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Education Labour Pregnancy

Expert Midwife Tips to Prepare for Labour

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: 

  1. 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. 

  2. 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. 

  3. 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.

Categories
Labour Pregnancy

Perineal Massage

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

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.

Categories
Education Post Natal Pregnancy

Avoid These Common Pelvic Floor Mistakes

I’m sure we’ve all done them at some point to try and get these elusive pelvic floor muscles working but stop right now! These mistakes are preventing you from feeling strong and getting back to the exercise you want to. They are preventing you from stopping your leakage and they are preventing you from having amazing sexual pleasure. Read on to see what you can do instead. 

When you are doing your pelvic floor exercises try to avoid theses common mistakes below.

3 most common mistakes:

  1. Tilting your pelvis – now we know this can be great for pelvis mobility and good for sexual pleasure but it does not help with your pelvic floor muscle activation while exercising! You want to find a neutral position with your spine and pelvis. So when you’re lying on your back, make sure your tailbone firmly rests on the ground without moving while you do your exercises. 
  2. Squeezing your butt cheeks together like there is a $100 note you don’t want to let go of – This is working your outside buttock muscle (your gluteus maximus) not your pelvic floor muscles. Yes your pelvic floor muscles go from your pubic bone at the front all the way to your tailbone at the back including around your anus but squeezing your butt cheeks is not going to get them working. Instead relax your buttock and focus around your vaginal area to connect with your pelvic floor when exercising. 
  3. Clenching your outer abdominals – this is probably the most common mistake I see in the clinic.  We’re so used to our rectus abdominis (6 pack abs) working that we forget there are deeper layers of muscles underneath. It’s also very hard to take a deep relaxed breath with these muscles working (hint hint – if you’re struggling to breathe at the same time as pelvic floor exercises this is probably why) Put one hand under your rib cage and the other deep down towards your pubic bone. The hand under your rib cage shouldn’t feel anything working underneath just relaxed and resting while you’re exercising. You can also think about your body being in half – the top is breathing and the bottom is gently lifting and squeezing through your pelvic floor muscles. Remember the feeling is all internal.

Hot Tip: your pelvic floor muscle contraction won’t feel like a big bicep contraction, they are small muscles and they are internal. I think one mistake people make is expecting if to feel like this huge contraction. It won’t, it will be subtle. 

Long term we do want our pelvic floor muscles to work with our deeper abdominal muscles with more functional exercises but that is down the track once you have mastered the pelvic floor muscles alone. Our Pelvic Floor strength systems for pregnancy and our new mum recovery program work with you every step of the way. Starting at the basics with video instruction and through to more functional exercises including your deep core and pelvis stability. 

​Unsure how strong you are?
Or if you can activate your muscles?

Take our Pelvic Floor Quiz for pregnancy or new mum’s to find out how strong you are!

Categories
Education Exercise Labour Post Natal Pregnancy

Pelvic Floor Muscles – All You Need to Know

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:

  1. Pubococcygeus (PC muscle)

  2. Iliococcygeus

  3. Coccygeus

  4. 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)

pelvic floor muscles
Pelvic floor muscles diagram
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.

 

Categories
Education Pregnancy

To Freeze or Not to Freeze – Part 3

Collection Day!

“You want me to do what to myself??” was the thought running through my head…..

Inject 3 needles a day into my stomach that’s still sore and swollen from my laparoscopic surgery. Oh WOW! Once I calmed down from the initial shock, I found it really hard to make a choice to physically do that to myself without knowing how it might affect my mind and body. Would I feel out of control, emotional? Would I be able to hold it together enough to work? How would my body react? I had to really take a few days to sit in the uncertainty to be ok with my choice, knowing the end result would be worth it. Having the initial conversation with the nurse at the fertility centre really helped with this decision. Lots of information but they answered all of my questions and there was no pressure to make a quick decision. I started warning everyone at work joking that I would put a sign up on my door saying “Enter at your own risk” I didn’t think that would be a great advertisement for my physio clients. I had to take quite a few breaths before inserting the needle the first time just to psych myself up enough to stab my stomach

. I kept telling myself “ I can do this, I can do this” Flinching at the initial pain as the hormone went into my body, followed by an after pain lasting a few minutes. As the injections need to be done at the same time every day I made the decision to do it early and allow myself to be slow and take my time with my morning routine rather than rushing around like my usual self. 

