By Lorraine Faehndrich

Persistent pelvic pain can, and often does, have an emotional component.  The pelvis is a part of the body that for many reasons tends to hold emotion, and when that emotional component is addressed alongside the physical components of pelvic pain it can be an effective combination.  

 

If you’re suffering with pelvic pain, or you work with patients who are, you are very likely already aware of the connection between mental and emotional stress and physical tension and pain.  Most of us have experienced that connection in one way or another in our lives.  Whether through an occasional tension headache or backache, or just increased tension in the places we tend to carry it (neck, shoulders, low back, etc).

 

When I say that pelvic pain can have an emotional component, I’m not referring to some abstract connection between the mind and the body, and I don’t mean that the pain isn’t real physical pain, or that pelvic pain sufferers are to blame for their pain.  There is actually a very real physiological connection between emotional energy and the muscles, nerves and fascia in the body.

 

How Emotions Can Contribute to Chronic Pain

 

Emotions are energy that is meant to move through our body in response to events in our lives.  In this way, they help us process, learn from, integrate, and let go of our experiences.

When emotions are flowing in this way, they not only help us move through stressful experiences more easily, they contribute to our health and wellbeing, and they don’t create physical tension or chronic pain.

 

Problems arise when our emotions are suppressed.  This can happen when the brain learns (usually through negative or traumatic early experiences) that certain emotions are a threat to our wellbeing.  When that happens, our brain and body will protect us from those emotions by unconsciously suppressing them, and they do that by stopping emotional flow.

 

There are two primary ways the body can stop the flow of emotional energy.  

 

1. Tensed and contracted muscles:  Muscles can tense in response to certain emotions to stop their flow.  In this way they protect us from feeling the emotions that our brain has learned are threatening to us in some way.  For example, it’s common for men to learn that it’s inappropriate to cry, or women to learn that they shouldn’t express anger.  Those emotions then get “buried” or suppressed in the body.  Chronically contracted muscles can hold back that emotional energy, over time impacting circulation, nerves, fascia, and surrounding tissue.  The neck, shoulders, jaw, back and pelvis are common places to hold emotion in the body, and the muscles there can be contracted for years before we end up with chronic pain. (Our bodies are actually pretty resilient that way.)

 

1. Restricted breathing:  Similar to contracted muscles, shallow breathing or holding the breath between the in-breath and out-breath, inhibits the flow of emotional energy.  If you have a hard time taking a full deep breath, this can be why.

 

Both of these mechanisms are unconscious.  We’re not aware of the emotions themselves, nor that we are suppressing them, until we bring our conscious attention to our body and begin to observe what’s going on.

 

To give you an idea of the impact that these patterns can have over time, you can do a little experiment.  Contract your bicep – nothing too intense, just gently engage the muscle.  Now imagine keeping it contracted like that for a full 24 hours.  Now imagine multiplying that by weeks, months, or years.  At some point, this is going to get uncomfortable, and eventually it will be painful.  And the pain is not going to stop until you relax your muscle.  Now, if you’re consciously engaging your muscle it’s not so hard to stop.  Or if it’s engaged because of a physical issue, a physical and occupational therapists can help you retrain and relax your muscle.  

 

But, if your bicep were contracted in order to hold back emotional energy that your brain is protecting you from feeling, the only way to permanently relax it would be to learn how to allow that emotional energy to flow.   Otherwise, no matter what you do physically to relax and strengthen the muscle, that protective pattern is going to keep kicking in.

 

In other words, in order to relieve the pain, you need to re-learn how to be with your emotions – and more than that, how to show your brain that that is actually a safe thing to do.

 

Chronic tension in the pelvis can be part of a long-term habitual and unconscious pattern of blocking emotional flow in the body, and the first step of unraveling it is awareness.

