Category: Labour

Expert Midwife Tips to Prepare for Labour

Post author By Melanie Platt
Post date July 5, 2023

Prepare For Labour with Expert Midwife Tips

Have you ever wondered how a midwife prepares herself for labour? Read on as I chat to Jedda Maggs who has been a midwife for 12 years and is a mum of 3 boys. She gives the expert midwife tips to prepare for labour. Pregnant women listen up and hear her answers to help you have a smooth and calm labour experience.

Mel: What do you think is the hardest thing for mum’s when having a baby?

Jedda: One thing mum’s really struggle with, probably the most is even in hospital is they get 3 different pieces of advice from 3 different midwives. It can be really frustrating for mum’s to know what to do. In general I say take everyone’s piece of advice and put it in your kitty bag, don’t throw any of them out but if you find one that works for your baby great. If it doesn’t work, it doesn’t mean it’s not right, its just not right for your baby.

M: What are your thoughts on birth plans?

J: It’s a great idea to know what you would like to happen – but really importantly, it needs to be flexible. You shouldn’t wrap up your success in your ability to meet your birth plan. Things can still happen that are outside of your control. Nothing works out perfectly.

M: Did you have a birth plan?
J: Nothing written down as such, I had in the back of my head that I was married to a giant who was a 9 pound baby. I thought I would end up with a caesarean but that didn’t happen and I was really proud of how things went.

M: What are your 3 biggest tips to get through labour?
J:

Best tip is something I learnt from doing calm birth. There is a definite link with a firm tight jaw and a firm tight cervix that doesn’t want to open. If you keep your jaw really open and relaxed despite the pain you are more likely to allow your cervix to open during labour. In essence don’t tense up your face muscles to deal with the pain. The best thing to do is relax the face muscles as much as you can. You can even try a guttural type sound on your exhale to keep your jaw relaxed.
Secondly Smile. Yes when you smile you release positive endorphins. It helps us think we can deal with the pain rather than the pain managing us. Which means you’re more likely to have a better experience with pain and therefore better able to approach labour with a move philosophy. The more active during labour you are the more likely you are to avoid the cascade of intervention. Still, at times an epidural or other interventions etc are necessary. Your body may be working against you in that time which is out of your control. Again this is where your birth plan needs to be flexible.
One breath at a time. A lot of women are just focussing on or thinking about the end or the next contraction, instead just be in the moment and breathe. One breath/contraction is what calm birth aims for, slowing your breath down during your inhale and your exhale. You don’t need to worry about the next contraction until it comes, staying in the moment rather than losing the control. Stay in the here and now and everything else takes care of itself.

M: Any last words of advice?
J: Do what your body is designed to do, get up off the bed and move around. Just because there is a bed in the room doesn’t mean you have to lie on it.
Things don’t always go to plan during labour, just being ok with whatever happens and trust that this is what needed to happed for the safety of me and my baby. Doesn’t mean failure of any sort if you have intervention. Trust medical opinion whether that be midwives, doctors etc.

Tags after birth, labour, midwife, pregnancy

Labour Pregnancy

Perineal Massage

Post author By Melanie Platt
Post date February 23, 2023

Perineal Massage for an easier birth...

Your go-to guide on how to perform Perineal Massage for an easier birth

Perineal massage might sound like some foreign sexual massage technique but it’s really just as simple as its name. Massaging your perineum – the section around the base of your vagina.

Now why would one do this you ask? Well there are several benefits, but the most popular one for mum’s-to-be is it has been shown to reduce the risk of perineal tearing during labour. Yes, finally there is something you can do yourself to reduce the complications of birth. Anything to reduce the risk of pain and the risk of 3rd and 4th degree tears (essentially tearing from your vagina to your anus). Which is extremely unpleasant and has long term effects that can be horrendous. So anything to prevent that is a go to in my book. Now being pregnant, it’s sometimes a bit hard physically to do it to yourself so you can have your partner do it for you so your bump doesn’t get in the way.

