Speaker 1: Who baby A baby? I need you, Oh how I
Speaker 1: need you? What to expect? As a production of I
Speaker 1: Heart Radio, I'm your host Heidi Murkoff, and I'm a
Speaker 1: mom on a mission, a mission to help you know
Speaker 1: what to expect every step of the way. Let's face it,
Speaker 1: your vagina is a pretty amazing organ and it is
Speaker 1: built to take it snug enough to slip a tamp on,
Speaker 1: in elastic enough to accommodate a baby's exit. But even
Speaker 1: if your baby arrives via c section, your vagina, not
Speaker 1: to mention, your paraneum and your pelvic floor muscles can
Speaker 1: take a hit during pregnancy and childbirth. Enter the vagina
Speaker 1: Whisperer Sarah Reardon. She's a pelvic floor physical therapist and
Speaker 1: she specializes in tender, loving care of your entire pelvic floor.
Speaker 1: Last week she was here on what to Expect, to
Speaker 1: talk about your pregnancy aches and pains, and how to
Speaker 1: prepare for birth. Today she's back to talk us through
Speaker 1: postpartum recovery. What will your recovery look like and how
Speaker 1: can you make it easier? Encourage healthy healing, come about
Speaker 1: a whole new set of aches and pains. Help you
Speaker 1: regain bladder control, go back to pooping as usual, get
Speaker 1: moving again, and what about sex? Does that have to
Speaker 1: be a four letter word postpartum? Sarah, welcome back, Thank
Speaker 1: you hiding. I'm so excited to be here again. So
Speaker 1: I guess we've delivered our baby. Now we have to
Speaker 1: find out what we do postpartum to nurture ourselves, because
Speaker 1: it's not all about the baby, it's about nurturing yourself
Speaker 1: as well. And I feel like there's a reason why
Speaker 1: we've changed the pregnancy timeline a bit, the traditional one
Speaker 1: that talked about three trimesters and then you have a
Speaker 1: six check up and then you're done. But pregnancy really
Speaker 1: is more of a for trimester process because recovery takes time.
Speaker 1: There are huge benefits to caring for your pelvic floor
Speaker 1: during pregnancy. But you say many patients don't show up
Speaker 1: at your door or virtual door until after they've delivered.
Speaker 1: Is it like better late than never? It's any time
Speaker 1: is a good time. So whether it's you know, days postpartum,
Speaker 1: we have folks calling us asking about taking their first
Speaker 1: postpartum poop or six weeks when they're returning to sex
Speaker 1: and exercise, or even later down the line. But it's
Speaker 1: always better late than never. And I think that oftentimes
Speaker 1: we think if we're out of the fourth trimester, then
Speaker 1: our healing should be done, that our postpartum period is over.
Speaker 1: But you and I both know that it really lasts forever.
Speaker 1: And there's just I think, such little care for moms postpartum,
Speaker 1: and we don't even know what care we need sometimes
Speaker 1: that we didn't even know where to start getting it
Speaker 1: on are the most common symptoms that bring new moms
Speaker 1: in to see you? So I would say some of
Speaker 1: the most common ones are urinary leakage. So that may
Speaker 1: be leakage with a call for a sneeze, running after
Speaker 1: a kiddo getting out of a chair too, or it
Speaker 1: may show up later when they are returning to exercise
Speaker 1: and they're starting to run and do jumping jacks. I
Speaker 1: think oftentimes we think, oh, it's going to happen a
Speaker 1: little bit in the beginning, but it'll get better. And
Speaker 1: research is really showing that a lot of folks who
Speaker 1: are experiencing leakage at three months postpartum may still be
Speaker 1: experiencing it at twelve months postpartum, So it doesn't necessarily
Speaker 1: just go away. If anything, we become more active when
Speaker 1: we start doing more and it could potentially get worse.
Speaker 1: So that's a common one. Another really common one is
Speaker 1: painful sex. That's kind of a scary one to enter
Speaker 1: back into. And you know, six weeks is this kind
Speaker 1: of arbitrary timeline that's come up with. I tell you know,
Speaker 1: my patients, it's totally fine to wait longer. There is
Speaker 1: no rush. But some things to think about are you
Speaker 1: may have vaginal dryness if you are lactating, you may
Speaker 1: have some scar tissue in the area that could cause pain.