 

How pelvic floor physical and occupational therapy and mind body healing can work together to relieve pelvic pain

 

As a mind body coach my goal is to help my clients become aware of their unconscious protective patterns (mental and physical), so they can learn how to consciously choose to feel their emotions and allow them to flow.  When the brain no longer perceives emotions as a threat, because it has been retrained to recognize that they are actually safe to feel, the muscles can relax.

 

(Remember, flowing emotions don’t cause chronic pain, suppressed emotions do.)

 

Depending on the level of negative early experiences or trauma a person has been through this can take varying degrees of time and support.  But it all begins with awareness, re-connecting to the body, and a willingness to be present with sensations – a little at a time, in a way that feels safe and supported.

 

And what I have seen is that physical and occupational therapy can help tremendously with this process!  Especially if the physical and occupational therapists is aware of the potential emotional component of the physical pain, and actively creates an environment where it is safe to allow emotions.

 

Creating a Safe Space for Emotions

 

If emotions start to move, or release, as a result of physical and occupational therapy, it is a great opportunity to learn how to be present with the sensations of those emotions and process them in new and healthy ways.

 

When the patient and practitioner work together to create a safe environment, emotional energy can flow and contribute to the healing process.  On the other hand if the environment feels unsafe, emotions can be suppressed and can hinder the healing process.

 

How to Allow Emotions to Flow

 

If you are already working with a pelvic floor physical and occupational therapists, and you suspect there may be a mind body component to your pain, here are some tips for working with that during your sessions and during any home practice that you’re doing – like stretching, using dilators, massage, etc.

 

1. Intend:  Set your intention to allow and be present with the sensations of your emotions in your body as they arise.  Simply being aware that emotions may come up and at the same time willing to feel them is a huge step in the right direction.  When you have that intention, you’ll naturally be more aware and welcoming of any emotional sensations that do arise.  

 

1. Breathe:  During your sessions (and during any home practice) maintain a gentle continuous breath into your low belly.  You don’t have to do this perfectly at all!  The idea is to stay present in your body and allow any emotions that may come up to flow.  If you notice you’re holding your breath or your breathing has gotten shallow again, simply bring your breath gently down into your low belly.

 

1. Track Sensations:  Keep your conscious attention on the sensations in your body paying particular attention to sensations that seem connected to emotions.  If you notice any emotional sensations like heaviness, dense or sinking feelings, tightening in your chest or belly, tingling or swirling, hot or cold; or you feel tears or anger swelling up, be curious about the sensations, allow them, and keep breathing.  You don’t need to understand why you’re having the emotions.  For now, just being willing to be present with the sensations of them is more than enough.

 

1. Maintain Good Communication:  Don’t push through anything that feels uncomfortable. Stay in communication with your PT.  If anything hurts, feels uncomfortable or overwhelming – physically or emotionally, let your therapist know.  Learning how to honor your body and go at it’s pace can go a long way to creating the safety you need to be able to feel on an emotional level.  

 

1. Get Support:  Consider getting support from a mind body coach or therapist who can teach you how to start feeling emotions in your body as they surface.   A mind body practitioner can help you process emotions in new healthy ways that won’t contribute to physical tension and pain.

 

Because of the nature of pelvic floor physical and occupational therapy most therapists will already be creating a welcoming and safe environment for their clients.   But if there’s anything else you need to support your staying present with the sensations in your body don’t hesitate to ask.  Most of my clients find that their physical and occupational therapistss are more than happy to support their mind body work when they do.    

 

If you’re a physical and occupational therapists or other bodywork practitioner, simply being aware of and creating space for this mind-body-emotion connection, and the potential for emotions to surface can be a great benefit for your patients or clients that do have an emotional component to their pain.  

 

It’s All Connected

 

We tend to think of the mind, body, and emotions as separate things, but they are not actually separate.  They are all part of one being that is us.  The mind, body, and emotions are inextricably linked, and supporting any one of them inevitably supports the others, creating the optimum conditions for healing and relief.