Benefits

Perineal Massage increases your blood flow which can help with your tissues stretching. As you know this is very much needed during the labour & delivery process. Sometimes it’s unclear as to how much your tissue will stretch during that process so this is a great way to enhance your tissues ability to stretch. Which may reduce your risk of needing stitches during labour.
Can help with anyone who has had a previous injury or scar in that area. Hello 2nd child!
It can also help you become more aware and familiar with some of the sensations you might experience during labour & birth. Which can help you be more relaxed and mentally prepared for labour.
Lowers your risk of tearing especially 3rd and 4th degree tears.
Significantly reduced your risk of needing an episiotomy.
Decreases your risk of perineal pain after delivering your baby.
My favourite – it can reduce your 2nd stage of labour duration which is a big one for reducing your pelvic floor dysfunction risk. Huge! Get massaging.

When is best

From 34 weeks pregnant 1-2 times/week for a maximum of 5 minutes. Now you might need to build up to the 5 minutes so take it easy. Breathe and relax your pelvic floor and allow your body to reap the benefits.

How to

Empty your bladder first. Wash your hands well, trim your nails or have your partner trim theirs. Either lie down on your back or on your side – if you’re doing it yourself a mirror can be handy and please don’t use your phone camera just in case you accidentally press record and send it to insta.
Using your index and 3rd fingers or using your thumb and 2nd finger whatever you find more comfortable.
Use a water soluble natural lubricant (we like Olive & Bee intimate cream) gently place your fingers inside your vagina around 3-5cm deep.
Gently put pressure on the wall of your vagina in a downwards position towards your anus and out to the sides of your vagina and hold for 60 seconds. You will feel a sight burning, stinging or tingling sensation.
Then gently work the lubricant around slowly like you’re sweeping the lower half of your vagina. Gently maintaining pressure and pulling your perineum (section between your vagina and anus) forward and outward a little as you go. (Away from yourself)

NOTE: A warm compress can help before and after if you are feeling strong sensations.

Perineal massage should not be performed:

Prior to 34 weeks pregnant
If you have been told you have cervical shortening or placenta prevue.
If you have severe blood pressure problems during your pregnancy.
If you have any yeast infections

*Doing it more than 1-2 times/week doesn’t increase the benefits.

Tags birth, labour, perineal massage, pregnancy

Education Exercise Labour Post Natal Pregnancy

Pelvic Floor Muscles – All You Need to Know

Post author By Melanie Platt
Post date October 19, 2021

Everything you need to know about your Pelvic Floor Muscles

There is a lot of talk about pelvic floor muscles, pelvic floor exercises and kegels lately. Do you think your pelvic floor muscles are as important as everyone says they are?

Do you know what they do? Well that’s what I’m here to tell you about. To let you know everything about your pelvic floor muscles.

These muscles have so many roles and really important ones too:

Help keep your organs inside and lifted
Prevent and stop urinary incontinence
Supporting you during your pregnancy
They help guide your baby into your birth canal
Holding wee and poo in continuously without you even thinking about it
Helping you feel pleasure by arousing your clitoris and increasing the sensation of your orgasms

I’d say they are pretty important muscles! And ones I would want to know about! Wouldn’t you agree?

Especially considering most of this happens without you thinking about it. Pretty intuitive body we have!

Where are these muscles?

They are shaped like a hammock or a half moon running between your pubic bone at the front and your tailbone at the back around in a loop so when the muscles contract they shorten and close off the area. Obviously there is a lot of structures here from ligaments, bones, blood vessels, nerves and connective tissue but the muscles of the deep pelvic floor are:

Pubococcygeus (PC muscle)
Iliococcygeus
Coccygeus
Puborectalis – the muscles runs between the outer layer and the deep layer so it’s more like a middle layer but acts like a constrictor as an outer muscle does.

These make up your Pelvic Floor Muscles (Levator Ani)

So where do things go wrong? Why do the muscles stop working well?

