Speaker 1: Welcome to the Kick Your Expert led podcast, helping you
Speaker 1: explore and learn everything about getting pregnancy, birth, and becoming
Speaker 1: a parent.
Speaker 2: On the podcast and our online pregnancy program grow My Baby,
Speaker 2: we share my experience of helping more than four thousand
Speaker 2: babies to be born.
Speaker 1: And our experience of running a women's health clinic and
Speaker 1: parenting for boys.
Speaker 2: We're here to help everyone to feel empowered in pregnancy
Speaker 2: and birth with real life, practical information.
Speaker 1: Welcome everyone, I'm Bridget Maloney and it's great to be
Speaker 1: back in your ears. Today. We have got the great
Speaker 1: Kath for Quee coming to join me. I'm flying solo today. Now, Kath,
Speaker 1: you might be familiar with Kath. We've had Kath on
Speaker 1: the podcast before. She is a women's health physiotherapist and
Speaker 1: she's probably one of the hardest working people that I know.
Speaker 1: She's a physiotherapist in Melbourne, Victory, Ria. She helps women
Speaker 1: in pregnancy and postpartum. She has an online training program
Speaker 1: called Fitness Mama that we highly recommend for anyone who's
Speaker 1: pregnant or postpartum. And she is a mum of three girls.
Speaker 1: Just on the weekend gone, I had the good fortune
Speaker 1: of hanging out with Kath at a conference all about business,
Speaker 1: so it's good to have my business buddies. But that
Speaker 1: was not the only conference Kath was on at the
Speaker 1: same weekend. Each morning, Kat got up at four point
Speaker 1: thirty to attend the annual research update on pelvic floor
Speaker 1: dysfunction during pregnancy and the first year of postpartum, and
Speaker 1: she has lots to share from her learnings. So if
Speaker 1: you're the person that's press play on today's episode, we
Speaker 1: know that you're the type of person who loves having
Speaker 1: information during your pregnancy that's expert led and back by research,
Speaker 1: and that describes Kat perfectly. I am so excited to
Speaker 1: get into this episode, so let's do just that. Welcome Kat.
Speaker 1: I'm so glad to have you on our podcast again.
Speaker 3: Thanks so much for having me, Bridget. It's great to chat.
Speaker 1: I love chatting with you. You're just a wealth of
Speaker 1: knowledge and every time we do chat, I think, oh
Speaker 1: my god, that needs to come back on our podcast.
Speaker 1: So here you are, right, Cath. I want to start
Speaker 1: with why should a woman have or want.
Speaker 3: A healthy public floor? Great question, Bridget. Let's start with
Speaker 3: the basics. We want to stay dry, we want to
Speaker 3: not be accidentally leaking, And when I talk about leaking,
Speaker 3: we're talking about incontinents of urine feces, flatal incontinent, so
Speaker 3: that's accidental, I guess, letting go of a fart for
Speaker 3: want of a better word. But there's the incontinent side
Speaker 3: of things, and then there's a prolapse side of things.
Speaker 3: So a prolapse, a public organ prolapse might be felt like.
Speaker 3: The sensation might include a bulge, a vaginal bulge, heaviness,
Speaker 3: a public dragging sensation. It could even be as subtle
Speaker 3: as the sensation that a temp is stuck, but you're
Speaker 3: not wearing a tampon. So there's some both subtle and
Speaker 3: not so subtle symptoms of prolapse. Pelvic health is also
Speaker 3: relating to pain in the pelvis area, So we know
Speaker 3: some women with chronic pelvic pain. So women listening who
Speaker 3: perhaps might have had endometriosis chronic trauma inside the pelvis,
Speaker 3: they might also have symptoms of constipation and hypertonic pelvic flaw,
Speaker 3: so it might cause issues of further pain and a
Speaker 3: bit of a cascading effect. So there's quite a varied
Speaker 3: list I guess of reasons why we want to be
Speaker 3: aware of this area, and pelvic flaw does become a
Speaker 3: bit of a buzzword. It's not something we're really aware
Speaker 3: of before pregnancy, and it's something I wish we could
Speaker 3: teach girls when they get their periods and as part
Speaker 3: of adolescence. You know, what are the basics of a
Speaker 3: pelvic floor and how do we care for pelvic health?
Speaker 3: And that can include everything from periods and our cycle
Speaker 3: and menstruation, but also issues around There's a lot of
Speaker 3: young women that have incontinents that are perhaps runners or athletes,
Speaker 3: or have urgency. Like it's not just a condition for
Speaker 3: pregnancy and postpartum, but it does become a bit of
Speaker 3: a buzzword.
Speaker 1: Yeah, and you mentioned a hypotonic pelvic flaw and chronic pain.
Speaker 1: I'm imagining that also has part to play in sexual
Speaker 1: health and sexual dysfunction as well and satisfaction.
