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Together, we are committed to providing more reassurance for parents with trusted products and this podcast helping us to all take those important steps towards greater confidence while building a community of support for every mom. This week, I want to learn all about why, as women, we need to take better care of our pelvic health with specialist physiotherapist Helen People now based in Dublin, Hellam is leading the way in pelvic floor education.

She was an official physiotherapist at the London 2012 Olympics and has been providing postgraduate tutoring for pelvic obstetric and gynaecological physiotherapy recorded just before the birth of her first baby.

Helen now understands the science and the real experience of carrying a baby, of putting her own pelvic floor to the test and shares with us her most recommended techniques and practices to help her stay strong and recover post birth from urinary incontinence to diocese's prolapse and perineum massage. Here, Helen shares her expert advice on at all.

Helen, thank you so much for coming on everyone on the podcast with me, especially as you are so close to birth, how many weeks of you left?

Thanks for having me. Tonight I am 37 weeks in two days time.

So really was a 23 days left. Yeah, yeah.

Although I'm really trying to not remember the due date, so I'm trying to remember like that period of the few weeks. But who knows, I could have five weeks left. I could have two days left. It's scary and exciting all at the same time.

The unknown about when they'll arrive is so it's hard. It's as you said, you're trying not to remember the due date, but it's very hard not to focus on that because I know because everybody wants to know it as well.

I'm like, no, no. Now, like when my friends and family ask, I'm like sometime around late September, early October. But yeah, it's tricky. And then obviously. Well, Chirikova Times I would have been so organized and have so much in the diary and be so planned. And I guess being through Kovik while going through covid has taught me to plan less ahead, but I still would be very much a planner. So not knowing the date is like it's a learning curve for my brain.

It's the first time that you realize that you don't actually have any control over this human know.

They will do what they want when they want for the rest of their lives. Oh, God. But how have you experienced pregnancy because it was treated you. Yeah, well, if I would say generally at this stage it's been good. But then looking back, it's completely not the pregnancy that I had imagined so naively. You know, I had just kind of imagined because I was fit and healthy and well that my pregnancy would be straight forward. And luckily, to be fair, in the end, it has turned out fine.

But at about 11 weeks when I had my booking appointment, they found out that I had a really short cervix. So when I was twenty five and had my first major test, I had some abnormal cells detected, so I went in, had a colposcopy long story short, I had to actually take away some of my cervix for treatment for these cells. And she said at the time, the doctor said at the time that I'd always be at risk of premature labor or miscarriage.

And you know, at twenty five, I'm thinking, well, I was not thinking about babies at that point, but of course that comment just always stuck in my head. So it was quite worrying is one of the words, I guess, that I felt like such an early stage to be told that from then on I would be high risk. So, you know, and it was obviously during lockdown. This is all happening. So it's kind of on my own and having three appointments on my own and stuff, which has been like, fine, but like, no, I guess what I would want in an ideal situation.

But then luckily the pregnancy has been fine. It was progressing. And I went for my fortnightly checkups where they checked my cervix and it luckily stayed put and didn't change at all, which was really good. So, yeah, it's been a roller coaster. I'm originally from the U.K., so and not being able to see any of my friends and family for my entire pregnancy has been against another thing I just never would have envisaged or imagined. You know, it's really it's just a bit of an odd situation because obviously I'm grateful to everybody as well.

And everything is good. It's just that kind of I don't know, that kind of count, the thought of, oh, I really miss everybody. And, you know, I wish I could see them and everything else, but everyone is healthy and well, which is, of course the main thing. But it's just being mad.

Yeah, but it's OK. It's OK, I think to you know, to say that you miss what you thought you'd have. Yeah. And being pregnant and even the physical changes of your body being pointed out and loved by your friends and family who only get to see you pregnant for such a short window being taken from you. That's really hard.

This isn't exactly and of course being my first pregnancy, you know, there's just so much unknown anyway and so much newness and so much. Yeah. That you're learning about yourself and so much changes. And yeah, it's been in my time.

I do really feel for my husband because he's been great, but I've obviously had to put on him a lot, lot more in terms of like support and everything else than I would have done. But he's been great. But I just wish I could kind of share the burden, you know, in terms of obviously the zoom and that's what's up. And those phone calls, of course. But yeah, it's been, as you say, like you meant to have your little support network and people around you.

