Top 6 tips for your ‘core’ in pregnancy

6 ways to care for your pelvic floor muscles and spine when you are pregnant.

From your experiences at your Fix Program classes, I hope you all have a new awareness of your pelvic floors, pelvis and spine. But with your changing body shapes and levels of that relaxin hormone rising as the weeks of pregnancy tick by, these areas of your body really are under strain. Here's my top 6 ways to incorporate your 'core' into your everyday, both now and for after baby arrives.

1. Think tall and long. By gently lengthening through your waists, you will be using your 'core' and supporting your spines well. Pelvic floor muscles work at that low level we require for everyday when you are tall. Try this sitting, standing and walking.

2. Make time to attend to your pelvic floor muscle exercises. Remember to pop our red dots about the house to remind you – behind the kitchen doors, on the dishwasher, on your computer monitor. Or associate drinking water with the time to lift our pelvic floor a few times.

3. Use your legs. When bending, lifting, or needing to generally get down low, remember your folding hips. Try to keep your trunk long and fold your trunk over the hips. This will keep your spine supported (see tip 1) and safely aligned.

4. Become familiar with 'the knack'. This is a strong lift of your pelvic floor whenever you feel a sneeze or cough coming on, or just prior to a bend or lift of the groceries or baby capsule. This supports the pelvic organs, strengthens your pelvic floor muscles and prevents any embarrassing leakage when the bladder is under pressure with baby in utero. (All very normal in pregnancy and early months post-natally.)

5. Keep your legs together (like a lady!). Pelvic girdle pain is very common in later stages of pregnancy. It can involve the joints of the pelvis in your buttock region (sacro-iliac joints), or the pubic joint at the front of the pelvis. Try to keep your legs together, avoiding separation at the pubic region when you get in and out of the car, or as you roll out of bed.

6. Keep up a high fibre diet. With your pelvic floor muscles already under immense pressure from baby, the last thing you want to do is to strain on the toilet. A diet high in vegies and fruit will stop this and any other associated rectal problems such as haemorrhoids and anal fissures, other common joys of pregnancy that no one tells you about!

Pebbles in the Pond – Imagery for Pelvic Floor Strengthening

The pelvic floor hammock at the base of your pelvis can be divided into deep and superficial layers. There are many muscles making up this hammock and we know that stretching of the muscle tissues in pregnancy and tearing or episiotomies in vaginal births can traumatise the muscle tissue.  This is why we must exercise to retrain and restrengthen this very important part of our body.

With natural vaginal births, potential damage occurs mostly at the superficial layers, so targeting your exercises to this layer is important. The superficial layers are pretty much the muscles that you see if you were to look at your vagina (and nearby areas) with a mirror.  Aiming for a ‘closing’ sensation at the urethra and vagina is the key, followed by the ‘lifting’ feeling of the entire pelvic floor (urethra, vagina and anus). This will best strengthen those muscles of the pelvic floor that have suffered most from birthing.     

So what about this pebble in the pond? Let me explain.

Can you imagine the picture of a still pond and a pebble falling into its centre? Picture the concentric circles of the ripples spreading out to the edges of the pond.  Now reverse this picture, so you can see the ripples moving back evenly to the centre of the pond and the pebble lifting out from the water’s surface.

This reversed picture is your pelvic floor contraction!

Quietly lying on your back with your knees bent or sitting comfortably, imagine this picture as you very gently activate your pelvic floor muscles. Don’t try too hard – just begin with a small and easy contraction.  Try to sense that you are gently ‘closing’ or ‘squeezing’ the front passage or vagina opening close, followed by a ‘lifting’ sensation of the muscles up towards your navel.   Remember the concentric circles of the ripples coming closer together evenly to really visualise drawing the muscles together around your vagina from all directions. Watch that you keep your buttocks soft and relaxed and keep breathing.

When you feel you have mastered this contraction, make each and every pelvic floor contraction feel this way. Remember, ‘close’ then ‘lift’.

Mastering this feeling is often very hard for new mothers. If you have not ‘got it’, don’t give up and keep trying every day. Try to even just imagine the picture of the pebble in the pond when you try contractions of your pelvic floor muscles. If you feel that you are making no progress within a few months after having your baby, I would suggest seeking assessment, advice and more specific pelvic floor training from Heba, our Women’s Health physiotherapist.  

Heba works in our CBD branch and can be contacted on 9264 0077.

Did you know that up to 10% of pregnant women in Australia suffer from depression in pregnancy?

I read this article late last year from the BBC and felt just awful. It explored the incidences of depression in both pregnant women and post-natal new mums. And more upsetting was the reluctance to speak up about it. More than 22% of these women in Britain suffering depression did not talk about their feelings and concerns honestly with their GP or obstetrician.

We are often reminded of the impact of having a baby and it is well written about in mother and parenting publications. The incidence of post-natal depression is spoken of openly. However, it is not often that you hear about the same terrible times had by some mums-to-be when still carrying their baby. This is called ante-natal depression.

This has really encouraged me to read up more and share with you some further reading.

So what defines ante-natal (or post-natal) depression? Because, as you may be aware, mood swings, anxieties and feelings of sadness are all a part of the most normal of pregnancies and early months of motherhood. It is however, not considered normal if these feelings (and many more – a very long list) become over whelming and last for more than 2 weeks. This is enough to interfere with your normal functioning life.

If this is you, please share your feelings – with your partner, friends, doctor or even online support groups. I hope you can find the time to read a little more. The PANDA site in particular had the most wonderful PDF handouts to download, of which I have linked one below.

http://www.bbc.co.uk/news/health-20265786

http://www.panda.org.au/