Speaker 1: You may have experienced trauma during birth that really could
Speaker 1: be affecting your intimacy or your muscle tension. So that's
Speaker 1: a really big one that I think you'd like to
Speaker 1: address with moms. And then lastly, probably you know cesarean
Speaker 1: scar restriction, cesarean scar pain. Moms are having cecerean births
Speaker 1: these days, and there's no follow up on how do
Speaker 1: I manage my scar? What if it's painful? What does
Speaker 1: it feel fuzzy or uncomfortable when I'm wearing pants? And
Speaker 1: we do a lot of cesarian recovery as well, what
Speaker 1: is your timeline for recovery, Like when do you feel
Speaker 1: if I don't if I don't feel good by now,
Speaker 1: something's wrong and I need to come to see you.
Speaker 1: In my ideal vagina world, I would see all folks,
Speaker 1: usually everyone I know. Hopefully we will live in that world,
Speaker 1: but I would see everyone for at least one visit
Speaker 1: POSTPARTU to say, looks good, you're doing this exercise properly,
Speaker 1: a everything looks like it's great and healing, carry on.
Speaker 1: Or to say there is a little bit of weakness here,
Speaker 1: a little bit of prolapse, a little bit of scar massage.
Speaker 1: Let's work on that. So around six weeks, we'd like
Speaker 1: to see them. I think if by twelve weeks you're
Speaker 1: still experiencing pain, leaked pressure, abdominal weakness, discomfort, I would
Speaker 1: go in and start seeing a physical therapist around that
Speaker 1: twelve week mark. So the O B is going to
Speaker 1: the midwife, is going to see you at six weeks,
Speaker 1: should we also come in to see you at that
Speaker 1: six weeks. That's when we ask our clients to come in.
Speaker 1: After they kind of get their medical clearance of everything
Speaker 1: looks good, You're good to return to normal, we have
Speaker 1: them come in to see us. Sometimes, you know, the
Speaker 1: very next day or within that week to get them
Speaker 1: started back to exercise, sex, living their daily lives. I
Speaker 1: mean we kind of get that sums up to like
Speaker 1: go back to your normal life, but like nothing is
Speaker 1: normally what is normal? And physically we haven't been rehabilitated,
Speaker 1: So how do we just go back to normal now?
Speaker 1: And if anything, it will be a new normal, but
Speaker 1: hopefully ultimately a better new normal with our help. UM,
Speaker 1: So let's get into a little detail about that first
Speaker 1: poop that you mentioned, because I gotta say it comes
Speaker 1: with a lot of dread, understandably, especially if you've had stitches,
Speaker 1: But even if you had a C section, you're still
Speaker 1: stressed out about that first poop. In fact, having a
Speaker 1: c section all that medication can make you more constipated,
Speaker 1: and also you're moving less, which can make you more constipated.
Speaker 1: So this too, shall pass, but how do we make
Speaker 1: it pass more easily? Initially? That's um one of the
Speaker 1: most common things I like to address with moms because
Speaker 1: we don't even especially first time mom, they don't even
Speaker 1: realize that that first poop might be an issue. So
Speaker 1: the number one thing I tell folks is to take
Speaker 1: a stool softeners so you have blood loss you have dehydration,
Speaker 1: you're in pain, whether you've had a vaginal or cesarean birth,
Speaker 1: and taking those stool softomers will help keep your poops
Speaker 1: off so that it's not really hard and difficult to pass.
Speaker 1: And also tons of hydration. Your milk maybe coming in again.
Speaker 1: You've got blood loss and dehydration, so making sure that
Speaker 1: you're really pushing the fluids the first two weeks and
Speaker 1: even after that. The other things are is to use
Speaker 1: a squatty potty. So we touched on this a little
Speaker 1: bit in our first chat together. But putting your feet
Speaker 1: up on a stool or a box or whatever you have.