 

If you’d like to learn more about a mind body approach to relieving pelvic pain – sign up to receive a free Mind Body Alchemy Kit at www.radiantlifedesign.com or register for Lorraine’s upcoming free class, Say Goodbye to Pelvic Pain, accessible by phone or online from anywhere in the world.

 

Regards,

Lorraine Faehndrich

Lorraine Faehndrich is a Women’s Mind Body Mentor and Pelvic Pain Relief Coach specializing in the relief of female pelvic and sexual pain.  Through her company Radiant Life Design, she empowers women with the skills and information they need to understand the connection between their mind and body, allow their emotions, access their inner wisdom, and go on to live radiantly healthy joy-filled lives!

 

By Stephanie Prendergast

 

Vaginal pain. Burning with urination. Post-ejaculatory pain. Constipation. Genital pain following bowel movements. Pelvic pain that prevents sitting, exercising, wearing pants and having pleasurable intercourse.

When a person develops these symptoms, physical and occupational therapy is not the first avenue of treatment they turn to for help. In fact, physical and occupational therapistss are not even considered at all. This week, we’ll discuss why this old way of thinking needs to CHANGE. Additionally, we’ll explain how the “Get PT 1st” campaign is leading the way in this movement.

We’ve heard it before. You didn’t know we existed, right? Throughout the years, patients continue to inform me the reason they never sought a physical and occupational therapists for treatment first, was because they were unaware pelvic physical and occupational therapistss existed, and are actually qualified to help them.

Many individuals do not realize that physical and occupational therapistss hold advanced degrees in musculoskeletal and neurologic health, and are treating a wide range of disorders beyond the commonly thought of sports or surgical rehabilitation.

On December 1st, physical and occupational therapistss came together on social media to raise awareness about our profession and how we serve the community. The campaign is titled “GetPT1st”. The team at PHRC supports this campaign and this week we will tell you that you can and should get PT first if you are suffering from a pelvic floor disorder.

 

Did you know that a majority of people with pelvic pain have “tight” pelvic floor muscles that are associated with their symptoms?

 

Physical therapy is first-line treatment that can help women eliminate vulvar pain

Chronic vulvar pain affects approximately 8% of the female population under 40 years old in the USA, with prevalence increasing to 18% across the lifespan. (Ruby H. N. Nguyen, Rachael M. Turner, Jared Sieling, David A. Williams, James S. Hodges, Bernard L. Harlow, Feasibility of Collecting Vulvar Pain Variability and its Correlates Using Prospective Collection with Smartphones 2014)

Physical therapy is first-line treatment that can help men and women with  Interstitial Cystitis

Over 1 million people are affected by IC in the United States alone [Hanno, 2002;Jones and Nyberg, 1997], in fact; an office survey indicated that 575 in every 100,000 women have IC [Rosenberg and Hazzard, 2005]. Another study on self-reported adult IC cases in an urban community estimated its prevalence to be approximately 4% [Ibrahim et al. 2007]. Children and adolescents can also have IC [Shear and Mayer, 2006]; patients with IC have had 10 times higher prevalence of bladder problems as children than the general population [Hanno, 2007].

Physical and Occupational Therapy is first-line treatment that can help men suffering from Chronic Nonbacterial Prostatitis/Male Pelvic Pain

 

Chronic prostatitis (CP) or chronic pelvic pain syndrome (CPPS) affects 2%-14% of the male population, and chronic prostatitis is the most common urologic diagnosis in men aged <50 years.

The definition of CP/CPPS states urinary symptoms are present in the absence of a prostate infection. (Pontari et al. New developments in the diagnosis and treatment of CP/CPPS. Current Opinion, November 2013).

 

71% of women in a survey of 205 educated postpartum women were unaware of the impact of pregnancy on the pelvic floor muscles.

