause the pelvic floor muscles to be more lax than normal.  Changes in posture during pregnancy, also cause changes to pelvic floor muscles.  For example, standing with your butt tucked under to accommodate growing belly, can cause tightness and change in tone in your pelvic floor muscles.  This can lead to pelvic floor dysfunction (urgency, frequency, leaking of urine, pelvic pain). 

Pelvic floor muscles are also involved if you pushed prior to cesarean birth.  Also, cesarean scars can cause issues with nerve function to the pelvic floor, where you might develop pelvic pain with sex, urethral burning, or feeling of needing to pee all the time.  It is important to get the pelvic floor muscles to function properly with your “core” after birth.  See a pelvic floor physical therapist to re-train your pelvic floor muscles and core to function properly again as you care for your family at home or during an exercise routine.  

Seeing a pelvic floor physical therapist postpartum is ideal.  If you are looking for someone in your area and would like a recommendation, just let me know!!  

Should We See A Pelvic Floor Physical Therapist Postpartum?

Image from Google Images 

Image from Google Images 

Just a little food for thought.  Delivering a baby, vaginally or cesarean, is a difficult job for our body.  I hate to say it, but birth is traumatic to our tissues.  The muscles are stretched during childbirth, some are torn or even cut through, in order to do what is best to get baby out safely.  As a pelvic floor physical therapist, I have often wondered, why are these women missing out on opportunities to improve the function of their pelvic floor and abdominal muscles after delivering a child?  In all other areas of muscle injury (strain) or rupture/ tearing, patients are usually advised to seek the help of a physical therapist for regaining muscle control, range of motion, strength, flexibility, stability and overall function.  For instance, someone might have a whiplash injury (similar to a childbirth with minimal or no tearing), they would see a physical therapist to stretch tight muscles and strengthen weak muscles.  If someone tore their Rotator Cuff, they may have surgery to fix the muscles (similar to repairing pelvic floor muscles or abdominal muscles after delivering a baby(ies)), then they would seek the help of a physical therapist to stretch the tight muscles, regain coordination of the muscles, teach the brain how to connect with the muscles again, and go through a program of improving range of motion and strength/ endurance of the muscles.  

I think we are missing this with our new moms.  Think about it.  Women are pregnant for approximately 9 months (posture changes, back muscles tighten, abdominal muscles weaken etc) and then they go thru delivery (with tearing or not) and their body's are expected to bounce right back while taking care of a rapidly growing new born.

What I see with my patients are poor postural stances of weakened and stretched abdominal muscles, tight and short low back muscles, sometimes tucked bums or ribs thrusts with carrying and lifting baby/ children/ car seat etc.  I think it would benefit so many new moms to be referred to a pelvic floor physical therapist postpartum.  Every new mom could come in for a screen to see if they are having any issues and if there are any things a new mom should be working on in the first couple of months.  I personally think, it would be beneficial to see a pelvic floor physical therapist for a screen PRIOR to getting back into an exercise program.  A pelvic floor physical therapist can evaluate women for diastasis recti, pelvic pain, pelvic organ prolapse, urinary incontinence and proper postural and body mechanics.  Hopefully with seeing  pelvic floor physical therapist, this would prevent more pelvic floor risks and issues in the future. 

So...see a pelvic floor physical therapist today, even for a screen, to see if you would benefit from starting a pelvic floor home exercise program.  Why not support your tissues for a stronger future?  

The Scoop on Poop

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Everyone poops.  This is a discussion I had with my 4 year old recently.  He was avoiding going "number 2", until we were getting home at the end of the day. 

We discussed how everyone poops.  Mommy poops.  Daddy poops.  Grandmas and Grandpas poop. His teachers at school poop.  His daycare lady poops.  All the kids he is around all day poop etc.  We talked about the different places people go too.  He seemed shocked that people would poop outside of their house.  I tried to explain, when your body is telling you it needs to get something out, aka for him a belly ache, then you need to listen and go to the bathroom instead of waiting all day and being miserable.  (As this can cause some pelvic problems down the road)

This is often a similar discussion with my patients.  Bowel movements are often a topic with pelvic patients, as the organs are supported by the pelvic floor muscles.  Constipation and frequent bowel movements can both cause pelvic floor issues so it is best to address them when treating pelvic floor symptoms.