Speaker 3: Yeah. Yes, it's a whole other area that public floor
Speaker 3: physios treat. It's women who are perhaps having pain with
Speaker 3: intercourse pain inserting tampon as I mentioned before, the chronic constipation,
Speaker 3: which is actually stemming from overactive pelvic floor muscles. So
Speaker 3: there is a subset of women where it might not
Speaker 3: be an issue of weak pelvic floor, which I think
Speaker 3: most people are quite aware of. It's that knowledge that
Speaker 3: our public floor can get weak. But also we can
Speaker 3: have the overactive pelvic floor, and an overactive pelvic floor
Speaker 3: doesn't necessarily mean a strong pelvic floor. We can have
Speaker 3: overactive and weak pervic floor. So it can get a
Speaker 3: bit complicated. And this is where it's an internal muscle
Speaker 3: to the body, like we can't see it. It's not
Speaker 3: as easy as can't flex it like a biceps exactly.
Speaker 3: So the only way we can really work out accurately
Speaker 3: what is going on is internal vaginal assessment.
Speaker 1: Yeah, okay, and I do want to talk about who's
Speaker 1: the best person to do that assessment. But before I
Speaker 1: ask that, I really want to know some people of
Speaker 1: our society more at risk of pelvic floor injuries or
Speaker 1: poor pervict floor health.
Speaker 3: Yes, so I guess let's talk about it perhaps pre
Speaker 3: pregnancy who's room, and then we can discuss the birth
Speaker 3: side who might be at risk because they're different sort
Speaker 3: of risk factors. The women who aren't yet pregnant that
Speaker 3: might notice or might not, but they might be at
Speaker 3: a higher risk of public flaw concerns might be women
Speaker 3: as I mentioned with chronic pelvic pain, so interstititial societies, endometriosis,
Speaker 3: perhaps this and a history of abuse or trauma to
Speaker 3: the area. They are one subset of women. There is thought,
Speaker 3: and I think there's a lot of evidence and a
Speaker 3: bit more research required in this area, but there is
Speaker 3: thought that maybe athletes and women who exercise a lot
Speaker 3: might have overactive pelvic flaw. And again, when I'm saying
Speaker 3: they might have, I just mean statistically speaking. I'm not
Speaker 3: saying if you were an athlete you do have public
Speaker 3: floor I just mean you might, statistically speaking, have a
Speaker 3: higher risk of public flow issues. But that's all so
Speaker 3: that research is in its infantile stages, so that might
Speaker 3: change with time. But it also does make sense a
Speaker 3: little bit. They probably also got tight hamstrings. They probably
Speaker 3: got tight glue muscles and need to get into those
Speaker 3: hip flexes, so the similar sort of situation. And then
Speaker 3: when we're moving into pregnancy, a few things to be
Speaker 3: aware of is if your mother or if there's a
Speaker 3: strong family history of pelvic health issues post birth, So
Speaker 3: if you're pregnant, it might be worth having a chat
Speaker 3: with the women and your family, your auntie, your mother,
Speaker 3: how is your birth, Were there any significant perennial tears,
Speaker 3: Was there any significant pelvic flowed trauma that then made
Speaker 3: you need to go on to have a hysterectomy or
Speaker 3: any surgery. So that can be helpful conversation just to
Speaker 3: I guess, become aware of any potential family history.
Speaker 1: I think at the moment, kath my mom is in
Speaker 1: the early stages of dementia and I just caught up
Speaker 1: with her yesterday. She's been a very private person all
Speaker 1: her life, and with the dementia, the filter has now gone.
Speaker 1: So she's telling me all about her periods and all
Speaker 1: about the fact that she had to have a hysterectomy
Speaker 1: because of heavy bleeding, and like, I've never heard these
Speaker 1: stories before. It was such a great conversation. I'm so
Speaker 1: glad that I had it yesterday. But the hard conversation
Speaker 1: sometimes if you've got a private family member that you
Speaker 1: want to get that intel from.
Speaker 3: But it's really helpful, and historically women, we would not
Speaker 3: have been having this conversation you and I, like, historically
Speaker 3: we didn't talk about this.
Speaker 1: Who talks about accidentally weing, who talks about not being
Speaker 1: able to hold in a fart? Who talks about being
Speaker 1: fecal incontinent, Like, this is topics that we all need
Speaker 1: to start talking about because it's so common.
Speaker 3: Yeah it is. I'm also mindful though, bridget that. Yes,
Speaker 3: I absolutely agree the more we know we can become empowered.
