What to know about healing from a C-section

I've never had a csection, so I can't speak to the healing process through a personal stand point. But I have worked with some amazing moms who had 1 or multiple csections with incredible results!

I'm going to share some of my insights from what I've learned over the years when working with these moms.

Start early

You can start reconnecting to your body in the hospital. When you aren't napping or taking care of baby doing some simple body movement is totally safe.

The focus of these movements are to keep you from becoming super stiff from laying in bed.

Movements like raising your arms over your head with an inhale.

Sliding your heels along the bed with an exhale.

Practicing the following sequence using an exhale every time you move, pausing between each segment.

  • Rolling from back to side
  • Sitting up from your side
  • Standing up
  • The reversing

These are movements you will be doing anyway, so why not become more mindful with some extra practice.

Starting to become mindful and reconnecting to your body while in the hospital sets the stage for your whole healing process!

Wear the right panties

Even though an incision from a csection is low, it can still be under direct pressure from clothes, especially underwear.

The solution?

The C-panty.

A high waist, gel lined panty designed specifically for csection recovery.

These are amazing and can be purchased at a ton of different locations. I just linked directly to the main website so you can check them out for yourself (no affiliation).

Go check them out, enough said.

Be gentle

You [just] had major abdominal surgery.

Be gentle on yourself. Don't feel like you have to do it all immediately or ever.

As for help. Get your family and friends to help you out. Or work with a postpartum doula!

Realize that your body will not be able to respond to your commands the way it used to.

You'll be sore and tired and may not want to do much other than sleep and care for you baby.

And that's OK.

Give yourself time

It takes time to heal from a surgery.

It takes time to heal from a pregnancy.

It takes time to reconnect to your new body.

It takes time!

Give yourself the space to have time. To slow down and heal. To allow your body to get nourishment and the time it needs to go through a proper healing process.

Then give yourself time to not have a pregnant body anymore. Your body just went through a the fastest physical change it ever will. It took 9 months (give or take) to grow your baby. Within that time frame your body had to morph into the mama powerhouse that it is. Then in minutes it is no longer pregnant.

Your body needs time to resume a non pregnant form again, which doesn't happen over night, especially after a csection.

It'll take at least 1 year (more if your breastfeeding) to regain some sense of normalcy in your body.

Give yourself that.

Learn how to open up

An incision from a csection has come a long way. No longer is it a large vertical cut but a few inch horizontal cut that is barely visible sometimes once healed.

The thing about csections [and really any abdominal surgery] is that your body will respond in a similar way no matter the size.

Your body will want to protect that area while it heals.

To do this your body will do the only thing it knows how to do to protect itself.

Create armor.

To do this it contracts muscles to guard against pain and it turns inward [into a flexed position] to reduce stretch on the sore tissue.

This is ok, to some extent, but not ideal for optimal healing.

What happens if we let the body take over is the muscles that are guarding become tight and shortened and the hunched position becomes habit causing an imbalance in posture, stability and pain.

This is compounded by breastfeeding in a hunched position.

What can help?

Learning how to open up the front of your body!

Allowing your body to safely go into extension to get your body to find a balanced state again.

You can still have pelvic floor problems

A common misconception about csection births are you are immune to pelvic floor problems because you didn't birth vaginally.

While there is a reduced risk of incontinence, you can still have pelvic floor problems like peeing your pants, painful sex, and prolapse.

This is because your pelvic floor was just holding up the extra weight of baby for 9 months and which weakened and stretched it out.

Your pelvic floor works with your abdominal muscles, mainly the transverse abdominus, to coordinate against forces placed on the body that may cause urine leakage and stability issues.

Your abdomen was stretched and weakened from pregnancy plus you have the added incision scarring to heal from.

So regardless of birth, pelvic floor problems can happen.

Find yourself an amazing pelvic floor PT

It's not easy caring for yourself and your baby after a csection.

Getting all the help you can get is not a fail. It's a win!

You just said F - this  to "you just had a baby so deal with it."  You just said "I'm not going to settle for half rate care that doesn't give me all the information necessary to fully heal from pregnancy and birth."

You're committing to your own self care because you know how much it'll help your entire family in the long run.

And a pelvic floor PT is the person who will help you create your self care path.

They'll become your partner in figuring out exactly what YOU need for healing.

They will make sure you can reconnect to your body, you can open up and find proper posture, will ease tight, painful tissue, will give you exercises that are appropriate for your stage of healing, and teach you all you need to know about using your new mom body to avoid future injury.

It's not just a "do your Kegels" kind of care. It's a whole body, whole life kind of care that will revolutionize how you live, new body and all.

So if you had a csection years ago or have one scheduled in a few months. Find where you are in your healing journey and start there.

If you're ready to commit to self care check this out to learn more!

 

Take Control of Your Bladder During Pregnancy

You're bladder can take a beating during pregnancy.

It gradually gets less space and less support to function as you grow.

With these changes your bladder may send you mixed signals and create new habits.

Yes, your bladder talks to you. It sends signals to let us know when it is appropriate time to go pee.

How does your bladder do this?

The bladder is an amazing muscular organ. As it fills with urine it stretches. When it stretches there are receptors in the fibers that senses by how much. These receptors send the signal to the brain to tell us when the bladder is "full." The brain then decides if it's time to go pee.

When we're little the bladder doesn't signal until it's actually appropriately full.

Over time and during certain stages in our lives the bladder can learn new habits based on our lifestyle.

Your bladder is influenced by your diet, pregnancy, job, pelvic floor awareness, movement, bowel habits, gut health, and your reaction to when you feel an urge.

The habits you formed prior to pregnancy can be an indicator of your bladder control.

Here are some simple tips for bladder control to follow while pregnant that'll keep your bladder - brain communication balanced.

Tip 1

Drink mostly water!

There are drinks and foods that can irritate the bladder.

The main culprits are drinks that are caffeinated, carbonated, citric, and sugary.

When you drink these it's like having a bad party guest in your bladder. Your bladder wants it to leave.

So instead of the bladder signalling when stretched to capacity it's signally because it's irritated. When this happens on a regular basis the stretch receptors become over sensitive and will signal when the bladder is barely full.

Leading to more urges and frequent trips to the bathroom.

Tip 2

An urge is a signal not a command.

Because your bladder may signal when it's not actually full you need to be aware of when it's actually appropriate to pee.

During pregnancy, your frequency will increase, but not by much and not until later trimesters.

You can still work within the normal range of every 2 to 4 hour during wakeful hours to pee.

So when you feel the need to pee, ask yourself "when was the last time I went to the bathroom?"

If your answer is 1 hour ago, you may not really need to go. If your answer is 2 hours or more then good to go.

Tip 3

Drink throughout the day rather than large amounts all at once.

Sometimes we forget to drink or we get busy that when we remember we down a whole bunch of water at once.

This puts the bladder under more pressure to function. And during pregnancy when space comes at a premium your bladder is going to have a hard time holding on to the pee if it's walls can't expand enough.

Tip 4

Know how to contract and relax your pelvic floor.

Your pelvic floor works with your bladder to function. Not only does it keep the bladder in proper position it involuntarily contracts to keep pee in and relaxes to let pee out.

When you feel an urge and your brain decides if it's time to pee or not, it'll message the pelvic floor to stay closed until you reach the toilet and then to relax when seated.

Sometimes you'll need to voluntarily contract the pelvic floor to make it to the bathroom. By contracting your pelvic floor it can help ease the urge and make sure no pee leaks out.

But then once you reach the toilet you need to know how to fully relax the pelvic floor (so no hovering ladies!) to pee.

Tip 5

With the extra weight, less space and weakened core there is also the possibility of leaking pee when pressure is placed on the bladder.

To prevent that from happening you need to energize and activate your deep core to keep the pee in.

The deep core includes the pelvic floor (bottom), transverse abdominus (front), respiratory diaphragm (top) and multifidus (back). When they are all activated at the same time you create a support all around the pelvis.

So whenever you sneeze, cough, laugh, lift, push, pull, or anything else you do that you feel pressure down into the pelvis contract your deep core.

These tips will come in handy through out your pregnancy and beyond.

If you want to learn more about supporting your body and bladder through pregnancy check out Expecting Pelvic Fitness for even more pelvic health education!

Running after Birth: How to Safely Run with Baby

Running with baby can be a great way to get your endurance exercise on without having to carve out time away from baby.