Poop kind of has a bad reputation, which is sad, because it can tell you a lot about your health.  So before you flush after your next BM (bowel movement), be sure to take a glance inside the toilet and just see what your poop is telling.  Yes, I said check out your poop!  

Your poop has gone on quite a trip to end up in the toilet.  Remember, at one point, that poop was food.  The salad you ate last night went into your mouth and started the digestion process with chewing (side note: try chewing 20-30 times with each bite to help with digestion).  When you swallowed, it ended up in your stomach where it continued to break down with acids and other organs helped with this process.  The nutrients of your dinner are absorbed in the small intestine. Then your salad became waste product as it reached the colon to begin it's journey of leaving the body.  When stool reaches your rectum, you get a signal from your brain that something is about to exit and make an appearance.  It is best not to hold back your poop, but to take the time to sit down on the toilet, with your knees slightly above your hips (squatty pottys), to have a nice relaxing bowel movement (breathing and "shhhhh-ing" are great tips to help with the relaxation).

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So what does healthy poop look like?  I get this question a lot and most people are surprised there are many types of poop, 7 according to the Bristol Stool Scale :). You want to strive for a Type 3 or 4. If you are more type 1 or 2 it is a sign of constipation, and adding water and/ or fiber can improve this.  If you are a type 5, 6 or 7 regularly, you may have an issue with absorption or have an infection. 

Color of poop is another thing to pay attention to as it can tell you what is going on with your organs.  Poop also gets it's color from your food so don't be too alarmed it if changes red when you eat too many beets or cranberries! Poop should be a nice milk chocolate type of color.  If it is a black, tar like color it can be a sign of bleeding so consulting a physician to rule things out is a good idea.  Stools green/ yellow in color can mean you are eating a good amount of green things or a sign of gallbladder issues.  If you are starting a diet, don't be shocked to have a variety of colors when you glance in the toilet. 

Last one, should your poop float or sink like the Titanic?  Floating poop can be a sign you have too much fat (bad fat) in your diet or issues with your liver or gallbladder.  Cutting back on pizza and fast food may give you a successful poop sink in the toilet.  

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Running Postpartum

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Your 4th Trimester is your recovery phase.  A time to restore your strength and endurance.  Think of your postpartum recovery more like a marathon vs a sprint.  If it were a sprint, you would see your OB at your 6th week check up and get released to resume exercise AND you would head home to go for a jog.  If this sounds like you, you will likely increase your risk for pelvic floor dysfunction (leaking urine, pelvic organ prolapse, low back pain, hip pain, pelvic pain...I could go on and on and on...). 

Retraining your pelvic floor and core muscles how to work for you is very important and should take time to get them back functioning properly.  I mean, the pelvic floor and abdominal muscles have been stretched for 9+ months and forgot how to work properly.   It is our job, as smart moms, to make sure they are functioning before running/ jumping with 10-12 times our body weight thru those muscles.  That's a lot of stress on those muscles.  Think about your life down the road with your pelvic floor, abdominal muscles and your organs...you want them working in the correct way when you are in your 60s, 70s and so on, right?!  I do!

For my friends and patients who love running, I advise waiting 4-6 months postpartum to begin running.  I really think closer to the 6 months would be best for our lovely pelvic floors.  4 months seems to be early when you think about life as a mom of 1, 2 or more children.  It is a challenge to train your muscles prior to that time consistently.  AND then we throw in breastfeeding (hormones), lack of sleep (increased cortisol-stress hormone-effects how our body heals and recovers) and then 6 months sounds a little early.  Especially with the hormones that are still heightened in our bodies.  If my patients are breastfeeding, we may push back running past 6 months, depending on how the body is functioning with movement and what the pelvic floor strength, endurance and tone is looking like.  

Before my patients are advised to begin running, they have completed certain pelvic floor/ core strengthening exercises and home exercise programs for a period of 8-12 weeks to set them up for good outcome when they go out for their run for the first time. 

Things to think about prior to going out for a run at 4-6 months postpartum:

1. Have you had an evaluation with a pelvic floor physical therapist to assess your pelvic floor function? core strength? function with posture and alignment?  You should!  All of us should postpartum!

2. If you pee your pants with coughing, sneezing, laughing, lifting, bending over etc you are not ready to run yet. 

3. Feeling of pressure or heaviness in the vagina? Worse after lifting? Or while on your cycle?  If you answered "yes", you are not ready to run yet. 