Rewind to the day before and I had my initial ultra sound and blood tests to determine day one of my cycle which allowed the timing for the rest of the cycle to be planned. The first 2 injections are to stimulate the follicles and the eggs for the 14 day cycle starting on day three of my cycle. Apart from some extra bruises adding to the war wounds on my stomach I felt great for the first few days. I actually felt clarity and focus which I wasn’t expecting. Then day 7 hit with a bang!

 A new hormone introduced as the antagonist (which in itself just sounds dooming) to stop me from prematurely ovulating (to stop the egg from being released before the collection date). A red rash around the injection site, pain, dizziness and fatigue like I have never felt before. Thankfully those symptoms settled within an hour however the tears followed. It’s the weirdest feeling, crying for no reason and not being able to stop it, I was sitting at my computer checking in with myself “I’m not sad, I’m not angry but there are tears just flowing down my face”. This is when I had a few SOS calls to some friends to reassure me I was going to be ok. Feeling hot, clammy, a little dizzy and very nauseous while trying to get ready for work was a bit of a nightmare. Have you ever tried putting on makeup while you’re crying? It doesn’t really work. I gave up to avoid having racoon eyes that day. Just reminding myself it’s short term. 

Also I wouldn’t recommend going on a first date the day you have to start hormone injections, feel bloated, swollen and trying not to be hormonal and blubber in front of the unsuspecting guy who has no idea what’s going on. Wasn’t a great look! Thankfully he was understanding and very sweet. 

What followed was blood tests and ultrasounds to count the number of follicles which allowed the egg collection date to be determined and to make sure everything is on track. I had 14 follicles on the last ultrasound which I was very happy with. The IVF clinic were great, my nurse was available to chat whenever I needed it and I knew what I had to do at each step so it wasn’t as overwhelming as I thought it was going to be.

As the days went by I progressively got more and more swollen, bloated and nauseas. My brain felt like mush the whole time! I have never been so happy to inject the last hormone which was number 5 of that day

; the trigger injection which is to help release the egg from the wall of the follicle so they can be retracted but not before the eggs are released out of the ovary. This is very precise and 36 hours before egg collection. The following morning I had to do an ovulation test which just happened to find me at a doctors appointment at the time I was supposed to take it so chilling out in the public bathroom while I waited for the result felt absolutely ridiculous. 

The morning of the egg collection was by far the worst. I felt like my insides were going to burst. Literally! Which happened to fall on day 14 of my cycle and 2 weeks before my 38th birthday! The Irony. There was a few moments just before I went in that I wondered to myself “What if there aren’t any eggs? what if this has all been for nothing”.  Because at the end of the day it’s up to your body and how it responds to determine the result. I took a big breath and knew that I had done everything they asked of me and the rest was out of my control. 

I woke up from surgery with everything attached to me to monitor my body (again i’m not great with anaesthetic, I tend to take my time to wake up, this was also my 3rd anaesthetic in 3 months) I wondered how many eggs they had taken. It was my first thought. Did it work? Then I heard the nurse telling the woman across from me that she had a number on her hand to tell her how many eggs they had collected. 

​Immediately I was excited and wondered if I had the same. I looked at my hand and there it was, the number 13 written in black marker on my palm. I actually cried happy tears. I was beyond relived that it worked, that I woke up and it was over. 

That afternoon I received a call from the IVF scientist telling me that 12 of my eggs were mature enough to freeze and were stored in liquid nitrogen. Again I felt relief and so much gratitude to my body for what it had gone through. I was finished and could start the recovery process.

Which in itself is a different story. Everyone recovers differently. It took longer than I expected, the first 3 days are the worst nausea was my biggest problem followed by swelling and difficulty getting my bladder and bowel to work properly again. The follicles need to refill after the egg collection and this process can go up and down as I discovered on a midnight trip to the emergency department with unbearable pain that medication was not changing. However it does settle and normal life does resume. What I asked of my body was huge!! All I could give to it was kindness and rest when it needed it.