Speaker 3: That there's also a bit of a trade off, I
Speaker 3: do feel in our day and this is going on
Speaker 3: to a whole different topic that maybe we want to
Speaker 3: get into. But with so many podcasts and so much
Speaker 3: knowledge on our doorstep with the Internet and Google, there's
Speaker 3: a lot of potential misfound fear in different things too,
Speaker 3: which I think is why it's so good to be
Speaker 3: selective of who you're listening to and what you're listening to.
Speaker 3: I guess, because it can become really overwhelming in a
Speaker 3: way that's potentially not helpful and not empowering.
Speaker 1: Yeah, I agree, so that I want to get into
Speaker 1: that too, because I want to talk about that TikTok
Speaker 1: trend that you told me about. But first, before we
Speaker 1: get to that, how about we talk about who is
Speaker 1: the right person to go to to have a public
Speaker 1: floor assessment and what does that look like and what
Speaker 1: does somebody expect from that appointment?
Speaker 3: Yeah, sure, I have I guess two categories. Yet these
Speaker 3: are some red flags. If you have any of these symptoms,
Speaker 3: I highly recommend you go and seek support. So they're
Speaker 3: the red flags that I talked about before. Any chronic
Speaker 3: pelvic pain, any chronic constipation, any leaking urine vices, wind,
Speaker 3: any urgency, having to rush to the toilet, any prolapse symptoms,
Speaker 3: any large family history, and you're feeling really anxious about it.
Speaker 3: These are women. I'd say absolutely, let's go get you assessed,
Speaker 3: have internal public floor assessment if that's appropriate for you.
Speaker 3: There's the different ways we can assess public flaw, but
Speaker 3: let's arm you with knowledge because you've got these potential
Speaker 3: risk factors. Then I've also got my what I call
Speaker 3: my gold standard that I would love all women in
Speaker 3: the world to have. And we are progressing in this area.
Speaker 3: I know in France, and I'm going ahead of myself
Speaker 3: a little bit, but in France all women now have
Speaker 3: a six week post SAD or public flow check and
Speaker 3: I'm sure we'll talk about this in a little bit,
Speaker 3: but this is so amazing, and this is part of
Speaker 3: my gold standard because we're learning more and more that
Speaker 3: there's things that we can do and be aware of
Speaker 3: that help potentially help our public floor function months, but
Speaker 3: even years and decades down the track. The research around
Speaker 3: this is evolving so rapidly, and it's such an exciting
Speaker 3: area that even what I'm saying today is different to
Speaker 3: what I've perhaps concentrated on a few years ago. And
Speaker 3: I'm sure if you're listening to this podcast a few
Speaker 3: years from now, it might have evolved even further so
Speaker 3: in terms of what I consider gold standard. And this
Speaker 3: is what I would have loved to have done myself
Speaker 3: back with my first pregnancy, which was now nearly thirteen
Speaker 3: years ago. Should I go into it? Oh, I love it?
Speaker 1: Yeah, I want to know what your gold standard is.
Speaker 3: I do just want to do a little disclaiming here.
Speaker 3: This is my personal gold standard, and I hold myself
Speaker 3: to a pretty high standard with my public floor. I
Speaker 3: am totally I'm a public floor physio. I live and
Speaker 3: breathe this every day, and I understand if this isn't
Speaker 3: everyone's gold standard, and that's absolutely fine, Like you do you,
Speaker 3: But this is me talking to myself thirteen years ago. Okay,
Speaker 3: there's five things I would want to tick off. Number one,
Speaker 3: which I did tick off, which is great to tick off,
Speaker 3: but it's exercising during pregnancy. And I don't mean exercising
Speaker 3: public floor, I mean all exercise, because we know that
Speaker 3: exercising during pregnancy is one of the best things we
Speaker 3: can do to help with your public floor function postpartum.
Speaker 3: So getting out there and walking, doing what you normally like.
Speaker 3: You know, it's going to the gym, bloody is whatever
Speaker 3: lights you up and it's appropriate for you during pregnancy
Speaker 3: is fantastic.
Speaker 1: Absolutely, you know, And it's something that if you start
Speaker 1: during pregnancy, if you haven't been an exercise to start
Speaker 1: during pregnancy, you know that routine, that habit that's been
Speaker 1: formed that can go on to after pregnancy and beyond.
Speaker 1: It's just a life skill, but it's so important in pregnancy.
Speaker 3: Yeah.
Speaker 1: Absolutely, I didn't quite take that off in my first pregnancy.
Speaker 3: I wish I had. It doesn't matter, But the thing is,
Speaker 3: and I guess the elephant in the room is I
Speaker 3: ticked it off in my first pregnancy. But with my
Speaker 3: second pregnancy, when I had public girdle pain, that was
Speaker 3: a whole other story. And I know women are exhausted,
Speaker 3: women get achy and sore, women get nauseous. It's not
Speaker 3: always simple and easy to just drop that an exercise
Speaker 3: Like here, I am saying, yeah, let's just exercise during
Speaker 3: pregnancy easy, but I one hundred percent no, firsthand, it
Speaker 3: can be challenging. This is where we need to be
Speaker 3: adaptable and work out what's right for us in our lifestyle,
Speaker 3: in our stage of our life and pregnancy. So sure,
Speaker 3: it might not be the sixty minute workout that you
Speaker 3: used to do at the gym. Might be five minutes
Speaker 3: of beautiful stretches in the sunshine in the back guarden.