Pregnancy – just the physical load on your body and the anatomy of your pelvic floor is enough to cause issues. Worse if you’re not strong to start with.
Labour – You are at risk of major trauma like perineal tears with a forceps & vacuum delivery. Where instrument use is necessary, episiotomy will significantly reduce your risk of OASI (Obstetric Anal Sphincter Injury – 3rd/4th degree perineal tears) especially if it’s your 1st child and you are needing forceps. OASI is a significant risk factor for anal incontinence. Also just add in the generic trauma associated with labour to this area, the muscles take time to recover and get functioning again.
Genetically – your pelvic floor consists of muscles and connective tissue based on type I & III collagen fibres. These fibres can have a genetic weakness factor, so some people are more prone to weakness in their pelvic floor muscles without any other contributing factors. (Hence why I love collagen support – read more on collagen )
Weight training – heavy prolonged weight training without the appropriate engaging of your pelvic floor or correct technique for your pelvis puts you at a higher risk of having pelvic floor dysfunction.
Coughing – prolonged coughing can increase the pressure load acting downwards on the pelvic floor muscles, if the muscles can’t sustain it with strength or active engagement when coughing pelvic floor dysfunction can occur.
Bowel Straining – As above with the pressure pushing down on the muscles, they sometimes weaken and reduce their resting tone with the pressure against them periodically. Especially if this has been chronic constipation or straining.
Alcohol, caffeine & dehydration – they can make your urine more acidic which can make you need to urinate more frequently which can change the way the bladder works and how it interacts with the pelvic floor. (read more on the bladder)
Pain & Swelling – pelvic pain, back pain, endometriosis etc can make these muscles switch off or slow down like they aren’t quite getting the message from the brain. Not to mention to trauma of birth within the pelvis.

So how does it feel when your pelvic floor muscles aren’t working properly?

Leakage
More frequent urination
Urinating through the night
Feeling of not being able to hold on to your urine (don’t want to jump or run)
Back pain
Lack of sensation during sex
Pain with sex
Constipation
Feeling like everything is falling out down below (heavy feeling)
Feeling your stomach bulging out when you get up of the chair
Lack of pelvis stability (wobbly or not quite working right when you exercise)

Tips to keep your pelvic floor and vagina working well and feeling amazing!

In General:

No soaps/moisturisers with chemicals – can irritate and cause infections.
Pelvic Floor Exercises regularly – start with one of our pelvic floor and core programs see results within 2 weeks. (See programs)
No straining to urinate or do number 2’s – This puts extra pressure on your pelvic floor muscles by increasing your intra-abdominal pressure downwards. This can lead to a pelvic floor dysfunction or to a risk of prolapse. Instead lean forwards with your trunk, lift up your heels so you’re on your toes and relax your pelvic floor muscles.
Pelvic floor muscles activated when doing weights or lifting anything including your baby. This is where you reach a functional level of pelvic floor control. It will make you feel stronger and also protect you from a possible pelvic floor dysfunction or risk of prolapse.
Good quality collagen for type 1 and II fibres to help improve the quality of your muscles and ligaments surrounding your pelvic floor.

Pregnancy & Birth

Ice Pads after birth or Padsicles – to help with the healing process and reduce any swelling. Spray your pad with water and witch hazel (distilled – avoid any that have alcohol in them) if you like, fold the pad back up and freeze in a freezer bag. Let them thaw for a few minutes prior to use, then use up to 10 minutes every hour as needed in the first 24-36 hours after birth.
Warm compress during pregnancy – helps your vulva tissue relax prior to labour.
Perineal massage during the late stage of pregnancy (from 34 weeks) to reduce your risk and severity of 3rd & 4th degree perineal tears, reduce your risk of episiotomies & decrease your perineal pain after labour. Follow the instructions and use a natural based lubricant. (Read more)

Sex

Well lubricated before sex – as the pelvic floor muscles help with stimulation to the clitoris and can increase arousal. Try doing some pelvic floor exercises before having sex in particular the Vagina Wink. Other options include using a natural based lubricant. We love Olive & Bee Intimate Cream.
Urinate after sex – can help reduce the risk of urinary tract infections which due to the increase in frequency of urination and the acidity can affect your pelvic floor muscle function.

Do we always need to do pelvic floor exercises?

The simple answer is yes. But think of it like this, do you always need to eat well to feel good? Or put petrol in your car for it to work? Do you want your muscles to be functioning well when you’re into your 80’s and live a great life being able to exercise and move about like you want to?