So but that will come on shore, like meeting other pregnant women, different classes and. Talking about things with these strangers that are quite personal, but all of a sudden they become your lifeline. Yeah, it's it's so important that that interaction continues because especially for you, you've built quite a really impressive and successful career around supporting women. So knowing what you've known as a professional, how has it compared with the physical experience of pregnancy? Yeah, it's it's definitely been eye opening, seeing it from this side because of obviously work with pregnant women for so many years and you know, you know, the theory and the advice and all the latest research and be helping and guiding women through their own pregnancies.

But going through it myself has been it's been fabulous. It has really been. I can see it from this side as well. And I guess it just makes me realize the first trimester and I know not everybody is the same, but it was the absolute pit in like nausea and fatigue and oh, my goodness, I wasn't actually sick once. I didn't actually vomit. But the feeling of being on the edge of thinking you're going to vomit any second now.

Twenty four, seven for like weeks and weeks was just horrific. I almost wish I was sick. I kind of think like somehow that would help relieve the nausea because the nausea was so bad. So I think just yeah. Like the first trimester definitely was like OK, wow. Like these poor ladies that come in who tell me they have been sick and you know, of course I'm listening and making something else. And so I never quite realized before, just the extent of which it can just be so consuming.

And I would normally love being well, I so do love being active and fit and exercise. And, you know, on a good week I'd kind of get to the gym about five times a week. But just having to really let go of my normal routines in terms of movement and activity, quite literally, there were weeks where if I made it for a walk around the park, which would be about a 20 minute walk, that was a good thing.

It was like and that compared to what I normally would kind of have in my mind set on my routine was just so reduced and, you know, just little things, just like what you're eating. So normally I'd be mostly good, maybe seven percent good, five percent so good with my diet. But yeah, just being like stripped back to like deep fried beijng or fancy. And, you know, again, I can't normally be quite within reason.

Like, I still love chocolate. But, you know, if I had like pizza and burger and whatever at the weekend, then I'd be like right now in the week I'll be a bit better. But yeah.

And I just kind of letting go, I guess, if any preconceptions that I'd have before. And just now having such a deep understanding of all the women that come in to me that, you know, so these things, it's just like it's mud. And I'm sure like many women, I had this vision again of like nourishing my baby, you know, like nothing but vegetables and, you know, like a really well balanced diet. But anyway, not to mention, obviously, the cocktail before I found out I was actually pregnant, you kind of think, oh, gosh, all of these things anyway, what can you do?

I'm sure I'm not the last one.

I might be the definitely not. And it's important, you know, as you said, like, yes, it's important to keep up as you as you know, you know, the benefits of keeping a physical exercise. You know, we all know the benefits of eating nutritiously, but also like to to to give ourselves a break from that negative cycle in our heads that's beating ourselves up over, you know, if all you can do is the twenty minute walk, that's enough.

Exactly. And actually what you need to do is honor yourself by listening to what your body needs and and trying to give it that. So if your body's saying stuff up to 20 minutes, then that's the right thing to do. This is exactly and I think we have what you said there is kind of nail on the head actually listening to your body because. Yeah, like, I think this would be the first time a properly tuned in to listen to my body in terms of like what it wants from a food and a drink and a movement point of view, because I would normally have gone on.

No exercise is good for you. You have to eat five times a week. And I'd kind of just even if I was a bit tired or feeling a bit not for it, I would still always get myself to the gym. And to be fair, I love it when I'm there. So that obviously makes it easier. But now actually listening to my body once rather than thinking, OK, this is what we should be doing. And, you know, it's really been I really like the aspect of actually kind of really been a big learning curve to actually see what my body's trying to tell me.

That's just be a little bit especially in pregnancy, be as kind to yourself as possible because your body is growing a human from inside. You talk to me, though, about how important it is to tune in and listen to your body when it comes to your pelvic strength.

Yes. So it is really, really, really important. And I guess like with pelvic strength, we could think about the pelvis itself kind of from an overall structure. So like kind of our pelvic joints and any pelvic girdle type stuff, because I definitely found that when I love to walk and especially with lockdown like the walk per, they became obviously like the highlight. So I would be walking quite a lot. So I found that as my pregnancy has progressed and I you know, I still am quite fit and active.

The actually I can't walk as fast. I can't walk as far because my pelvis just I can just kind of feel the changes happening, you know, I can feel a bit more pressure happening. That's a bit of pain and twinges in my pelvic joints. So I know a lot of women that I've seen as well over the years would have pelvic girdle pain so we could think of pelvic strength in that sense, kind of like an overall extrinsic strength and structural at a structural level.

