What is Vulvodynia?

Before I explain what Vulvodynia is, let's have a little anatomy lesson. Let's talk about the vulva. The vulva is the external genitalia for someone who has a vagina, this is so important as many call both the inner and outer workings a vagina. Even my two year old calls her vulva, a vulva and I truly believe the sooner we are all comfortable using correct terminology without shame and embarrassment the better.

The vulva protects the vagina and urethra and is responsible for much of the sexual response for women. The vulva includes the labia (outer and inner), clitoris (please tell me you know about this???) the mons pubis and vestibule and anything in between. Check out the picture for a close up look. 

Back to Vulvodynia, vulvo means vulva and dynia means pain. So Vulvodynia means pain in the vulva, but can also include any burning, stinging, itching or irritation to the vulva. Vulvodynia is not linked to a known cause and is considered a chronic pain condition that has been present for longer than three months.

Ouchy.. No thanks.

Then comes sub categories.. Clitorodynia - meaning pain in the clitoris and Vestibulodynia, pain in the vestibule region of the vulva. 

Regardless of where the pain is and what type of pain is experienced, those with Vulvodynia are all in chronic pain, and many suffer with anxiety. Wearing underwear and tight pants can be uncomfortable and vaginal penetration is usually painful,  there can be vaginal pressure and burning and many have urinary symptoms of, 

• Urgency

• Increased frequency

• Incomplete emptying

• Burning sensation with urination

• Light bladder leakage

What causes Vulvodynia?

Part of the classification of Vulvodynia is that the cause is unknown. So what do we know? We know that Vulvodynia is usually associated with potential factors. These include;

• Hormonal, the vestibule is very sensitive to estrogen and androgens, where imbalances can result in irritation. 

• Musculoskeletal components - 90% of those with vulvodynia also have overactive pelvic floor muscles, and then there are other myofascial and biomechanical factors that can influence pain in the vulva. 

• Inflammatory conditions such as Lichen sclerosus and Lichen planus

• Infections - recurring conditions such as bacterial vaginosis and thrush. 

• Nerve related, in pain. For some this is due to neuroproliferation - too many nerve endings in the area, for others there is irritation to the nerves supplying the vulva e.g. pudendal nerve.

• Iatrogenic, meaning it is related to a medical procedure, postoperative pain, cancer treatment, hormone therapy, trauma and lacerations associated with childbirth or genital mutilation.

How do we treat vulvodynia?

Firstly, any infections or inflammatory conditions need to be identified and managed.

Kathryn Johns is extensively trained in the area of vulvodynia, where she uses a combination of techniques including internal pelvic floor myofascial release (with consent), this can help to decompress the main nerve (pudendal) that supplies and refers pain to the vulva and help relieve tension in the overactive pelvic floor muscles.  Externally, there is body work to the fascia leading to the vulva and the muscle, nerves and joints that influence this area. 

Kathryn works closely with the other osteopaths in the clinic with our Vulvodynia patients. Kathryn concentrates on the pelvic health components, and our other experienced osteopaths work on the external components contributing to this condition. 

As vulvodynia is a chronic pain condition and with this comes a nervous system that is over-stimulated, part of the treatment is focused on helping to calm the nervous system down using gentle osteopathic techniques. 

We also give advice on lifestyle, breathing patterns, prescribe movement practices and mindfulness.

What is Vaginismus?

Vaginismus is a condition where the vaginal muscles, aka the pelvic floor muscles, involuntarily contract in association with vaginal penetration. This can make it very painful and or difficult for not just a penis to enter, but those who experience vaginismus may also have difficulty inserting a finger, a tampon or menstrual cup, sex toy or participate in a pelvic exam using a speculum. 

Vaginismus is the leading cause of unconsummated marriage and a major cause of dyspareunia (the blanket term for painful sex).

