Moms, it’s not about ‘snapping back’ — strengthen your pelvic floor the right way after giving birth

Rachel Nicks, a certified doula and fitness expert, is an In The Know by Yahoo parenting contributor. Check out her site, Birth Queen, and follow her on Instagram for more.

Snatch the phrase “snap back” out of your vocabulary.

You did not snap your fingers and grow a baby in 40 weeks, so why does anyone expect a mother to “snap back” to her pre-pregnancy body in six weeks?

Pregnancy and birth take you through a transformation, and you come out the other side of your birth a new woman, a mother. The only direction is forward, not backward, so let’s commit to dropping the “snap back.”

I would love to steal some of your time to chat with you about my favorite muscle group — the pelvic floor. It is important to have the information you need for a functional pelvic floor to prevent the occurrence of incontinence, as well as give you the tools you need to heal.

OK, so I think it’s safe to say that most of us have heard about kegels — exercises that help strengthen the pelvic floor. For years, magazines have encouraged us to “do kegels” with the goal of “keeping it tight.” Well, did you know that some of us are too tight (overactive pelvic floor) and experience pain with sex (vaginismus)?

When it comes to childbirth, we want to know how to relax our pelvic floor to allow our creation to enter the world — not tighten. The last thing we want to do is shut the pearly gates. This makes labor longer and increases your chances of tearing.

So do I have your attention?

Great! Keep reading, mama. I have some serious tea that I need you to also share with every woman you know. I am so over women suffering in silence. 

Credit: Khalid

So, what is a pelvic floor?

The pelvic floor resides at the base of your pelvis. It resembles a new taut hammock supporting pelvic organs with an opening in the middle for your baby to pass through vaginally. It is important to put as much emphasis on maintaining the strength and flexibility for a healthy and functioning pelvic floor. Pregnancy and birth increase the chances of incontinence since the pelvic floor is stretched, so it is important to do your exercises during pregnancy and postpartum to maintain your strength. Doing that prevents incontinence and maintains your flexibility for birth and comfort during intercourse. 

Pelvic floor exercises

Homework: A great way to know if you are engaging your pelvic floor is to place one finger inside of your vagina, exhale and lift all three layers of your pelvic floor. At the base of your finger/knuckle, you should feel the opening of your vagina close. Then continue to exhale and lift, feeling the next two layers at your middle knuckle and then the tip of your finger. Hold. Then you inhale and release each layer one at a time, starting from the tip of your finger, top to bottom.

I use the image of a jellyfish swimming to the top of the ocean on the exhale and expanding and then relaxing on the inhale. Once you understand how to engage and release, commit to trying these exercises for a few minutes a day. I suggest doing them in isolation until you feel confident you are doing them correctly. Then you can start to do a little kegel multitasking — kegel while feeding, folding or cooking, etc. 

The following are exercises I encourage you to do for a few minutes each day: 

  1. ENGAGE AND RELEASE: Exhale engage, and inhale relax. Repeat 10 times.
  2. HOLDS: Exhale engage, and hold 10 seconds. Relax and repeat five to 10 times.
  3. BLINKS: Exhale engage, and inhale relax. Repeat at a quick pace 20 to 40 times. 
  4. ELEVATORS: Exhale and engage, lifting layers one, two and three. Hold. Inhale and release layers three, two and one. Visualize elevators on their face. (That is your vagina.) Then close the doors, and lift layer by layer/floor by floor to the top, and release floor by floor/layer by layer.

I encourage everyone to go to a pelvic floor therapist to have a clear understanding of their pelvic floor’s function. The exercises I have provided are a great place to start and helpful to have in your toolbox, but getting the specifics about your pelvic floor can truly be life-changing. I encourage you to go before you have a problem.

When sex is painful

Pain with sex is referred to clinically as vaginismus. It is not often discussed but must be!

I want to share a personal story about my friend. I am so grateful that she felt safe enough to share with me that she has suffered from vaginismus for years but never knew there was a name for it or a solution. It wasn’t until I posted a video with a pelvic floor therapist a couple of years ago that she could identify her issue and get care from the proper provider.

It guts me to know that women are not receiving proper support and care. Pain with sex is something a woman should never endure. There are solutions. While we are taught just to tighten and tighten, we also benefit from learning to relax the pelvic floor. Different sexual positions can also alleviate discomfort. 

Please know that six weeks postpartum means nothing about the healing of your pelvic floor and core. This milestone usually has to do with clearing you for sex. By six weeks, most women have stopped bleeding but not all. If you are ready to have intercourse, wonderful, but also know it is OK to take your time. Your body, mind and emotions endure a major transformation. Mothers need the space and time to heal all of their pieces. Everyone’s journey is unique, so give yourself grace and embrace your healing process. 

Many physical therapists and urologists encourage giving your pelvic floor six to nine months to fully heal before introducing high-impact exercise. Once you give birth, you can begin practicing your pelvic floor exercises right away. Women who have had vaginal births and cesarean sections both need to do pelvic floor exercises. Both mothers also experience bleeding postpartum, which isn’t common knowledge. Both mommy and baby go home in a diaper. (But the baby’s diaper is way cuter.)

Fitness

Begin with your pelvic floor exercises right after birth, and incorporate ab toning/diaphragmatic breathing exercises to engage your transverse abdominals. Avoid forward flexion and twisting for around six months to give your core a chance to heal and allow the transverse abs to return to the center, healing possible diastasis recti.

I also recommend gentle stretches for the neck, chest and hips. I encourage mamas to get outside daily for a walk. Listen to your pelvic floor. She will tell you when you have reached your limit. I do not recommend any high-impact exercises, running or jumping, for around six months. There are many other ways to incorporate cardio into your routine without jeopardizing your safety. No one wants incontinence or prolapse! Be patient and allow your body to heal and rebuild strength. Do not underestimate the power of rest, hydration, proper nutrition and positive self-talk. 

Pro tip: Anytime you cough, laugh, sneeze, lift or jump, ENGAGE your pelvic floor muscles first, and you won’t tinkle.

I could go on for days about this, but if you ever need me, slide into my DMs and we can chat or have Zoom date. 

Happy kegeling!

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