Tagged / Childbirth

Conversation article: how to recover from childbirth – an expert guide

Rosie Harper and Malika Felton write for The Conversation about the physical changes that take place during pregnancy and childbirth and share advice on recovery.

How to recover from childbirth – an expert guide

Rosie C Harper, Bournemouth University and Malika Felton, Bournemouth University

After all the physical changes during pregnancy and following childbirth, many women are left wondering how to get active again and where to begin. Of course, activity after childbirth is an individual journey with multiple things to consider – and one of the first considerations may not be what you expect: your pelvic floor.

Your pelvic floor muscles sit at the base of the pelvis. The muscles form a hammock-like structure that supports the bladder, womb and bottom. As many as one in three women experience unwanted bladder leaks or vaginal prolapse in their lifetime and many of these symptoms can start during pregnancy or following childbirth. This is because this small muscle group takes the weight of the baby for nine months and may be stretched during vaginal delivery.

Your pelvic floor supports the bladder and vaginal tissues, helping bladder and bowel control and vaginal position. Recovery of these muscles prevents unwanted leaks, improves internal comfort and allows women to confidently increase activity.

This article is part of Women’s Health Matters, a series about the health and wellbeing of women and girls around the world. From menopause to miscarriage, pleasure to pain the articles in this series will delve into the full spectrum of women’s health issues to provide valuable information, insights and resources for women of all ages.

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So focusing on your pelvic floor around pregnancy and postnatally can help you to recover more easily after childbirth and will allow you to get ready to be more active when you feel up to it.

If you’ve just given birth (or are about to) and you’re wondering where to start, here’s what you need to know:

1. Keep your poo soft

Straining on the toilet can overstretch the pelvic floor muscles which makes it harder for them to work properly. To avoid this you can keep your poo soft by drinking lots of water and increasing the fibre in your diet, such as high-fibre cereals, brown pasta and nuts.

Also, consider your position on the toilet. The use of a stool underneath your feet can make it easier to poo without straining as it helps to straighten the end of the bowel.

2. Get your pelvic floor moving

Squeezing and relaxing the pelvic floor muscles daily can improve blood flow to the area and speed up recovery following childbirth. This is because pelvic floor activity can improve the strength and function of the muscles to help bladder control and vaginal support.

The evidence shows that it usually takes a good three months of regular pelvic floor use to change symptoms – and every squeeze can make a difference. After a vaginal delivery and even after a c-section, the recovery time for the pelvic floor continues for up to one year.

Woman lying on a bed with baby in the air.
You can do pelvic floor exercises anytime.
pexels monica turlui, CC BY

One of the biggest problems with pelvic floor training is that women aren’t sure they are doing the exercises correctly and regularly forget to do the exercises.

To engage your pelvic floor muscles imagine you are holding in wind and trying to close the vaginal opening at the same time. You may feel a lifting and tightening inside of you. Try to breathe normally and relax other muscles like your tummy and buttocks.

To check you are doing it correctly, you can use a mirror to look at the area between your front and back passage. This area (the perineum) will move slightly up and inwards with a correct contraction. After each contraction, let your pelvic floor muscles fully relax. Pelvic health physiotherapists recommend squeezing your pelvic floor for ten seconds before relaxing for ten repetitions, followed by ten short squeezes. And to do this three times a day.

3. Let things settle and go gently

The pelvis and abdominal muscles also need time to recover from carrying a baby. Many women have a normal stretch and separation of their tummy muscles, which in a lot of cases improves around eight weeks after delivery, for others it can take six months. The tummy helps to support the pelvis so rushing back to activity too quickly can put unnecessary strain on these areas.

Opt instead for a gentle increase in activity to help the muscles and joints settle such as walking, yoga or pilates rather than starting higher impact activity, like running, too early.

4. Check your mental health

The pressures on women postnatally can feel overwhelming and combined with sleep deprivation things can take a toll mentally. The National Perinatal Mental Health Project Report focuses on improving mental health support for women after they have given birth by providing more support services. These services can be accessed by speaking to your GP, midwife, health visitor or pelvic health physiotherapist.

Although a good level of activity can improve mental health, over-training can have a negative effect on the body, so take it steady and keep checking in with yourself to make sure you’re functioning at a pace that feels comfortable and that you’re not overdoing it. Listen to your body and avoid comparison as everybody and every pregnancy is different.

Above all else, remember to be kind to yourself, your body has just gone through a massive change. Looking after your mental health and concentrating on your pelvic floor are good starting points. Getting more active with the muscles around your pelvis, including your tummy, can all help during the natural recovery time frame. But listen to your body and take things at your own pace.The Conversation

Rosie C Harper, Clinical academic PhD candidate, Bournemouth University and Malika Felton, Senior Lecturer in Health and Exercise Physiology, Bournemouth University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Last BU paper of 2021

international, open access, Publishing, writing

The scientific journal Nepal Journal of Epidemiology published its fourth and final issue of 2021 on December 31.  This issue included our systematic review ‘Epidemiologic characteristics, clinical management and Public Health Implications of Coronavirus Disease 2019 (COVID-19) in Pregnancy: A Systematic Review and meta-analysis’.  This review covered the published literature on the epidemiology, clinical management and public health prevention aspects of pregnancy and childbirth and coronavirus (COVID-19) up until December 2020.  We worked hard and fast to submit the paper as soon as possible after the end of 2020 to be able to publish up-to-date findings.  We managed this and submitted the paper on March 5th, the peer-review took some months and so did the making of the revisions.  As a result we resubmitted the manuscript of 29 September and we got the acceptance email within a week.  We made it into the next issue of the Nepal Journal of Epidemiology which published exactly one year after the data collection period had ended for our systematic review.