 

21% of nulliparous women in a 269 women study presented with Levator Ani avulsion following a vaginal delivery (Deft. relationship between postpartum levator ani muscle avulsion and signs and symptoms of pelvic floor dysfunction. BJOG 2014 Feb 121: 1164 -1172).

64.3% of women reported sexual dysfunction in the first year following childbirth. (Khajehi M. Prevalence and risk factors of sexual dysfunction in postpartum Australian women. J Sex Med 2015 June; 12(6):1415-26.

24% of postpartum women still experienced pain with intercourse at 18 months postpartum (McDonald et al. Dyspareunia and childbirth: a prospective cohort study. BJOG 2015)

85% of women stated that given verbal instruction alone did not help them to properly perform a Kegel. *Dunbar A. understanding vaginal childbirth: what do women understand about the consequences of vaginal childbirth.J  Wo Health PT 2011 May/August 35 (2) 51 – 56)

Did you know that pelvic floor physical and occupational therapy is mandatory for postpartum women in many other countries such as France, Australia, and England? This is because pelvic floor physical and occupational therapy can help prepartum women prepare for birth and postpartum moms restore their musculoskeletal health, eliminate incontinence, prevent pelvic organ prolapse, and return to pain-free sex.

 

Did you know that weak or ‘low tone’ pelvic floor muscles are associated with urinary and fecal incontinence, erectile dysfunction, and pelvic organ prolapse?

 

Physical and Occupational Therapy can help with Stress Urinary Incontinence

Did you know that weak or ‘low tone’ pelvic floor muscles are associated with urinary and fecal incontinence, erectile dysfunction, and pelvic organ prolapse? 80% of women by the age of 50 experience Stress Urinary Incontinence. Pelvic floor muscle training was associated with a cure of stress urinary incontinence. (Dumoulin C et al. Neurourol Urodyn. Nov 2014)

30 – 85 % of men develop stress urinary incontinence following a radical prostatectomy. Early pelvic floor muscle training hastened the recovery of continence and reduced the severity at 1, 3 and 6 months postoperatively. (Ribeiro LH et al. J Urol. Sept 2014; 184 (3):1034 -9).

Physical and Occupational Therapy can help with Erectile Dysfunction

 

Several studies have looked at the prevalence of ED. At age 40, approximately 40% of men are affected. The rate increases to nearly 70% in men aged 70 years. The prevalence of complete ED increases from 5% to 15% as age increases from 40 to 70 years.1

Physical and Occupational Therapy can help with Pelvic Organ Prolapse

 

In the 16,616 women with a uterus, the rate of uterine prolapse was 14.2%; the rate of cystocele was 34.3%; and the rate of rectocele was 18.6%. For the 10,727 women who had undergone a hysterectomy, the prevalence of cystocele was 32.9% and of rectocele was 18.3%. (Susan L. Hendrix, DO,Pelvic organ prolapse in the Women’s Health Initiative: Gravity and gravidity. Am J Obstet Gynecol 2002;186:1160-6.)

Pelvic floor physical and occupational therapy can help optimize musculoskeletal health, reducing the symptoms of prolapse, help prepare the body for surgery if necessary, and speed post-operative recovery.

 

Did you know….

 

In many states a person can go directly to a physical and occupational therapists without a referral from a physician? (For more information about your state: https://www.apta.org/uploadedFiles/APTAorg/Advocacy/State/Issues/Direct_Access/DirectAccessbyState.pdf)

You need to know….