There are risks, there is pain, there is character growth when you inflict pain on yourself but overall there is a much bigger picture that is worth going through all of that for. 
Time and the chance to be a mum one day.

​Mel xx

Categories
Education Nutrition Pregnancy

Do You Need Pregnancy Vitamins & Minerals?

Do you need Pregnancy Vitamins & Minerals?

What do vitamins and minerals actually do in the body?

What is their role and all the hype?

They are involved in 100’s of roles within the body from building healthy strong bones, to making hormones and even helping maintain your heart beat.
However the biggest role they have is the thousands of reactions within each cell of your body every second of the day to open the cell and receive the nutrients from your food so your body can utilise the food you are putting in.

The next question to ask yourself is do I need Vitamins and Minerals during my pregnancy?

The simple answer is yes. Vitamins and Minerals are involved in keeping you healthy and helping you grow the healthiest baby you can so why wouldn’t you want to do everything you can to build a strong and healthy baby.  

It can be really confusing not knowing which ones to have, but here’s a run down of the must have vitamins and minerals during your pregnancy, and how you can find them naturally.

We should all aim to get the recommended quantities of vitamins and minerals through a balanced diet but that is not alway possible due to the quality of our foods and our time poor lifestyles. This is where supplementation is key and not all supplements are made equal.

Key Vitamins & Minerals
  • Iron: Is vital in the formation of blood cells and the transport of oxygen to your blood cells. Your body is producing a much larger blood volume to accomodate for the placenta, up to an extra 9L of blood in your body. Your absorption of Iron is enhanced by Vitamin C. The Royal Australian and New Zealand College of Obstetricians and Gynaecologist (RANZCOG) recommend being tested for Iron before taking a supplement, however the daily dose required is 60mg .

    Food: chicken, eggs, red meat, beans, tofu, legumes, pumpkin & sunflower seeds.

  • Folate: Is a B vitamin, when it is added to food or as a supplement is known as Folic acid. It’s vital in many metabolic processes of the body (breaking down food & repairing/rebuilding our cells & body). Not having enough folate in pregnancy has been linked to an increased risk of neural tube defects such as spina bifida. RANZCOG recommends 0.4mg/day one month prior to pregnancy and for the first 12 weeks of pregnancy. Foods: kidney beans, cooked spinach, asparagus, broccoli, kale, tomato, avocado, walnuts, cabbage.

  • Iodine: A really important mineral that is essential for the development of your baby’s brain (IQ) and nervous system. It’s also very important in the role of your thyroid gland. Your thyroid gland takes Iodine and converts it into thyroid hormones. Your thyroid hormones determine your metabolic rate, the rate at which your body uses energy and it is vital for every cell in the body to function properly. RANZCOG recommend a dose of 150 micrograms/day. Food: seaweed, strawberries, eggs, seafood.

  • Zinc: Is essential for normal growth and development of the bones, brain and other parts of the body. It is known as a trace element and a catalyst for a number of enzymes in cell division and cell growth (which is what happened in the bones cells everyday rebuilding and regenerating). It’s also great for boosting your immune system. Foods: red meat, dairy products, beans, seeds.

  • Calcium: The RANZCOG recommend 1000mg/day for pregnant women 19 years and older. This can reduce the incidence of you having high blood pressure and having your baby early. Foods: Dairy, green leafy vegetables.

  • Vitamin D: Not something you would think could be low in Australia, however recent research is showing there is a deficiency emerging. Vitamin D helps the body absorb Calcium, it’s also vital in preventing osteoporosis for you later in life. Deficiency can also lead to an impaired skeletal development in your baby. You may get enough from the sunshine, however if you are unsure consult your doctor for a blood test and look into supplementation. Foods: Tuna, salmon, orange juice with fortified vitamin D, dairy & plant milks with fortified vitamin D.