Yeah, exactly. So like appreciating the pelvis is kind of like the connector between the legs and the upper body, but and also the supports and the protector of the organs and the baby that's kind of growing in and then just above the pelvis. But also really importantly, of course, would then be the internal strength of our pelvis. So by that, I would also be referring to our pelvic floor muscles, which I'm sure every listener would definitely have at least heard of by now.

I hope so. But it's okay if you haven't, because as though plenty of women that I meet that happen from a pelvic floor muscle point of view, more like the name Talisa, they sit at the bottom of the pelvis and they're mostly internal muscles, actually. So you can't really see them from the outside. And if you are trying to strengthen your pelvic floor muscles, then you'll feel most of the movement on the inside as well. And they are just so, so crucial.

They're like the unsung superheroes of the body because they just have such important functions to do that when they're working really well. We don't think about them. I guess like any muscle, if you can climb the stairs, it means your legs are working. Well, if you can pick up the glass of wine, your arm muscles are working. Well, you know, we don't think about our muscles unless that's a problem. And the same would be for the pelvic floor.

So if we have any weakness or tension or trouble with the pelvic floor muscles, then we'd know about it by changes in our bladder or bowel control and habit or with sexual function. So they're really important muscles. And during pregnancy, we're all meant to be doing some pelvic floor squeezes every day. So I don't know how many are you doing tonight, not daily, daily?

I have I've always done palazzos and like that's just been, I suppose, my not just in pregnancy, I mean, for years, like, it is sort of my physical non-negotiable because I had back surgery a few years ago. So I have been introduced to the the the value, I suppose, of maintaining your pelvic floor muscles. And and I probably did them quite a bit on my first pregnancy and had I'd like to say, quite a positive labor experience.

Now, I'm not going to say that that's the end of pelvic floor strength and pelvic floor recovery after birth. But since becoming quite heavily pregnant, now I see how much damage that first pregnancy must have done, because quite early on in the pregnancy, the second time round, I'm like, I really need to go to the toilet.

I really need to wait. And both my babies have have grown very deep, very low, very heavy. I don't have a high sitting. I don't get heartburn. I don't have it up in my abdomen. They're both very they were both very, very low, but I've so recognized and as you said, they're about, you know, the covid walk being your mental health in the day. But I was freaking out over where I could access a toilet when it was proper lockdown because I'd walk for three or four minutes after leaving the house and I'd be like, I have to turn around again.

I have to go back. So and I know I'm not alone on that, and that's why I think this conversation is so important, because we are given a fountain of knowledge when it comes to what we should do for our bodies and our babies in pregnancy. But I still feel like this topic isn't known enough about. Yeah, absolutely. And you're so right when you're saying that you're not alone, because even in the first trimester, so even in those early weeks of pregnancy, our uterus has already begun to expand the normally are you sitting in the pelvis with the bladder?

So even when, you know, the bump isn't really showing yet, there's still already excess pressure on the bladder. So I would say a lot of ladies who would be kind of earlier on without a bump and they would be telling me the same thing, like, why do we need to go to the toilet so often already? It's it's a sign of things to come. And so it's, you know, and then obviously, the more you progressed, then you do have the extra weight then pushing on the bladder and the pelvic floor.

So and I don't know about you, but. Well, the night before last, I woke up in the morning and I'd only go once for a week and it literally felt like heaven, like, oh my God, I've only got out once for this long.

And I generally can't remember the last time it was only one, you know, normally anything between one to four times per night. And you're just like, oh God, it's constant.

And it's even like before I when when you when you're downstairs watching TV and you decide, right, OK, it's time for bed. I might have a lead by the time I've gotten to the bedroom. I have to go again. I haven't gotten into bed yet. Like it's constantly and it's it's becoming a real like if we're going out I need to know where the pit stops are. Yeah. And so I am conscious of making sure that and the other thing to say is you're the hormones are creating faster kidney function.

So it's not always just a physical thing. That is the hormonal influence as well. Plus, I'm conscious of how performing pelvic floor muscles. Correctly will help the situation, because what I don't want is for this to continue post birth, I want things to return to normal as quickly as possible.

Yeah, exactly. And that is where pelvic floor squeezes do really come in. So, like, a really simple way to think about your pelvic floor is a bit like a trapdoor to all of the holes. So it really simply if we need to go for a week, if you're trapped or holding in the right way and if it's strong enough and it's holding for long enough to get you to the toilet in time.

