Let’s talk about Pregnancy

Welcome to the journey that will change your life!

Useful Videos

Huge congratulations firstly if you are pregnant, it can be a journey in itself to get to this point for some and others not so much. We are all unique.

Pregnancy is often portrayed as this smooth, sailing journey where your hair gets thicker and you glow like a crystal ball.

Reality can often be a little or a lot, different.

Sweating from body parts you didn’t know you had, seeing your boobs balloon before your eyes, not being able to get your lower half dressed without sitting down and that’s before any medical tests, checks and a gazillion appointments you may have to attend. I could go on…

Pregnancy is a bumpy ride emotionally, sometimes physically and mentally your hormones really do wreak havoc with your memory so do expect to become forgetful.

What I hope you will gleam from this section is:

Safe advice about exercise in pregnancy

Exercise advice about what, where, when

Links to specialised pregnancy trained fitness professionals

How to feel, find and work your pelvic floor and the WHY it’s so important

What is happening to your abdominal muscles

UR CHOICE a calculator tool that identifies if you have any pelvic floor dysfunction indicators

What running looks like on your pelvic floor

Perineal massage information

⁣⁣
Welcome to the journey that will change your life⁣

Huge congratulations if you are pregnant. It can be a joyous wonderful time but equally a nerve-wracking, stressful ride. Whatever journey your pregnancy takes you on, it is unique to you and you alone.

While there are many similarities pregnant people go through, no two pregnancies are the same as we are all different with many different unique characteristics, medical health histories, support teams and other lifestyle factors to juggle, jobs, older children, family care, etc, etc.

My goal is that one day I will write a pregnancy app that shows the changes to the “mother” and what their body is going through. I religiously followed the pregnancy apps with mine that all told me how big my baby was and was s/he was growing that week and so on.

What I never knew and there is still a huge gap in this area is what was happening to me, to my body, to my brain and it CHANGED enormously during that time.

Enjoy the journey and if it all goes smoothly, wonderful enjoy it. If there are bumps in the road then I think that is the NORM for the majority of us and if it goes sadly wrong, know that I am deeply saddened and hold deep sympathy for you.

Our journeys are all DIFFERENT but we are all UNITED in process.

Be kind to yourself. Be gentle.

I’m pregnant, is it safe to exercise?

The answer for the majority of us is a simple YES, absolutely. There are now volumes of evidence to support exercise in pregnancy.

Here’s a great visual from Tommy’s about staying active in pregnancy.

Yes it’s tiring, exhausting, nauseating and all the rest of the lovely things pregnancy can bring BUT it’s so important we keep moving.

You don’t have to hit the gym to have a good work out.

Go for a regular walk – use your core stability muscles to help you.

Work on your posture and your spine and ribs with thank you for that extra mm of space to allow you to breathe easier.

Head to the pool and offload aching sore joints by walking in the water or doing gentle movements at the edge of the pool – you don’t have to swim to benefit from exercising in the pool.

Keep moving, keep well and feel better.

Always discuss your medical health with your midwife/consultant if you have any concerns around your pregnancy as for the small minority exercise is not advised in certain conditions.

⁣⁣Exercise in pregnancy: What, when, where and how??

This is as individual and unique to your exercise preferences and choices as an apple is to a pear!

Without wanting to give you more questions than answers, things to consider are:

Did you exercise before pregnancy?
Are you feeling well/not?
Can you talk and walk ok without severe breathlessness?
Do you have any pregnancy niggles, aches or discomfort?
What exercise do you enjoy?

The best things we can do depend on what we enjoy and what we need.

WHAT exercise in pregnancy?

Breath work – is an exercise form. It can be relaxing, empowering, calming and help you really connect to your body and your baby.

Core work – pregnancy pilates helps you to engage and relax your all important tummy and pelvic floor muscles and keeps you moving. Pilates exercise will strengthen your whole body and make you more body aware which are great for labour and post natal stages.

Yoga – pregnancy led classes are great for body movement and releasing as you move through certain postures and positions. It helps you to calm, connect to your baby and can ease away aches and pains.

Walking – unless you have severe pain we should all be walking in pregnancy. For some of us that may mean doing side steps or backwards walking with support. The distance is irrelevant, the how is important.

Running – not for everyone but if you ran before there is no reason not to continue in pregnancy unless you have been advised not to.

Dancing – carry on and enjoy the movement. Listen to your body and make smaller movements when you get heavier or as your body tells you.