Speaker 1: You know, in the hospital, I turned the garbage can
Speaker 1: sideways and put my feet on it so that I
Speaker 1: could help my hips relax a little bit. Getting into
Speaker 1: that squatting position helps relax your pelvic floor so that
Speaker 1: you can poop. And those hospital toilets are high. You know,
Speaker 1: there's a little travel squatty potty that you can literally
Speaker 1: pack up and bring in your hospital back. I'm like,
Speaker 1: we need to rethink the hospital bag because we need
Speaker 1: pelvic floor support for moms in there. What are we bringing, Oh,
Speaker 1: we're bringing a travel squatty potty. We're bringing a little
Speaker 1: peribottle with a curve nozzle so that it's a little
Speaker 1: more sophisticate it in the hospital ones. I love compression
Speaker 1: garments that aren't waste trainers, but give moms a little
Speaker 1: support for swelling and healing. The ice pack always an
Speaker 1: ice pack. I love an ice pack. Um, and I
Speaker 1: tell folks to ice even after they get home from
Speaker 1: the hospital the first week, so um, the stool softeners,
Speaker 1: the stool under their feet, and then when they're pooping,
Speaker 1: it actually encourage them to use their hand to support
Speaker 1: the parenneum. So that area vaginally and at the pareneum,
Speaker 1: whether you've had a tear or not, can be really
Speaker 1: vulnerable and we're trying to like push something out, So
Speaker 1: I tell them to take their hand and kind of
Speaker 1: hold up the volver and pyneal area as they bear
Speaker 1: down to poop. And if you've had a cesarean birth,
Speaker 1: to put a pillow over your tummy and hold that
Speaker 1: area when you're trying to have a poop. So just
Speaker 1: kind of protecting those really vulnerable areas when you're trying
Speaker 1: to exhale and bear down to empty the balls. And
Speaker 1: clearly your hands are clean or actually you can use
Speaker 1: toilet paper, I tell me up over their hand. That's
Speaker 1: a good tip, great, great clarifica, no thanks. I really
Speaker 1: appreciate your poop PEP talk. We all need it sometimes.
Speaker 1: So on two P. The first time you pee, you
Speaker 1: may feel like it's kind of hard to because your
Speaker 1: bladder might feel paralyzed. You might need some encouragement. I always,
Speaker 1: you know, use the running water and you know, warm
Speaker 1: water over your paraneum. Um. What are some things you
Speaker 1: can tell us about that first P and subsequent peace
Speaker 1: and how to keep them healthy? Right, So the very
Speaker 1: first P, I think is a big one. That you
Speaker 1: kind of feel a little bit frozen down there. And
Speaker 1: so that's the experience that I had, And I had
Speaker 1: to get into the shower and let warm water run
Speaker 1: over me, and that warmth and that water running kind
Speaker 1: of helps you relax a little bit and then pan
Speaker 1: a shower. Everybody, it's a great place to pee. It's
Speaker 1: a totally fine, safe place to pe um. But when
Speaker 1: you're in the hospital you can do that and then
Speaker 1: also taking some just big deep breath, really not having
Speaker 1: mom's push when they p. We want those big deep
Speaker 1: breasts to help the muscles relax and then the bladder
Speaker 1: can push the p out for them. Um. That's if
Speaker 1: they're standing or sitting. And then again if they're sitting
Speaker 1: over the toilet or sitting on the toilet, having a
Speaker 1: little stool or support under their feet to help them
Speaker 1: relax because those toilets are high. And then I even
Speaker 1: tell moms that they're really you know, not able to
Speaker 1: start their stream. Another thing for their hospital back to
Speaker 1: keep peppermint essential oil in their hospital back and you
Speaker 1: put ten or twenty drops of that in the toilet
Speaker 1: water and then you sit over that and the aroma
Speaker 1: or the fumes kind of stimulate the urine area sphincter
Speaker 1: to relax a little bit. So all of these just
Speaker 1: things to help options so that you don't end up
Speaker 1: getting right to a catheter. But you have some tools
Speaker 1: to help facilitate relaxation. But if you've had a catheter
Speaker 1: because you had an epidural, that's going to make it
Speaker 1: even harder, right, And so that's why you really want
Speaker 1: to work on the they'll take that catheter out, you
Speaker 1: still want to work on the breathing, maybe the running water,
Speaker 1: maybe the peppermint drops in the toilet water. All things
Speaker 1: to really facilitate relaxation of that pelt floor. And also
Speaker 1: it's it's hard to be lying down, isn't it. I
Speaker 1: mean if they give you a bad pan. So bladder control,
Speaker 1: we talked a lot about that because it's an important topic.
Speaker 1: Can you regain it after you've lost it? Yeah, I
Speaker 1: mean I think it's variable depending on kind of the
Speaker 1: level the extent of loss of bladder control. So which
Speaker 1: will you know, typically present like urinary leakage, And that's
Speaker 1: one of the things is that a lot of moms
Speaker 1: one of two things happens after you give birth is
Speaker 1: that you can't pee at all, where you get up
Speaker 1: from the bed and like water gushes out and you're like, wait,
Speaker 1: I already had the baby. That's not my water breaking,
Speaker 1: and it's your bladder, right, it's your bladder leaking. And
Speaker 1: you've got a lot of urine loss because the muscles
Speaker 1: are just tired. So it's one of those things that
Speaker 1: after the first two or three weeks it should get better.