Vaginismus is classified into two categories. Primary, meaning it was present from the first time vaginal penetration was attempted and Secondary, meaning the person had gone through a period of no symptoms with vaginal penetration before symptoms began. 

Does vaginismus result in pain?

Many experience pain, for others there is no pain. For them it may feel like their partner’s penis (or tampon, sex toy, finger etc.) is hitting a wall as the vaginal muscles contract, preventing or making entrance difficult.

When pain is experienced with vaginismus, it is usually accompanied with fear and anxiety, a complex pain cycle can be the result, making vaginismus difficult to fix at home without the help from medical healthcare providers.

How is vaginismus treated? 

Kathryn, has years of experience treating and helping those with vaginismus, and has completed extensive training in female sexual disorders. Her approach to the treatment of vaginismus is very holistic and may include; internal and/or external pelvic floor myofascial release work, stress management, working with breathing strategies, improving posture and alignment and general osteopathic techniques. Kathryn has a major emphasis on the fascia and the fascial lines present in the body that impact the pelvic floor and the breath.

Kathryn works closely with the team of osteopaths at Eastern Osteopathy where patients regularly see Kathryn for internal pelvic floor myofascial treatment and specific chronic pelvic pain treatment while also seeing the other osteopaths if general treatment is required. Our osteopaths will educate their patients on movement practices to help lengthen the pelvic floor, breathing and meditation to assist with anxiety and stress, and the appropriate use of dilators to ensure all facets of their patients’ care are met.

What is Bladder Pain Syndrome/interstitial cystitis ?

What is Bladder Pain Syndrome/Interstitial Cystitis ?

A little bit of anatomy first, the bladder is a muscular organ that receives filtered urine from the kidneys. As the bladder fills the bladder wall is stretched. This stretch automatically sends information to your brain, making your brain aware of how full the bladder is and when it will be an appropriate time to wee. When the time is right you will feel the urge to void and, with that sensation, look for a toilet. 

Bladder pain syndrome (BPS/IC) typically involves bladder hypersensitivity with symptoms of bladder urgency, frequency and pelvic pain in the absence of any infection. In extreme cases it is common to visit the toilet in excess of 40 times a day. 

BPS is a complex pain condition involving the bladder, pelvic floor and nervous system. 

BPS is more common in women than in men and it is estimated that 1.2 million Australians are living with this condition. BPS is often associated with negative cognitive, behavioural, sexual or emotional consequences and can be linked to a reduced quality of life (Engeler et al, 2020).

What are BPB/IC symptoms?

Symptoms vary between individuals, but can include,

• Suprapubic pain (pain above the pubic bone)

• Bladder pain and pressure with filling, that is not relieved with a void

• Burning sensation with a void

• Increased urgency and frequency of void

• Vulva pain - vulvodynia 

• Phantom UTIs

• Generalised back hip and pelvic pain

• Dyspareunia - general term for painful intercourse 

What causes BPS/IC?

There is much debate on this topic, and no consensus; some believe it is caused by Hunner’s lesions, a dysfunction in the lining of the bladder. However only 10% of those with BPS have these lesions. 

What we do know is that 87% of those with the condition have overactive, tight pelvic floor muscles (Peters et al, 2007). We also know that these muscles, when tight, can cause referral patterns that mimic the sensation of urgency and/or bladder pain. When these muscles are released it gives the bladder an opportunity to function optimally. 

We also know that after having experienced 3 UTIs the bladder can be up-regulated, making it easily irritated.  

How do we treat Bladder Pain Syndrome?

According to the American Urology Association, pelvic floor therapy is the first line of treatment for BPS/IC. 

Kathryn, our pelvic health trained osteopath has completed extensive training in the field of BPS/IC where she has studied under and been mentored by some of the world's leading experts in pelvic health and BPS/IC. She has an incredible understanding of the anatomy and facial connections impacting both the bladder and the pelvic floor muscles. 