 

Pelvic floor physical and occupational therapy can help vulvar pain, chronic nonbacterial prostatitis/CPPS, Interstitial Cystitis, and Pudendal Neuralgia. (link blogs: https://pelvicpainrehab.com/patient-questions/401/what-is-a-good-pelvic-pain-pt-session-like/, https://pelvicpainrehab.com/male-pelvic-pain/460/male-pelvic-pain-its-time-to-treat-men-right/https://pelvicpainrehab.com/female-pelvic-pain/488/case-study-pt-for-a-vulvodynia-diagnosis/)

Pelvic floor physical and occupational therapy can help prepartum women prepare for birth and postpartum moms restore their musculoskeletal health, eliminate incontinence, prevent pelvic organ prolapse, and return to pain-free sex: https://pelvicpainrehab.com/pregnancy/540/pelvic-floor-rehab-its-time-to-treat-new-moms-right/

Early pelvic floor muscle training hastened the recovery of continence and reduced the severity at 1, 3 and 6 months in postoperative men following prostatectomy. (Ribeiro LH et al. J Urol. Sept 2014; 184 (3):1034 -9). (Link blog: https://pelvicpainrehab.com/male-pelvic-pain/2322/men-kegels/

A study from the University of the West in the U.K. found that pelvic exercises helped 40 percent of men with ED regain normal erectile function. They also helped an additional 33.5 percent significantly improve erectile function. Additional research suggests pelvic muscle training may be helpful for treating ED as well as other pelvic health issues. (link blog:https://pelvicpainrehab.com/male-pelvic-pain/2322/men-kegels/

 

….that you can and should find a pelvic floor physical and occupational therapists and  Get PT 1st.

To find a pelvic floor physical and occupational therapists:

American Physical and Occupational Therapy Association, Section on Women’s Health:

http://www.womenshealthapta.org/pt-locator/

International Pelvic Pain Society: http://pelvicpain.org/patients/find-a-medical-provider.aspx

 

Best,

Stephanie Prendergast, MPT

 

Stephanie grew up in South Jersey, and currently sees patients in our Los Angeles office. She received her bachelor’s degree in exercise physiology from Rutgers University, and her master’s in physical and occupational therapy at the Medical College of Pennsylvania and Hahnemann University in Philadelphia. For balance, Steph turns to yoga, music, and her calm and loving King Charles Cavalier Spaniel, Abbie. For adventure, she gets her fix from scuba diving and global travel.

By Melinda Fontaine

Back By Popular Demand: Here is the sequel to my 8 Pregnancy Tips. This is what a Pelvic PT/Mom wants you to know about labor and delivery. First off, you have little to no control over it. This can seem scary, so it is important to be flexible. I am a supporter of birth “plans”; I even made one myself. However, the term “Birth Plan” is a misnomer. Perhaps a more accurate name would be “Birth Ideas If Everything Goes The Way I Want And There Are No Surprises”. If anyone can be labeled as in command of this voyage, it would be Baby. Who better to control a birth than Baby?!  At any moment, Baby could decide that it is time to be born and will change the flow of hormones throughout the body and start the uterus contracting. Conversely, if Baby is having any trouble, your doctor or midwife may recommend a different course of action. As GI Joe would say, “Knowing is half the battle”, so here are some possibilities of what may occur during a birth and what choices you have.

 

What Happens

Toward the end of pregnancy, the baby moves lower into the pelvis which is usually what starts the effacement/thinning and dilation/opening of the cervix of the uterus. Stage 1 is when Mama starts to feel contractions and the cervix dilates to 10 cm. A typical rate of dilation is 1 cm per 2 hours. Stage 2 is when Mama feels the urge to push and delivers Baby. This stage lasts 1-2 hours on average for a first birth and an hour or less for subsequent births. Stage 3, the afterbirth, is when the placenta, amniotic sac, and umbilical cord are expelled within an hour of delivery. Baby suckling at the breast helps signal the uterus to expel them. Your midwife or doctor will check the placenta to make sure it is complete to avoid bleeds. Now that you know what happens, how do you prepare for it?

 

Store Up Energy

Having a baby is like running a marathon in many ways. Both require an immense amount of energy. If you can, get a lot of good sleep in the days before the main event. You will also need good nutrition for energy, so eat well prior to delivery. I ate the same breakfast protein packed breakfast before running my marathon and before delivering my son.