So that's why in clinic with the ladies that I see when I'm testing their pelvic floor muscles, the aim, more or less for everybody is to be able to get to holding your pelvic floor for 10 seconds and also in standing. So like a lot of ladies I would see would be quite good doing that squeaks and lying or sitting there in the car or at traffic lights, things like that, I hear all the time. But the piece that people often miss out, which is a really crucial piece, is actually doing them all and standing and telling me that when you say doing, I think it's really important for people listening.

You say doing what physically are we doing?

So let's all do one together now, because I think that's just like an easy way if we just have a go. So the first thing to get comfortable basically. So either sit down or lie down standing is hardest, but you could give it a go. And if you can't feel anything, then you can move to sitting or lying. But the best thing for it to take a really big breath in and out because the diaphragm is attached to the pelvic floor.

So if we do that breath in and out, it just helps to reset everything. So take a big breath in. Breathe out and then what we now need to do is activate the pelvic floor, and this has been given about seventy five different names. So activating, contracting, squeezing, lifting Cagle's, it's all exactly the same thing. So no matter what you hear, everybody, everybody is referring to this one movement. And it's been shown that if we try and focus our effort on the back passage, then that is a far better way to get a very good squeeze to go.

So trying to imagine that you're stopping urine is really outdated now. So why are we so we're comfortable. We've taken our big breath in and out. And then so what you need to do now is you need to tighten and lift from the back passage as if you're stopping wins and then you let it go again. So with the tightening and the lifting. It's a small movement like the actual if you were to actually kind of look at what your muscle is doing, it's only moving by a few centimeters if that.

So the actual movement itself is quite subtle and the muscles aren't very big. So you shouldn't be able to really see anything happening either. It should just be that subtle internal lifting up. And then when you let go, it should not you should be able to feel like the release back down again. So that would be a pelvic floor squeeze or whatever we're going to call it. And in order to do a 10 second hold, the I was just talking about and standing, it's exactly the same thing.

So you take your big breath in and out, tighten and lift from the back passage that you're trying to stop wind. But this time you now try and hold it for 10 seconds before you let go. So the first one was a short one, the ten second hold would be a long one and ideally we should be doing a mixture of those each day, especially during pregnancy and in that post-natal period once we've had our baby.

But. Yeah, that's that's in a nutshell for us, is each of them doing so, the short ones versus the long hold ones, how are they individually benefiting or is it just that the combination of both is up to them?

Yeah, no, they do both have different really crucial benefits. So the short ones are really increasing the power of our pelvic floor and the short reaction. So like, for example, when we cough or sneeze or something or someone, the pelvic floor should be able to kick in quickly just before that pressure happens. And when it doesn't, it's optimum. We leak like if we're coughing or exercising or something like that. So the short ones really help that quick activation of power.

And the long coats are really important as well, because they would be the ones that enable us to get to the toilet in time and kind of hold on basically whilst we're doing things, but also really helping the general day to day function because the pelvic floor muscles have to work pretty much all the time anyway to stop us from leaking. So when we go for a wee or a poo, the muscles are actually letting go. So that kind of relaxing for the pelvic floor muscles are always a little bit on to stop those things from happening all the time.

So the longer holds or so, just help support that function of them as well. So what are you seeing in clinic? You know, when women are coming to you, what is the most frequent initial conversation that you're having with them? Are there common reasons that women are coming to you? Oh, yeah, definitely.

Definitely. I do actually see very few, but a few men as well in my clinic with their public close. But to be fair, my days are so, so varied, which is what I love in clinics. So I could see anything from. Well, what's the most common thing? I would say probably prolapsed or bladder leaks are the most common thing I see. Talk to me about prolapse. Yeah. So a prolapse is the name given to when one of the pelvic organs.

So the bladder, the bowels or the uterus is sitting a bit lower than what it normally would have done.

So unless it's very severe, which is quite uncommon, like a prolapse isn't necessarily a permanent state, it's just a reflection of what's happening at that moment in time. So our products can be treated really well, really easily from the national guidelines that the first thing we need to do is pelvic floor squeezes. So that's why I see a lot of them in clinic, because nearly everybody improves with a bit of physio or pelvic floor work is just by how much.