Kathryn believes in adapting a multi dimensional approach to treatment, including internal and external myofascial release to the pelvic floor muscles and the fascia supporting the urethra and bladder. Education and home exercises on breathing, yoga hip and spine movement practices and meditation along with self care and self compassion.  

Tips for Prolapse During Pregnancy

Have you been diagnosed with a prolapse and are wishing to conceive or are already pregnant?

This can be a scary time. Worried that pregnancy and birth might make your prolapse worse? Trust me this is common concern and a conversation we have with patients regularly. And it is scary and frightening, but it’s important to know that having a prolapse while pregnant is manageable and safe with some guidance, exercises and lifestyle modification. Our tips for managing this time are below.

Connect with your breath and pelvic floor

Spend time observing your breath, feel the subtle lengthening and decent as you breath in & as you breath out notice the pelvic floor engage and lift. Once you have connected with your breath you can add a gentle lift and engagement of your pelvic floor as you breath out. You can do this while in a semi-reclined position, seated, childs pose and standing.

SEE a Pelvic Floor practitioner

If you have a prolapse please make an appointment to see a qualified pelvic floor practitioner (osteopath/physiotherapis) to have your pelvic floor assessed and an individualised pelvic floor rehabilitation program created. This may involve strengthening exercises, breathing strategies and or ways to improve neuromuscular timing and coordination

Manage your constipation

Constipation is commonly experienced during pregnancy and along with straining is a major risk factor for prolapse. Consuming adequate water & fibre along with creating a healthy bowel routine while adapting good pooping posture & not straining is essential for minimising impact of prolapse on the pelvic floor. Oh and don’t forget the squatty potty to help achieve optimal pooping posture and the use of ooo cha to help expel the unwanted waste.

Listen to your body

Take the time to listen to your body; understand that your body, posture and centre of gravity is constantly changing and with this your prolapse symptoms can also change. A easy activity last week can cause a pressure and dragging sensation today. Knowing your body will allow you to alter your movements strategies to minimise impact on prolapse.

Use the Recovery Position

When feeling tired and extra pressure, bulging and dragging sensation in your vagina, taking some time to rest in a recovery position is important. Lying on your back with your legs up the wall or resting on a chair. Placing a pillow under your pelvis encourages your organs to move away from the entrance of your vagina. Then observe the natural rhythm of your breath & gently engaging your pelvic floor with your exhale. If lying on your back is uncomfortable, makes you feel dizzy or nauseous; please stop this exercise.

Exhale with Exertion

As you roll over, sit to stand, lift and other activities that involve some exertion; perform the activity with an exhale. As you prepare to move, exhale and gently blow out. By gently blowing & feeling your core engage & then moving, minimises the force directed to your pelvic floor and pelvic organs.

Look at your Posture

We know postural changes can influence the force and pressure applied to the pelvic floor. We also know pregnancy is a time of ever changing posture. Rather then sinking into these poor postural changes try to stand, sit and lye in alignment with our natural curvature. A quick way to test if your posture is optimal, check in and see if breathing is effortless, then we know our posture and alignment is on point. Having trouble try untucking your butt!!

Stay Active and whole body strengthening

Staying active & strengthening your whole body is great for overall pelvic health. It is important to exercise symptom free and under the guidance of your health care provider and/or within the pregnancy guidelines.

As a bonus regular exercise can help stimulate a bowel movement.

Manage your stress

When looking at our pelvic health we know stress can impact your ability to have a bowel movement and constipation is a risk factor for prolapse. We also know when stressed you will clench your pelvic floor muscles which in turn impacts the ability to contract effectively. Studies tell us when stressed our prolapse symptoms will bother us more. This doesn’t mean the symptoms are worse just that they bother you more causing more stress. Developing good stress management strategies is essential.

Common Questions about Babies and Osteopathy

Can Osteopaths help babies?

