Your pelvic floor is one of those things that you don’t even have to think about pre-pregnancy You cough, and it automatically squeezed to prevent you from leaking (You didn’t have to ask it!). Your bladder told you in plenty of time when it needed to be empty and there was no dramatic rush to get to the toilet.

Now, after childbirth, you are probably feeling like you don’t’ know your own body anymore. You might be feeling like everything is going to fall out of you and that your bladder is controlling you and not the other way round.

The newborn haze is real! All the feeding, burping, nappy changes, and caring for your newborn leaves very little time for you to focus on your own body and its needs. It is so easy to forget about yourself and your pelvic floor.

Here are some simple and easy ways to support your pelvic floor recovery after childbirth.

1.     Rest

There is a reason that this is first on the list. It is essential for recovery.

It sounds like it should be an easy one but as women, we are hard-wired to stay going even when we know we could (and probably should) be resting. There is always another wash to put on or meal to be prepped and suddenly it is evening time, and your body is exhausted, but your baby might have plans for a marathon feeding session. Many of the symptoms’ women experience postnatal could be prevented with more rest in the first 6 weeks.

There is so much pressure on women to do everything and be everything. So, I will say it here and now – Stop and Rest. You are the only one who can allow your body the time to heal.

Healing and allowing your body to recover should be the focus during the first 6 weeks after childbirth. This is not the time to be supermum or achieve fitness goals. Allow your body this time to heal.

Being on your feet is inevitable as a new mum but getting rest whenever you can, aids pelvic floor recovery. And I mean horizontal rest – yes lie down. Lying down reduces the pressure on your pelvic floor and reduces swelling. This will speed up your recovery and not hinder it! Even 10 minutes a few times a day can help you feel so much better.

There are many days ahead to be supermum but for now, allow your body time to heal.

2.     Increase fibre and fluid

Nobody tells you about the challenges of pooping after childbirth. How did something so natural become such a struggle!

Straining from constipation lengthens and weakens the pelvic floor. Plus, the extra weight from constipation creates downward pressure on the pelvic floor.

To promote healing of your pelvic floor, it’s important that you do not strain to open your bowels. Fluid and fiber are key to keeping your bowels regular.

About 2L of fluid is recommended for health but this increases if you are breastfeeding. Many women find the refill bottles with markings on them great to remind them to drink enough water. After all who can rely on the baby brain to remember how much you have drunk today?

A fibre-rich diet is essential for healthy bowels. When you are sleep-deprived and grabbing food quickly you can easily make poor food choices that promote constipation. You may involve organising your partner or family involved in ensuring you have fibre-rich meals and snacks ready for when you need to grab food. Lots of great information is available on Orla Walsh | Dietitian (@orlawalshnutrition) • Instagram photos and videos for tips on increasing your fibre intake.

If fluid and fibre are not enough to keep your bowel regular it may be a good idea to use a laxative in these early days after childbirth, to soften your bowel motion and prevent straining.

3.     Get a footstool for your bathroom

You may have heard the term “squatty Potty” but a simple footstool does the same job. A small investment with huge results in reducing strain from constipation (therefore protecting your pelvic floor).

Your bowels open much easier when your knees are positioned higher than your hips (like a squat). Having your feet resting on a footstool when on the toilet increases the rectal canal angle by putting you in a squat-like position (minus all the leg burn). When you squat during a bowel movement or use your footstool, the sit bones (in your bottom) can separate open the angle. This allows the sphincter to fully expand and waste to move through with the help of gravity. No more straining!

A 2010 Japanese study found that squatting created an angle in the rectal canal that led to less strain when opening the bowels.  A 2017 study of 33 participants echoed these findings. Researchers found that pedestal toilet bowel movements, where the user is seated upon the toilet, took an average of 113.5 seconds. Meanwhile, using a footstool lowered the average to 55.5 seconds. All but one participant reported less effort in a squatting position. Now all you need to do is plan how you will spend this extra time.

4.     Manage any swelling in the perineum

Did we mention rest??? Any part of the body that is swollen will not work well. If I had a swollen knee, you would not ask me to run up and down the stairs, would you? We must give the same respect to your perineum.

Standing will increase the swelling so let’s reinforce – rest when you can even if it is only 5-10mins. You probably find that at the end of the day your perineum feels heavy. Regular short rest during the day can prevent discomfort building in the evenings.

Cooling ice packs for the perineum can be great to manage the swelling. Here is the link to one reusable brand Lansinoh Cold & Warm Post-Birth Relief Pad (universitypharmacy.ie). Alternatively, you could pop your maternity pad into the freezer for 20mins before use and you will have your own homemade cold pad.

Perineal spritz and sprays are full of natural essential oils which can help to ease perineal discomfort. soothing pain relief, antibacterial properties, and help promote healing. Apply 2 to 3 sprays directly over the area a few times a day or use in the bath. Here are 2 great sprays.

Lansinoh Organic Post Birth Relief Spray 100ml | LloydsPharmacy Ireland

Spritz For Bits, Perineal Spray | LloydsPharmacy Ireland

Once you are able, I also recommend wearing a compression garment (SRC recovery shorts) to provide your pelvic floor and abdominal muscles with support.

5.     Start gentle pelvic floor exercises

This can feel like the last thing you want to do when everything is sore but if you start gently pelvic floor exercises can help you feel better.

Initially, pelvic floor exercises aim to help with healing and increase blood flow to the area. Strengthening will come later as your body heals. At this phase squeeze gently within your pain limit. There is no need to push into pain.

Research has shown that the best cue is to “squeeze your anus”. Try thinking this when doing your pelvic floor exercises.

It is normal to feel like nothing is happening in the beginning as your pelvic floor may still be swollen and inhibited so don’t expect to be able to hold for 10 seconds straight away.

Start by holding your squeeze for 1-2 seconds and build up to 10 seconds as your body is able.

10 contractions, x 3 times a day is the recommendation for pelvic floor exercises.

You will often hear that you can do your pelvic floor exercises anywhere, however, after childbirth, you might find that you need to lie down as reconnecting with your pelvic floor can take time and lots of concentration.

6.     Book an appointment with a women’s health physiotherapist

You won’t regret it.

Think about all the changes your body has gone through over the last 9 months. How could you possibly understand them all? The postnatal body can be overwhelming and difficult to navigate back to strength alone. Parts of your body that used to work without having to think about them are now bulging, leaking, or maybe even feeling like they might fall out on the ground beneath you.

“I had a 6-week check with my GP.” I hear you say. Many women will feel the 6-week check with the GP is enough, however, the time is not available for that appointment to be a thorough physical assessment.

When you attend an individual assessment with a women’s health physiotherapist you get a detailed assessment of your body, tummy muscles and pelvic floor. It will help you understand where your body is at now, help you reconnect to areas that you are struggling to feel and most importantly get you started on a plan to get you back to regular physical activity.

And above all be kind to yourself. Your body is amazing.