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To Support or Not to Support…..That is the Question.

My passion is to educate and empower women, especially during their childbearing years.  I feel there is still quite a lack of education out there for women after they have a baby.  I’ve often been surprised at how many classes are offered while a woman is pregnant (Childbirth Classes, Breastfeeding Classes, Infant CPR Classes, etc), but then once a woman has her baby, the “classes” stop, and the woman is often left to just figure out how to get her body back in shape on her own.  She may get out some video tapes, take a “Baby Boot Camp” class or even hire a personal trainer, but are any of these options going to provide her with knowledge about….. How to stop leaking urine?  How to improve her prolapse?  How to have sex without pain?  How to get back to running/working out without pelvic pain?  Sadly, the answer is:  NO.

One of my biggest questions throughout my women’s health career has been:  Why aren’t we telling women to support their perineum after they have a baby?  We actually did tell women to do this back in the 40’s and 50’s.  My grandmother had six children between the years of 1942 and 1955, and when she passed away (at the age of 100 J), we found a postpartum booklet in her dresser drawer that had a wealth of information about how to take care of your body after childbirth.  I was shocked!  Why aren’t we doing this now?  The booklet was full of wonderful information about how to control the swelling of the perineum, how to do certain exercises that we would now call “inversions” to use the effects of gravity to encourage the pelvic organs to migrate back to their original positions.  It also explained the importance of wearing a girdle and lying down once a day. 

As I tell many of my patients, “This is not rocket science.  It makes complete sense to do these types of things.”  When we sprain an ankle, don’t we “support” it with an ace wrap so that the ligaments can heal?  When we have some carpal tunnel symptoms, don’t we place the wrist in a neutral position with a splint so that the nerve is not being compressed?  When we strain our back, shouldn’t we wear a support brace if we have a job that requires lifting?  Isn’t motherhood a job that requires lifting???  Well, I think it’s time that we stop trying to be Supermoms, and realize that we are human and need to take better care of our bodies after childbirth by wearing a support, taking some rest breaks here and there and managing symptoms in our pelvic region the same way we would manage them in other parts of our body.  If something’s swollen, use ice.  If something hurts and impacts our function, see a physical therapist.  Again, it’s really not rocket science.

Here is a Top Ten List on how to take care you and your pelvic region after having a baby:

Rest – Try to lie down once a day for the first 6 weeks to take pressure off the perineum and promote healing.

Ice – Continue to use the ice packs supplied by your nurse or make your own by placing a wet maxi pad in the freezer.  The ice will help decrease perineal swelling and provide pain relief.

Girdle /Spanks – Purchase a girdle/spanks to support the perineum, especially when on your feet for long periods or carrying your baby.

PFM exercises – Practice contracting & relaxing the Pelvic Floor Muscles very gently, focusing on the quality more than the quantity.  Consult with a Pelvic PT if you are not sure how to perform these exercises correctly.

Scar Massage – Once the stitches have dissolved, you can gently massage any perineal scar.  Again, consult a Pelvic PT if you have any questions.

Inversions – Once you have stopped bleeding, try lying down with legs supported up on a wall or assume a “Downward Dog” position for 2-3 minutes 2-3X/day to help the pelvic organs migrate back to their previous positions.  You can also perform Kegels in these positions.

Pelvic brace with lifting – ALWAYS remember to perform a slight Kegel and pull your navel toward your spine prior to lifting your baby or any item.  This will decrease the strain on your back and prevent further prolapse.

Good posture with nursing – Always remember to use a pillow or Boppy while breastfeeding so that you are not forced to slump over.  Also try to look up occasionally and perform backward shoulder circles to help stretch the muscles in your neck and chest.

Walk – If it does not cause any pelvic or back pain, walking is a great “first exercise” after having a baby.  Try to take stroller walks each day, starting off with short distances and progressing slowly.

Diaphragmatic Breathing – Deep, belly breathing not only feels good, but it has many physiological effects.   It helps calm down our nervous system, it improves our colon motility and it stimulates the movement of lymphatic fluid, which will ultimately decrease swelling.
This is just a short description of what we should do after having a baby. 

For answers to all your questions, please contact one of the therapists at Foundational Concepts, Inc.

Let us help YOU have the best possible health and fitness after BABY!
Shannon DeSalvo, PT, CAPP 

This blog is here for your help. It is the opinion of a Licensed Physical Therapist. If you experience the symptoms addressed you should seek the help of a medical professional who can diagnose and develop a treatment plan that is individualized for you.  If you enjoyed this blog, check out our website at for more blog entries and to learn more about our specialty PT practice, Foundational Concepts.  Follow us on Twitter @Foundational1 and like us on Facebook/Foundational Concepts for updates.

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