  • Omega 3 fatty acids: Also know as Docosahexaenoic acid (DHA) and Eicosapentaenoic acid (EPA). Our bodies do not make this on it’s own we have to ingest it. Research has show only 10% of women of childbearing age meet the recommended dietary levels of DHA. This is essential for your baby’s neural, brain and eye development. There is huge concerns and confusing information around the safe intake of fish during pregnancy. The RANZCOG recommend 2-3 serves of fish/week (salmon, trout, sardines & mackrel) of 150g/serve. However achieving adequate amounts of Omega 3 fatty acids is difficult with food alone. There is research showing supplementation as a convenient and effective way to get the required daily dose to reduce the risk of having your baby early. Not all supplements are made equal or with quality, ensure you look for one with both DHA and EPA with at least 500mg of DHA and no more than 1000mg/day. Foods: Fish, seafood, nuts, seeds – chia, walnut, plant oils – flaxseed oil.

  • Vitamin B12: If you are vegetarian or vegan you will need to supplement your B12 as well. The RANZCOG recommended dose is 2.6mcg/day. Check with  your doctor if you are unsure if you need a supplement. Foods: Fish, meat, eggs, yoghurt, nutritional yeast, tofu.

So all that may seem confusing, the simplest step would be to aim for a rainbow of colours and get your 5 cups of veggies and fruit in/day and look into supplementation especially for your Omega 3’s. Speak to your health practitioner with any concerns.  

 

Reference: Vitamin and mineral supplementation in pregnancy (C-obs 25) RANZCO

Categories
Education Labour Pregnancy

How to Prepare for Birth & Labour

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. 

Categories
Education Exercise Labour Pregnancy

Do Births Always Go to Plan?

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. 

Categories
Education Exercise Post Natal Pregnancy

Pelvic Floor Facts You Need to Know!

When talking about your pelvic floor muscles what are the essentials you need to know?
These small and sometimes seemingly insignificant muscles do a whole lot that you probably don’t even know about and wouldn’t even realise. 


Reality is you can thank these muscles for pleasure and avoiding embarrassment!These important muscles form a sling like support system at the base of your pelvis. They work on some level without you even knowing it which is why sometimes they stop working as well as they should. Hence we need as strengthening program to get the working well but also learn to switch them off when needed.

Here are some must know Pelvic Floor facts:

  • The pelvic floor muscles are made up of Pubococcygeus, Iliococcygeus, Coccygeus & Puborectalis. They sound really long and complicated but make up our superficial and deep layers of the muscles.
  • Pelvic floor exercises are the same as “doing your Kegels” ( kegels is just the American term. You have no idea how many times i’m asked this)
  • When pelvic floor muscles are tightened or contracted you get a closing and a lifting sensation of the vaginal walls.
  • They are important to us throughout our whole life especially as a woman. During pregnancy, the post partum period and onwards.
  • The muscles play a role in starting and stopping the flow of urine based on a contraction of the detrusor muscles. For more see our bladder blog 
  • Men have pelvic floor muscles too. Surprise, surprise They are important for avoiding the post urinating drip. They can also have issues when the prostate becomes enlarged and presses on the nerves innovating the pelvic floor muscles.
  • They provide support your pelvic organs from below. Vital for any kind of exercise especially jumping & running. Also anything that causes an increase in intra abdominal pressure Eg coughing, sneezing & laughing.
  • They play a role with sexual sensation. The pelvic floor muscles help the clitoris become enlarged with contraction and can increase the sensation of an orgasm when contracted at the same time. 
  • Assist in baby delivery. The pelvic floor muscles help guide the baby’s head into the birthing canal when the time is ready.
  • They are just like any other muscles in the body. They have blood flow, you can strengthen them, relax them and they can become tight and cause other issues.
  • Slow twitch and fast twitch fibres.  Which work like any other muscles, slow to perform endurance type activities and fast to stop the flow of urine quickly. 
  • Pain and swelling can inhibit your muscle control. The same as a lot of muscles in the body when we have pain and swelling it can interfere with the function of your muscles. 

So many reasons to be thankful for these muscles! And if you don’t think you know how to activate them or wondering how strong you are? Take our Pelvic Floor Quiz below and find out. 

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