Swimming – carry on and enjoy the lightness the water brings as you offload your joints. Breast stroke legs can aggravate some discomfort in the front of you pelvis so if this is you try crawl legs instead with breast stroke arms if that works, or a different stroke.

Exercise in water – so beneficial and really lovely to offload pressure through your joints. I did a lot of exercises in the water with my second pregnancy, like squats, calf raises, leg extensions, tricep dips in the baby pool. It was a wonderful way to keep mobility and strength in my body.

Lifting heavy – you’re about to have a baby, a car seat, a pram, shopping, etc to LIFT and so strengthening in pregnancy is important. If you have never done this before then please do so with a pregnancy qualified fitness professional. Technique is important in pregnancy. Breathing out with the heavy lift (effort) is important and not holding your breath is crucial to avoid overloading your pelvic floor and abdomen.

Things to consider/avoid:

Contact sports – anything where there is a risk of being hit in the tummy such as;
Kickboxing, Judo, Squash, Netball, Football, Hockey, Basketball, Tennis.

A possibility of a fall/loss of balance such as; Horse Riding, Downhill skiing, Ice skating, Gymnastics, Cycling.

Exercising at an altitude over 2500 metres until you have acclimatised to it.

Exercising flat on your back after 15 weeks can lower your maternal cardiac output as the weight of your growing uterus + baby causes compression to your heart vena cava vein. The signs for this are nausea, feeling faint, dizzy or breathless. Move onto your side if you get any of these symptoms. Please note these symptoms do not happen to everyone but there are so many other positions you can exercise safely in that for many of us, we really don’t need exercise flat on our backs.

Scuba -diving – the BIG No no as your unborn baby is not protected against decompression sickness or gas emboli.

Use your judgement and know your limits.

WHEN should I exercise?

It’s safe for the majority of us to exercise throughout our pregnancies. Listen to your body. You may feel queasy and sickly in your first trimester and not have the energy to do anything or you might feel ok and continue with your normal routine. We are all different. There is no right or wrong way.

WHERE should I exercise?

Ideally alongside a pregnancy qualified fitness instructor/physiotherapist who knows about the changes in pregnancy and can adapt exercises to your needs. Please be mindful of classes that say pregnant people welcome but are not specific classes as many do not have the correct knowledge to ensure you are exercising safely in pregnancy.

Specialist pregnancy led exercise classes in your area are a good starting point or gyms with trainers who have pelvic floor training and awareness. Ask other pregnant or post natal people in your area for recommendations.

HOW much exercise should I be doing in pregnancy?

The Royal College of Obstetricians and Gynaecologists (RCOG) recommend “in the absence of medical or obstetric complications, 30 minute sessions four times a week to daily of moderate exercise”.

If you were previously a non exerciser then start 15 minutes, three times a week building up to the above recommendations.

Effort wise, it is important you maintain a TALK & WALK type of level of exertion if exercising whilst pregnant. Your heart rate is naturally faster and your body temperature can heat up quickly so you need to monitor the intensity of your workout.

Make sure you are working hard enough to start breathing through your mouth and not your nose but you can carry on a conversation.

Running in Pregnancy

💕 Click on this image to see an incredible visual about running in pregnancy & the effect it has on your pelvic floor 🏃‍♀️

@mypelvicfloormuscles has an amazing visual video of this which I’ve included as a picture/video that speaks a thousand words.

Notice the bladder organ in yellow and the pelvic floor looks like a sling/hammock in brown. Even without running our pelvic floor muscles are taking excess load in pregnancy as they stretch and lengthen over 40 weeks give or take.

Like any muscles, we need to strengthen and relax them completely in pregnancy to help prevent leaking pee and pelvic organ descent (prolapse) but they also help reduce low back pain which is extremely common in pregnancy.

Head to my pelvic floor page for some HOW TO videos and get squeezing and relaxing your muscles today.

⁣⁣Prevention of pelvic floor disorders is UR Choice in pregnancy

UR CHOICE is the pelvic floor disorder risk calculator: a must-know for mothers-to-be.

Have you heard of the UR-CHOICE pelvic floor disorder risk calculator?

A research paper written by Wilson et al in November 2014 highlights several major risk factors that when scored in their calculator can tell “mothers-to-be” or those who don’t identify as mothers, what their pelvic floor dysfunction could potentially be.

It is widely recognised that vaginal birth is a major cause of pelvic floor dysfunction for many.

Pelvic floor dysfunction refers to:
* urinary incontinence (peeing involuntarily),
* faecal incontinence (pooing involuntarily) and
* pelvic organ prolapse (bladder, bowel or uterus moves lower into the pelvis and sometimes feels like a heaviness or dragging down sensation) in this instance.