However, there are many factors that need to be considered when running with baby to make sure you are supporting your body as it continues to heal from birth.

Factor 1

You have been cleared by your OB/Midwife to exercise. Even if you ran prior to and during pregnancy you'll want to discuss returning to exercise with your birth practitioner.

Your body just went through tremendous change, quickly. Whether you had a natural vaginal delivery, a csection, episiotomy, tearing, or other trauma your body has to heal.

Much of your tissue healing will occur in the first 6-8 weeks after delivery. But this doesn't mean you're fully healed. But it does give your birth practitioner an idea of how well your body is healing and when you may be ready to return to more rigorous exercise.

Factor 2

Be screened for a diastasis recti. Most women have some form of abdominal separation during pregnancy, which should heal on it's own over the next year after birth.

For those with a diagnosed diastasis recti, it takes more support to regain full functioning of the abdominal wall.

Running takes a lot of core activation to support your joints and pelvic organs. If your abdominal wall is not up to coordinating with the rest of your deep core to withstand the forces placed on the body, it can cause imbalance in the intra-abdominal pressure. This can lead to incontinence, pelvic organ prolapse, low back or pelvic pain, or a hernia.

Factor 3

Make sure you can do a proper pelvic floor contraction.

If you have never had a pelvic floor assessment, testing what your pelvic floor awareness and control is, this is a must after birth.

It gives you a chance to deepen your understanding and awareness of the pelvic floor. Find out how pregnancy and birth affected your pelvic floor, even if you had a csection.

Your pelvic floor has to do A LOT of heavy lifting when running.

Every time your foot hits the pavement the pelvic floor contracts to protect your organs, joints and prevent any unwanted pee or poo escaping.

If you don't know how to voluntarily contract the pelvic floor, your body won't know how to do it on demand.

Leaving yourself at risk for causing [more] damage to your pelvic floor leading to incontinence and prolapse.

Factor 4

Timing your run to avoid breast issues.

When you breastfeed running can be a challenge for many reasons.

One, your breasts need more support.

Two, baby may want to eat in the middle of a run.

When breastfeeding your breast tissue is more susceptible to damage. The force placed on the breast tissue when running is tremendous and unfortunately you can't just contract your pectoral muscles to keep your breasts stable.

Side note: yes, having strong pecs will help with breast support, but typically these muscles are tight in postpartum, so don't over do the chest presses.

The best way to support your breasts is to double up your sports bar. You want to make sure there is no to very little movement of your breast tissue as you run. But also not be too squeezed that you are cutting off blood supply. This will reduce the shearing that can occur on the ligaments and milk ducts, as well as reduce friction on the nipples, while keeping proper nourishment to the tissues.

The second thing you'll want to do is time your run to just after a feeding. This reduces the size of your breasts prior to running, so less needs to be supported, but also making sure you don't get engorged while running. Avoiding the risk of blocked milk ducts and blips.

Factor 5

Start off slow [even if you ran before and during your pregnancy] and always warm up.

Warm up with some dynamic stretches like knee lifts, leg swings and arm circles.

Then begin with intervals. Walk 5 minutes to get your blood flowing then run for 1 minute. Really focus on proper form during that 1 minute versus going as fast as possible. Gage what feels right in your body [which will be different for everyone], my stride will be different than yours which will change my pace. Going too slow will also be awkward. 

Doing intervals will give you time to really tune into your body as you build your endurance and stability for longer run periods.

Then to avoid tight, achy muscles afterward. Cool down with some static stretches or rolling out your fascia.

Factor 6

Lastly, don't be a robot.

Allow your trunk to twist when you run. Just a little rotation through your spine and pelvis is necessary to run in proper form. It gets your abs and hips really working and improves your overall spine mobility.

This can be challenging when you are holding onto a stroller, so you can do one of two things [unless you figure out another safe way!].

One, hold the stroller with one hand allowing yourself the freedom of movement through the other arm. This is helpful if you have less than optimal shoulder mobility, which is common in postpartum from breastfeeding and carrying baby. There are two caveats to using one arm...you want to switch it up and it's harder to control.

You will want to change which arm holds the stroller, so you aren't always using one arm. This will ensure you are building up strength in both arms and allowing both sides of your body to be mobile.

Plus, using one arm may be harder to control the stroller, especially if you are on uneven pavement or surface.

Two, improve your shoulder mobility, so you can twist with anchored arms. Doing exercises that increase your shoulder/rib disassociation is ideal in postpartum, not only for running but for other tasks through out the day. One of my favorites is a kneading action (bending the elbows) through the arms while on all fours.

There you have it!

The major factors you should be considering before running with your baby [or running in general]!

If you've checked all these factors and feel ready to run...have fun!

If you don't know where to begin, comment below or send me a message, we'll figure it out together!

Constipation

CONSTIPATION!

During pregnancy constipation can become a problem. The combination of slower digestion, less room for food, and iron supplements makes it harder for your body to poop.

After birth weaker abdominals or unbalanced seperation, scar tissue, pain medication, and lack of activity can lead to constipation.

Constipation is defined as having less than 3 poops a week. This can cause straining, pressure on the bladder which may lead to incontinence or urinary urgency, and hemorhoids. Chronic constipation which is considered if you've been constipated for longer than 3 months.

When you have difficult pooping, you tend to strain. This straining can stretch the pelvic floor weakening the muscles and tissues. Not being able to poop can make you irritable, sluggish, and can lead to pelvic floor dysfunction.

There are ways to help avoid constipation during pregnancy and after birth.

Here are a few of my tips to stay regular!

1. Stay active

Movement and exercise helps your gut stay balanced. It increases blood flow to the gut. It improves tissue mobility and intestinal motility.

2. Be core aware

Have a strong and functional abdominal wall gives the intestines support. This means making sure that you reconnect to the abdominals properly after birth and being tested for a diastasis recti (dysfunctional abdominal separation).

3. Eat recommended daily fiber

Mix up the type of fiber you do eat. Eating fruits, vegetables, beans, and grains ensures you get both soluble and insoluble fiber, which keeps your gut more balanced.

4. Drink recommended daily water

During pregnancy and postpartum your water intake should increase than your regular amount due the increased demand on your body. Drinking at least half your body weight in ounces of water is recommended.

5. Discuss iron intake with practitioner

If you need to take an iron supplement, there are ones out there that are non constipating.

6. Massage

If you had a csection doing scar massage will help make sure no scar adhesions disrupt your digestions.

7. Breath

Using your breath to help you relax the pelvic floor.

When you poop your pelvic floor is meant to relax. This naturally happens when you inhale. Focusing on opening your pelvic floor on inhale rather than holding your breath will get the respiratory diaphragm to help push the poop out while the pelvic floor is relaxed.

If you are prone to constipation, there is no better time to focus on staying regular than now.

When Breastfeeding Becomes a Pain in Your Neck

Breastfeeding is one of those things you're told is great for baby.

It improves your bond, it increases baby's immunity, it provides nourishment and nutrients, it helps with baby's gut health and so much more.

Breastfeeding isn't always easy though.

It can take a while for baby to figure out how to latch, causing nipple pain.

You may worry if baby is getting enough to eat.

Your breasts may become engorged leading to blocked ducts or mastitis.

These are things that are typically mentioned if you see a lactation consultant or at least chat with a friend whose breastfed.

But what about how breastfeeding affects the rest of your body?

Yes, breastfeeding can help you slim down from the pregnancy weight. And it can prolong the return of your period.

What you may not have known is it also keeps estrogen and progesterone circulating in your body longer, which means your tissues are softer longer and more susceptible to injury or dysfunction.

This means:

  • your pelvic floor muscles may be strong but you still leak when running.
  • your sacroiliac joint (that joint that connects your sacrum and your pelvis) may continue to be problematic because it's hasn't regained it's support.

What breastfeeding also means for your body is neck and back aches and pains. Holding your baby to breastfeed can take a lot of effort. For a healing body that is already weak, this means compensations and bad habits form.

You may slouch to bring the breast to baby instead of propping up with a pillow.

You may twist or cross your legs.

You're sitting more.

If you nurse lying down you may jut out your ribs to bring your breast to baby.

You're constantly looking down at baby. Because really who doesn't want to stare at baby 24/7?

All this adds up to pain.

So how can you avoid getting a pain in your neck or back while breastfeeding?