Speaker 1: But you know, working on strengthening those muscles, reconnecting with
Speaker 1: those muscles can definitely help you improve bladder control over time. Okay,
Speaker 1: that's a good news, and if not, they should definitely
Speaker 1: see a pelvit for therapists. Correct, don't wait, don't wait
Speaker 1: for it to get better, right, don't wait, just go
Speaker 1: ahead and go. I mean I say that all the time,
Speaker 1: like if we have, you know, I think of all
Speaker 1: the appointments I have. When you know, COVID ended, I
Speaker 1: was like, I'm getting my hair done, I'm getting my
Speaker 1: nails done, getting my eyebrows done, and like go see
Speaker 1: your public four therapists, like put that on your list
Speaker 1: of things you want to do after baby is born
Speaker 1: as well. Absolutely. Okay, So let's talk about some recoveries specifics,
Speaker 1: which are going to be different depending on how your
Speaker 1: baby has arrived, whether it was your first baby or
Speaker 1: your fourth baby. Maybe how hard or how easy, or
Speaker 1: how long or how short your labor and delivery were,
Speaker 1: how much pushing you did. So from your perspective, what
Speaker 1: are the most important things a woman should know if
Speaker 1: she's recovering from a vaginal birth. Two. We already touched
Speaker 1: on how to pee and how to pool, like one
Speaker 1: and two. Next is I think icing We touched on
Speaker 1: this a little bit, but really the cold in the
Speaker 1: very beginning helps decrease inflammation. UM minimize infection, improve healing,
Speaker 1: So you know, having a little ice pack that you
Speaker 1: put on the area for twenty minutes several times a
Speaker 1: day for the first week. UM. Also having a little
Speaker 1: peri bottle filled with warm water or which hazel that
Speaker 1: you sprits on the area. That can also help facilitate
Speaker 1: your urine stream if you can't pee, but definitely rinse
Speaker 1: after peeing, after pooping, and even just you'll still be bleeding,
Speaker 1: so kind of rinsing the area so that you don't
Speaker 1: have to wipe aggressively. And there are a lot of
Speaker 1: sprays and bombs and different things you can use if
Speaker 1: you've had a tear or you have some soreness in
Speaker 1: the area that can be helpful that they may give
Speaker 1: you in the hospital. You can also keep at home.
Speaker 1: But really baby the area, I mean really, you know,
Speaker 1: be tender to it, don't overdo it, and give yourself
Speaker 1: the first few weeks to really really rest and recover.
Speaker 1: Like you have been through a lot and you're sleep
Speaker 1: deprived now, so um, really just focusing on recovery those
Speaker 1: first few weeks. Now, Pecotomys are faithfully rare theseas how,
Speaker 1: if you need to have an apseotomy, and it would
Speaker 1: only be if you absolutely need one. How would you
Speaker 1: say it's best to heal and speed recovery. Ice is
Speaker 1: a big one again for that. So when a psotomy
Speaker 1: is a cut, when they actually cut the muscle, and
Speaker 1: typically they're doing that now only and medically indicated. Back
Speaker 1: in the day, it was like everybody got one, and
Speaker 1: now we're showing that it's actually gonna be better if
Speaker 1: we just see what naturally happens to the muscles and
Speaker 1: tissues with birth. And most women do tear a little bit,
Speaker 1: but it's typically a minor tear, so in a psotomy
Speaker 1: is what we consider a grade to like into the muscle.