Speaker 3: If you're feeling nauseous, you know something that can help
Speaker 3: to revive our body and replenish our body rather than
Speaker 3: deplete it. Further, I could talk all day about that,
Speaker 3: So I will move number two. Okay, number two. I
Speaker 3: would recommend a pelvic floor assessment in the third trimester,
Speaker 3: early third trimester, so about thirty two thirty three, you know,
Speaker 3: thirty four weeks. This assessment. It's like a preparing for
Speaker 3: birth assessment. So this would be with a public floor assessment,
Speaker 3: and if it's appropriate for you, it'd be a vaginal
Speaker 3: public floor and internal public floor assessment. And the benefit
Speaker 3: of this is, apart from looking at all the issues
Speaker 3: with aches and pains and whatever else is going on.
Speaker 3: But from a public floor perspective, we can a make
Speaker 3: sure you're doing a public floor muscle exercise correctly. And
Speaker 3: that sounds basic, but we know from research there's quite
Speaker 3: a few women out there there's quite a high percent
Speaker 3: actually not or you're actually pushing down and doing opposite.
Speaker 3: As I said at start, they're an internal muscle to
Speaker 3: the body, Like, how do we know?
Speaker 1: And actually with our physio at work. After my third
Speaker 1: baby was the first time that I had any involvement
Speaker 1: from a physio in any of my pregnancies. First time listener, No,
Speaker 1: Pat didn't neglect me. He wasn't around the first time
Speaker 1: and second time, so third pregnancy, he's like off to
Speaker 1: the physio. And the physio taught me that I was
Speaker 1: actually bearing down and she showed me an ultrasound that
Speaker 1: I was bearing down when I was trying to do
Speaker 1: my This is postpartum bearing down trying to do my
Speaker 1: public floor exercises.
Speaker 3: Interesting, isn't it? Were you surprised?
Speaker 1: I was surprised because I love sport and I love
Speaker 1: exercise and actually thought I knew my body pretty well.
Speaker 1: So when I could see that visual, I was like, oh,
Speaker 1: I had.
Speaker 3: It pretty quickly, like did you get the hang of it? Yeah?
Speaker 1: And it's that feedback, so she was able to say, no, Bridget,
Speaker 1: I want you to squeeze here, put here, pull here,
Speaker 1: you know, like you know, I can't remember. It was
Speaker 1: a long time ago now, but like it was enough
Speaker 1: for me to go, Okay, I know where which muscle
Speaker 1: I'm trying to contract here now? Yeah.
Speaker 3: Yeah, it's powerful. And when we think about preparation for birth,
Speaker 3: if you're having a vaginal birth, do you have the
Speaker 3: birth canal to be like open and relaxed or zipped up,
Speaker 3: closed and tense. So we really want those muscles, because
Speaker 3: the muscles are at the base of the birth canal,
Speaker 3: we really want them to be relaxed and open to
Speaker 3: just give way, let the baby come through the birth canal, uninterrupted, unimpeded.
Speaker 3: And having that ability to understand this is how I
Speaker 3: relax my muscles. You'd much prefer to learn about that
Speaker 3: a few months before your birth rather than on the
Speaker 3: day in the moment. Yeah, absolutely, all the other factors
Speaker 3: going on.
Speaker 1: Absolutely all right, So your third gold.
Speaker 3: Standard, third gold standard, So at that appointment we can
Speaker 3: discuss early couple of weeks postpartum and how to look
Speaker 3: out public floor and the first pooh after the birth
Speaker 3: and all those sorts of things. And then the next
Speaker 3: part it would be of the two week online the
Speaker 3: telehealth checking with your physio who you saw during pregnancy,
Speaker 3: because then you can talk through how the birth went,
Speaker 3: if there was any potential pelvic flawed trauma, you know,
Speaker 3: you can talk them through any paraneal tears, if there
Speaker 3: was any four slips, a pisiotomy, any pain postpartum, you
Speaker 3: can talk through any concerns, and then the physio can
Speaker 3: tweak her recommendations to you to get you through with
Speaker 3: a six week postnatal check, which is my fourth part,
Speaker 3: my gold standard. So at that six week postnatal check,
Speaker 3: that would be preferably. Again, it depends if you've had
Speaker 3: a cesarean, you've got no symptoms, no concerns, no family history,
Speaker 3: nothing at all. I would quite often do a transa
Speaker 3: abdomal ultrasound quick little check. Is that what you had bridgid?