But there's lots of options available. So, yeah, mainly prolapse or bladder leaks. But then I would also see women after having had babies and they want to get the muscles back together. Or I would see young women who have never had babies before who might be finding it really hard to have sex comfortably. That got a lot of tension in that pelvic floor. I would also see women pre surgery or after surgery. So that would be kind of like gynecological things, like hysterectomy or and Dmitri osis or pelvic floor repairs and.

A bit of everything, really, which is what I love also about problems as well. So kind of in the same way that it's not always easy to control our bladder, exactly the same thing can happen to our bowel. So getting to the toilet in time or controlling wind, controlling stool also would be doing a lot of kind of Skarbek with ladies if they've had C sections or maybe a perennial tear or an episiotomy scar or something like that. Everything, really, and that's a really common concern for women heading into birth, and I suppose it's a really.

Under-resourced. Injury as well, like, you know, so many women have to have Yasmine's so many women experience challenges and healing from episiotomies, and there's more to the recovery than just the skin. You know, there's there's muscles that have been that have been severed. And it's I just think it's so valuable that women know there are resources available to them to help them build back up towards that strength in a very safe way. This is exactly exactly because an appeal to me is actually the equivalent to a second degree terror and so a second degree terror involves the muscles as well as the skin.

So completely hellebore on it. You know, it wouldn't normally not ever have any long term consequences of an appeal to me or a second degree to, as in, we can make a full recovery from them. But there are definite things we can do to kind of speed up the process and definitely score a massage. If anybody's done any peroneal massage in the build up to giving birth, then if you could do like a similar thing on your episiotomy or peroneal tear or where the scar was.

So any time from about six weeks, as long as it's fully healed, then that helps massively with the healing process. And then of course, because the tear or the piece of me involves the pelvic floor muscle, it does mean temporarily that whilst that muscle is healing, we do lose a bit of strength because that's just a normal thing the body does. So when we have any kind of injury to a muscle, the body won't let you use it too much because then that will hinder recovery.

So we have to wait for it to heal, which is normally anything up to about six weeks, gets the mobilization going to get it moving. And then as in kind of a bit of massage, but then also get it strong by doing those pelvic floor squeezes again. So there's so many facets to needing to use it, so whether it is just from a leaking, whether it is just about strength and holding your your baby, the physical waste that's bearing down on us in pregnancy, but then also in that postpartum recovery, it sounds so valuable.

Yeah, it's definitely so. And like a common myth, I guess I would hear a lot is women that come in who have had C sections and though believe that they don't have to do as many pelvic floor squeezes.

And whilst, you know, if you compare a C-section delivery to a long kind of a bit more of a traumatic physical vaginal delivery, in theory, that, yes, that is less direct insult to the pelvic floor muscle with a C-section. However, we've still gone through pregnancy and pregnancy itself can really weaken the pelvic floor. So even if you've had a C-section, pelvic floor squeezes are just still so important for just getting that strength back up again and ensuring you had a full recovery on the other side.

And talk to me then, but I always mispronounce this, but the DEA says that, but I always trip up on that word because again, other bombs grow.

All of our muscles have to reposition in order and our organs have to reposition in order to allow this little human to develop. And of course, that means there's a whole lot of shifting going on.

And sometimes we feel that in digestive pain, you know, or definitely after eating, you're just so uncomfortable because your stomach is such that a room. But then the muscle is keeping everything together, are put out of place. So exercising through waves is always so challenging. And definitely the exercises that you probably did before are no longer serving you. They're actually working against you. And there's just so much learning around that as well in order to protect the.

Yeah, definitely. And that was actually one thing that also took me by surprise, because, again, being a physio and for how long I've been doing it, I know that a blastocyst is completely normal. There's no way that we can prevent it or that we should prevent it during pregnancy. But for me, again, naively thinking, because I was so fit and active beforehand that I don't know, I just really consciously thought about it. But I realized when I could see coning happening in my tummy, what I thought was quite early on, like from about 16 to 18 weeks, that really surprised me.

So thinking, oh, you know, I'd kind of only really even with the experience, I had a tribute to a tribute to the two ladies with big bumps, because in clinic, that's typically what I would see. So if you have a bigger bump, then you'd have more of the Koening evidence.

But it really, really, really is nothing to fear during pregnancy. What we would say is if you can keep generally active, then that's really beneficial because it really helps to reduce the severity of it. So if you ever see kind of any coning or Domingue in your pump during pregnancy, which is kind of, well, unless you've not paid attention, like it would happen to everybody. So most commonly, I don't know about you, but not if I'm if I'm on the sofa and then trying to stand up or in bed and trying to sit straight up, which is a no go just like that for so long.