4. Do you have an abdominal separation in your midline that is weak (Diastasis Recti)?  If so, I would wait to go out and run. 

"So...what can I do instead?"

I love having patients find hills in their neighborhoods to walk up and down.  Prior to doing this, patients have been walking on a flat surface (for a long time) with no increased symptoms from above.   Patients are to practice proper alignment while walking to promote proper core recruitment.  I cue patients to rotate their upper body arm swing while ascending and descending hills. 

   

What You Eat MAY Affect Your Hormones

The talk of how crazy women can be has been going on for centuries.  Did you know a hysterectomy was thought to cure women of "hysteria"? Crazy right?!  The thought was women were going crazy (mood swings) because their uterus was searching for children.  So they must be cured if you remove it. 

I am thankful to be living in times of modern medicine.  We know so much more now days about what can affect our hormones.  There are lots of options out there, but I will be focusing this blog on more food related items. 

So how can our hormones get "imbalanced"?  The most common causes are: 

  • excess stress
  • lifestyle choices
  • aging
  • genetics
  • lack of nutrients
  • pregnancy, miscarriages and abortions 
  • environmental exposure to toxins

We have quite a bit of control over the above, especially our genetics.  New studies have shown that we can turn on and off genes in our DNA with external factors (such as diet, sleep and stress). How cool is that?!  The DNA is still passed down to your children and grandchildren, but the choices you make today, can affect your great grandchildren.  Pretty amazing.  

So what choices can we make to make a positive change?

  • Start adding dark, leafy greens: most nutrient dense food, yet lacking in a lot of people's diets
    • dark greens clean you blood, improve circulation and improve your immune system by restoring strength and reducing inflammation
    • Start by adding in a 1/2 cup of cooked (lightly sauteed or steamed is best) greens to your day.  Slowly work your way to 3-4 cups of raw and cooked greens
  • Add more healthy fats (Fats! Handout)
    • Women's bodies are made up of about 60% fat.  That's almost 50% more than males and it is important for our fertility (that's hormones ladies!). 
    • When we eat a low fat diet, our bodies have a harder time digesting fat-soluble vitamins (Vitamins A, D, E and K) which play an important role in hormone regulation. 
    • Add more Omega 3s to support brain function (deficiencies have been linked to ADD, ADHD etc) 
    • Examples of my faves: coconut butter and avocados
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How much fat do I need?  It depends.  Start by keeping a journal and see how you feel after eating good fats. I feel better when eating meals with more healthy fats and I find I am eating more fats now than ever before, somewhere between 30-50% of my daily food, especially while pregnant. Eating more healthy fats has been shown to help some women regulate their hormones to getting their periods/ cycles back on track (while reducing their carbs, not eliminating them).

  • Chewing starts your digestion and most of us aren't chewing our food enough.
    • Chewing less makes it harder for food digestion to occur and can cause bloating, gas, abdominal pains, constipation/ diarrhea etc 
    • TRY chewing your bites 20-30 times and see if you notice a difference in how you feel!

So again...

  • Take longer to chew your bites (20- 30 times)
  • Add 1/2 cup of leafy greens to 1 meal a day, working up to each meal 
  • Add good fats to one meal.  It might be avocado slices to your eggs in the morning or to a salad at lunch.  

Pelvic Organ Prolapse: 50% of Women Who Have Had Children May Have This

Pelvic Organ Prolapse (POP) is a diagnosis women can get postpartum and after childbirth.  Statistically, 50% of women are at risk for POP after pregnancy, but you can develop POP prior to pregnancy.  I ended up having a little pelvic organ prolapse during my "training for half marathon" days, which then worsened postpartum (with each of my pregnancies).  Know this though, having prolapse does not mean you have to stop exercising. I certainly have not and I am pregnant with my third! :)    

Picture from Google Images

Picture from Google Images

Prolapse can tend to be a scary word, so let's go over what it is.  Pelvic Organ Prolapse (we will discuss female anatomy) is when the pelvic organs are pushing against weakened pelvic floor muscles that are not functioning to support the organs within the pelvis (bladder, uterus, rectum, urethra) and women can begin to feel pressure in vagina (sometimes women feel like an old tampon is coming out) from the organs starting to come down into the vagina.   