Speaker 1: Yes?
Speaker 3: Yeah, yeah, And that can give a really nice visual.
Speaker 3: So that's the probe on the tummy muscles and you
Speaker 3: can have a nice visual on the screen. If you
Speaker 3: lift a public floor or relaxing. If someone's had a
Speaker 3: vaginal birth, on recommendation could include an internal public floor
Speaker 3: assessment similar to what you had at the thirty two
Speaker 3: thirty three week mark, and then we can in great
Speaker 3: deal assess let me if there's any prolapse, if there's
Speaker 3: any tears, how the public flow is. So many elements
Speaker 3: to that public floor assessment that I won't necessarily go
Speaker 3: into detail, but what that can do is really help
Speaker 3: to guide you with your postnatal rehab because there are
Speaker 3: some conditions, for example, that we don't necessarily want to
Speaker 3: be doing heaps and heaps of pelvic floor strengthening. And
Speaker 3: this is quite new research coming to light that I
Speaker 3: was talking to you about a few days ago, where
Speaker 3: it's still in its infantile stages, and so I'm a
Speaker 3: little bit cautious, I guess, discussing this research. But there's
Speaker 3: a shift happening, and I'll try to explain it. To
Speaker 3: take a step back, if we had an achilles tear,
Speaker 3: like a tear in a muscle in our calf or foot,
Speaker 3: you'd be unlikely to be recommended to do really strong
Speaker 3: calf strengthening exercises in that six week postnatal period. Probably
Speaker 3: couldn't exactly exactly if there's any injury to the muscle
Speaker 3: or whether muscle's you know, coming away from the bone,
Speaker 3: you would be encouraged to rest. You know, let's let
Speaker 3: that healing happen, that natural recovery, and then once that
Speaker 3: natural recovery has occurred, let's start some gradual strengthening exercises.
Speaker 3: So if we don't know what is happening inside with
Speaker 3: our muscles and our tendons and inside that air after
Speaker 3: our vaginal birth, we can't really guide you whether or
Speaker 3: not you to back off on your public floor exercises
Speaker 3: or you know, you're good to go, let's get you
Speaker 3: started with this you know, good strengthening program. That's where
Speaker 3: that for me, that gold standard really comes in. And
Speaker 3: I really hope Australia follows in the footprint of France
Speaker 3: and offering all women a public floor six week post
Speaker 3: natal check.
Speaker 1: Yeah, and that speaks to the title of this episode,
Speaker 1: which is stopped not everybody should be doing public floor
Speaker 1: strengthening exercises. So you're recommending that people should know before
Speaker 1: they start doing the strengthening exercises after birth.
Speaker 3: Yeah, And it's what we said at the start. It's
Speaker 3: being empowered to know what are my steps for my
Speaker 3: personal journey, Like we all have different journeys and pregnancy
Speaker 3: and postpartum like so varied cesarean vaginal like it's just
Speaker 3: it's limit as you know, like it's endless, all the
Speaker 3: different ways our birth can transpire. So to know what
Speaker 3: your steps are for recovery, it's so amazing. And the
Speaker 3: women that I see that feel the strongest and you know,
Speaker 3: the happiest, and they've reached their postnatal rehab goals. And
Speaker 3: they're not necessarily runners, you know, they could just be
Speaker 3: wanting to be pain free, able to run around with
Speaker 3: their kids at the park, you jump on the trampoline
Speaker 3: with their kids, Like it doesn't need to be these
Speaker 3: big grand goals. But the women I see who are
Speaker 3: achieving their goals are those that had the plan, they
Speaker 3: did the work, they did the rehab. Sure like rehab.
Speaker 3: And this is similar to the whole pregnancy exercise side
Speaker 3: of things. Right, it's all well and good for me
Speaker 3: to say, let's do exercise during pregnancy. It's the same
Speaker 3: without postnatal rehab, which is a fifth part of my
Speaker 3: gold standard. But we've got a newborn, we might have
Speaker 3: toddlers running around. We might have, you know, breastfeeding issues,
Speaker 3: an unsettled baby, and there's obviously the sleep depora. There's
Speaker 3: a lot of reasons that we might not be able
Speaker 3: to necessarily prioritize our rehab and that's fine. That's that
Speaker 3: knowing what you can do to help guide that in
Speaker 3: your own time, at your own trajectory, I think it's
Speaker 3: really powerful.
Speaker 1: And I think that one thing that I still struggle with,
Speaker 1: and like I have a twenty one year old, I
Speaker 1: also have a twelve year old. But the one thing
Speaker 1: that I struggle with is feeling okay to do that.