1. Posture

Be mindful of your posture. First you need to make sure you are in good posture alignment. This means finding pelvic neutral, where your sitting on your sit bones , your ribs are centered over your pelvis and your spine is long with the natural curves. If the surface you are sitting on is inhibiting this then change where you are sitting or use props. Put pillows behind your, sit on a harder surface, anything that will help. Then use pillows, cushions, blankets, anything  except your body to prop baby up to reach your breast.

When you nurse on your side you want to consider the same thing. You want to make sure your body is in a neutral position. If you twist, make sure it's more of a log roll twist and put a pillow behind you. Make sure your head is supported and your shoulders are away from your ears.

2. Stretch

Stretching tight muscles after nursing is a great way to reduce aches and pains. And over time you'll maintain soft supple tissues rather than dehydrated tissue that will cause even more problems.

Doing simple stretches like:

  • neck rolls
  • reaching your head up and away to the side as you reach your opposite arm down and away
  • looking down to your arm pit
  • bringing your arms up and behind your head to open your chest
  • clasping your hands low behind your chest and reaching back
  • lying on your back and doing snow angles with your arms
  • rib twists
  • side bending
  • cat/cow
  • lunge stretches
  • taylor sit (criss cross applesauce) and bending forward from the hips then switching legs

These are all super simple stretches that you can hold for 30 seconds after nursing. And mix it up, you don't need to do all of them each time.

3. Strengthen Your Core

Reconnecting with your core after birth can take a while. But breastfeeding is a great time to start. Taking a moment to focus on your breathing and tuning in to the movement of the pelvic floor - out on inhale, in on exhale - is the first step. Then start to energize the pelvic floor on exhale, zippering up through the abs, while keeping your bony structure soft and in good posture.

Then when you start to feel up to doing more exercise, starting with basic core connecting exercises is the safest. This is where seeing a maternal health PT is helpful, so you can make sure you are doing the exercises correctly, and there isn't anything else going on that may become problematic.

Breastfeeding is a magical experience that can do wonders for your baby's health. Let it be a time you focus on yourself too!

 

 

Round Ligament Pain Keeping You Down?

If you have been pregnant you have probably experienced round ligament pain.

It can be a mild ache to a sharp stabbing pain.

What is the round ligament?

It is a cylindrical ligament that attaches from the uterus to the pelvis. It keeps the uterus from twisting or shifting too far out of place.

During pregnancy the round ligament needs to stretch as the uterus expands.

However, depending on how fast it stretches or how tight it is, it may cause pain.

Pain is usually felt in the lower half of the abdomen, near the hip.

It may only occur when you transition from sitting to standing, as the tissues in the front of the hip stretch.

Or it may last all day, lingering.

Even though your round ligament needs to stretch during pregnancy, it doesn't need to be painful.

Remember, just because you are pregnant doesn't mean you have to experience the common aches and pains associated with pregnancy.

So what can you do about round ligament pain?

Here are a few tips to ease the pain you may be experiencing as your uterus expands and stretches.

1. Heat

Using a warm heating pad or taking a warm bath can sooth the achey tissues. If you use a heating pad, avoid electric ones, just in case you fall asleep you don't want to burn yourself.

2. Stretch

Doing simple stretches like pelvic tilts, side bends and and lunge stretch can help length the tissues around the uterus that may be inhibiting the round ligament.

As always when you stretch during pregnancy, avoid extreme positions, modify as necessary and use props!

3. Posture

Being mindful of your posture during pregnancy is not only good practice for overall health, but will put less strain on the round ligament as it supports the uterus.

4. Be core aware

Using your core muscles properly and doing simple core exercises improve your support of the uterus. This reduces the amount of work the round ligament needs to do, so it can stretch with less forces on it.

5. Where a maternity brace

If you are unable to provide enough muscular support, wearing a maternity brace that helps lift your tummy the way your abs are meant to can help relieve some discomfort.

6. When all else fails see a specialist

If you are experiencing severe round ligament pain that is really inhibiting your way of life, seeing a specialist may be your best bet. A pelvic floor PT who specializes in maternal health can perform manual therapy to release tight tissues and ease discomfort, help you find good posture, give you stretches most appropriate for you, and guide your through strengthening exercises.

Don't let round ligament pain get you down. Head over to Expecting Pelvic Fitness to try out my signature program for FREE to learn good posture during pregnancy, safe exercises and more.

When Labor Fails to Progress

So you're in the middle of labor, things have been progressing nicely and all of a sudden your midwife, OB or nurse say labor has stalled.

Well, what the heck happened?

This happened to a patient of mine recently.

She was having some complications at the end of her pregnancy with severe Braxton Hicks, so her OBs decided it was time to induce her.

She went over her plan with her OB and doula to make sure they were all on the same page in terms of how high the Pitocen would be for the strength of the contractions because she knew they would be stronger than her current contractions and she really wanted to avoid having an epidural.

So, she was laboring at the hospital and things seemed to be progressing until a new OB came on shift.  As my patient puts it "she wanted to kick it up a notch."  So she increased the Pitocen dose, which made the contractions incredible painful and constant.  So my patient had no break.

She said, "we're getting the baby out now."

My patient voiced her concern and asked to reduce back to the original rate. Her feelings were dismissed by everyone in the room based on the new OBs advice.

Her labor slowed and she was in so much pain, she needed an epidural.

So now she was no longer progressing and she had to have more of a medicated delivery than she had planned.

Now, my patient has chronic sacroiliac dysfunction from a traumatic fall years ago, which we had worked really hard to get under control.  She has a hard time relaxing because she is a high energy person and she tends to forget to breath in intense situations.

All of these things are recipe for a harder delivery before adding in the fact she now did not feel comfortable with the OB who would potentially be delivering her baby.

Her body decided to stop her labor.

Our bodies have a protective mechanism - fight, flight, freeze.

When you are presented with a situation that is threatening or may be harmful your primal brain does a quick assessment without you even consciously being aware.

Your body will them respond by either fighting the threat, fleeing from the threat or freezing until the threat is gone.

In all of these situations our bodies produce more cortizal and endorphins which are stress hormones.  During birth, these hormones will slow progression.  In my patients case, her body froze and completely stopped progression.

Fight, Flight, Freeze

For many who are put into this situation where they do not feel comfortable either with the amount of activity in the room, a person in the room, a procedure that is being suggested or performed, will respond in this way.

The medical community calls this "failure to progress."

Some births truly fail to progress because of pelvic structure or babies position.

However, for many moms it's because they subconsciously do not feel comfortable in the situation they are in. So until they do feel comfortable the body will not thaw.

 

This is precisely what happened with my patient. Once the OB she did not feel comfortable with, went off shift, her body went back into dilating and she was able to birth her baby boy within an hour.

This can be an amazing tool of our body when allowed to work itself out.  But only when someone recognizes it as such, can you give the mom space to open up and birth.

Working with your body, not against it allows you have a much smoother labor, delivery and recovery.  You just need to know how!!

If you're interested in learning ways to assist the body in working through distractions and uncomfortable situations during birth contact me!

The Purest Form of Pelvic Health

Now that we have a newborn in the house again, this means DIAPERS...

With our daughter we cloth diapered. So we decided to cloth diaper again.

But what I learned when my daughter was a babe is what I believe to be the purest form of pelvic health, called elimination communication.

Elimination communication is following your babe's verbal and physical cues when they need to go to the bathroom.

You've all heard a babe grunting or a toddler hide in the corner when they poop. These are less subtle than the noises they make when they need to pee. But it is the way your child expresses his needs. Just like the different cries for being hungry, tired or wet.

So elimination communication is essentially respecting your babe's needs by listening and following their cues for bladder and bowel control. Thus establishing the earliest pelvic health habit.

It is an incredible feeling to have your babe smile up at you after they have finished pooping on the toilet!

Since we were successful with our daughter, we decided to give it a go again with our son. The first week he was born, I pulled out our little potty bowl and followed the same steps I did with my daughter.

After every nursing session I would wait about 5-10 minutes then offer him the potty bowl and cue by saying "psssss" or grunting. My verbal cues re-enforced his cues and eventually he was becoming more vocal when he needed to pee or poo.

Once we had established I would listen to his needs, I now ask him if he needs to go both verbally and with sign language. Then based on his response or the timing of when he went last I bring him to the toilet, holding him in a secure squat position.