3 Most Common Types of POP:

Picture from Google Images

Picture from Google Images

1: Cystocele: bladder prolapse.  Women may complain of feeling pressure in vaginal canal.  Sometimes the pressure is felt when the rectum is filling with stool and pushing in on cystocele.  Other times it is felt after lifting or carrying weight (same with all 3 types), such as babywearing.

2. Uterine: The uterus can lower post pregnancy and delivery.  Sometimes it is difficult to keep a tampon in due to a lower uterus or some women find intercourse uncomfortable because their partner may be hitting their cervix during deep penetration.  Do keep in mind, the uterus does move during our cycles (higher and lower) and this is why some women may feel this during their days 14-21 of their cycle (different for everyone). 

Picture from Google Images

Picture from Google Images

3. Rectocele: Rectum prolapse:  Some women may complain of feeling a bulge in vagina when the rectum is full of stool.  Some women have to "splint" or insert their fingers vaginally to push back on the rectum to void during a bowel movement. 

Prolapses are measured by grades of 0-4.  "0" meaning no degree of prolapse and "4" meaning the prolapse is bulging outside of the vaginal opening.  Your doctor can give you your grade of pelvic organ prolapse in their office.  I like to look at my patients' prolapase in the clinic in a few different positions and let the patients see what they are feeling in their vaginal canal. Remember, 50% or more of women can have some kind of degree of POP after baby and some can be asymptomatic and manageable. Some POPs cause more issues so it's important to seek proper postpartum exercises and the help of a pelvic floor physical therapist to assess what exercises would benefit you and help you get back to certain exercises that interest you.  

With being early postpartum, and/ or if you are experiencing "feeling of pressure in your pelvis" or "pressure down there", it is important to avoid certain activities and exercises:

  • Avoid standing for prolonged periods of time: this could be household work, baby wearing through the grocery store,  carrying toddler, lifting heavy weight (moving furniture) etc 
  • Avoid wide leg squats and lifting from a deep squat, especially while holding your breath may increase your prolapse
  • Avoid abdominal exercises: such as crunches, sit ups, planks and push ups (not saying avoid forever)
  • Avoid running, jumping, HITT workouts, plyometrics and burpees etc ( I like to avoid these until 4-6 months postpartum AT LEAST to help the pelvic floor muscles heal properly after delivery). 

What you can do while exercising in early postpartum:

  • Pay attention to what you are feeling in your vagina while exercising and afterwards.  Increased bulging and pressure are bad.  If you feel this, you may have increased your exercise time or intensity too soon. 
  • Focus on your posture and alignment while exercising.  Remember to keep ribs stacked over pelvis.
  • Watch your breathing with exercises.  EXHALE during exertion and avoid holding your breath with exercises.
  • Focus on core and pelvic floor strengthening and retraining to get the muscles on the right tract to support you and your organs again
  • Do exercises in different positions: lying on your back, back and hips elevated, sidelying, sitting, standing (avoid too much of this one due to gravity)

I like to suggest to new moms to seek the help and guidance of a pelvic floor physical therapist before getting back into running or plyometric exercises to avoid POP and other pelvic floor dysfunctions in the future (especially if they are having signs of pelvic floor dysfunction: urinary incontinence, pelvic pain, feeling of pressure, diastasis recti, low back pain, hip pain etc).   . 

Pregnancy Journal: 27 Weeks!

On the hayride to go find our pumpkins!

On the hayride to go find our pumpkins!

I am closer to 28 weeks than 27 weeks while posting this, but our house was hit with the stomach bug this weekend and life got away from me.  

Landon doesn't like sitting on the hay.  Jackson was so excited to sit by the pumpkins!

Landon doesn't like sitting on the hay.  Jackson was so excited to sit by the pumpkins!

So #27weekspregnant and continuing to feel great!  This is my favorite time of year.  I love the fall, Midwest weather, the clothes, the smells, the food (but really, who doesn't love food while pregnant?!), and the outside activities.  My boys and I went to a local Pumpkin Patch this weekend (prior to getting sick), and had a blast. 

I am feeling baby move more and more each day.  Especially when Jack and Landon talk to my belly.  They love telling "Baby Fred" (that's what they have named him) all about their days, what they ate and what they did.  I need to record these conversations because they are freaking adorable!  