Speaker 1: I still have a level of mother guilt when I
Speaker 1: take myself out of the family picture and go and
Speaker 1: do my gym or walk or whatever it is. And
Speaker 1: I think that you set expectation as a mum of
Speaker 1: a newborn. You set that expectation that everybody is expecting
Speaker 1: you to go and do your self care exercise, Like,
Speaker 1: just do that from the stuff that is what I
Speaker 1: wished I had have done. And the guilt that you
Speaker 1: feel is the guilt that you have that nobody else
Speaker 1: is thinking about it, thinking good on bridget for going out.
Speaker 3: And doing some exercise.
Speaker 1: The kids love it when I come back from the
Speaker 1: because I've got a little lindorphin Russian and they go, yeah,
Speaker 1: Mum's back from the gym. So you know, there's no
Speaker 1: one saying that I'm neglecting them. It's me. It's this
Speaker 1: mother guilt.
Speaker 3: I'm also going to flip that and let's actually stop
Speaker 3: the guilt of not exercising too. Ah. Yeah, so many
Speaker 3: women that they message abound on Instagram. Oh my gosh,
Speaker 3: six months postpartum. You know, I haven't been able to
Speaker 3: do anything yet, any exercise. And that's okay too. Like
Speaker 3: we all have our starting points and we just build
Speaker 3: from there. And I think if we can take away
Speaker 3: that guilt, motherhood guilt, you know, it doesn't matter what
Speaker 3: you do.
Speaker 1: Know either side. I just think if you wake up
Speaker 1: that morning, you get a chance to recommit to excellence,
Speaker 1: whatever your excellence looks like. That might be, you know,
Speaker 1: being able to wash your hair for the day, but
Speaker 1: that's what it is.
Speaker 3: Like. Every day is a new day.
Speaker 1: And the person who taught me that was my nineteen
Speaker 1: year old because I was doing that exact thing, I
Speaker 1: was like, oh god, I haven't been to the gym.
Speaker 1: Goes it doesn't matter, Mom, Tomorrow's a new day. You
Speaker 1: get to recommit, isn't it lovely? Yeah? I mean he's
Speaker 1: my cheerleader. Yep. Absolutely, so a gold standard, cath Bequi's
Speaker 1: gold standard for a pelvic floor rehabilitation. It's setting up
Speaker 1: a habit for a lifetime because you know, a lot
Speaker 1: of our listeners they're coming into pregnancy in their later thirties,
Speaker 1: maybe forties, maybe they're having their second and they're forty.
Speaker 1: They're sort of teetering on the edge of perimenopause as well,
Speaker 1: So that is another life stage, isn't it for your
Speaker 1: pelvic floor?
Speaker 3: Absolutely? And I should have said that as one of
Speaker 3: the risk factors as well. You know, with age, we
Speaker 3: are more likely to have public floor issues. So if
Speaker 3: we are, you know, getting to that stage, then maybe
Speaker 3: that's another reason to add a public floor assessment to
Speaker 3: your to do list. But also I'm just wary that
Speaker 3: there might be a lot of women listening who are
Speaker 3: second time pregnant or further down the track and haven't
Speaker 3: had one. And again, forget the mum guilt, don't worry
Speaker 3: about Tomorrow's a new day. What can we do moving forwards?
Speaker 3: Like women haven't been having public floor assessments for thousands
Speaker 3: of years. Like it's okay, but let's just get a
Speaker 3: plan moving forwards.
Speaker 1: Yeah, exactly. Now I want to talk about this TikTok trend.
Speaker 1: Tell me what is it.
Speaker 3: It's amazing. Okay, I'm blown away. I'm not a huge TikToker.
Speaker 3: I do have to say I'm perhaps a little bit
Speaker 3: old for that. But having said that, I have been
Speaker 3: on Instagram and TikTok doing coulic floor exercises for quite
Speaker 3: some time, and then about twelve months ago, I thought, oh,
Speaker 3: not everyone wants to keep hearing me do these public
Speaker 3: floor exercises, and I get even a bit of a break,
Speaker 3: and then I've started back up again. I don't know
Speaker 3: whether maybe it's just because I'm now being hit with
Speaker 3: them with a good old algorithm, but there's some public
Speaker 3: flow reels that have got millions and millions of views,
Speaker 3: and now I think this is fantastic because it's raising
Speaker 3: awareness for public flow and it's brilliant, and they have
Speaker 3: a bit of motivation and a bit of a bit
Speaker 3: of a kick to do some public floor But that's
Speaker 3: why I created this podcast episode on my podcast, because
Speaker 3: I just want to just give a little bit of
Speaker 3: a warning signal that Okay, this might be fantastic, but
Speaker 3: there are a group of women where perhaps it's not
Speaker 3: the best thing at this stage of your life for
Speaker 3: you at this time.