I believe that listening and following your babes cues, just like with feedings, you're showing them they are respected and teach them they know their body.

This creates a good habit of communication, since they can't get to the toilet on their own, and helps establish good bladder and bowel control and hygiene.

In other countries this is the norm. Diapers are not used very often if at all and babes are "toilet trained" in infancy, by listening to the infants own cues.

Elimination communication is not for everyone. And we are not as hard core as I could be. But I strongly believe both my children have better toileting habits for it. My daughter has never been constipated, even when she began solid foods. My son already has a regular bowel movement routine, which he established himself!

Yes, there were many hard times with my daughter, especially when our routine was thrown off by a milestone or a trip. But it was well worth it!

I bring the same compassion and devotion to your care.

  • I listen.
  • I observe.
  • I communicate.
  • I work with you to build your body confidence.
  • I empower you to connect with your body again on a deeper level.
  • I expand your knowledge about your health.
  • I support you through flare ups and set backs
  • I help you establish habits that create long term pelvic health

So I begin another elimination communication journey, or the earliest stages of pelvic health and wellness, with my babe.

How can I help you?

Rhythmic Movement for Birth Pain Control

Birth is a life changing event that many women have a desire-fear relationship with.

The idea of knowingly putting yourself through pain can be daunting. Even with modern pain medication, which you may want to avoid.

So your pregnant and want to try for a natural birth or at least wait as long as possible before getting pain medication (if at all).

What are some strategies to cope with the pain of birth?

The first pains that are felt during birth are the result of uterine contractions. These contractions pull the cervical muscle up and out of the way to allow baby to descend. The widening of the cervix  pulls on the surrounding muscles and ligaments. These pelvic floor tissues are packed with nerves wit pressure and pain receptors and are the source of the strong sensations during contractions. The tighter or tense these tissues the more intense the pain response.

In early labor contractions and sensations are less intense and infrequent.

As labor progresses, the sensations intensify, lengthen and become more frequent. This is how you know your body is priming for full delivery. However it also becomes more challenging to cope.

The second set of pains is the stretch of the pelvic floor tissue as baby’s head is delivered.

Some call this the “ring of fire” because it feels like a burning sensation as the tissue stretches. Again, being more intense if the pelvic floor muscles are tense or tight.

Other pains that may be felt are back pain, especially if baby is posterior occiput breech, meaning face up. Others may experience vaginal or rectal pain in the form of pressure.

Most pain during labor and delivery is absolutely normal and healthy. But there are ways to influence and cope with the pain naturally.

Many people think of breathing strategies to cope with pain. I can't agree more. But there are other strategies that help your body work through the aches and pains during labor.

One strategy is to MOVE!

There are many ways to move during labor ... walking, sitting on the birth ball, yoga poses ...but one of the most influential movement is rhythmic.

Rhythmic movement targets the autonomic nervous system, which controls how you FEEL pain.

When you are in labor your body triggers your sympathetic nervous system due to the stress your body is under, which controls your fight, flight or freeze mechanism, which sharpens your senses, including pain.

Even though your autonomic nervous system is not under our direct conscious control you can influence it by targeting your parasympathetic nervous system, which suppresses the sensation of pain.

Rhythmic movement relaxes your muscles and taps into this system. Helping you take the edge off of labor pains.

During my second birth, I found my body automatically moving in a rhythmic way when the contractions became more intense.

What are rhythmic movements?

A movement that recurs repetitively to a certain pattern.

This could be rocking, shaking, bouncing, swaying.

In early labor I used my birth ball by rocking my pelvis, bouncing, and swaying my hips with wide legs.

When labor progressed and I was "resting" on my side in bed, every time there was a contraction my body (but mostly my pelvis) would rock back and forth. This movement was soothing and allowed me to stay calm and work with the pain rather than stiffen against it.

There is no one correct way to move. You can practice throughout your pregnancy to create muscle memory and a mind-body connection that your body can call upon when you are in labor. Then you're body will move in it's own unique way.

Rhythmic movement allows you to take charge of your labor and work with the pain.

FEEL how your body wants to move and let your body move freely...creating your birth dance!

 

Baby Wearing: Posture 101

I LOVE baby wearing!!!

Baby wearing is an exceptional way to be able to carry baby around the house, go on walks, get tasks done, hands free nursing and to sooth baby.

I wore my daughter daily for the first year of her life and then almost daily until she was 2, when she was more interested in roaming around on her own when we went for walks.

I loved using a stretchy wrap when she was newborn for the first 6 months of her life. It was easy to wear throughout the day, even when not wearing her. So that if I needed to scoop her up and put her in I wasn't fussing with putting the carrier on first.

Then I switched over to a soft structured carrier.  This distributed her weight more evenly through my body as she grew and I was able to put her on my back.

I tried woven wraps, but never became proficient with them to the point that they were more convenient than the soft carrier.

With my son I've been switching between the stretchy wrap and soft carrier based on the weather. Each season brings a different challenge. In the winter you need to make sure baby and you are warm without over heating.

On warmer days I've been using the soft carrier because I can snuggle him under my husbands wool vest staying toasty warm without either of us overheating. On colder days I've been using the soft carrier since I put him into his bunting which is too thick for it to be comfortable in the stretchy wrap.

And I can't wait to explore carriers to wear in the water this summer!!

Since baby wearing is becoming more popular there are so many types of carriers available and I suggest doing major research to find the type, brand, material, budget, etc that is right for YOU.

Each carrier has it's own comfort level and fits each body type slightly differently. There are some great blogs out there that offer more information about carrier fits for body type.

Designs have come a long way for comfort and support to the wearer, especially since some of us wear baby for hours. But even with a great fit, wearing baby for hours can be tiring and can cause discomfort.

This discomfort is more likely if your body is unable to provide the core support and endurance necessary to carry extra weight.

The biggest factor that effects the comfort of baby wearing, beyond the type of carrier is your POSTURE.

During pregnancy posture shifts and changes as your belly grows and your center of gravity moves forward, increasing your low back curve tipping your pelvis forward, and lifting up the front of your ribs. This is exaggerated with the stretching and weakening of your abs and pelvic floor.

And after months of working on overdrive to support your body and growing baby your core muscles need to recoup and recover after birth. Especially if either muscle groups are injured during birth, such as tearing, episiotomy, or csection.

However, a natural birth without injury can also take time to reconnect to your core, especially if you have never consciously connected to your core before.

And after birth your body has a lot of adjusting to make to resume proper posture, including stretching tight muscles, strengthening weak muscles, shifting joints, moving organs all while healing.

This means that sometimes posture never resumes proper alignment. Because let's be honest many of the tasks needing to be done as a new mom can put you into new awkward postures.

So being mindful of posture as a new mom is very important during the healing process to prevent body aches.

Since baby wearing challenges your core it can reinforce improper postures learned during pregnancy as well as cause new bad habits.

What I've noticed the most with myself while baby wearing is needing to be mindful of where my ribs are positioned. I tend to pop my ribs forward, like a bell ringing to the front of my body. If I were to keep this position while wearing my son for an hour my back would be very achey.

So how do you check in with your posture while baby wearing to avoid back ache?

Do the following after you have baby in the carrier:

  • Find pelvic neutral - Imagine your pelvis is a bowl. The front rim of your bowl is your pubic bone and the back rim of your bowl is sacrum. Tip the bowl to pour water out the front and then back and settle into a position where your bowl is open upward.
  • Blossom the back of your pelvis out to the sides - From the center of your back pelvis (just below belt line) imagine arrows pointing in opposite direction outward gently creating space around your sacrum.
  • Lengthen your spine - Lift through the top of your head and reach through your tailbone creating length and space in your spine.
  • Soften your ribs - Imagine your ribs are a bell. Make sure your bell is open down toward your pelvis. So the openings of your bowl and bell face each other. Softening through your chest and opening up through your mid back.
  • Relax your shoulders - Let go of any tension in your shoulders and neck by rolling your shoulders and keeping an equal distance between your shoulders in the front and back.

Once you have found this position, focus on using your core to support it. So each time you inhale fill your ribs in all directions and fill down into your pelvis and belly, without over expanding your belly. When you exhale follow the inward movement of your belly with your pelvic floor and abdomen, feeling a lifting of the pelvic floor and flattening of the tummy without loosing your good posture.

Why is posture while baby wearing (& in general) important to your pelvic health?

