Saturday, 27 January 2018

Honouring the Postpartum Body

Honouring the Postpartum Body

I have been reflecting on the words “normal” and “change.” Our bodies are designed to undergo changes through various points in our lives as women; puberty, childbirth and menopause. Rather than honouring these changes in a positive manner, we normalize problems and create a society of “not enough”. 

Women are either in a state of wishing they could go back (living in the past) or striving to achieve this idealistic image of a future self. What about being and feeling happy in the now?

I think we have a lot of work to do to help women feel good about their new bodies in the various stages of life. It just seems that as women we are constantly being bombarded and told what we should look like and feel like rather than helping women embrace change, find real solutions if problems arise and provide positive ways to interact with ourselves.

What got me thinking about this is the realization that I too think about my body negatively after childbirth. I am 21 months post partum and although I don’t think this way all the time, I do catch myself thinking of the past and the way my body used to be. I realized that this type of thinking on my part is not very helpful. I cannot go back. 

Then I started thinking, wait a second, what’s wrong with me in the first place? All my negative thinking and wishing was based on a pre-conceived notion that I placed on myself. I “must” go back to normal? What is normal?

Why would I think I’m not normal after giving birth? Yes my body is different, but why wouldn’t the body be different after children? I did grow life inside my body for 9 months and birthed a beautiful child naturally. So why am I feeling ashamed of my body after this beautiful event?

Whatever happened to its normal for the body to need time to heal? Why have we chosen to normalize the problems after childbirth that have actual solutions but not normalize that our bodies do change after childbirth.

For example a woman may still have some baby weight several months post partum despite eating healthy and walking everyday and yet she is made to feel she is not doing enough or exercising hard enough. While another woman is being told, your leaking is normal, you had kids, just go get some pads. This seems a bit backwards. We should be honoring our bodies for what they just went through and discussing solutions/treatments appropriate to the problems.

In my practice, I am seeing women rushing back to the gym before their bodies are ready, not eating enough calories and thinking very negatively about their bodies. It is these habits that I find worrisome.

I believe that behind these behaviours is a sense of we are not enough. We aren’t attractive enough, working hard enough, losing the weight fast enough compared to others, not as good as the other moms.

So I feel the need to spread that word that you are good enough, beautiful enough. If you stop to think for a moment how amazing the process of bringing life into this world is. You did that! Your body did that! Honour your body, love your body, feed your body good food, move it around safely, the rest will fall into place. If your having some troubles, love yourself enough to ask for help when its needed. Most importantly there is help.

There are post partum doulas, there are pelvic health physiotherapists, there are sleep consultants, naturopathic doctors, nutritionist, lactation consultants and all sort so health coaches if you open yourself up to contact them.

My wish is for women to take back the beauty of childbirth, embrace the change and seek solutions to move forward in a healthy and happy way.

The Pelvic Health Lady

Saturday, 13 January 2018

Let's Talk About Episiotomies and Tears

An episiotomy is something women may get during a vaginal delivery. It is when the doctor cuts along the vaginal opening to take pressure off the tissues and assist with the baby’s head passing through. The cut can be done straight down or at a diagonal.

I realized over the past couple of weeks that many of my clients don’t know much about episiotomies and they wish they had known more about them. I think knowing in advance about medical interventions is helpful because it gives you an increased sense of comfort over what is happening to your body versus something being done with no knowledge. The comfort comes from knowing the risks/benefits of a procedure, so that even if the procedure is necessary you understand why.

So after making this realization I thought it would be helpful to talk about this for women who are pregnant or women who have given birth and are curious about what’s happened.

There are a number of reasons an episiotomy may be performed.

1. The doctor sees a high risk for tearing upwards through the urethra
2. The doctor sees a high risk for tearing downwards into the anus
3. The baby is under distress and the tissues around the vagina has not stretched enough delaying the exit of the baby
4. Multiple births occurring at the same time and doctor needs to speed up the birth
5. Routine practice by the doctor

I believe knowing the possible reasons in advance allows for a more open discussion with your healthcare provider about the intervention and allows you to advocate under what circumstances you want an intervention performed. There are lots of women that want the birth to be as natural as possible with no medical interventions, so talking about episiotomies in advance can reduce surprises later if one becomes necessary.

So what about tearing naturally? Is that better than having an episiotomy? There is no right or wrong answer to this question, it comes down to consent I believe. The ability to choose based on an open discussion in advance, so that no matter the outcome, you feel you made the choice.

So episiotomies are controlled cuts, whereas natural tearing will happen on its own till the pressure is released around the vaginal opening allowing baby’s head to pass. However it is important to note that having an episiotomy does not preclude you from tearing past the cut or tearing in another area. 
In some cases the episiotomy spares more severe tearing.

Did you know there are different grades of tears?

Grade 1 is tearing of the skin and fascia
Grade 2 is tearing past the skin, fascia and mucosa layer into muscle but not to the anal sphincter
Grade 3 is tearing past the skin, fascia, mucosa into the anal sphincter
Grade 4 is tearing past the skin, fascia, mucosa, muscle past the anal sphincter and into the rectal mucosa lining. (1)

I hope this helps you understand more and gives you a context under which you can ask more questions.

The Pelvic Health Lady