It’s also best to have a pelvic floor exercise program that targets your muscles specifically so you can feel what it feels like to you when your pelvic floor muscles are working well. Everyone is different and everyone will feel it differently. Then you can add more functional movements so your body learns to use these muscles again without you thinking about it. Like our programs at PPF!

No matter where you are on your journey we have a program for you.

So what can you do?
Well for starters take this Pelvic Floor Quiz so you have an idea of how strong you are!

Then try our 3 day trial on the PPF App and see for yourself. You’ll feel your muscles in 3 days and really see a difference in 2 weeks.

References:

Okeahialam NA, Wong KW, Jha S, Sultan AH, Thakar R. Mediolateral/lateral episiotomy with operative vaginal delivery and the risk reduction of obstetric anal sphincter injury (OASI): A systematic review and meta-analysis. Int Urogynecol J. 2022 Jun;33(6):1393-1405. doi: 10.1007/s00192-022-05145-1.

Dieb AS, Shoab AY, Nabil H, Gabr A, Abdallah AA, Shaban MM, Attia AH. Perineal massage and training reduce perineal trauma in pregnant women older than 35 years: a randomized controlled trial. Int Urogynecol J. 2020 Mar;31(3):613-619. doi: 10.1007/s00192-019-03937-6.

Abdelhakim AM, Eldesouky E, Elmagd IA, Mohammed A, Farag EA, Mohammed AE, Hamam KM, Hussein AS, Ali AS, Keshta NHA, Hamza M, Samy A, Abdel-Latif AA. Antenatal perineal massage benefits in reducing perineal trauma and postpartum morbidities: a systematic review and meta-analysis of randomized controlled trials. Int Urogynecol J. 2020 Sep;31(9):1735-1745. doi: 10.1007/s00192-020-04302-8.

Education Labour Pregnancy

How to Prepare for Birth & Labour

Post author By Melanie Platt
Post date July 30, 2020

How to Prepare for Birth & Labour

Let’s face it you are about to go through the marathon of your life! It’s no easy task but there are a few things you can do to help yourself get prepared and ease your stress.

There are many things you can do to prepare your mind, body and home for pregnancy, labour and a new born. Here are just a few practical tips.

1. Pelvic Floor muscle strength and endurance prior to delivery. You may only think you need to do this after birth when you have symptoms eg urinary leakage or to get your body back after birth. However the pelvic floor muscles also have this amazing ability to help guide your baby down into your birth canal Win Win! anything to help that process go more smoothly is a key!
You can also learn how to activate, strengthen, switch off and control these muscles to prevent said leakage from occurring. Your muscles have a memory pattern, so starting earlier makes it easier for the muscles to remember how to work after giving birth and can help improve your recovery. Helping you get back to your strength and coping with life as a new mum quicker and easier. Again winning! Get your Vagina Wink Guide here

2. Muscle Strength – Maintaining your body’s strength during pregnancy is vital to help with your labour and your recovery. Most important for labour will be your leg strength. Being able to move into different positions during labour and be able to sustain those positions will be very helpful for you. So having muscle endurance is the key. Another exercise I love for women who are pregnant without any pelvic pain is the wide leg squat – you can do it against the wall with a swiss ball for greater stability but it helps to open your hips and prepare for labour. You can also sit on the swiss ball and gently stretch your hips and inner thigh too. Upper body strength will serve you well when you are feeding and carrying around your little one and everything that goes with them. Our pregnancy pelvic floor exercise program incorporates both lower body and upper strength with a pelvic floor focus, along with stretching too.

3. Mental Health – music, breathing techniques, relaxation and meditation are all great to practice prior to giving birth for your well being while pregnant and so you can feel calmer when things that you can’t control pop up. You can also use these techniques if you want to during labour to feel as calm as you can and stay focused on something positive.