I was low on iron so I have started taking an iron supplement and eating more iron rich foods (greens, spinach, beans etc) to help improve my levels.  My eyesight has improved with doing so.  My eyesight was getting pretty bad over the last month so I am glad my doctor caught that.  

I am continuing to eat a diet high in good fats and protein.  Lots of good research out there with having a diet high in healthy fats while pregnant and breastfeeding.  I am adding more avocado, coconut MCT oil, and Omegas to my meals and snacks throughout the day.  I definitely feel better when I do, especially when I am staying hydrated, I notice less swelling in my labia and legs.  I mentally feel better too! That's a bonus as a mom of 2 (soon to be 3!).  

Eating a diet high in healthy fats is also great for women of all ages because they help regulate our womanly hormones.  How wonderful is that!!  We could all use a little help with our hormones, am I right?!  hehe

Anyways, I'll be making a post on that soon!

Have a fabulous week!  If you want to chat about anything, remember, I do virtual consults now :)

Amanda 

5 Important Pieces of Information About Diastasis Recti (Abdominal Separation)

Copied from Bing Images

Copied from Bing Images

Abdominal separation (Diastasis Recti) of your mid line of six-pack muscles is all the chat right now in social media.  So...I want to give you the low down on what the hype is all about.

When I first started my training with pelvic floor physical therapy, I was under the impression that a 2 finger split was considered normal.  With time, more research and growing knowledge about this topic, we now know that not to be true.  

After you read this I hope you feel more comfortable about this topic.  

5 Important Pieces of Information About Diastasis Recti (Abdominal Separation)

Fact 1 :I feel like a see 3 new sponsored posts daily on this topic.  An abdominal separation can happen to the linea alba, the connective tissue within your mid line, due to the laxity that happens from growing uterus and baby.  Try not to stress out about an abdominal separation.  It is very common among pregnant and postpartum women and very possible to heal a diastasis recti (men can have Diastasis Recti too).  A study by Diane Lee, found 100% of women have abdominal separation at 35 weeks gestation (pregnancy).  Your body is smart one and knows what it is doing.  Your belly stretches to accommodate your growing uterus and baby. The study found that by 6 months postpartum, diastasis had decreased to 35-39%.  So it is important to check in with belly every now and then to see if yours has gotten stronger.  

Copied from Bing images

Copied from Bing images

Fact 2: Posture and alignment are important with strengthening the gap.  Pay attention to how you are standing, lifting and carrying baby. Make sure your shoulders and ribs are stacked over pelvis to keep your torso in good alignment, which decreases pressure in your abdomen (less pressure pushing on linea alba-midline of abdomen).  Try to be mindful of how you are lifting/ carrying baby, especially when in the car seat or baby wearing. This is also a great place to start seeing a pelvic floor physical therapist so they can help you with your alignment with activities and assist you on your road to recovery.

Fact 3: Another way you can decrease the pressure in your belly is by breathing out (exhaling) when you are lifting baby.  This is great to remember when lifting baby into car, crib, picking toys up from the ground, lifting holiday decorations etc.  

Fact 4: There is NOT one exercise that will heal your abdominal separation.  There is also NOT one exercise that will ruin your abdomen.  There may be exercises that you need to avoid while you are working on strengthening your separation, but you can get back to those exercises when your body is ready.  For instance, if you are seeing a pelvic floor physical therapist, they may ask you to avoid certain core strengthening exercises, like a plank, but that doesn’t mean you will have to avoid them forever.

Fact 5:  The internet gets us caught up in the separation of our abdomen.  Is it 2 fingers wide, 3 fingers wide or more.  I tend to not get caught up on the separation split width and try to not get my patients too excited on this either.  I am more interested in the tension created between the 6 pack muscles that run from the breast bone to the pubic bone. I want my patients to improve in their “bridge” between their mid line, meaning more “taut” with activities of lifting, carrying, exercise etc.  When your tension improves, you are getting stronger!   

Pregnancy Journal: 26 Weeks

#26weekspregnant 

#26weekspregnant 

#26weeks, feeling great and baby boy is the size of a head of lettuce!  Received my Bao Bai Maternity Belly Sport Band in the mail this week and I am in LOVE!  I am now doing my morning walks with the band and NOT my V2 because the band relieves enough pressure in my belly to decrease swelling in my labia.  Love that!  I still wear my V2 and compression hose during the day to help with blood flow, but when working out and walking, I just wear the belly sport band and feel good.