If you plan to deliver in a hospital, you will not be allowed to eat until after the baby is delivered. This is to keep you safe in case an emergency C-section is needed. Having a full stomach during a surgery increases risk for aspiration. If you want to eat something for energy while you are laboring, be sure to eat it early on, prior to admission to a hospital.

 

Get Things Rolling

So you’re ready to get this show on the road? You may find yourself ready for Baby to come, but labor is not beginning or progressing as you and your doctor or midwife would like.  An example would be if your water breaks, but there are no contractions, the pregnancy has continued too long, or you have been in the first stage of labor for a really long time.  There are different ways to induce labor. Prostaglandins are lipids that act like hormones. They are inserted vaginally near the cervix to help it thin and open in preparation for delivery, which may initiate uterine contractions. Pitocin is a synthetic form of oxytocin, the hormone that signals the uterus to contract. Pitocin is often administered intravenously in the hospital. It may also be used to help stop bleeding after delivery. Other fun ways to get your body to start producing oxytocin include nipple stimulation and orgasm. Midwives will sometimes use castor oil to get the uterus to start contracting (side note: it is also a very strong laxative, so be prepared). Lastly, a doctor or midwife might sweep the membranes that connect the amniotic sac to the uterus, or if your cervix is already dilated, they may rupture the membranes of the amniotic sac to progress labor. To avoid putting your baby at risk, do not attempt to induce labor unless you have your doctor’s or midwife’s seal of approval.

 

Delivery Options

You know how Baby got in there; now how will Baby get out?  The two options are through the vagina or through an abdominal incision known as a Cesarean section.  For a vaginal delivery, the bones and soft tissues of the pelvis stretch and open wide enough to pass Baby through. The uterus contracts to help push Baby down and out.  Mama bears down like having a bowel movement to further increase abdominal pressure and push Baby down and out.  Sometimes pushing is coached, meaning a healthcare professional instructs Mama when to push.  Stay tuned for Malinda Wright’s upcoming post about the ‘how to push controversy’!  Sometimes a doctor has to guide the baby through the birth canal using his or her fingers, a vacuum, or forceps. Episiotomies used to be routine in the 1980s. Now they are reserved for rare instances when the perineum is impeding the progression of the delivery.  C-sections may be performed in cases of maternal or fetal distress, large fetal head, small maternal pelvis, labor not progressing, Baby in an awkward position, placenta previa (placenta covering the cervix), etc. VBAC is a term that is increasingly popping up in conversations, and it means Vaginal Birth After Cesarean. Your doctor or midwife should discuss with you whether or not VBAC is a safe option for you.

 

Support The Perineum

The perineum is the tissue between the vagina and the anus.  It has to stretch a lot during vaginal delivery, and sometimes tears when it has to stretch too much too quickly. Perineal massage is often recommended for mothers considering vaginal birth to prepare the tissue to stretch.This massage can be done starting at 36 weeks of pregnancy and involves using thumbs or fingers to hold a prolonged stretch on the tissue.  This can also be assisted by devices such as

EpiNo or Materna.  A physical and occupational therapists can instruct you or your partner on how and when to perform perineal massage. During delivery, the doctor or midwife can apply counter pressure or heat to the tissues to encourage good stretching.

 

Manage Pain

The all too common image in the media of a woman screaming in pain during delivery is not necessary.  The process is painful, but there are ways to manage the pain.  There is no one right way to have a baby. Pick the pain management technique that is right for you and your baby.  Epidurals and other medical pain relievers are often very effective at reducing pain.  Hypnobirthing involves techniques to release the fear and tension associated with birth and to use one’s subconscious mind to thwart the feelings of pain. I chose hypnobirthing, and it worked unbelievably well – No really, my next three nurses all had to verify that the story they heard about my birth was true. A partner or doula can give massage and counterpressure to the pelvis and low back to relieve tension, and a warm shower or bath may also feel good.