  • Poor posture slows the healing of diastasis recti and vice versa. A diastasis recti contributes to poor posture. So being mindful of good posture will help the connective tissue in your abdomen heal and strengthen reinforcing proper abdominal muscle function. And proper abdominal function helps with bladder control, organ support (avoiding pelvic organ prolapse) spine function, digestion, body mechanics and much more.
  • Poor posture puts more pressure into the pelvis. When your pelvis is under more pressure the organs within, muscle around and the joints supporting are under pressure. This means they all have to adjust how they function under normal pressure to high pressure and typically it means not doing what they are suppose to. For example, controlling your pressure becomes more challenging.
  • Poor posture leads to all types of musculoskeletal pain, not only in the pelvis, more commonly in the sacroiliac joints and pubic symphysis, but also up and down the chain, into the spine, hips, even further out to the shoulders, knees and feet.

Every time you practice this good posture and core support you reinforce proper joint mechanics and muscle & organ function which provides long term health for your pelvis and all around body.

Making baby wearing not only more enjoyable but a sneaky way to get in some exercise!

If you want to learn more about proper posture and body mechanics as a new mom and reconnecting with your core to make those every day tasks easier and more enjoyable check out my self-paced, pelvic health education packed signature program, Expecting Pelvic Fitness.

After Birth Care for Your Pelvic Floor

I've given birth twice now.

Each experiences has shaped how I view birth and my ability to reach deep down to the inner strength with in.

However, each birth resulted in different recovery needs.

My first delivery I needed to push for at least an hour, if not longer, I really can't remember. The umbilical cord was wrapped around my daughter's neck and every time I pushed the cord pulled tight and prevented her from descending. Then when I "relaxed" between contractions all the progress I made with the previous contraction was lost.

It wasn't until my midwives flipped me on my back and said "push" did I realize something may be wrong.

So I dug down and pushed with all I had left. This delivered her head. My midwife cut the umbilical cord then I was able to birth the rest of her body.

That push that birthed her head resulted in a grade 2 tear. I wasn't focusing on relaxing the pelvic floor as I had been previously I was just focusing on delivering my babe.

The tear needed a few stitches. It was uncomfortable to sit. It was uncomfortable to poop. It was uncomfortable to wear pants with a seam down the middle. I wore padscicles for several weeks around the house. I tried to reconnect with my pelvic floor the next day and couldn't feel much. And once I was feeling ready to be intimate with my husband again, there was a spot of pain.

My second birth was vastly different. I pushed twice to deliver my babe, taking only 8 minutes. I was swollen but did not tear. It was only uncomfortable to sit when I was transitioning from stand to sit to the reverse. I could wear jeans without discomfort. I successfully reconnected to my pelvic floor within 12 hours of delivery. And only being 3 weeks from birth I can't compare intimacy yet.

Looking back, even though I had prepared pretty much in the same way as the first birth, I trusted my body more the second time around. I followed the signals it gave me rather than what I thought I should do based on what I learned in class or what the midwives were telling me.

The result of each birth and recovery has effected how my pelvic floor functions. After my first birth, there was pain effecting my pelvic floor's role in bowel movements and sex. After my second birth, my pelvic floor is functioning properly, thus far!

Giving birth has been said to equate to a marathon or an Olympic event.

I can't agree more. However, there are some major differences.

After a marathon or Olympic event (if all goes well) you come out of not much different than when you started. All the training you did pays off and your body will be tired, but otherwise unscathed.

After birth, even a natural, unremarkable birth, your body is not immediately the same.

There are so many variables that effect the outcome of birth and recovery. Your body is different from mine, your baby is different from mine, your medical history, location and pain tolerance are different from mine. These variables and others make each birth and recovery unique.

However, there are similarities that can be addressed in similar ways to get the same outcome during recovery....a healthy pelvic floor that functions properly for you for the rest of your life.

Here is what I did to recover from my births. Remember some of these things every mom should do and others are more of an individual basis.

1. Afterease

I took an herbal tincture made by my midwife specific for after birth cramps. These cramps are caused by your uterus contracting and shrinking back to pre-pregnancy size and are usually most intense while nursing. This can cause some significant pain.

After my first birth, even though the after birth pain was intense, I didn't not take anything. I didn't want to take any over the counter medication if I could avoid it, since I was breastfeeding, though there are some medications that are safe to take. Being a first time mom, I wanted to avoid everything. And I didn't know about an herbal tincture that could help.

Taking something appropriate for after birth pain, will greatly improve how you feel while recovering.

2. Peri Bottle

After giving birth wiping with toilet paper can be rough and uncomfortable. Especially if you are swollen or tore.

So using a peri bottle to rinse off your perineum will keep you clean and the cool water will sooth the area too.

3. Herb Sitz Bath

A sitz bath is a great way to reduce inflammation and promote healing of swollen, bruised or torn/cut pelvic floor tissue.

Adding in healing herbs like Lavender or Epsom salts boosts the healing power of the sitz bath.

There are some great herb mixes specific to postpartum sitz baths, like Earth Mama or you can look on Etsy or you can make up your own. Here's a good recipe!

These mixes can also be brewed and added to the peri bottle or to padscicles instead of witch hazel.

4. Padscicle

These are frozen menstrual pad. You add either witch hazel or an herb ticture to saturate the pad, then pop it in the freezer.  After birth wearing a padscicle is a great way to sooth a hot, swollen or injured pelvic floor and speed recovery.

Some hospitals give you an ice pack specific for post birth swelling.  These are great, but I'd suggest making up padscicles as well to add the extra healing power of the witch hazel or herb tincture.

5. Adult Diapers

Adult diapers are a necessary evil after birth. You will continue to bleed as the uterus losses the endometrial lining that protected baby. Diapers are much easier to use and provide more protection than pads immediately after birth.

6. Menuca Honey

Honey has antibacteria and antifungal properties that help promote healing. It's like a natural version of Neosporin, but safe for your pelvic floor.

Dabbing a tiny amount on the perineum goes a long way!

7. Lymphatic Massage

After my second birth I had a good deal of swelling. So during my sitz bath I would do lymphatic massage to promote movement of the inflammation. 

Lymphatic massage is a very light massage to very specific areas in the body directed toward the heart. It is a safe and very effective massage to reduce swelling when performed properly!

8. Pelvic Stretches

In addition to lymphatic massage to reduce swelling I did pelvic stretches after my sitz bath. Stretching out tight muscles around the pelvis, like hip flexors and adductors gives more space for the swelling to move out of the area.

9. Breathing Exercises

The last thing I did after giving birth to promote healing was to reconnect with my core. I did this through breathing exercises while I nursed.

Every time I inhaled I took a full diaphragm breath filling my trunk. Then as I exhaled I would follow the natural movement of my core inward, feeling my tummy and pelvic floor drawing inward.

By reconnecting and activating my core muscles I created a muscle pump. This pump improves circulation to the area, flushing out the inflammation and bringing in healing nutrients with each contraction.

I also found that this breathing helped me get through the after birth pains.

Since I gave birth vaginally my after birth care looks different from a mom who gave birth with a csection. However, initially there are only a few differences. For examples padscicles may not be necessary. But scar care is added.

I go more in depth for immediate after birth care and progressive care in my signature program for pelvic health, 4th Trimester Expecting Pelvic Fitness.

By taking care of your pelvis after birth you are encouraging not only short term relief but long term pelvic health.

Top 6 Activities to do with Your Newborn

So you've just had a baby, now what, other than rest?

You may have been told that newborns eat, sleep and poop. But there is a good part of the day that they are awake.  This is a perfect opportunity to play with baby.

Playing with a newborn is very different from kid play.

Playing with a newborn involves bonding with you and your partner, learning different sounds, colors, smells, textures and taking in the environment around them.

It is such as fun time to be able to think again like a child, with wonder about the world around us.

Here are my top activities to do with your newborn that strengthens your bond.

1. Mimicking

Follow babies lead. Babies learn from reciprocated action, so when baby coos, coo with baby.  If baby waves her arm, wave back.

Mimicking what baby does teaches baby you are paying attention to her.  She will learn that you respond, and there is a reaction to her vocalizing or moving.

2. Emote

Babies love faces.  She will spend a lot of time exploring your face. So when she is doing this talk to baby in different tones of voice and make different faces.  See how baby reacts. She will learn emotions and facial expressions that match tone of voice with these games.

