Delve into five common postnatal problems many women experience after birth, as postnatal yoga pros Hannah Barrett and Finola Burrell talk us through the solutions.
Your baby is finally here and your body has just done something utterly incredible. You’ve made a tiny human and all around, your life is more than hectic. But have you checked in on what is going on in your body? After delivery a baby your body changes both physically and emotionally and needs time to heal. Below we look at five common postpartum issues and things you can do to help.
Postnatal Problem: Prolapse and Incontinence
A prolapse involves the organs of your pelvis (uterus, bladder and bowel) dropping down into the vagina. Symptoms of this can include:
- Lower abdominal pain
- Low backache
- A lump in your vagina
- Problems passing urine
- A feeling of heaviness around the vagina area, usually worse at the end of the day
- Faecal or urinary incontinence
It’s also common to experience postpartum incontinence (although this does not need to become your new normal). Incontinence and prolapse happens due to a weakness of the pelvic floor muscles and supportive tissues. During pregnancy and when breastfeeding, the hormone relaxes the ligaments which reduce the support of the pelvic area. The weight of the baby, experience of childbirth itself and a sudden increase in activity after giving birth can all weaken and overload the area further.
To compensate for this common postnatal problem, pelvic floor muscle strengthening is vital. Symptoms can usually be improved with pelvic floor exercises. To activate your pelvic floor, take a deep inhale, then as you exhale engage your pelvic floor by imagining gently pulling up your front and back passages (as if trying to stop yourself passing urine and flatulence) without clenching your buttocks.
You don’t want to feel a pushing down sensation. If this happens take a few deep breaths into the stomach to relax and try again. Continue to breathe normally while holding for five seconds. Relax and repeat ten times, a few times a day.
If you suspect you have prolapse we strongly advise speaking to your GP or a women’s health physiotherapist. Prolapse is one of those things people don’t like to talk about, but it is a common postnatal issue. Know that if you’re suffering from prolapse, you are not alone and help is out there.
Postnatal Problem: Diastasis Recti (aka mum-tum)
Another common postpartum issue is Diastasis Recti. This is the separation of the abdominal wall. It can happen in pregnancy due to stretching and thinning of the linea alba, which is the tissue that connects the left and right abdominal muscles.
It has been suggested that 2-2.3cm (approximately 2 fingers width) above, around and below the belly button is considered greater than normal. The gap can reduce on its own within a couple of months. However, it is still important to strengthen these muscles.
The abdominals are essential for core control and function. If Diastasis Recti is not addressed, it may lead to lower back pain, and you may be more susceptible to ‘mummy tummy’. Try not to worry as exercises have proved to be effective in treating most cases. The main aim of exercises for diastasis is to increase tension in the linea alba and activate the transverse abdominals (deep abdominals), before rectus abdominal activation (for example with crunches) to close the gap.
To activate the transverse abdominals, take an inhale, then as you exhale imagine your hip bones are magnets and are being drawn in towards each other and pull in your stomach gently as though you are trying to put on a pair of jeans. Hold as you breathe normally for five breaths. Inhale to relax and then repeat ten times a couple of times a day.
Postnatal Problem: Pelvic Floor Over-Activation
Most people think of the pelvic floor being under-active as is found with incontinence and prolapse, but these muscles can also become over-active. This can result in a variety of symptoms including difficulty opening your bladder and bowels, back pain, constipation and a feeling of pressure or pain in the area.
This happens for a few different reasons postpartum. Stress and anxiety can cause muscles to tighten up including the pelvic floor muscles. It can also happen if you try to keep your stomach pulled in and the abdominals remain under tension during the day.
To help with this there are a few simple techniques you can try. One is the full yogic breath where you focus on breathing starting from the stomach, which causes the deep muscles to relax.
Come into a seated position, place one hand on your stomach and the other on your chest. Take a deep inhale breathing from the base of your stomach, feeling it rise underneath your hand. Then send the breath up into your chest feeling the ribs moving frontways, sideways and backwards. Lastly, fill the lungs as much as you can feeling the collarbones slightly lift. Take five slow deep breaths like this, each time trying to extend the exhale even longer. Try this a few times per day and after performing pelvic floor or core strengthening exercises. As well as relaxing the pelvic floor and deep abdominals it will help to reduce anxiety and relieve stress.
Postnatal Problem: Upper Back Pain
Whether you are breastfeeding or not, holding your newborn requires constant use of your upper back, neck and shoulder muscles. Staying in prolonged positions and postures can easily provoke pain in the upper back and shoulder areas. By conditioning your muscles through exercise they are more able to cope with the increased demands on your body.
Here are some extra quick tips on how to reduce and prevent pain here in the meantime:
- When feeding, sit in a chair with your back and arms supported by pillows
- Place a pillow under your baby to support their weight
- Whenever possible, during breastfeeding, lie on your side
Postnatal Problem: Tears and Episiotomies
Vaginal tears and episiotomies during childbirth are common. An episiotomy (a surgical incision) may be required to increase the diameter of the vaginal outlet to allow space for the baby’s birth. It is normally done during the last part of the second stage of labour or delivery. This procedure is done with scissors or a scalpel and requires repair by suturing. There are different types and grades of spontaneous tearing, with a fourth-degree tear being the most severe.
Unless told otherwise by a health professional, starting gentle pelvic floor exercises will be very helpful. It improves circulation to the area to help with healing and swelling, as well as reactivating and strengthening the pelvic floor which is weakened during delivery and after a tear or episiotomy. They can be started the first day after birth, once you have passed urine for the first time or once your catheter has been removed. It may feel more comfortable lying on your side to perform your pelvic floor exercises and whilst breastfeeding as it avoids pressure on the stitches. For those with 3rd or 4th-degree tears’ gradually build up the amount of pelvic floor exercises you do as comfort allows.
Please stop any exercises that result in pain, difficulty controlling wind, loss of bladder or bowel control, an increased sensation of pelvic pressure or if your lochia becomes redder or heavier. This may be a sign that you are overdoing things.
Strength Through Yoga by Hannah Barrett and Finola Burrell is available for £39.99 at www.yogagirllondon.com
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