No, it's more of a five point turn and it's more like a lorry trying to move out of a cul de sac.

And so that that is because, well, obviously the the bump, the getting bigger and the muscles are just so active at a disadvantage to enable us to just sit straight up. Or if you're lowering yourself down into a bar or something like that, then generally if you look down at those points, when you're doing those movements, then you look down and you'll look a bit more pointy, a bit like a giant Toblerone, you know, like point to the middle.

So what we want is a nice confectionary reference, though. What about the chocolate always comes up. Just imagine the chocolate.

So we would like if you can see that Toblerone happening, then we don't want that happening really, really often. So that kind of would be the one piece of advice during pregnancy. So if you notice the coning or Domingue, then whatever makes you do that, try not to do over and over and over and over again, because that is thought to increase the glass, which is the stomach muscles separating basically because what's underneath is pushing through.

Exactly.

Exactly. But then when you look at the anatomy of our tummy muscles, if you look at I'm sure you can only imagine like in a textbook, if you cast your mind way back to school and if you look at like the six pack muscle, then it has those lines in action drawing out here.

But obviously measuring what I'm doing, I can say let's let's imagine Zac Efron and his six.

Exactly. So you and you can see that when you look at especially someone like that, like his midline line and then the horizontal lines going across. Yeah. And so I'm with you.

I'm with you actually from Tigran.

And so just by its very design, like we all have that six pack muscle and those lines of ligament, I can assure you I do not.

Others absolutely do. It's in there. And those that middle that middle vertical line and those horizontal lines that go across in all of us. And so by its great design, the muscle is meant to give. So it's much easier for our muscles. I'm sorry for the ligament to stretch rather than muscle. So, yeah, and you're right, that blastocyst refers to the middle vertical line that stretches in our six pack muscle that we definitely all have. And so the only time really when we want to pay a lot of attention to that middle vertical line or the diathesis, as we call it, is when we were about eight weeks after having had the baby.

So a day to that stretching of that middle vertical line is completely normal during pregnancy and completely normal for those first two weeks after having had the baby as well. So the only time that we really need to get involved is from about eight weeks. I don't expect anybody to become an expert in assessing their own tummy muscles. And if you're ever in doubt, then just get on somebody who knows, like a physio or a specially qualified personal trainer or somebody that can basically help you.

But if you think you still have one, get it checked out. And the most important thing to do is, believe it or not, pelvic floor squeezes. OK, so you think I need to work on my abs, so you're thinking crunches and sit ups, but actually it comes back to the pelvic floor that so many things come back to the pelvic floor, so.

When we've checked your pelvic floor and checked with the associates, we do begin to layer on abdominal exercises, but to kind of go straight into crunches and sit ups and things would be just wouldn't really be advised without being checked first. And if we can get our pelvic floor really strong again. So we kind of always aiming really for that 10 second hold and standing and some of the short ones and standing. If you can do that really easily, then, you know, you've got a good baseline.

But until that point, keep going with your pelvic floor and it will really help your tummy because it's all so connected.

I want to ask then, so as you are heading towards the exciting arrival of your baby in a few weeks time. And knowing what you know, as an expert, what what are what are the postpartum essentials that you are going to do for you in order to bring you back up to strength?

One thing I'm going to I'm one thing I'm doing now to really help predominately is perineum. I thought I can if anybody's not yet had their baby or watch this ahead of time. And if you have the time, then I would really, really, really recommend doing perineal massage. Like the benefits of doing so are just so, so good. It really reduces your risk of tearing and needing that to me and having pain on the other side and. Yeah, it's just it's another thing as well, actually, that I would always advise women to do, but had never done it myself before.

So I really, really, really massoudi advice. And we can't obviously control everything. But if you can lessen your chances of having physical trauma to have to deal with on the other side, then I don't think it's a no brainer.

And when I think about it is we for 40 weeks lather our skin in oil in an attempt to help us to stretch without damage. Yeah, you're right. Yeah.

And the one area that we need to stretch in order to allow our baby to safely exist we ignore is exactly, exactly so true.

If there was one area that you should be putting oil and massage into, it is your parenting. This is exactly as women.

We need to get better at getting, you know, more confidence in doing what our body needs for itself. And parenting massage before birth has been so proven to be so beneficial. And I would much rather. Feel a bit squeamish doing parenting massage beforehand, then have to have frequent visits because of a terrible tear.