 

Educate Yourself

You will be faced with certain decisions that you have to make for Baby, so think about them beforehand. Would you like to delay clamping the umbilical cord to allow Baby to get extra blood from the placenta? Would you like to bank Baby’s cord blood to store stem cells for your family or others? Would you like to do skin-to-skin, which is when Baby is placed on Mom’s bare belly as soon as possible after delivery? Routine baby care can be done while Baby is on Mom’s chest. Would you like your Baby to receive antibiotic eye ointment to kill possible bacteria that can cause blindness, a Vitamin K injection to prevent possible internal bleeding, and the Hepatitis Vaccine? Would you like to breastfeed? Will you offer Baby a pacifier, which has been linked to preventing sudden infant death syndrome (SIDS) and may interfere with breastfeeding. When would you like Baby to have the first bath, and who should be there? Who will be Baby’s pediatrician? If Baby is a boy, would you like him to be circumcised shortly after birth? The US is split on this decision about 50/50 right now.

 

Ask Questions

Six weeks after the birth of your beautiful baby, you will see your doctor or midwife. They will check you out and if everything is fine, they will give you the all clear to have sex and start exercising. Take this time to discuss your plan for birth control now that you are cleared for sex and have your doctor’s attention. If you notice anything uncomfortable when you do return to sex and exercise, call your doctor. They will often not follow up with you until your next PAP unless you bring it up. Common complaints are that sex is uncomfortable due to scar tissue or muscle spasm, that urine leaks out when you cough, laugh, or sneeze, and that there is a heavy feeling in the vagina. These may all be treated with physical and occupational therapy, so ask your doctor for a referral.  Another complaint after a C-section is meralgia paresthetica, which is a compression of the nerve that runs down the outside of your thigh and creates a feeling of tingling, numbness or pain in that area.

 

How PT Helps

Have you heard the myths about how it is “normal” for mothers to pee when they laugh, lose the tone in their abdomens, and have pain with sex? Well, the cat’s out of the bag now…though these are common, they are NOT normal. They are signs that something is off within the body.  Physical therapists help mothers with urinary and bowel problems such as incontinence, as well as prolapse, diastasis recti, and pain. Stephanie Prendergast is giving a lecture today at the Sexual Medicine Society of North America conference in Las Vegas on Physical and Occupational Therapy for Postpartum Sexual Wellness.  Check out her slides.

 

Postpartum Care

Baby is not the only one who needs tender loving care after a birth.  What about Mama? Abdominal binders worn during the first 6 weeks after delivery help the uterus to return to its pre-pregnancy size and approximate both sides of the rectus abdominus to reduce diastasis. Vaginal delivery or a significant amount of labor prior to a C-section will create swelling in the vagina.  Ice, witch hazel, and elevation help to reduce swelling. Every time someone asked me if I needed anything, I asked for a fresh ice pack.  Scar massage to vaginal or C-section scars will improve healing. Estrogen levels plummet after delivery, so new moms may note dryness, urinary incontinence, or painful penetration. Since the vagina is so sensitive to estrogen levels, a topical estrogen cream can be very useful. Breathing is affected in pregnancy when the baby is large enough that it limits the excursion of the diaphragm.  Good posture helps with breathing and prevents future injuries. Postpartum doulas help families learn about how to care for Baby and Mama and help with chores and errands to reduce the workload for the family.

 

At the end of the day (or days), your baby’s birth story is what it is: a miracle! The story of how this miracle occurs is special and unique. Be proud Mama!

Share your birth story or delivery tips in the comments section below!

All my best,

 

Melinda

 

Melinda is a native of Concord, California and is part of our Berkeley team. Melinda earned her bachelor’s degree in exercise biology from UC Davis and her doctorate in physical and occupational therapy from Simmons College in Boston. When she’s not at PHRC, you’ll find her either dashing around in her running shoes or cooking up delectable meals in her kitchen. She’s famous for her killer baked chimichangas and her inability to stick to a recipe.