3. Play with Sensations

Everything is new to a newborn. So let baby have time to explore and take in her surroundings.

You can do this by introducing different textured surfaces to lie on for tummy time, playing with toys that have sounds, bring different smells within a safe distance.  Then describe what the baby is feeling, hearing, smelling.

4. Get down on the Floor

Babies need to time to stretch out and learn how to move in an open space. This is a perfect time for you to also get down on the floor and stretch out. Lie next to baby and play with babies hands, feet, legs, tummy. Again, telling baby what you're doing, so they learn the body.

5. Explore the Environment

Hold baby and walk around the house describing what baby may be seeing.  Get close up to pictures on the wall, or ordinary objects like a cup and tell baby what it is.  If the weather is nice, bring baby outside and let baby breath in the air, take in the smells, sights and sounds.

6. Snuggle

My personal favorite!! Newborns, need a lot of time being held and loved on.  They thrive through touch.  So put some music on, and sway with baby, sing to baby or just curl up on the couch with a good book to look at.

These are just a few activities that you can do during those first few weeks home with baby when you're just getting to know each other and your body is still healing.

So take the time to slow down, take a deep breath and have fun!

What I'm Doing to Prepare for Birth

At 39 weeks pregnant with my second the realization that my birth is fast approaching comes in waves.

I am still in awe to the fact that I'm pregnant and will be doing this birth thing again.

I reflect on my birth experience with my daughter. How it was text book until the midwives needed to cut the umbilical cord before her body was born. Then she needed to be resuscitated and brought to the hospital to make sure she was okay.

My plans for delayed cord clamping and peaceful bonding experience were dashed.

I didn't have the same daily or exercise routine this time around. During my first pregnancy I worked 40 hours a week in an outpatient hospital setting as the women's health physical therapist. I had a solid exercise routine running several times a week,  and doing my yoga and Pilates to keep connected to my core, maintain my balance and flexibility.

This time around I am running around with a 3 year old, building a local business while creating an online presence with my signature program to reach moms beyond the Seacoast and helping with a house renovation to be ready for new baby.

So what am I doing now to prepare for my second birth?

Physically

Practicing my squats

Squats are a great way to open up the pelvis and work on hip flexibility.

In a squat position the sitz bones, those bone structures we sit widen, opening up the lower ring of the pelvis and relaxing the pelvic floor.

By adding flexion (forward bend) or extension (back bend) of the spine it will open or close the upper and lower rings of the pelvis. This works the tissues connected to the pelvis and sacrum getting them ready to move and expand during birth.

You can do a squat with or without support.

An unsupported squat works more on the endurance of the leg muscles and your stamina.

A supported squat works more on the flexibility of your hips and pelvis. As you get closer to your due date, this is the way to go.

Being supported by sitting on a variety of seats can help you gradually increase flexibility and comfort.

The height of the seat and the amount of hip flexion (bend) will depend on your comfort. Sitting on a chair or ball and working to a lower seat like an ottoman or mediation pillow will bring your hips into more flexion and a deeper squat.

Then leaning forward or back onto a cushioned chair or ball will change the sensation of relaxation in your pelvic floor. Experimenting now is a great way to prep your body.

This is what I do when I play with my daughter on the floor or fold laundry or just sit to practice my breathing.

Getting on my birth ball

I love sitting on my birth ball to rock, roll and shake my pelvis. My body create a muscle memory for controlling the movement of the ball while I loosen tight muscles, ease muscle aches, bring awareness to my core and help babe get into a good birth position.

Simply sitting on the ball and rocking your pelvis back and forth, side to side and in a circle. Paying attention to the sensations in the pelvis, hips and spine for ease of movement so you can then use this as a guide for where you need to do more stretches.

Massage

 This includes two forms of massage.

Going and getting a whole body massage.

And perineum massage.

A whole body massage is a great way to reduce muscle tension, stimulate stress relieving hormones, and reduce swelling.

Perineum massage is a great way to connect with your pelvic floor.  You're physically touching the area that babe will be birthed. Then doing the massage, which is more of a stretch gets you to start to feel the "burn" that happens during birth.

The goal of perineum massage is to work on your tolerance of the 'burn' not necessarily to stretch out your muscles. When you can work through this sensation without fear and with a deeper relaxation you improve your chances of being able to do so during birth.

The benefits of perineum massage is reducing risk of tearing and other medical intervention that may result in urinary incontinence and vaginal pain.

Getting down on the floor

Getting down on the floor to stretch on hands and knees is a go to position for me. This was the position my body chose for my first birth and it provides a lot of relief for back discomfort and feeling of abdominal fullness. 

When on hands and knees I do cat/cow stretch, I shift my weight from side to side and front to back, I roll my hips in circles and figure eights.

You can work through your hips, your pelvis, your spine all the way up to your head when on hands and knees. It is such a versatile position to move your body in through out pregnancy but especially as you near birth.

Mentally

Practicing my mind-body connection through breath

Breathing is a very powerful tool to use for birth.

It can help with pain relief, progression, relaxation, and so much more.

Practicing a variety of breathing methods prior to birth (I'm talking many months before) allows your body to create a muscle memory which can be used when you are in the middle of labor and delivery when your mental capacity to make decisions (which is on purpose) is diminished.

I'm practicing my connection with pelvic floor relaxation on inhale through exhale, prolonging my breathe cycle to see how long I can breath, short breathes and a variety of nose/mouth breathing.

Imagery of the birth

Imagining how your birth will go can help you mentally prepare for birth.

Picturing baby descending throw the birth canal. Your pelvis widening, your pelvic floor relaxing and opening. Baby's head emerging followed by his body.

By using this imagery again you are creating a conscious connection to process of birth that you're body can unconsciously call upon during labor and delivery.

I practice this when I'm doing my breathing or just before bed.

Organizing my birth space

Since I'm planning a home birth, mentally preparing for birth also means making sure the space I'm birthing in is ready.

I don't want to caught laboring and feeling uncomfortable or annoyed that something is not in place or ready.

Making sure our lovely new soaking tub is cleaned, the speaker for our music is in the bathroom, the essential oils and diffuser or spray bottle is easily accessible.

Having my birth kit handy and all the extras like towels and baby's blanket.

This is my version of getting my hospital bag ready.

Emotionally

Positive affirmations

Being in a positive mindset reduces fear and stress hormones that may impact labor and delivery.

So saying positive affirmations is a great way to get into this mindset.

This could be as simple as:

"My body is made to birth a baby"
"My pelvis is just the right size for baby"

Really believing what you are saying and repeating is frequently is very important.

Pretending to be an animal with my daughter

Since we are planning on having a home birth, my daughter will be in the house when I'm laboring and when her little brother or sister is born.

So to get her prepared for the noises I may make, we are making noises for fun.

Growling, moaning, roaring, puffing, grunting.

Even though each birth is unique and your body is different from mine, your birth prep will look differently from mine, but may include some of what I practice.

You have to chose what is right for you!

If you want to learn more on how to prepare your pelvis for birth check out my Prepare Your Pelvis for Birth Package!

Happy birthing!

Could sitting in the car be causing you pain?

The Holidays are coming, which for many of us means traveling.

After sitting in the car for 3 hours (one way) while driving the the Seuss Museum over the weekend and then the thought of driving another 3.5 hours to visit family over Thanksgiving, thoughts of making my travel more comfortable and least stressful on my body came to mind.

Sitting in the car to go to the next town over or several states over can put your body into strange postures.

Car seats are built for safety, not so much for good posture.

What this means is you need to be mindful how you are sitting in the seat, which may include props or modifications.

By sitting in the car in an odd posture for 10 minutes several times a day, 30 minutes a week or several hours all add up to wear and tear on your body.

Good posture in the car becomes especially important during pregnancy and as a mom.

As a mom you are reestablishing your core and have to constantly adapt how you are moving and using your body to take care of your little one(s). Being intentional about your posture will help your body heal, reconnect, and move in a more efficient way. Thus in the long run nourish your body and avoid pain.

During pregnancy, good posture can be harder to find and manage, especially if the seat you're sitting in forces you in to an odd posture.

And since sitting in general during pregnancy can cause your joints to settle leading to aches and pain, it makes it even more important to pay attention to.

When sitting in the car, especially for longer than 10 minutes, your body tends to get tired of sitting in one position when it lacks the support from your core.