Ask for alternatives!  

Ask for alternatives!  

Well, this week I had my Glucose Test.  Did you know you have a choice on how you want to intake your sugar (50-100 grams depending on your doctor) for the Glucose Test?  You don't have to drink the orange, Glucola drink.  You have choices and there are alternatives for your body (and growing baby).  Which I think is awesome!  I try not to ingest too much sugar in my daily food intake (less than 40 grams daily), so to have options where I don't have to drink a sugary drink (because I avoid sugary drinks anyways) for the test, completely rocked my world.  If I am going to splurge on sugar, I would rather do it as a meal or dessert, than a drink full of ingredients I don't want in my body.  So...I called my doctor's office and asked if it was alright to take an alternative approach.  They said yes and gave me their acceptable substitute for the Glucola drink.  It consisted of unsweetened Cherrios, regular milk, orange juice, white toast and a little sugar.  Much better tasting than the "orange drink" and I didn't feel awful after eating it (like I have in my past pregnancies).  So...ladies...be an advocate for yourself and ask your doctor/ midwife what your options for the test are.  I think you'll be happy you did.  

Pregnancy Journal: 25 Weeks

Rocking my sweet compression hose (and V2)

Rocking my sweet compression hose (and V2)

Finding myself full with eating small meals these days. I am working on eating meals higher in healthier fats with this pregnancy and I am feeling better when I do!  A few of my favorites are adding avocados and good oils to meals.  

Over this last week, I have been having more low back spasms after being on my feet for prolonged periods of time.  I continue to walk my dog in the mornings (my reflection time) and have a little round ligament pain occasionally, mostly on hills.  I work on core hugging during the hills to lessen the pain.  I am hoping to try a core belly support here soon to help ease the pain as well.  Baby boy is the size of a cauliflower this week and kicking like crazy!  Jackson, my oldest, has been calling this baby "Fred" for the last couple of months.  So much, that I am having a difficult time coming up with a name for this child, because now we all are referring to my bump as "Baby Fred".  Any name I say, Jackson will reply with, "Fred is a fine name for a baby".  He is too cute!

Continuing to get in some core, arms and legs workouts, along with some prenatal yoga (very relaxing...pretty sure I fell asleep in class), after my morning walks and between patients, biz and mom life.  Life is crazy, busy right now, and I love it! 

 

Peeing My Pants Postpartum

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Growing a child is pretty wonderful.  Have you ever noticed how much excitement is brought to the room by a growing belly, the "pregnancy glow" or the changes in life that are about to happen as this new little human enters your world?  So much advice is given to you about what to name your child, how to raise it, what to feed it etc but what about the real information we need to hear as moms?  

I mean, I love my mother, all my aunts and female cousins in my family, but none of them, not even my sweet soft-spoken grandma, told me there would come a day when I would pee my pants (during pregnancy AND after baby) when laughing during a night out with friends, or while jumping on a trampoline OR when I sneeze during allergy season.  

Some would say, but Amanda, you are a pelvic floor physical therapist, you should have known this day would come.  Yes, I may have the background knowledge on this topic, but a little insight from friends and family BEFORE delivery would have been nice.  Maybe at Baby Showers, women should be given a handout of all the things that really happen to your body after baby arrives.  I do think, as women, we need to stick together and warn each other of the possibilities of peeing your pants after having baby and how soon this can start.  In reality, if you are leaking at 6 weeks postpartum, there is a high percentage you will STILL BE LEAKING at 12 weeks postpartum and EVEN 5 years postpartum.  So, if you happen to chat with a friend/ family member around 6 weeks postpartum or beyond- speak up!  Don't be afraid to say, "hey, you should probably speak with a pelvic floor physical therapist".  

I certainly don't hold back anymore.  My goal is to educate women on the changes that may happen to them and let them know they are COMMON but NOT NORMAL parts of motherhood. 

So, this week, I encourage you to speak to someone you know, (don't be the weird, creepy person in the grocery store telling women about incontinence---leave that to me hehe) about pelvic health.  You can help improve their health by planting a little seed of knowledge.  

Have a safe and wonderful week!

Amanda