Yes. The osteopaths at Eastern Osteopathy have all completed further studies in the field of babies and children. Our osteopaths can help to assess and release tensions induced during birth or pregnancy which may be causing symptoms such as: difficulty latching, constipation, reflux and poor sleep.

Is osteopathy good for babies?

An osteopathic treatment can be very beneficial for babies from a very young age. Each baby presents with their own unique strain patterns which contribute to their symptoms and your osteopath is trained to assess and treat these often subtle tensions/restrictions. Treatment is always very gentle and non-invasive. Many babies even fall asleep during their treatment.

Why do babies need osteo treatment?

There are many reasons parents bring their baby in for an osteopathic treatment. Some of the more common reasons are:

• difficulty sleeping

• favouring turning the head one way

• reflux

• vomiting, constipation

• hiccups

• difficulty getting a burp up

• trouble latching

• being generally unsettled.

These symptoms are often caused by the birth - whether vaginal or caesarian birth, quick or slow, with or without intervention - many forces are put through the baby’s system during birth and can result in tensions as the baby grows.

Osteopath treatment for babies sleep

At Eastern Osteopathy we often treat babies that have difficulty sleeping. Each baby is different and a case history of the pregnancy and birth will be taken along with a hands-on assessment to help determine why your baby is having trouble getting to sleep, or only sleeping for short periods. Often there is tension in the cranial bones contributing to poor sleep. Sometimes there are strains in other areas or systems of the body causing discomfort and interrupting the sleep process.

Osteopath treatment for babies with reflux

Babies often come to the clinic for treatment because they have reflux. A case history and assessment can help determine the cause of the reflux. Often times, tensions from birth contribute to irritation through the diaphragm, oesophagus, stomach or the beginning of the small intestine resulting in pain or vomiting following a feed. Sometimes immediately after a feed, other times 30-60 minutes later. Treatment is always based on each baby’s individual presentation.

What can an osteopath do for my baby?

An osteopath that treats babies is trained to recognise and feel subtle changes in the anatomy and physiology of babies. They can help to gently release strains or tensions that may be present from the birth or in-utero. Some common reasons babies are bought in for a treatment are: trouble feeding or latching, constipation, wind, reflux and trouble sleeping.

Osteopath treatment baby breastfeeding

As osteopaths we often treat babies that have difficulty breastfeeding. These difficulties can result from a variety of reasons. Some babies have trouble turning their head one way, so may latch easier or more comfortably on one side than the other. Tension through the base of the head or the jaw may be impacting the ability for your baby to open their mouth wide enough to get a good latch.

Osteopath treatment for flat head

During their birth, baby’s bodies can be subjected to a lot of force - some natural and some from necessary intervention. These forces can result in strains, tensions and restrictions that osteopaths are trained to recognise and release. Some of these restrictions can lead to a baby preferring to turn their head one way and can result in a flattening to the area of the head the baby spends most time on. Treating the cause of WHY the baby prefers looking one way as well as ensuring the cranial bones are functioning and moving optimally can allow for improvements to the flattening.

Osteopath treatment for babies digestive problems

Many babies present for an osteopathic treatment due to digestive problems. Common symptoms are: constipation, straining and grunting to poo and being unsettled in the lead up to a bowel movement with relief following. Osteopaths are trained to assess and treat the cause of these symptoms, which can often be related to strains induced from the birth. Every baby is different and a thorough case history and assessment is always performed to determine why your baby has their symptoms.

Common Questions about Pregnancy and Osteopathy

Can I see an osteopath while pregnant?

Yes. And the great news is, the osteopaths at Eastern Osteopathy have all completed further studies in the field of pregnancy including:

• Spinning babies

• Preparing the pregnant patient for birth

• Active birth practitioners

• Visceral osteopathy in the field of obstetrics and gynaecology 

• Pregnancy and pelvic girdle pain

• Prenatal yoga and pilates training

Our osteopaths provide the best osteopathic and pregnancy care in Melbourne and suburbs surrounding Kew and Hawthorn.