4. Food and Hydration – Depending on what restrictions are in place by your hospital or doctor this is something to consider. I don’t know about you but i’m hungry all the time so don’t think you won’t be during labour, because it could go for awhile. If you’re hungry and your hospital allows it you should eat, especially in early labour as you need to keep your energy levels up. Choose small snack portions of foods that are easily digested e.g. plain crackers, yoghurt, easy to eat fruits like sultanas, a wrap, a protein bar or veggies sticks. Recent data has suggested inadequate hydration can lead to a longer labour with your contractions slowing down, taking small sips of water during labour can help maintain your hydration and energy levels. Also keep in mind that your hydration stores need to be kept up, so maintaining hydration in the days leading up to labour is a must! Note: If you have a high risk pregnancy and may need a caesarian ask your OBGYN first.

5. Be mentally and emotionally prepared – This is probably the most important part of labour. Being prepared for what might happen, will happen and what choices you can make can help you feel slightly in control of a situation that is hard to comprehend. Talk to your friends, talk to your health professionals and talk to your partner. And at the end of all that research, take the time to think and feel for yourself and make decisions based on what you need and what’s best for you and your family. Then visualise that happening and work with positive thoughts.

Tags birth, labour, pregnancy, prepare for birth

Education Exercise Labour Pregnancy

Do Births Always Go to Plan?

Post author By Melanie Platt
Post date April 9, 2020

Rebecca Barr has recently joined our team at Perfect Pelvic Floor as our guest blogger. She has been a Physiotherapist for over 10 years with years of experience in pelvic floor retraining and incontinence. Here is her beautiful birth story and I just love her beautiful baby girls name Emmison.

After seeing those two lines appear, I knew I had to do another test just to make sure. This time the digital pregnancy stick which told me I was 1 – 2 weeks pregnant!

I had feelings of excitement and elation, which quickly turned to slightly frightened and nervous about the long nine months ahead. I was healthy and fit, what could possibly go wrong?! After the initial nerves, I did sail through most of my pregnancy without a worry. Even my obstetrician made a comment asking if I had done this before!! He had never seen a first time mum so relaxed. Each appointment he would ultrasound scan me and say yes baby is perfect, and measuring well.

At 37 weeks when I went in for another routine check, the obstetrician wasn’t so quick to say what I had been hearing from him at every other appointment. Instead he said he would like me to have a different scan to measure size and weight more accurately. Off I went to have this scan and returned to him telling me I had low amniotic fluid levels. Not too low to have anything done right away, but low enough to be closely monitored to ensure my baby was still growing.

Over the next two weeks I was a lot more aware of my precious little bubs movements. There used to be a lot of kicks when I would drink a cold glass of water, and as soon as I would get into bed to relax after a long day on my feet, I would usually feel the summersaults inside me. This had certainly started to reduce and I was quite anxious about what bub was doing in there!! The hospital were fantastic when I rang to say I felt there was reduced movement. I was told I could go in as much as I want and have a CTG whenever I felt I needed reassurance. A CTG is a Cardiotocography which monitors both the foetal heart rate and the contractions of the uterus.

My obstetrician decided at 39 weeks that I would be induced, which was a relief to be honest, as everyday I felt like I was overanalysing my baby’s movements or lack there of!

So the induction day came around quickly and it was lucky I was super organised and had my bags packed ready to go! My husband and I went in to hospital and I was first given the gel which helps to bring on contractions and soften the cervix. My waters would then be broken the next morning if nothing happened spontaneously. Overnight I felt mild contractions at no regular intervals, surprisingly I did get a good nights sleep! The midwives were in getting me up early and took me around to the birthing suite where I was to have my waters broken and then get comfortable for a long day ahead of me.

Once my waters were broken the contractions started almost immediately. What I thought were contractions overnight were measly little cramps, this was the real deal! I was able to walk around and there was a fitball in the room which I could use to hug and lean forwards onto during the strong contractions. My husband was very supportive and was following me around the room helping to massage my back but it got to the point where nothing I or he could do would help the intense pain! I then opted for an epidural and alas, I was able to function again!!

Having an epidural was great, I could lie down and relax after all those exhausting contractions. It did however prolong the active labour, although the obstetrician was in regularly checking my progress. I got to 8cm dilation when the obstetrician said my baby had turned posterior. Bummer! I was so close. He organised a theatre room and said we could try turning baby with forceps or vacuum. I was not keen on either of these methods as I had done my research and knew particularly forceps was quite damaging to my baby and my pelvic floor muscles. I had discussed this with the obstetrician during a previous appointment and he knew I did not want this method in my birthing plan. So I then consented to an emergency caesarean.