Speaker 1: So I really encourage, you know, a really good nutrition
Speaker 1: because we want that for wound healing. So vitamin C, food,
Speaker 1: vitamin C, fish oil, you know, making sure that you're
Speaker 1: still taking your prenatal vitamins, good nutrition, good hydration, icing
Speaker 1: the area, maybe even using a little steak cushion to
Speaker 1: sit on, so that you're kind of staying off that
Speaker 1: wound while you're sitting, especially when pumping or breastfeeding. Would
Speaker 1: you say a donut to sit on. I don't love
Speaker 1: doughnuts filled with air. They have so many great options
Speaker 1: that are kind of a phone that are kind of
Speaker 1: a little bit softer to sink into, or even your
Speaker 1: body pillow just turns to put that in the chair
Speaker 1: and just sit right on that, you know, and just
Speaker 1: something to kind of elevate that area. And then actually
Speaker 1: it's a great time to kind of start thinking about
Speaker 1: doing little keygal contraction, so not really tight ones, but
Speaker 1: just to contract and relax, to start pumping some fluid
Speaker 1: out of that area, getting some blood float of the
Speaker 1: area to help appealing. I was going to ask about
Speaker 1: that because when you know, I'm all about keegals. But
Speaker 1: I remember so clearly trying to do keygles right after birth,
Speaker 1: and I think I could, but I couldn't feel myself
Speaker 1: doing them, So is that normal? Yes? I also tried
Speaker 1: to do them right after birth, and I was like, wow,
Speaker 1: it is radio silence down there. That is normal. These
Speaker 1: muscles are tired. But what we're just looking for is connection.
Speaker 1: We're just looking to say, can I, you know, could
Speaker 1: wake through his muscles often, you know, I do tell
Speaker 1: people every once in a while you might want to
Speaker 1: be urinating and test it, like can you contract your
Speaker 1: muscles and stop your stream. Don't do keegels during peeing
Speaker 1: as an exercise, but every once in a while you
Speaker 1: can test it, yes, just to tell that you're doing
Speaker 1: them correctly, right, because otherwise you could end up with U, T, I,
Speaker 1: S and all kinds of Yeah, that's not a good thing. Okay.
Speaker 1: So besides not you know, rushing in it, listening to
Speaker 1: your body, not overdoing lifting with care. What about a
Speaker 1: mom who has had a C section? And as you said,
Speaker 1: thirty percent of moms are going to have one, whether
Speaker 1: you know we like it or not, and we should
Speaker 1: try to reduce those rates. But in the meantime, if
Speaker 1: you've had a c section, how do you best recover
Speaker 1: from that? For both of these and I didn't mention
Speaker 1: this with the psotomy either said there's kind of an
Speaker 1: early stage of healing and then like a later stage
Speaker 1: of healing. So so Sarian Recovery really love moms to
Speaker 1: use like a really simple abdominal binder in the hospital,
Speaker 1: and most hospitals will provide it if you ask. They
Speaker 1: don't always offer it. And I'm not talking a waste
Speaker 1: train or I'm talking like a really gentle soft wrap
Speaker 1: that just gives you a little bit of support when
Speaker 1: you are trying to get in and out of bed
Speaker 1: and lift the baby. Next is you can ice your
Speaker 1: scar right away. That's going to help produce inflammation. And
Speaker 1: then you know, even starting to do just some gentle
Speaker 1: breathing exercises to kind of bring just like you were thinking,
Speaker 1: do a couple of keegles to kind of wake those
Speaker 1: tissues up. Just take some breaths to kind of help
Speaker 1: open up and expand the abdominals and then start walking
Speaker 1: on day one. So often our Cesrian moms want to
Speaker 1: hunch over and it's so painful. But the more that
Speaker 1: you can push yourself upright, So walk the baby around
Speaker 1: in the bassinet in the hospital and kind of help
Speaker 1: that push yourself up into a more upright position so
Speaker 1: that your abdomen, your chest can open instead of just
Speaker 1: kind of staying hunched down, because long term that's going
Speaker 1: to make it a little bit more difficult for healing. Absolutely,
Speaker 1: And how about getting out of bed? How do you
Speaker 1: recommend getting out of bed? And this is why we
Speaker 1: love to teach moms this during pregnancy, is that we
Speaker 1: encourage moms to roll to their side, so you kind
Speaker 1: of don't even use your abs, you roll all the
Speaker 1: way to your side, let your feet kind of dangle
Speaker 1: off the edge, and use your arms to push up
Speaker 1: so that you can allow those abdominal muscles to relax
Speaker 1: a little bit, and you're using your upper and lower
Speaker 1: body to help you so you don't have to do
Speaker 1: that sit up position. This is another tip that I
Speaker 1: like to tell a lot of moms is to exhale
Speaker 1: when they're picking up the baby or when they're lifting something.