Speaker 1: Good. I hope that message has got through. So those
Speaker 1: it's a visual of someone like doing a pelvic floor
Speaker 1: sort of movement or something, is it? Yeah, there's and
Speaker 1: it's doing within a time frame. Yeah, okay, all right.
Speaker 1: So if someone's seeing that and going, my I need
Speaker 1: to do my pervic floor exercises right now, you're saying,
Speaker 1: just stop. What stage of life are you at? Yep?
Speaker 1: How's your it's.
Speaker 3: A public floor. Any symptoms that we discussed, any family
Speaker 3: history that we discussed, have you had any? But you
Speaker 3: know the birth PUBLC floor concerns that we discuss, like
Speaker 3: where are you at with your pregnancy postpartum stage and
Speaker 3: is it possible would you like to go and have
Speaker 3: it vaginal public floor assessment doesn't have to be vaginal.
Speaker 3: There's lots of ways weakn access to pelvic floor, but
Speaker 3: do you think it might be worth having public floor
Speaker 3: assessment before you get stuck into all these pelvic floor
Speaker 3: exercises that you're finding out on social media.
Speaker 1: Yeah, perfect, all right, So I love your five points
Speaker 1: to your gold standard, And if anyone wants to hear
Speaker 1: about that in more fleshed out detail, hopover to Kat's podcast.
Speaker 1: I'll put the links into the show notes. But for
Speaker 1: those people who perhaps don't have access to the gold Standard,
Speaker 1: and we know that there are lots of people, and
Speaker 1: let's say that the only access they get is they're
Speaker 1: still in the hospital life baby has been born. What
Speaker 1: is the most important question they could ask their midwife, obstetrician, physiotherapist,
Speaker 1: whoever it is that is there with them about their
Speaker 1: pelvic floor law? Do you think if that's the only
Speaker 1: health professional that they're going to be around, and it'd
Speaker 1: be a sad state of affairs, But you know, sometimes
Speaker 1: that is the case.
Speaker 3: Oh that's such a great question, So i'd probably possible.
Speaker 3: How was my birth because sometimes and I was the same.
Speaker 3: I had no idea my first berth I did have
Speaker 3: a tear and they gave me a few stitches, but
Speaker 3: when I went back to the ward, I had no
Speaker 3: idea what sort of tear. I had no idea, So
Speaker 3: I didn't know if it was in first, second, third, fourth,
Speaker 3: So I think let's find out. There's a lot of
Speaker 3: women that I see in the clinic that come and
Speaker 3: see me for an assessment, and when I ask about
Speaker 3: any tares, they don't know what degree tair they had,
Speaker 3: like what type of tear. And I think that can
Speaker 3: be really powerful because we know like first and second
Speaker 3: degree tears, for example, lower risk of long term issue.
Speaker 3: Third and fourth degree tare. Okay, perhaps we need to
Speaker 3: pay this bit of attention because there is slightly larger
Speaker 3: risk of longer term you know, concerns with those public
Speaker 3: issues that I talked about. That would be one question
Speaker 3: for the birth team. And then if I could have
Speaker 3: one more question another great.
Speaker 1: For this is a hypothetical world.
Speaker 3: Why not pathetical, But if you've got any concerns about
Speaker 3: your bowels in those early days, ask your healthcare team.
Speaker 3: Perhaps you need a stool soft now, because it's not
Speaker 3: a stage you want to be straining on your pelvic
Speaker 3: floor like we discussed a little bit earlier. This is
Speaker 3: a stage we really want these muscles to relax. They've
Speaker 3: just had stretch. They stretch up to three hundred percent
Speaker 3: their length, beautifully built for the job of you know,
Speaker 3: stretching out for the baby. To come through. But what
Speaker 3: we want now in the postpartum period is that natural
Speaker 3: recoil to occur. We want that natural recovery to occur
Speaker 3: as much as possible, because it's not just about muscles
Speaker 3: that we want to recover. It's attendons and the ligaments
Speaker 3: and all the soft tissue connective tissue, and that really
Speaker 3: does just take time. And that's why we discuss that,
Speaker 3: you know, six the magical six week mark, which might
Speaker 3: not be the magical six weeks, but that's the sort
Speaker 3: of time frame that we give at the moment, but
Speaker 3: especially in those first few days, that's when we do
Speaker 3: want to try to avoid constipation if we can. And
Speaker 3: there's a few little oh, this is going on to
Speaker 3: a whole other topic, yes, Bridgid, but a few little
Speaker 3: quick tips for you know, you can ask the healthcare
Speaker 3: team about passing your first bow motion because you might
Speaker 3: even need to give support to the area. You know,
Speaker 3: wrap up some paper towel on, some toilet paper on
Speaker 3: your hand, and if you place that at the front
Speaker 3: of your peraneum, like at the front of your palvis.
