Managing the Motherload

Preparing for motherhood, can feel like you are preparing for a marathon. A woman’s body goes through enormous physical and hormonal changes during pregnancy. These changes affect the mother’s posture, strength, energy level and overall sense of well- being. The good news is that gentle stretching and movement will often decrease muscle spasm, improve spinal movement and result in decreased pain. Most women report that giving birth, either vaginally or by caesarean section, is one of the most physically demanding, “marathon-like” events of their life. What marathon runner wouldn’t train well for the big event?

So, what are the top tips to best prepare the body for the physical demands of pregnancy and motherhood?

Keep active and moving

For most pregnant women exercise is safe and healthy, but ensure you have clearance from your treating doctor. There are 3 key components:

Cardiovascular or aerobic exercise

Low impact exercises such as walking, low impact aerobics, swimming or water aerobics and pregnancy specific exercise classes are ideal. Exercise at a mild to moderate intensity for 20-30 minutes, most days of the week. Remember to drink enough water and avoid overheating.

Strengthening – Target the muscles supporting your back and legs by strengthening your lower abdominals, buttocks and pelvic floor. Avoid doing exercises lying on your back after 16 weeks and avoid heavy abdominal work during pregnancy. Keep an eye out for abdominal separation (more about this later).

Pelvic floor muscles deserve special mention. These are the muscles that form the floor of the pelvis attaching from the pubic bone at the front and extending to the tailbone at the back. Practicing regular pelvic floor exercises during pregnancy will help support your organs and growing baby and will also speed recovery of the muscles after birth. Remember, not only is it important to strengthen the pelvic floor muscles but also to use them prior to and during times of increased load, such as coughing, lifting and even getting up from a chair.

Stretches – Key muscles that often contribute to back pain during pregnancy include the back, hamstrings (back of the thigh) chest and neck muscles. Regular stretching of these muscles will keep you moving more freely and reduce pressure on your joints.

Maintain good posture

Many recall the frequent nagging of “stand tall and stop slouching” while growing up. Posture becomes even more important during pregnancy. As your baby grows and your centre of gravity moves forward, increasing weight is placed on your spine and pelvic joints. While it is inevitable that as the pregnancy progresses, there will be a slight increased arch in your lower back, avoid giving in completely to gravity. A good way to help you maintain a more upright posture is to aim to keep your pelvis and ribs in line, as best you can. This will lessen the pain felt in your back and pelvis; not to mention strengthens your lower abdominals and pelvic floor muscles. If you haven’t already done so, put the high heels at the back of the cupboard for now too, these will only push you further forward. When sleeping, pillows become your friends! Try placing them between your thighs and even under your uppermost arm to prevent twisting in your upper back when lying on your side.

Pregnancy is a time of excitement, joy and nervous anticipation. There will be some stages however of discomfort, aches or even pain. Some discomfort in pregnancy is to be expected. Keeping active will help to prevent or ease many of the physical discomforts but sometimes a little help may be needed to ease the muscle and joint pain experienced. Tanya Hayes is an experienced women’s health physiotherapist and mother of three. Tanya can give additional advice and hands on treatment to get you back to enjoying the journey of motherhood.

The marathon is over, let recovery begin!

When the marathon of pregnancy and giving birth is over there are a few key things to consider and will help you recover:

Abdominal wall separation

During pregnancy the connective tissue in the middle of the outer most abdominal muscle can stretch. It acts like a pressure release valve for the growing baby. Incorrect posture, intensive abdominal exercises during pregnancy, rapid weight gain and sometimes genetic make-up can further add to the amount of separation. A small amount of widening at the midline of up to 2 to 2.5 finger widths is considered normal. If your separation after birth is larger than this there are several ways you can help. It is best to avoid activities that place extra strain on the joining connective tissue such as sit ups, crunches and heavy lifting. Maintaining correct posture as well as commencing gentle abdominal bracing and pelvic floor exercises will also assist in “closing the gap”.

Massage the scar

Scarring is a natural part of healing but sometimes pain can develop in the area of an episiotomy or caesarean section. It can even contribute to low back pain and sexual dysfunction. Massage of the scar once it has healed can improve its ability to move, reduce sensitivity to touch and ease pain.

Return to exercise

The main focus for some new mums, is to regain pre-pregnancy shape and fitness. Be patient and give it time. Enjoy the transition from “Mum-to-Be” to “Motherhood”. Generally, low impact exercises are best until 6 weeks, starting with a 5-minute to 10-minute walk and progressing gradually as you feel able. If you have previously attended the gym and are keen to return this can commence from 6 weeks, following clearance from your doctor. High impact exercises, such as running and jumping should be avoided until 3 to 4 months. Ideally it would be better still to have your pelvic floor muscles checked by a women’s health physiotherapist to ensure safe return to sport and other high impact exercises.

Promoting pelvic floor awareness in pregnancy, childbirth and beyond, as mums are reminded that bladder and bowel problems and pain during intercourse are not a natural part of childbirth and ageing. These conditions will not get better on their own and something can be done. Start by adopting healthy habits: eat well, drink well, exercise regularly, keep your pelvic floor toned and practice good toilet habits…