There are two lessons here, first even when submitting to an online journal one will experience a delay in publishing.  Secondly, the 36 papers we had appraised and included were published in 2020, meaning these scientific  papers were submitted in mid-2020 at the latest in order to make it through the peer-review process, get accepted and formatted for online publication.

In the resubmitted version we had to add as a weakness of this review that: “It is worth noting that this extensive systematic review only cover papers published in 2020, and hence studies conducted in or before 2020. This was before the emergence of variants of COVID-19, especially the delta and omicron variants.”

 

Prof. Edwin van Teijlingen

CMMPH (Centre for Midwifery, Maternal & Perinatal Health).

Widespread media coverage in Nepal for BU researcher

international, open access, Publishing, student research, writing

This week Dr. Preeti Mahato in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) appeared in several newspapers and new website in Nepal. The media reported both in Nepali [1-4] and in English, the latter in South Asia Time [5] on her recently published paper on birthing centres in Nepal.  This latest paper from her PhD was published in the scientific journal  PLoS ONE [6].  The paper is co-authored by CMMPH’s Dr.Catherene Angell, Prof.Edwin van Teijlingen and Prof. Vanora Hundley as well as BU Visiting Professor Padam Simkhada (Associate Dean International at the School of Human and Health Sciences, University of Huddersfield.

We are very grateful to BU’s Dr. Nirmal Aryal for engaging with all his media contacts in Nepal to achieve this great coverage.

 

References:

  1. https://ekantipur.com/diaspora/2020/06/02/159107091260531499.html
  2.  https://www.nepalilink.com/2020/06/02/5326.html
  3. http://www.nepalbritain.com/?p=79336
  4. https://globalnepalese.com/post/2020-06-942777589?fbclid=IwAR3RJlHpeG4p3PdryUWzhvCDG0yiYjNrdnQZNJo4uzznyuFA8cF6DKLbKU8 
  5. https://www.southasiatime.com/2020/06/04/birthing-centers-are-savings-lives-in-rural-nepal/
  6. Mahato, P., van Teijlingen, E., Simkhada, P., Angell, C., Hundley, V. (2020), Evaluation of a health promotion intervention associated with birthing centres in rural Nepal PLoS One 15(5): e0233607. https://doi.org/10.1371/journal.pone.0233607

New BU publication on birth centres in Nepal

international, open access, PG research, Publishing, student research, writing

Congratulations to Dr. Preeti Mahato in the Centre for Midwifery, Maternal & Perintal Helath (CMMPH) on the acceptance of the  paper ‘ Evaluation of a health promotion intervention associated with birthing centres in rural Nepal’.   This paper is part of Dr. Mahato’s PhD work and will appear soon in the international journal PLOS ONE.   The journal is Open Access so anyone across the world may copy, distribute, or reuse these articles, as long as the author and original source are properly cited.

The research in this thesis used a longitudinal study design where pre-intervention survey was conducted by Green Tara Nepal a local non-governmental organisation (NGO) in year 2012.  The health promotion intervention was conducted by the same NGO in the period 2014 to 2016 and the post-intervention survey was conducted by Dr Mahato in the year 2017.

The intervention was financially supported by a London-based Buddhist charity called Green Tara Trust.   The results of the pre- and post-intervention surveys were compared to identify statistically significant changes that might have occurred due to the intervention and also to determine the factors affecting place of birth.   This study is co-authored by Professors Edwin van Teijlingen and Vanora Hundley and Dr Catherine Angell from CMMPH and FHSS Visiting Professor Padam Simkhada (based at the University of Huddersfield).

 

 

Congratulations to Dr. Alison Taylor

PG research, Publishing, student research, writing

Congratulations to Dr. Alison Taylor whose PhD paper ‘The therapeutic role of video diaries: A qualitative study involving breastfeeding mothers‘ has just appeared online [1].  This paper, in Women and Birth (published by Elsevier), was co-authored with her PhD supervisors Prof. Emerita Jo Alexander, Prof. Kath Ryan (University of Reading) and Prof. Edwin van Teijlingen.

The paper highlights that despite breastfeeding providing maximum health benefits to mother and baby, many women in the United Kingdom do not breastfeed, or do so briefly.  Alison’s study explored in a novel way the everyday experiences of first-time breastfeeding mothers in the early weeks following birth.  Five UK mothers were given a camcorder to capture their real-time experiences in a video diary, until they perceived their infant feeding was established. This meant that data were collected at different hours of the day by new mothers without a researcher being present.  Using a multidimensional approach to analysis, we examined how five mothers interacted with the camcorder as they shared their emotions, feelings, thoughts and actions in real-time. In total mothers recorded 294 video clips, total recording time exceeded 43 hours.