Speaker 1: If you hold your breath, it kind of like tightens
Speaker 1: up everything a little bit. But if you exhale gently
Speaker 1: picking up the baby or you know, pushing something, pushing
Speaker 1: the stroller, it helps those muscles relax a little bit
Speaker 1: and takes the pressure for abdomen. Do you have other
Speaker 1: tips for lifting or for bending to help with your
Speaker 1: back pain? Yeah, I mean always like a squat position
Speaker 1: is better than like the bending over arching your back.
Speaker 1: Another thing is break down the load. I mean, my
Speaker 1: husband used to make fun of me because in my
Speaker 1: third trimester I would put the trash in a wagon
Speaker 1: and wheel it out to the backyard instead of like
Speaker 1: lugging the doing that will he traveled, so I was
Speaker 1: so during the week. But that's a great question. You know,
Speaker 1: even things like that just break down the load instead
Speaker 1: of curing all of these huge things, doing smaller you know,
Speaker 1: little trips with smaller amounts. And a lot of us
Speaker 1: have other kids when we have when we give birth,
Speaker 1: So again, practice that explation when you're lifting the kiddos
Speaker 1: in and out of the car, in and out of
Speaker 1: the bathtub, and you can also hug them from a
Speaker 1: sitting position. I know, I know, and it's it's hard
Speaker 1: and it's kind of sad because you feel like you
Speaker 1: can't do the things that you want to do. But
Speaker 1: it really does come back with time, oh for sure.
Speaker 1: So speaking of that, of course, your body has been
Speaker 1: through a lot. Your pelvis has been through a lot.
Speaker 1: All those muscles have been through a lot, a lot
Speaker 1: of stretching, a lot of pressure. So of course you're
Speaker 1: going to expect some pain. How much pain should you
Speaker 1: expect if everything is normal, whether it's bad pain, paraneal pain,
Speaker 1: pelvic pain, and when did you start looking for help?
Speaker 1: Really within the first two weeks is when the majority
Speaker 1: of healing, real like wound healing, and if an infection
Speaker 1: is going to happen, If something's gonna happen, it's gonna
Speaker 1: happen within the first two weeks. So after that two
Speaker 1: week mark, if you're really like something doesn't feel right
Speaker 1: my scar my paraneum, I'm like, you've got to go
Speaker 1: to the doctor, because that's when we really want to
Speaker 1: kind of start looking for red flags of infection and
Speaker 1: things like that. But even after those two week marks
Speaker 1: is when I start saying, like, start getting out and
Speaker 1: walking a little bit more. Start you know, we start
Speaker 1: doing some breathing with some abdominal contractions. And if you're
Speaker 1: having pain even after that two week mark that doesn't
Speaker 1: just feel like exhaustion or deconditioning, but real pain, then
Speaker 1: I say go back to the doctor, and then you know,
Speaker 1: check in with the PT after you get that six
Speaker 1: week mark. I concur Yeah, so what do you mentioned walking?
Speaker 1: And walking, of course is a great exercise for late
Speaker 1: pregnancy also when you have a new baby, because first
Speaker 1: of all, the fresh air is going to do so
Speaker 1: much good on every level. How do you at the
Speaker 1: same time rest up enough and also make sure that
Speaker 1: you're moving enough. How much exercise do you recommend and
Speaker 1: what kind? At what point I really recommend the first
Speaker 1: week one to two weeks, you were like at home
Speaker 1: in bed, and I think the past year has really
Speaker 1: taught us that moving slowly and having less on our
Speaker 1: plates and less visitors can serve us well, oh my god,
Speaker 1: silver lining, silver lining, I know, and I think it
Speaker 1: was something that we all really felt like we needed
Speaker 1: to slow down, and especially our moms who had tons
Speaker 1: of visitors come over and we want to go to
Speaker 1: lunches and things like that. So the first one to
Speaker 1: two weeks is focused on healing, doing things around the house.
Speaker 1: And I always say the rule of thumb is if
Speaker 1: you have an increase in pain or an increase in
Speaker 1: bleeding when you do an activity, you're probably overdoing it.
Speaker 1: That could be a load of laundry, dish is or
Speaker 1: a walk. Around two weeks, I say start getting outside
Speaker 1: to go for walks around the block, maybe fifteen minutes,
Speaker 1: twenty minutes. If you feel okay, you can start doing
Speaker 1: two of those a day, and then you can start
Speaker 1: going for thirty minutes. So every week, just kind of
Speaker 1: bump it up a little bit, and then around six
Speaker 1: weeks starting to do more core exercises, really basic, not
Speaker 1: sit ups, but like little contractions and bridges and maybe
Speaker 1: some squats and things that kind of start some movement
Speaker 1: and then return to higher intensity around twelve weeks, and
Speaker 1: at this point you might be wondering core, what core?