Oh, 100 percent. Yeah, I could not agree more. I'm not saying if you are a bit squeamish and hate the thought, then it's a good time now to try to lessen that and just try to practice and kind of get a bit more comfortable with the area of your body, because I think as well, just where in society just never, ever thought really about self care and especially about our vulva and vaginas. Like nobody tells us to be checking them or looking at them or, you know, like they might of women that I meet who have never looked at their vagina over before is I would say that's more so the norm compared to women who do self-respect and who are more comfortable.

But there's so much benefits to be gained by even just because that's the thing. That's when I see a lot of women who are distressed by how everything looks after having had a baby. And then I'll have to look before. And they have no idea. They never really looked before. And then we kind of like delve a bit deeper in terms of their thoughts and stuff. And it turns out they're comparing what they can see with a pre made conception of what Evolva should look like.

You know, actually, if we yeah, I really recommend it. Take a few minutes and look at your vulva, look at your vagina and just see what's going on, because I think well, I know it would be so, so beneficial. I know. We digress.

It's a really important conversation to have. I'm so happy that we are because it is where literally birth is going to happen. And the more we can do to to prepare ourselves to not be ashamed of our bodies, to celebrate our bodies, to be empowered by the fact that, you know, this is birth. Yeah. This is where it happens. And. We need to not feel like we can't talk about us or to know enough about us, you know, it's an incredibly powerful part of our body and it deserves a whole lot more attention.

So we give it. Yes, I agree.

And then I'm going back to what you are saying. Sorry about what will I be doing post. Yes. So I no matter what happens, because obviously we can be as prepared as we like, but we never quite know what's going to happen. I will definitely be doing some I've got myself one of those terrible things, you know, that you can squeeze water all over you. Yeah. In case of any tests. And even if there aren't any tests, I'm still expecting pain and discomfort.

And I like it, as you well know, that be a whole lot going on down there.

Yeah, it's it. And it has suffered a trauma. It is. It's it's very swollen. It's inflamed. You know, that first time that you have to go for a week afterwards, you're terrified of how it's going to feel. Yeah. Yeah, and for and certainly if there is damage and there is tears or stitches, it's stinging, you know, there's so anything that can reduce that that pain is incredibly important.

Yeah, I've actually been very organized and I bought some of those peroneal cold packs. Yeah, they're great. Yeah. So they they're like maternity pads, a built in cold pack in them. So I've only bought very few for I think five of them or something because and I feel guilty about the frequent wasteful. But in order to have a bit of cooling and soothing effect, I'm going to just soak a normal maternity pod in water and put that in the freezer.

Yeah. And so, yeah, I've got some of these posh ones, but when it's really bad and then use kind of new ones for the rest of the time, but I'll definitely be doing pelvic floor squeezes.

So it's just so important to begin as soon as you can within reason to get those muscles kind of connected again. So and if you've been doing your squeezes in the pregnancy, it definitely will then be easier in theory to connect with them again once you've had your baby and if you well as you will be swollen and sore, even just doing like one or two every time you feed your baby can just really help the healing process. So it's not all about getting your ten short, your ten longdon or anything like that at all.

It's just about very gentle movement to help circulation, to help shift that swelling away, to help bring new blood to the area and just really help the healing process basically.

So definitely doing goes and I'm really interested to know what my muscles look like in my tummy, because so many women that I've spoken to say that it just feels so odd and so disconnected and just so like jelly, obviously I haven't experienced that for myself yet, so I'll be really interested to know what my tummy muscles feel like. Although to be honest, in those first four to six weeks, regardless of how it goes, I'm planning on really not doing a lot.

Like, I'll go for maybe a short walk if I feel up to it, but I'm not making any plans, I'm not putting any expectations on myself, because in those first few weeks, my company has to have to recover. It has to shrink back down again. Things have to knit back together. And I've seen it so many times before that women want to rush back to exercise and getting really active again. And actually, if you do it too quick, it can actually delay the healing process.

So, yeah, I'll be doing pelvic floor squeezes, trying to breastfeed because I'm planning on breastfeeding. So that will kind of take my priority in the first few weeks. And getting that set up, I'm not really like really, really, really, really not a lot, honestly.

And then the whole point, do you think that women should be looking at what was now kind of coins that the mummy motty, that the full, I suppose, analysis as to where you're at physically?

