AS EXPECTANT MOTHERS, we immerse ourselves in books, classes, apps and everything the world has to offer about pregnancy and labour.
We know exactly what to expect when we are expecting, but what about when it’s all over? Who prepares us for the reality of recovery? So much attention and care is given in pregnancy, but once a baby is born all too often that attention shifts to them. What about Mum?
As women’s health physiotherapists, we know how important it is to open up conversations on real-life topics experienced by new mothers. We have a key role in educating and supporting women to know what’s normal so they don’t feel alone in their recovery.
It is a vulnerable and often lonely time. Mums can feel isolated and struggle with symptoms they were never prepared for. With that in mind let’s discuss some of the top issues facing mums after childbirth.
All too often the conversation about sex after delivery revolves around contraception and when is safe to resume. However, with one in two women reporting painful sex at three months, and one in five at one year post partum, the conversation needs to broaden.
Painful sex can result for a number of reasons, including scar tissue, nerve damage, skin conditions and muscular pain.
But one of the big issues post partum is vaginal dryness. In a recent Instagram poll of our followers, over 60% of women were not aware of this common post partum symptom. It occurs as a result of hormonal changes after pregnancy, which can also cause loss of libido.
These symptoms can be exacerbated by breastfeeding. One of my top tips for post partum sex is to use a good lubricant. Aim for organic and non-scented products. Don’t be embarrassed about using lubricant, be open with your partner; this is very common after delivery, you’re not alone. For many women, once your period returns, symptoms improve. However, if you continue to experience pain, book an appointment with a women’s health physiotherapist for assessment.
These are swollen veins at the back passage which can cause pain and bleeding during bowel movements. They are often caused by pushing during labour or constipation in those early weeks after birth.
Although they are not life-threatening they can be quite painful.
Avoiding constipation is key. You may need to increase your fluid and fibre intake. Learning how to poo effectively to help reduce straining can be a game-changer. On Day one of our post partum app, MoCo Health, we show you exactly how to do this. Pooing with the correct posture and breathing can help reduce pain.
If symptoms are not settling link in with your pharmacist or GP regarding stool softeners, creams and suppositories for pain relief. If haemorrhoids persist you can be referred for injections or surgical consultation.
Approximately one in three women experience urinary incontinence post partum. This can come as a shock to new mums. Some women report urine leakage with coughing/sneezing/jumping, which is known as stress incontinence. And some report leakage when they get the urge to pee, but can’t make it to the toilet in time. This is called urge incontinence.
Leakage can be more profound in the first few days and weeks post partum, as the body recovers. But it should improve and settle over the first six weeks.
Faecal incontinence, which is leakage of poo, is less common, occurring in one in 25 new mums. However, it can, understandably, be more distressing than urinary incontinence. It’s more common in mums who sustained 3rd or 4th degree tears during vaginal delivery. If you are experiencing incontinence please see a women’s health physiotherapist, for assessment. We work to rehabilitate the pelvic floor and improve symptoms.
It may come as a shock, but yes, all that flatulence and sweating is pretty normal. Hormones have a huge role to play in both of these symptoms.
Hormonal changes affect our gut motility, causing an increase in gas.
Couple that with any damage or dysfunction in the pelvic floor, it will be no surprise you find it hard to control all that wind. It can be embarrassing, but I personally find blaming the baby works a treat. And hormones are to blame for the increase in body odour you’re noticing since having your baby. These symptoms will settle in the first few months after delivery but until they do, know you’re not alone.
One in two women will develop prolapse. Genetics has a significant role to play here along with constipation, heavy lifting, chronic coughing and vaginal births. Assisted deliveries (i.e. forceps or vacuum) and larger babies (>4kg/8lbs 13oz) are thought to be additional risk factors.
Symptoms include a heaviness/dragging in the vagina, a feeling of something coming down or a bulge at the entrance to the vagina.
We know that prolapse can be a scary diagnosis. As women’s health physiotherapists, we can offer you support and guide you on the treatment options available. Education and reassurance are key. These include conservative management strategies, such as lifestyle advice, including bowel habits, avoiding constipation, advice on practical things like baby wearing with prolapse and guiding women on safe return to exercise.
We can also assess suitability for pessary. This is a device that you insert into the vagina to support and lift the prolapse. A bit like wearing a good sports bra to lift and support your breasts, a pessary can lift and support your prolapse. Surgery is also an option if prolapse is more advanced, and you are finished having your family. Whatever your symptoms, there is help there and there’s nothing that cannot be helped with the right advice, so you can enjoy your time with your new arrival in comfort.
Eimear Lynch and Aoife Harvey are Specialist Pelvic Health Physiotherapists and co-founders of MoCo Health, a post partum app that discusses these topics and much more, to support women in their recovery after pregnancy. More via Instagram at: @moco.health @thephysiogirl.ie @womenshealthdublin
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