Speaker 1: How do we find that core and how do we
Speaker 1: best support it at that point, So around six weeks
Speaker 1: I encourage folks to start working more on specific core stuff.
Speaker 1: So I always start with the breath. I haven't you know,
Speaker 1: started doing some diaplematic breathing and then on the exhale
Speaker 1: of their breath, I haven't learned to contract their public
Speaker 1: floor to pull in their transverse abdominals. And that takes
Speaker 1: sometimes a little bit of work in practice, and that's
Speaker 1: why it's great to do it before birth as well.
Speaker 1: But you know, working on some of those simple exercises
Speaker 1: and actually the foundation for everything, the keegel in the
Speaker 1: you know, lower abdominal contraction is the basis for all
Speaker 1: core exercises. So whether you're doing a push up, a plank,
Speaker 1: a squat, a lunch, you have to pull that pelvic
Speaker 1: for an abdomen in before you do it. Okay, So
Speaker 1: then there's sex or is there is there? There doesn't
Speaker 1: have to be. I mean, let's take the pressure off
Speaker 1: of moms. So like, you know, get right back to
Speaker 1: it now. You get the clearance at six weeks, but
Speaker 1: you may not feel emotionally or physically ready. What do
Speaker 1: you want new parents to know about postpartum sex that
Speaker 1: the first time it may not feel comfortable. So a
Speaker 1: common think that a lot of our patients says that
Speaker 1: they don't realize it's going to be so dry. If
Speaker 1: you're lactating or breastfeeding, you typically have lower estrogen levels,
Speaker 1: which causes your vaginal tissues to feel drier. So I
Speaker 1: say proactively use a lubricant. I like to use a
Speaker 1: water based lubrican in or some folks use an all
Speaker 1: natural coconut oil. The forecast is mainly dry for the
Speaker 1: time that, yes, go slowly, mainly dry, and honestly, if
Speaker 1: there's pain, stop like you don't need to push through
Speaker 1: the pain. You might just need a little bit more
Speaker 1: time for recovery, or you may have some scar tissue
Speaker 1: that's still healing as a paradem, or you may even
Speaker 1: need to do scar massage so to the Cesarean scar
Speaker 1: or the barren Neil scar. So you know, I think
Speaker 1: that dryness taking it slow. If there's bleeding or pain,
Speaker 1: you obviously want to stop, and then you know, just
Speaker 1: kind of see how you feel. You may be a
Speaker 1: little bit sore afterwards, so it's okay to ice, But
Speaker 1: consistent pain with sex is not normal, So if it
Speaker 1: continues to be painful, I think it's worth addressing. Are
Speaker 1: there certain postpartum positions that you would prefer? So? I
Speaker 1: think it's really variable, you know, depending on how somebody feels,
Speaker 1: But typically lying on your back kind of in your
Speaker 1: on your back and your partner's on top is a
Speaker 1: less penetrating position. Your partner behind you in the spooning
Speaker 1: position is less penetray rating, but if your partners behind you,
Speaker 1: that may be more penetrating and more uncomfortable. If you've
Speaker 1: had a para meal tear, that may be meant an
Speaker 1: or more uncomfortable position. And then some women like to
Speaker 1: be on top because then they can kind of control
Speaker 1: the pace of it as well. So I would say
Speaker 1: the most kind of uncomfortable position right away might be
Speaker 1: a woman on their hands and knees and the partner
Speaker 1: behind them, and your your sexual gps may have changed
Speaker 1: quite a lot. You know, you should make sure you
Speaker 1: also listen to your body and see what's comfortable what's not.
Speaker 1: I think communication is key, you know, to kind of
Speaker 1: express what you're feeling, what's going on. And I also think,
Speaker 1: you know, I really want to take some of the
Speaker 1: pressure that we feel as women, as moms afterwards, it's
Speaker 1: like we have to get back there. It's a six weeks.
Speaker 1: We feel bad for our partners and I used to
Speaker 1: feel this way. Or you can have insecurities about your body.
Speaker 1: You may be licking breast milk. I mean, you may
Speaker 1: still be bleeding. There's so many things that I really
Speaker 1: think if we give ourselves some grace and some time
Speaker 1: for recovery, it doesn't have to be so traumatic for
Speaker 1: us or so um exhausting for us. Yeah, for sure.