Yeah. So I'll be breaking in for my personal check at about six to eight weeks. So and it's really from that point on, so, you know, when women come to me for that check, I'll check that pelvic floor that tells me how they got diathesis. What's that breathing like? What's their movement in terms of their back and everything. So that's really when I'll be looking to do that around the six to eight week mark, but not before.

And so I would advise all women to not get back into exercise before that point. And even if you feel really good, like I would see a lot of women who come in and they don't have any symptoms and they just want to have a check, and that's really, really good. You know, proactive is great because prevention is always easier than cure. But even if you have a straightforward delivery, you can still get back to doing exercise too quickly.

You know, our body has still been through pregnancy. Delivery itself causes massive changes like pelvic floor, get stretched to muscles, get stretched. There's still so much that needs to happen in order for recovery to be efficient. And even if everything has gone really well, as I keep saying, you can still get back too quickly. So I would just try to. Yeah, just try and resist too much too soon. So in those first kind of month or two, just pelvic floor squeezes, deep breathing every now and then just to help the diaphragm get moving again, a little bit of walking.

But again, long walks can actually put quite a lot of pressure on our pelvic floor, and especially if we're wearing the baby, if you've got a sling or carrier which are fab for soothing the babies and the babies love them, but it can be quite a lot for our pelvic floor. So if you're really, really, really, really desperate to get back to something that may be a bit of very light, kind of static bike, if you can handle sitting on a saddle.

But really, you know, there's yeah, there's not a lot anybody should be doing really in those first in that first month or two.

And then have a professional assessment, see where you're physically and build up slowly. Yeah, exactly. I'd love to see the day. Like in France, for example, every single lady who's had a baby will get offered pelvic health physio and they get I think it's up to like eight sessions of physio. Perper, regardless of what happens. And I just claimable I know like I'd love to a day in the UK and Ireland is offered it's standard, not even eight, just one you can even just one check would be amazing for long term health for all women.

So yeah, if you're able to it would be such a good investment in yourself just to even have one check by a physio and then you'll know exactly where you stand and we can let you know if you do have a prolapse, if you are doing the right thing, when you squeeze your pelvic floor and we can let you know exactly where you are, like what is your power, what is your endurance? And then give you a kind of Tailor-Made program then in terms of what to do and depending on what you want to get back to, because some women would be lifting weights, some people want to get back to swimming.

Some it might be yoga, you know, like depending on what your own exercise goal is, then we can make up a plan for you. I think that's really important advice because we are starting from scratch in some ways, and every pregnancy, every body, every birth is completely unique and we get checked so frequently in pregnancy that we it just falls off a cliff as soon as baby is here. But we are our physical form and our emotional and mental form needs to get checked by all manner of professionals in postpartum as well for us to return to our best.

Definitely. And, you know, those two things are so interlinked. There was a study that came out last year, I think, at this age, and it said that if we leak urine within the first six weeks of giving birth, it doubles our risk of post-natal depression. Lack of physical and mental health are so intertwined and so interlinked. And I think especially in pregnancy and post-natal, with so many hormones flying around, so many changes happening, you know, there's nothing not there's nothing that's bigger, I guess, in terms of change than having a new baby.

And I just think it's it's so, so crucial. And the check is obviously a bit of a tick box exercise. And it's not as absolutely not having got the GPS on, are there really time poor and a lot of pressure on them. And I know they ask about mental health, but. The GHP check isn't enough on its own, but we need to be doing, yeah, a bit more ready to help these ladies have babies and just the and not even like reaching out when there's a problem, but.

Supporting and checking women before problem even arises. Completely agree, which is why I'm so happy to be able to have this conversation with you, because if it empowers one woman to at least go and book that check and and hopefully many, many more than one, then it was so beneficial.

Thank you so much for joining us today. I'm so happy that we got to have this very honest conversation with a professional who supports women on a daily basis, or at least did before your maternity leave started, but as dedicated a career to us and is now also experiencing it.

So you know what it's like, you know what we need. And I think it's going to make you an even better professional when you return to the clinic.

Yeah. Oh, I hope so. Thank you so much for having me. It's been an absolute pleasure and I hope it's been helpful.

So helpful. Thank you. Thank you so much for listening, if you enjoyed this episode, it really helps our show to grow. If you subscribe to relieve review, share this episode across social and get in touch with this week's expert guest at Helen Keibel video on Instagram. Talk to you again next week. This series of kindly supported by water wipes, water wipes are an essential for everyone from the first nappy change to during those messy waiting months as creators of the world's poorest baby wipes.

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