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Binky asks bloss expert Clare Bourne – our bloss Pelvic Health Physiotherapist – all the questions YOU want to know about your pelvic floor postpartum.

  • What are your top tips for a new mum after birth?
  • What are pelvic floor exercises and why are they important?
  • Why do we talk about waiting 6 weeks before returning to exercise?
  • What is the best way to return to exercise?
  • What symptoms might you experience or should look out for?

Postpartum pelvic floor – what you need to know

Binky: Hi guys, Clare has come to my house today to do my six week postnatal check. Clare is on our bloss platform and we’re going to go through a few questions after Clare explains a little bit about what she does – here she is!

Clare: I’m a Pelvic Health Physiotherapist and a mum of two. What we do as Pelvic Health Physiotherapists is look after women during pregnancy, postpartum, and throughout their lives with anything related to pelvic floor and the tummy. We help them understand how to get back to exercise, if they’ve got any concerns around symptoms of incontinence, or difficulty returning to sex.

We’re here to deal with the nitty gritty but make sure that women feel safe, looked after, and know how to exercise in a safe way so she can really enjoy it and not feel like she has any setbacks. 

Binky: Brilliant! I know there are a lot of women out there who are too scared to ask the questions or know the answers, but it is so important. We’ve worked together for a few years now – I absolutely adore Clare, I trust her implicitly and you’ve seen every part of me!! But it’s not awkward at all!

Right, I’m going to ask you a few questions we’ve got.

What are your top tips for a new mum after birth?

Clare: Depending on how a mum gives birth – vagianal or caesarean – either way, the main tip is don’t underestimate rest, taking it slow, and knowing that your body needs to recover.

After a vaginal birth, if you’ve got any wounds or stitches, make sure you allow them to air. Keep them clean, but not with lots of soap. If you’re having trouble going for a wee, you can take a nice warm cup of water to help flush the area straight away afterwards. Make sure you’re not getting constipated, allowing your bowels to open. Sitting down can be uncomfortable so try rolling up some towels or using a cushion to sit on. Make sure you’re not sitting down for too long. Get going on your pelvic floor exercises early, but not too many to start with. Just go steady.

From a caesarean birth point of view, it’s about respecting your body. Your body has been through major surgery; you don’t have to be super mum, you can take it steady. Getting moving is great but take it steady. Same principal with the wound; it needs air, it needs to be clean but not scrubbed clean – water is great. Support the area if you’re going to cough. You can now sleep on your back (yay!); put a cushion under your legs to take any strain off the scar. Take it steady and allow things to recover.

Those are my top tips for either type of birth.

Binky: Definitely need to try to relax after birth and not get straight back into it! I think I did a little bit more this time.

Clare: It’s hard the second time, right?

Binky: Yeah second time you’ve got a toddler and you just think, ‘oh I can do this, I’ve done it before’ – and then I hit a bit of a wall. I was so tired!

Clare: That’s the thing, it catches up with you. Your body is putting energy into lots of things – you’re struggling to sleep, your body is still trying to heal, you’re potentially also trying to establish breastfeeding. There’s a lot of strain on one system and it’s just about remembering all of that. When you feel frustrated in yourself or you hit that wall, you need to be compassionate with yourself because you’re going through so much and doing so well keeping a human alive!

Binky: Very true!

What are pelvic floor exercises and why are they important?

Clare: Great question. I think we often hear about pelvic floor, but where are they and what do they really do? So pelvic floor muscles are literally where they say they are – in the floor of the pelvis. They come around the back passage, around the anus, and then around the vagina as well.

What do they do? Very key roles – they keep us continent (I think we’ll all agree – very key!), contribute to sexual pleasure (again, very key!), support our pelvic organs, and they actually help pump lymph around the area. They also work with other muscles. For example, in pilates you might have worked with your pelvic floor and your deeper core, working together to help support your spine and other joints of the body.

So really key, but essentially more simple than we often give them credit for. I always say to women to think about holding wind – squeezing the back passage (most of us have done that at some point in our life!). Just think about holding wind and letting go – that is a pelvic floor contraction. In terms of how many, we often say try 10 in a row of ‘contract’, ‘let go’. The ‘letting go’ is also really important, don’t just think about squeezing. And then ‘contract’, ‘hold’, ‘let go’ – try to do 10 like that as well. So 10 of each and I say try to do some with every feed, whether that be bottle or breast. If you’re doing them every feed, it will happen. If you’re trying to do it on top of something baby related, it’s just so much more to fit in.

Also think about doing them standing as well. Most of us don’t have symptoms, such as being incontinent or heaviness in the vagina, sitting down – it’s when we’re standing up. And we want to get back to jumping and running, so let’s allow our pelvic floor to train for those movements, rather than just sitting because most mums don’t sit for that long – I mean this is probably the most we’ve sat since I’ve arrived!

Binky: Absolutely, and I think that even though you want to get back into your running, your  jumping, I love the fact you are so adamant that you’ve got to make sure you get yourself checked before you even think about it. What we said earlier is get your inner strength built before you even think about it first. You don’t want anything happening do you.

Clare: You don’t and you will never regret going slower. Often most women are like, ‘dammit why didn’t anyone just tell me to go slower, I would have listened’. But I think the hard thing for women is thinking that things are off the table and they just want to get back to various things. But actually if we give you an incremental plan to get there then it’s so much more enjoyable when you get there.