Speaker 1: And the most important kind of intercourses the talking kind, right, Yeah,
Speaker 1: I call it outer course. Of course. Well that could
Speaker 1: mean something else too, which is also might be more
Speaker 1: comfortable at this point, exactly exactly. Not all roads have
Speaker 1: to lead to, you know, vaginal sex. So there's a
Speaker 1: lot of options out there, yep, So explore those roads, Sarah.
Speaker 1: There are a lot of things that I wish I
Speaker 1: could go back in time and tell my newly delivered
Speaker 1: mom self about my postpartum recovery. Now that I know
Speaker 1: what to expect. But what is your most important message
Speaker 1: to all about to become moms about postpartum recovery? Yeah,
Speaker 1: I have three. I think this isn't being related to recovery,
Speaker 1: but it's related to postpartum. Is that to get help
Speaker 1: with breastfeeding. I knew everything about pelvic floor and I
Speaker 1: had wonderful bursts and wonderful recoveries, but my biggest struggle
Speaker 1: was breastfeeding and I didn't know I didn't prepare enough
Speaker 1: for that, and I felt like that really almost made
Speaker 1: my postpartum traumatic or really difficult, and despite my pelvic
Speaker 1: floor being in good shape. So the second is to
Speaker 1: take it slow. And it's such a generic and corny
Speaker 1: and cheesy term, but I just look at how fast
Speaker 1: I tried to get back to walking and running and
Speaker 1: socializing and wanting to get my body back, And you know,
Speaker 1: twelve weeks is a sliver of time in the big
Speaker 1: scheme of things. And I really find now that my
Speaker 1: mom's who take it slow and really give them some
Speaker 1: time to heal and then get back into fitness and
Speaker 1: exercise do way better in the long run. So that's
Speaker 1: a really big one. That's probably one of the bigger ones.
Speaker 1: And then you know, lastly is that if it hurts,
Speaker 1: get help. You know, we don't have to deal with things.
Speaker 1: We don't have to suffer. And whether it's physical, emotional, mental,
Speaker 1: whatever the case may be, is to really um we
Speaker 1: mentioned this in our previous chat, but strength isn't isn't
Speaker 1: asking for help and not feeling like we just have
Speaker 1: to bear the weight of the world and power through,
Speaker 1: you know, and we're not going to use the phrase
Speaker 1: just do it. Yeah, and you don't have to just
Speaker 1: deal with it. You know, we have so much to
Speaker 1: deal with us new moms. I think that you know,
Speaker 1: I'm really seeing this. It takes a village come back.
Speaker 1: And maybe we're doing it virtually or on social media,
Speaker 1: but I really see moms rising up together saying we've
Speaker 1: been through this and you know, here are some tips,
Speaker 1: here resources, here's this amazing podcast, and just really trying
Speaker 1: to support one another through the process. We know what
Speaker 1: I say, motherhood is the ultimate sisterhood. We've got to
Speaker 1: help our sisters out, that's right. So thank you for
Speaker 1: helping us out today. We really really appreciate And for
Speaker 1: those who don't already follow you, where can they find
Speaker 1: you from? More tips. The biggest place I have a
Speaker 1: presence is on Instagram as the Vagina Whisperer, and then
Speaker 1: it's also the Vagina whisper dot com, where we have
Speaker 1: a ton of blog posts about pregnancy and birth and
Speaker 1: online resources and courses to help support moms. It's awesome.
Speaker 1: Thank you so much, Sarah, Thanks for having me Baby Belove,
Speaker 1: my baby Belove. I need you, Oh how I need you.
Speaker 1: Thanks for listening. Remember I'm always here for you. What
Speaker 1: to Expect is always here for you. We're all in
Speaker 1: this together. For more on what you heard on today's episode,
Speaker 1: visit what to Expect dot com slash podcasts. You can
Speaker 1: also check out What to Expect when You're Expecting, What
Speaker 1: to Expect the First Year, and the what to Expect app.
Speaker 1: And we want to hear from you. Connect with us
Speaker 1: on our community message board or on our social media.
Speaker 1: You can find me at Heidi Murkoff and Emma at
Speaker 1: Emma bing wt E, and of course at What to Expect.
Speaker 1: Baby Love is performed by Riley Peterer. What to Expect
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