Here are some of my tips for sitting in the car.... to travel during the holidays or for every day driving.

Adjust Your Seat First

There are so many ways to adjust seats now, so take advantage of your options.

When you first get into the car play around with your seat position. Explore the different positions you can put your seat in.

  • Does your seat raise and lower?
  • Is there adjustable lumbar support?
  • Does the seat tilt?
  • Can you adjust the steering wheel (if you're driving)?
  • What is the distance you can safely and comfortably be from the steering wheel?

Know What Proper Sitting Posture Looks Like

Adjusting your seat will only be effective for you if you know how to adjust for good posture in sitting.

There are some basics to always follow and then some modifications to play around with.

Here are some basics:

  • Pelvic Neutral
    • You want to make sure your pelvis is not tipped in one direction. Car seats tend to force us into more of a posterior tip, making us sit on our tailbones.
    • You also want to make sure you are not twisting in one direction, by crossing your legs or shifting your weight to one side.
  • Spine Neutral
    • You want to make sure your spine is nicely stacked over the pelvis, not rounded or arched or twisted
    • Car seats lend more to rounding your back because of the concave nature of the seat back.
  • Knees in line with each other
    • This is especially true when you are driving
    • Make sure when you are sitting your knees line up with each other, rather than having one more forward
    • This is typically a twist in the pelvis
  • Neutral hips
    • Avoid sitting with legs crossed, significantly turned out or in, or squeezed together or wide apart

Here is a modification:

  • Hips and Knees should be around 90˚ flexion (or bent)
    • This is when you are a passenger. When you are driving your knees will not be at 90˚ to reach the petals while at a safe distance from the steering wheel.
    • This may not always be achievable in a car based on height of the seat. For example you may drive a sedan and be tall. The seat may only raise up so high to accommodate your long legs. Unlike a SUV that seat is already higher.
    • As your belly grows so does the angle your hips can be at for comfort.

How to Find Good Posture

Now to combine playing around with your seat options and knowing your posture guidelines.

When you first get into the car adjust your seat. Find the position that brings you the closest to the 90˚ at hip and knee, or even around 100˚ hip flexion (think more open between thighs and belly, like opening a book).

Once you've figured that out, adjust the distance between you and the steering wheel if you're driving. I've found that when I adjust the seat height I get too close to the steering wheel.

The rest is based on you.

After adjusting your seat to avoid the common rounded, slouched or closed off position, you have to help your body find the comfortable neutral.

Use your pelvic tilts to find pelvic neutral.

Grow your spine out of your pelvis in both directions, stacking your vertebra, ribs, shoulders and head over your pelvis.

Adjust your seat again, if your lumbar support is too much or little. I find that sometimes the lumbar support doesn't actually align with where you need the most support. Think just above the sacrum or belt line. You should feel your sacrum (widest part of pelvis) and your ribs are softly reaching into the seat.

Look at your legs. Are they neutral or twisted? Are you crossing your legs? Are you shifted to one side, so you can quickly look back at your kiddo(s)? I'm guilty with that last one.

As you settle into your neutral body position and find your good posture, now you can adjust your mirrors to match your needs.

Keeping it up on long rides....

Can be support challenging. Don't feel you need to stay still the entire time you are in the car.

By all means shift and move.

This will keep your muscles from becoming stiff, your joints from settling, and boost your overall awareness of your posture.

If you rode with me you'd see me doing pelvic tilts, pelvic circles, glutes squeezes, neck rolls, deep breathing with core coordination, leg shakes and more.

This keeps my body awake, but at the safe time relaxed and more comfortable, avoiding very common aches and pains in the low back, pelvis and hips....especially when you transition out of the car to standing.

 

 

Pubic bone pain stopping you in your tracks?

During my second pregnancy I have experienced pubic bone pain more often and with more severity than during my first pregnancy.

There have been several times that it was so intense I could barely walk.

If you've had pubic bone pain you'll know what I'm talking about. The sensation that the front of your pelvis is grinding together and ripping apart. It's not pleasant.

But why do some of us experience pubic bone pain during pregnancy and sometimes even into postpartum?

Pubic bone pain is a very common pain syndrome during pregnancy. It is associated with Symphysis Pubis Dysfunction. The symphysis pubis is the joint that connects the two halves of the pelvis in the front. Your abdominal muscles, pelvic floor muscles and inner thigh muscles attach to the pubic bones.

There are four main causes of pubic bone pain, these can happen exclusively or more commonly in combination:

1. Posture

Your spine and pelvis is designed to be held in a particular position in relation to each other.

You have natural curves through the spine that allow forces to be translated efficiently and safely through the joints.

During pregnancy your posture tends to alter these natural curves because of your growing belly shifting your center of gravity forward and a stretched & weaker core.

When this happens your lower back curve increases and your pelvis tips forward, in standing. Or while sitting we tend to slouch into curved position. With a weakened core it's harder to pull out of this position.

This puts more weight on the symphysis pubis, that it is not meant to have to bear, straining the joint.

2. Alignment

Our pelvic joints go together likes puzzle pieces. There is one way they fit together, any other way is like jamming the pieces together.

Picture how painful that could be.

This is more commonly considered Pelvic Girdle Pain. Issues in the sacroiliac joints (back of the pelvis) that translates to the symphysis pubis.

Your joints are more susceptible to not fitting well during pregnancy and during recovery because of relaxin, estrogen and progesterone, which soften the ligaments and connective tissue that support and stabilize the joints.

When your joints are not "put together" they no longer efficiently manage forces, putting more strain on them.

3. Muscle trigger points or spasms

Trigger points and muscle spasms are locked up, dehydrated, sometimes over-worked muscle fibers. They tend to get stuck in a pain cycle of communication until "unlocked."

During pregnancy and  postpartum, with weaker core muscles, other muscles work harder to stabilize the pelvis and spine.

When muscles repeatedly work harder they form trigger points and muscle spasms.

These trigger points and muscle spasms can effect the joints they are attached to, referring pain  or causing imbalances in the joints.

4. Weak core

Without being extremely mindful as well as diligent with corrective exercises your core muscles will weaken, loose natural reflexes and disorganize function.

When this happens they no longer support and stabilize your joints and body.

So every time you move, like getting up from sitting or rolling in bed. Your joint are able to manage the forces going through them and your body responds with pain.

For me it has been a combination of old injuries causing alignment issues and trigger points reducing my body's core coordination. This all happened after two incidences:

One while lifting and moving too many boxes and furniture without asking for help.

The other after slipping on wet leaves covering my shed's ramp while doing yard clean up after a big storm. The caused me to tense up to avoid a full on split.

Both certainly not my finest hour, but I was able to get resolve pain fairly quickly with self care I've learned over my pelvic health years that I know work for my body.

If you answer "yes" to the following questions then it's time to listen to your body and ask for the help you deserve....

1. Do you experience pubic bone pain when you role or shift in bed?

2. Do you get pubic bone pain when you walk?

3. Are you several months postpartum and your pubic bone is on fire?

4. Do you want to have a natural birth and wonder how you'll manage because of your pubic bone pain?

There are simple tips and tricks to reduce your pubic bone pain.

Top tips....

Take smaller steps while walking...

Stand and sit tall keeping your pelvis and spine in neutral...

Warm up your pelvis with pelvic tilts before standing up...

Keep your legs together and roll like a log when moving in bed...

And lastly....

Set up a breakthrough call to learn what your body needs.

When Baby Becomes a Pain in Your Ribs!

During my first pregnancy my daughter liked to nestle right up into my ribs using my liver as a dance floor.

I didn't expect anything less during this pregnancy, and this baby has not disappointed.

The difference between the two is, this baby doesn't use my liver as a dance floor, but likes to use my ribs as a trapeze in the middle of the night!

When I'm sleeping all of a sudden I'll feel the big push into my ribs, which causes a burning sensation in my muscles as they strain to stretch and withstand the force.

This is no way comfortable and really disrupts sleep....I'm sure many of you can relate!

During pregnancy one of the many body changes we experience is an expanding rib cage.

This is meant to give your organs and baby more space.

But in the process it can lead to tissue imbalances in your trunk resulting in pressurization changes and force inefficiency.

Combine that with baby making itself comfortable up and under your ribs and this is a recipe for nagging discomfort.

This can really be a pain, especially when you are trying to sleep.