So, what are the major risk factors and why is this information essential for all “mothers-to-be” to know?

  • Urine incontinence before pregnancy
  • Ethnicity
  • Age at birth of first child
  • Body Mass Index
  • Family history (Mother and sister) with pelvic floor dysfunction
  • Baby’s weight of >4kg
  • Maternal height < 160cm

The scoring system can help give “mothers-to-be” the correct information for pelvic floor dysfunction prevention before (ideally) and during pregnancy. This is a brilliant incentive to help all who are pregnant or wanting to be, to do their pelvic floor exercises with good reason why. Hurray!

To calculate your pelvic floor risk go to http://riskcalc.org/UR_CHOICE/ and type in your answers to the above questions.

It’s simple, quick and very useful to reinforce WHY pelvic floor muscle training is IMPERATIVE to all pregnant people.

It’s important during your antenatal appointments that you discuss any pelvic floor problems as prevention of symptoms becoming worse in pregnancy is so important for quality of life post birth.

Have you heard of perineal massage?

Perineal massage is exactly that…massage to your perineum.

What/where is that?

Your perineum is the soft tissue found between your back passage and your vulva.

When should you start it?

It is advised from 34 weeks pregnant to start perineal massage (unless unsafe to do so) as there is evidence to show that it reduces the chance of perineal tearing and the need for an episiotomy. It greatly aids healing especially after your first vaginal birth.

What are the benefits of it?

Massaging your perineum in pregnancy can help:

  • increase the elasticity of your perineum
  • improve the ability to relax your perineal area
  • give you more confidence in your ability to give birth.

When is it not safe to massage your perineum?

If you have any of the following please DO NOT start perineal massage:

  • a bacterial infection
  • risk of premature labour
  • unexplained bleeding
  • thrush
  • vaginal herpes
  • premature rupture of membranes

How do you do perineal massage?

Ideally, you should be taught the correct technique by your midwife or a women’s health physio.

You place your thumb or finger(s) into the back part of your vulva and apply a downwards pressure towards your back passage. You should apply a sweeping motion from left to right. Once or twice a week is ideal for about 5 minutes.

If you are not keen to use your own thumb/fingers you can always try a birth trainer. The EPI-NO has been widely talked about on social media on accounts like @clarebournephysio.

A birth trainer can also:

  • increase the elasticity of your perineum
  • improve the ability to relax your perineal area
  • give you more confidence in your ability to give birth
  • decreases the chances of perineal trauma

Ideally, you must be taught the correct technique by your midwife or a women’s health physio and commence use from 37 weeks pregnant.

A birth trainer is a silicone balloon that you insert into your vagina and can pump up to help stretch the tissues of the perineum up to the size of a baby’s head in preparation for birth.

For a how-to video have a look at here. It is a very effective mentally empowering tool.

There are times when an EPI-NO is not safe to use as well as certain medical and pregnancy conditions that should avoid using it also.

  • a bacterial infection
  • risk of premature labour
  • unexplained bleeding
  • thrush
  • vaginal herpes
  • premature rupture of membranes
  • vaginal varicose veins
  • breech/transverse lie baby position in
  • utero
  • placenta previa
  • paraplegia
  • nerve damage
  • M.S.
Why am I peeing so much in pregnancy?

Why am I peeing so much in pregnancy?

During pregnancy, the female body undergoes a transformational change due to the wonderful hormonal orchestra being played out. Pregnant and peeing for England! springs to mind. Many will notice subtle body changes like tender achy breasts, a heightened...

Resources

Find a physio and pelvic health fit pro in your area here.

Instagram accounts to follow:

@tommys | @kicks.count | @pandas_uk | @thepositivebirthmovement | @kickscount |@physiomumuk | @clarebournephysio |@_luluadams | @natalactive | @mixing.up.motherhood | @mamstefit | @urban_hatch | @tommys_pregnancyhub

Books:

The Positive Birth Book, Give Birth Like a Feminist by Milli Hill

Ina May’s Guide to childbirth by Ina May Gaskin

Mindful Hypnobirthing by Sophie Fletcher

POGP FREE pregnancy download leaflets:

Pregnancy-related Pelvic Girdle Pain for Mothers to be and new mothers

Aqua-natal Guidelines: guidance on antenatal and postnatal exercises in water:

Fit for Pregnancy

Improving your Bowel Function

Pelvic floor exercises