Speaker 3: And I know this is a podcast and here I
Speaker 3: am doing the visual on the camera, but if you
Speaker 3: can place it at the front whilst you're opening your bows,
Speaker 3: then that sort of can really give a sense that
Speaker 3: everything's not heading south and I can relax and then
Speaker 3: you can relax your public floor muscles to allow the
Speaker 3: bow motion to come through. Whereas if you're sitting on
Speaker 3: the toilet thinking, oh my gosh, everything's heading south, Yeah,
Speaker 3: that can actually increase constipation. So having that pressure or
Speaker 3: that gentle support with your hand can be really that
Speaker 3: first bowl motion good.
Speaker 1: Okay, so your two questions were just to recap. One,
Speaker 1: ask your birth team and ask them about, you know,
Speaker 1: what happened to your pelvic floor, if you had any tearing.
Speaker 1: And your second is if you've got any issues with
Speaker 1: your bows after birth. But I know he really likes
Speaker 1: women to have passed their first bowel motion in the hospital.
Speaker 1: But people are staying less and less time now, so
Speaker 1: sometimes that doesn't happen. But you know, make sure that
Speaker 1: you talk to them about perhaps getting some stool softness.
Speaker 3: But whatever is appropriate for that, yeah, whatever.
Speaker 1: Yeah, is it important to know, like you might lose
Speaker 1: track of time, Like, is it important to know how
Speaker 1: long you've been pushing for.
Speaker 3: That is another risk factor for pebvic floor issues, So
Speaker 3: that could be a question for your birth team, like
Speaker 3: was it under ninety minutes versus over ninety minutes? Again
Speaker 3: that it's about ninety minutes, it tends anything more than
Speaker 3: that perhaps is a bigger increased risk of public floor
Speaker 3: issues to be aware of.
Speaker 1: I remember when my obstetric came into you see me
Speaker 1: after and midwives see me after the birth. It was
Speaker 1: just lovely, doubly like they were just it's the baby cute,
Speaker 1: and oh you did so well. I look at you,
Speaker 1: and let me look at the scar. And I wish
Speaker 1: that perhaps I had, particularly my first birth, which was
Speaker 1: an emergency Caesar and the second, which was a feedback
Speaker 1: that didn't proceed, so I probably would have asked more
Speaker 1: questions like use that time. This is the time for
Speaker 1: you to ask your birth team, Hey, what was my
Speaker 1: birth like? Because honestly, you sort of lose track of
Speaker 1: exactly what happened, and maybe your birth partner didn't keep
Speaker 1: notes either, So use it. It's not just about giving
Speaker 1: the babylake little smiles and that's cute too, but like,
Speaker 1: use it to your advantage.
Speaker 3: Absolutely, what was my birth like? And what can I
Speaker 3: do now to help support my recovery.
Speaker 1: Perfect done.
Speaker 3: Love it.
Speaker 1: Kath, Thank you so much for joining us today. I
Speaker 1: love talking to you about before. More people aroused at
Speaker 1: the conference must have been going, oh my god, those
Speaker 1: two are talking about pause again.
Speaker 3: But love it.
Speaker 1: Thank you for sharing your knowledge and your expertise on
Speaker 1: our podcast.
Speaker 3: Always a pleasure. Thanks so much for having me back
Speaker 3: bridget our pleasure.
Speaker 1: I hope you enjoyed today's episode. I particularly like how
Speaker 1: Cather reminds us to focus on being overall physically fit.
Speaker 1: And if you need help to do this because you
Speaker 1: either have an issue like pulvic girdle pain or you
Speaker 1: have a goal to remain injury free during your pregnancy,
Speaker 1: you can join Kat's online program. It's really worth it.
Speaker 1: We highly recommend it, and I'll put the link in
Speaker 1: the show notes if you're looking for it. It's called
Speaker 1: Fit Nest Mama. Okay, that's it for today. Thank you
Speaker 1: so much for joining us. Thank you for your amazing feedback,
Speaker 1: sharing our show with your friends and family, and your
Speaker 1: fantastic topic suggestions. We love them so much and it
Speaker 1: helps to form content that we know is really relevant
Speaker 1: to you. We'll be back in your ears next week.
Speaker 1: Until then, keep well life and our.
Speaker 2: Hey.
Speaker 1: Even though doctor Pat is well a doctor and we
Speaker 1: get lots of other doctors and other experts on our podcast,
Speaker 1: I just need to remind you that this podcast is
Speaker 1: for informational purposes only. We share lots of medical insights
Speaker 1: and experience, but everything we talk about is general in
Speaker 1: nature and may not apply to your specific situation. Please
Speaker 1: always consult with your own healthcare provider for your individual
Speaker 1: medical advice. When you grow your baby