This paper focuses on one theme, the therapeutic role of the camcorder in qualitative research. Four subthemes are discussed highlighting the therapeutic impact of talking to the camcorder: personifying the camcorder; using the camcorder as a confidante; a sounding board; and a mirror and motivator. The paper concludes that frequent opportunities to relieve tension by talking to “someone” without interruption, judgement or advice can be therapeutic and that more research is needed into how the video diary method can be integrated into standard postnatal care to provide benefits for a wider population.

Alison is Senior Lecturer in Midwifery and a member of the Centre for Midwifery, Maternatal & Perinal Health.

 

 

Reference:

  1. Taylor, A.M., van Teijlingen, E., Alexander, J. & Ryan, K. The therapeutic role of video diaries: A qualitative study involving breastfeeding mothers, Women Birth (2018), (online first)  https://doi.org/10.1016/j.wombi.2018.08.160

Last review of the year

international, open access, Publishing, writing

This morning as Associate Editor I reviewed one academic paper resubmitted to BMC Pregnancy & Childbirth.  After this I had to invite three reviewers for another paper newly submitted to BMC Pregnancy & Childbirth. 

This afternoon I peer-reviewed a paper submitted to Women & Birth.  For readers of our BU Research Blog who are not involved in academia, the volume of requests to review for scientific journals has gone through the roof in the past few years.  And these are legitimate requests from high quality journals.  There is a whole heap of so-called predatory journals pestering academics for reviews (and papers and editorial board memberships).

All that is left to be done before the Christmas Break is editing six short book chapters, submitting one scientific paper, and answer seventy odd emails.

Merry Christmas and a Happy & Healthy 2018

Prof. Edwin van Teijlingen

Understanding disabled women’s experiences of pregnancy, childbirth and parenting

Birthrights, a national charity for the rights of women during pregnancy and childbirth has today launched the interim report of a study undertaken by staff from Bournemouth University and the University of Liverpool, about the experiences of disabled women during pregnancy, childbirth and early parenting.

The current work arises following their 2013 Dignity in Childbirth survey which highlighted less positive experiences of women who identified themselves as disabled (Birthrights 2013). In response, Birthrights commissioned research to explore the experiences of disabled women throughout pregnancy, childbirth and the first few post-natal weeks (the pregnancy continuum). A multidisciplinary team, comprising of Dr Jenny Hall, Jilly Ireland and Professor Vanora Hundley from CMMPH and Dr Bethan Collins from the University of Liverpool, have just completed the first phase of the study, which has been released by Birthrights as an interim report today. This first phase of the study used an online survey to identify experiences of women in the UK and Ireland with physical or sensory impairment or long term health conditions during the pregnancy continuum.

Although overall satisfaction with services in general was scored highly by most women, challenges were described in women’s experiences. These included lack of continuity of carer, meaning that women needed to repeat their information again and again; women feeling that they were not being listened to, which reduced their feeling of choice and control; feeling they were treated less favourably because of their disability. More than half of the women (56%) felt that maternity care providers did not have appropriate attitudes to disability. Accessibility of services was also highlighted as poor, in some situations.

These findings resonate with recommendations from the recent maternity services review (National Maternity review 2016), which highlights the importance of personalised care, that is woman-centred, with opportunity for choice and control, and continuity of carer for everyone. The current study highlights how imperative this approach is for disabled women.

A follow-up qualitative study is underway to establish in-depth views and experiences of human rights and dignity of disabled women during the pregnancy continuum to develop our understanding of how best to enable this group. This second phase is due to be completed in Spring 2017.

The Interim report outlining the results from phase 1 is released today by Birthrights and may be found on the CMMPH web site.
https://research.bournemouth.ac.uk/wp-content/uploads/2013/10/Interim-Report-Sept16.pdf

Successful BU Festival of Learning debate of media and fear in childbirth!

Festival of Learning

Yesterday saw the lively debate organised by Prof. Vanora Hundley on the motion: ‘The media is responsible for creating fear in childbirth.’

 

Elizabeth Duff from the NCT and HSC Prof. Edwin van Teijlingen affiliated with the Centre for Midwifery, Maternal & Perinatal Health and against the motion argued Joanne Dewberry (http://joannedewberry.co.uk/about-joanne/ ), independent blogger, journalist and successful business woman and Dr. Ann Luce from BU’s  Journalism and Communication Academic Group. 

The debate was part of BU’s Festival of Learning event to explore the role of the mass media in shaping such beliefs and identify whether media portrayals are responsible for rising rates of intervention.  The audience voted in favour of the motion, but the media team managed to get some people to reconsider their views on the impact of the mass media on women’s view of childbirth.

Professors Vanora Hundley and Edwin van Teijlingen

CMMPH