So what can you do to provide baby with enough space while supporting your body?

Deep Breath

What I mean by this is fill your lungs and ribs in all dimensions when you inhale.

Our lungs and ribs are meant to be able to expand 360˚ - front-back, side-side, top-bottom.

We tend to breath more to the front or just down.

This neglects a huge portion of our ribs and the muscles that make the ribs move with start to shorten and become tight.

Thus when your ribs need to expand to make more space, these muscles will be strained.

By focusing on allow your breath to fill your entire lungs stretches these muscles and tissues from the inside out.

Rib Openers

You should also stretch these muscles from the outside in.

Doing simple rib openers like side bending, child's pose, seated twisting, can all really help your ribs release the tension and open up more.

These are great to do through out the day, especially after sitting for a while.

You may notice one side is tighter than another, for me it's my right side.

This is normal, since we tend to favor one side of our body for activities. Think about how your hold your bag/purse, hold your older child(ren), etc. 

Fascia Nourishing

When your muscles become tight they become dehydrated and undernourished. This causes them to become more susceptible to injury and strain.

Doing simple fascia nourishing helps restore hydration and fluidity.

You can do this by gently poking around your ribs, looking for areas of discomfort.

Once you find a spot, you'd hold gentle pressure over this area while picturing a melting sensation and tissue release.

Getting to all areas can be really challenging and that's where having a partner, or professional help you out.

This is exactly what I do for myself, trying to stay ahead of growth spurts.

And remember that these tissue and muscle imbalances in the ribs affects the pressure system of your trunk, which in turn can lead to pelvic health issues like prolapse and incontinence.

So paying attention to your ribs can help you avoid pelvic issues, especially during postpartum recovery when your ribs start to find a less expanded position.

If you are or someone you know is experiencing rib pain during pregnancy, you can check out a quick video of a few rib openers on my Instragram or Facebook pages.

Or you can sign up for a free break through call to find out other ways I can help you find relief.

 

 

Preparing for Birth

During pregnancy our bodies go on this journey of incredible change that prepares us physically for growing another human being and ultimately leading us to birth.

Our body institutionally knows how to birth, but that may not make it any easier on us to actually birth because there are factors that are within our control and outside of our control that play a role in birth as well.

Birthing is a very physical activity that even the fittest woman may not be prepared for.

It takes a great deal of inner awareness to let go of the tensions in our body while using a dynamic stability and stamina to maintain postures that promote the baby’s descent into the pelvis and through the vagina.

Wouldn’t it be nice to influence the factors that we have control over, before you are in labor?

These factors may be your ability to relax the pelvic floor, your awareness of pelvic positioning and hip flexibility. All within your control prior to labor but never really mentioned in your prenatal visits or well meaning friends and family when they tell you stories of their birth experiences.

Regardless of your birth method choice having a better sense of your body prior to birth will help you recover and figure out your new body after birth.

You can do this through therapeutic maternal specialist training. Not typically mentioned or suggested at your prenatal visits, you are expected to know everything there is to know about how to birth…or your told to go to a childbirth class, which is great but will not give you the same level of body awareness as one on one training. Childbirth classes are so important for providing information about different methods of childbirth, certain medical interventions and varying pain management skills.  But they do not go over postures, positions, stretches and birth recovery that is so paramount for the health of our bodies.

Your physical health affects your mental & general health…who hasn’t heard “a happy wife a happy life.” Well this goes for moms too (because you don’t have to be a wife to be a mom).  If we don’t take the time to really invest in our bodies during pregnancy to reduce the effects these changes have that can cause serious long term problems (incontinence, prolapse, pelvic pain, to name a few), then we are only giving part of ourselves to our loved ones.

If you agree with me, spread the word.  We need to create a new culture surrounding the maternal care system when it comes to moms health.  Other countries have been doing this for decades, why not the US. So let’s start right here in the Seacoast. (especially if you had a C-section...if you think about it, you just went through major surgery...any other major surgery, i.e. total joint replacement, heart surgery, etc...you'd automatically be sent to rehab...not so for moms).

The best part, you don’t need to go to your OB to get a referral in NH, ie. this can be your choice. We rely very heavily on the medical expertise of doctors, which is absolutely needed, but when truths and education is inadvertently omitted from conversations, we need to listen to our inner voice.  So bring it up at your next visit or just contact a highly trained maternal physical therapy specialist in your area….ME!

And to be honest…we’re not all created equal.  We all bring different modalities and thinking to the table. For me I’m a nontraditional PT. Yes, I have the same doctorate training as many of my colleagues and I did some of the same post-graduate training in pelvic floor rehab as others in my area, ultimately receiving my Certification as a Women’s Health Clinical Specialist.

What I also bring to the table is my years of experience working with woman from across the spectrum, so I know the devastating outcomes that can happen if we leave our bodies to their own devices or *gasp* improper fitness training.

Oh, and did I mention I have additional training in manual myofascial release therapy which is a powerful tool for helping muscles come back “on line” from not being able to work for us then add to the mix Pilates exercises.  But I’ll tell you, I’m a non-traditional Pilates trainer.  I believe, as do my instructors that it is less about performing specific classical exercises and more about how the body performs movement while using the inner body (core).

Every day I’m amazed at how this combination of training really serves the expecting and new moms so well.

So let’s circle back around, our body goes through tremendous changes during pregnancy, to the point that our structure will never be the same, no matter how many crunches you do (please, please don’t do crunches).

But there are ways you can reduce these affects on the body by improving your awareness of your inner body through specialist care.

The main thing that matters is you are taken care of, now and in the future, so you can continue the activities you love, explore new activities, give the most you can to your loved ones without the fear of causing harm to your body.

Take care of yourself today

And stay tuned for more on "What Your NOT Told About Birth"...

Sleep during Pregnancy

As I drove to work this morning I listened to a podcast by Katy Bowman, a biomechanist, about SLEEP.

If you've never heard of Katy, she is a proponent of nutritional movement and varying our movement in our daily activity for optimal physical health. Our beliefs align on so many matters, which is why I enjoy listening to her podcasts.

This morning was no exception.

The style of this particular episode was answering questions from listeners and the first listener was an expecting mom.

Thus, the reason why I'm sharing my thoughts to all you lovely ladies.

To paraphrase this moms question,

"should I sleep on my left side?"

She is generally a very mobile sleeper, but had heard that during pregnancy she should sleep on her left side. She however, feels that this is causing one side of her body to be "overworked" and the other side to be "underworked."

To be honest, I didn't completely agree with Katy's answer, which was essentially, "I don't know."

But she did have some good insight, especially since she did some digging into the research to see if there was any evidence to support this position while sleeping during pregnancy.

This is what she found....NOTHING!

There is no research to back up the very commonly prescribed, sleep on your left side during pregnancy.

However, there is evidence to show that if a mom lays on her back for long periods of time it can slow down blood flow to the fetus. This is because of the weight of the fetus within the uterus pressing back onto our large blood vessels in our gut that shunt blood back to our heart.

The cool thing is our bodies will tell us by becoming light headed, nauseous or uncomfortable, or the baby will slow her movements.

Then typically all we have to do is roll to our left side, because the vessels are predominately on the right side of our spine. Or sit up.

How does this relate to sleeping then?

Hopefully for most of us we are sleeping for at least 7 hours. Of course during pregnancy this may be altered because of discomfort, our bladder, hunger, or just being restless.

But if we are sleeping for longer than 1 hour stretches, this is a long time for our body to be in one position, right?

So the theory is, if you start on your left side during pregnancy, you are reducing the compression on your vessels.

Then through the night if you find yourself in other positions, it's okay.

Remember, your body will let you know when to move.

I am a mobile sleeper and am constantly in different positions, there was no exception during my pregnancy. But I didn't stay on my left side the whole time.

I respected and listened to my body.

The other thing to consider is if you are laying on your side to reduce pressure on your vessels, then wouldn't laying on an incline also provide this relief?

YES!

So if you are at all worried about having to always be on your side, but it's getting super uncomfortable, there are ways around it.

This can be said for any sleeping position, if it's uncomfortable, maybe there are ways around it or modifications you can do, or activities you can do prior to bed to provide relief.

The big take away is to honor your body and listen to what it is telling you. Take the time to vary your movement and stretch through out the day to reduce restlessness and improve your body awareness over all.

Happy Sleeping!