By Louise Hurley
When you hear the term postnatal, you usually think about those first few months after giving birth. Most of us would instantly think about a mum with a little baby; up all night with them feeding, cuddling, rocking, changing nappies. But how long after having a baby should a mother no longer be considered postnatal? At which point in time does a mother suddenly transform from postnatal to non–postnatal? In my professional opinion, never.
This might come as a surprise, but once your pregnancy ends, you will always be postnatal.
How is it possible to be postnatal forever?
- Well, prepare yourself for another truth bomb… Postnatal is forever because it’s impossible to get your pre–baby body back. Your body goes through significant changes growing a baby and giving birth. It’s impossible for your body to go back to exactly how it was pre–pregnancy. It will always be slightly different (keep in mind, different doesn’t mean worse, different is just different). When it comes to moving your body when you’re a mum, it doesn’t matter whether you enjoy walking alongside the kids on their bikes or enjoy intense CrossFit training, having had a baby (no matter how long ago) will have an effect on the way your body moves and functions
- The reality of birth related injuries is, if they are not treated, symptoms can continue even years after having a baby. During pregnancy and birth, you can sustain a range of physical and mental health injuries including (but not limited to) damage to the pelvic floor muscles, which can cause incontinence, pelvic organ prolapse, internal and external tearing of tissue, abdominal separation, painful back, wrists and knees, depression, anxiety or post traumatic stress disorder. Occasionally, some of these physical injuries (such as internal tears or mild abdominal separation) will heal on their own over the first six months after giving birth. Most of the time, however, pregnancy and birth related injuries need specialist care and treatment. Very often, these injuries and symptoms do not go away on their own over time, and if left untreated, can continue for life.
How do I know if I’m experiencing symptoms of a birth related injury?
No matter how long ago you had a baby, you can still experience:
- Pelvic floor dysfunction. This includes pelvic floor laxity, pelvic floor tightness and pelvic organ prolapse and can all be a cause of incontinence (especially leaking when running, jumping, sneezing, coughing or laughing), recurrent urinary tract infections, lower back pain, inability to orgasm, painful intercourse or a feeling of heaviness down through your pelvis, especially towards the end of the day or a long period of time on your feet
- Postnatal abdominal separation (is the lack of tension in the connective tissue that runs in between the two sides of the abdominal muscles). Multiple studies suggest that abdominal separation occurs in 100% of full term pregnancies* and almost 33% of women still experience it twelve months after giving birth**. When there is a lack of tension in the connective tissue of the abdominal wall you can usually feel a deep, soft gap with your fingers in between your six–pack muscles, or sometimes you can see a ridge or a dip running down the abdomen during certain exercises.
What can I do if I’m experiencing these symptoms?
- Firstly, my advice is to know and understand your birth story, even if it happened years ago. When you know what happened when you gave birth you can start to understand how it affected your body. For example, if you experienced a second stage labour (the pushing stage) that was too short or too long, your pelvic floor may have been consequently injured, which would explain why perhaps you now feel a heavy sensation down through your pelvis. Or if you had a caesarean section birth you might now experience tightness in the fascia (tissue that covers muscles) that was cut during surgery. Understanding your birth story helps you to connect the dots. If you’re unsure of what happened when you gave birth or if you’re unsure of how it could have affected your body, talk to your medical provider or a women’s health physiotherapist, which leads nicely to my second piece of advice.
- Book an appointment with a women’s health physiotherapist. No matter how long ago you had a baby, they’ll help you start to address the symptoms you’re currently experiencing. There’s a misconception that all you need to do to stop incontinence is Kegel exercises (contracting and releasing the pelvic floor muscles), but it’s not that simple. A tight pelvic floor can also cause leaking, but repeatedly contracting this muscle group that is already tight won’t make it stronger– it’ll make it more tired, and consequently more leaking. This is why an appointment with a women’s health physiotherapist can be so helpful at any stage of motherhood.
- If you’d like to return to exercise or you’d like to increase the intensity of your exercise but pain, discomfort or incontinence is stopping you, look for a trainer who has specific qualifications in postnatal exercise or women’s health and fitness. A trainer with the right qualifications will work hand in hand with your women’s health physiotherapist to help you reach your goals whilst increasing your strength from the inside out.
Many mums feel that because they’ve had children it’s normal to put up with leaking, backache or a weakened pelvic floor and core, but it’s never too late to start doing something about it. Life’s too short to not jump on the trampoline!
*Gonçalves Fernandes da Mota, et. al (2015) Manual Therapy. ** Sperstad, et al. (2016) British Journal of Sports Medicine.
Louise Hurley – As a MumSafe™ trainer and Pregnancy and Postnatal Corrective Exercise Specialist, Louise’s mission is to help mums at every stage of motherhood safely start or return to exercise. Louise is the owner of Strong Mums and runs small group training and 1:1 PT. Find out more at www.strongmums.com or on social media @strongmumsgosford