Within 10 minutes I was down being prepped in the theatre room. I could see on the monitor that baby’s heart rate was dropping, however all the staff seemed so relaxed and positive for me. The caesarean section was the quickest part of the whole experience, I just remember seeing my beautiful baby girl passed over the drape so that I could cuddle her straight away. My husband then cut her umbilical cord and seeing her being held in his arms I knew we had unconditional love for her.

Rebecca Bar has been a Physiotherapist for over 10 years and has post graduate qualifications in Women’s & Men’s Health and lives in Victoria Australia.
She has a keen interest in helping people improve their quality of life and loves spending her time playing tennis, hanging out by the beach and spending time with her beautiful daughter.

Education Exercise Labour Post Natal

5 Essentials for New Mums

Post author By Melanie Platt
Post date December 12, 2019

As a new mum, you generally forget about yourself and look after everyone else. Hands down it’s about survival. However, I’m here to remind you the 1st 8 weeks are by far the best time for your body to recover!
Research has shown the best recovery gains in your stomach muscle separation and function are within the 1st 8 weeks. Don’t freak out, there are very easy and gentle exercises that you can do at home within this time frame, none of which put your body at risk.
Read on for 5 easy things to do:

1. Work on your pelvic floor from day one! This is so vital and important. Make sure your pelvic floor muscles are working, strong and able to hold everything in. You can start activating your pelvic floor muscles 24 hours after giving birth, regardless of the way you gave birth. Remember you may not be able to feel much happening down there and it may hurt. Keep going slowly and start to connect the pathway from your brain to your muscles by trying daily.

2. Have your abdominal separation checked and go slow. Don’t even think about an abdominal crunch until your separation has been checked multiple times by health professionals and you feel strong within your pelvic floor. You have a window of 8 weeks post baby to really work on getting your separation as close together as it will go. See someone early and start gentle exercises early.

3. Start gentle lower tummy exercises. Transversus abdominis especially, this is a great muscle providing lower back, pelvis and stomach support. Start gently by lying on your back and trying to slowing draw your belly button to your spine without tilting/moving your bottom/pelvis or spine. This is a great one to help activate those deeper muscles to help with your abdominal separation. If you have a separation add gentle compressions with your hands to close the muscles together.

4. If you are keen to get back into running, surfing or more high impact exercise build up to it once your pelvic floor and deep stomach muscles are strong. You need to start by by building a base and this can be done with general walking. Move onto pilates, yoga and more dynamic exercises as you feel stronger, again ensuring your pelvic floor is working during your other exercises. Your hormones are still changing which means your muscles can’t possible be at their maximum strength until 3 months post baby so don’t even think about running or any high impact exercise before this time.

5. I’m all for women getting back into exercise and sport and reaching some kick arse goals but that takes time. This is the time to focus on strength, not weight loss or pre baby body etc. There is no such thing! Your body has gone through something amazing and is like nothing else you will ever go through. You can’t possible expect your body to be like it was. That’s way too much pressure on yourself. Relax, be kind to yourself and take away the pressure. Aim for strength and posture. The weight loss will come later.

I have seen some clients feel good and think their pelvic floor is strong and go back to the gym at 6 weeks post partum and end up with a prolapse. The inside takes time to recover and heal. Focus on healthy choices and gentle movement. My general rule is no running until you can hold your pelvic floor on for 10 full breaths while walking and even then not before 3 months post partum.

Hot tip: TAKE YOUR TIME! Your body needs nutrients to support you and your baby. Be healthy, eat good nutritious food and go slow getting back into exercise. Remember it can take a year to recover from pregnancy and labour. Be patient and kind to yourself, you’re a mum now.

There is help! Join our new mum recovery program and get all the exercises you need for your 1st 12 weeks.

10 exercises/week that are super gentle and don’t take up much of your precious time.

New Mum Recovery Program

Prepare For Labour with Expert Midwife Tips