Can Osteopathy help during pregnancy?

Yes. Our osteopaths have lots of experience treating pregnant patients for a variety of pregnancy related aches and pains including back and pelvic girdle pain, carpal tunnel, light bladder leakage, headaches, hip pain, and round ligament pain. 

Research has shown that pregnant patients who receive osteopathic treatment throughout their pregnancy experienced a reduction in pain intensity during birth, a reduction in the length of their birth and a reduction in episiotomies. 

Osteopathy and pregnancy near me

With two convenient (Kew and Hawthorn) locations in the Eastern Suburbs, Eastern Osteopathy provides expert pregnancy care for the following suburbs, Kew, Hawthorn, Richmond, Abbotsford, Collingwood, Camberwell, Malvern, Hawthorn East, Balwyn, Ivanhoe, Fairfield, Thornberry, Alphington, Toorak, Prahran, South Yarra, Surrey Hills and Melbourne CBD. 

Our osteopaths experience and reputation has seen them treat and help pregnant patients from all over Melbourne and Victoria. 

Our osteopaths provide the best osteopathic and pregnancy care in Melbourne and suburbs surrounding Kew and Hawthorn.

Osteopath treatment after pregnancy

Our Osteopaths are just as passionate about helping the new mother in the postpartum period as they are about helping with pregnancy osteopathy.

We have highly skilled and trained osteopaths in the fields of:

• Pelvic floor assessment and treatment

• Coccyx pain

• Wrist pain

• Upper back pain associated with feeding

• Back and pelvic pain

• Scar treatment

• Mastitis manual treatment and the use of ultrasound

• Diastasis recti treatment and rehabilitation

• Prolapse treatment and rehabilitation

• Return to running and exercise post baby

• Our Osteopaths provide the best osteopathic and pelvic health care for new mothers and are passionate about helping our patients transition into their new role as a mother/parent. 

Osteo treatment for Pregnancy and Sciatica

Our Osteopaths have years of experience helping the pregnant patient with sciatica using a variety of osteopathic techniques to help relieve the symptoms associated with pregnancy and sciatica. 

What can an Osteopath treat when pregnant?

Our osteopaths have experience treating pregnant patients with a variety of conditions including: 

• Lower back pain

• Pelvic girdle pain

• Round ligament pain

• Diastasis recti (abdominal separations)

• Light bladder leakage

• Childbirth education

• Preparation for birth

• Rib pain

• Pubic bone pain (pubic symphysis dysfunction)

• Wrist pain and swelling

• Mid back and neck pain

• Foot pain and swelling

• Headaches and neck pain
  

Osteo treatment for pregnancy and pelvic girdle pain

At Eastern Osteopathy, all of our osteopaths have completed further studies in the field of osteopathy and pregnancy including pelvic girdle pain. They come with 35 years of combined experience and pride themselves on providing the best osteopathic care for pregnant patients in Melbourne. 

Can my Osteopath help prepare me for birth?

Yes. All of our osteopaths are passionate about creating space in the pelvis of their pregnant patients and enjoy educating their pregnant patients on their upcoming birth and breathing techniques, active birth positions and the use of robozou and exercise balls to help create space during the birth. This education extends to the birthing partners.  

At Eastern Osteopathy we have Osteopaths who are childbirth educators, pelvic health trained, have completed further studies around creating space within the pelvis and who have completed further studies with spinning babies.

Our osteopaths pride themselves on providing the best possible osteopathic care and education for expectant parents. 

Do I need a referral to see an osteopath when pregnant?

No. You do not need a referral to see an osteopath when pregnant. Our osteopaths,  with your permission, will communicate with your medical team including midwife, obstetrician, doula and other allied health professionals to help create the best possible care for you while pregnant.  

Can I have pelvic floor therapy while pregnant?

Yes. Unless you have been told by your healthcare provider not to have vaginal penetration you are able to have internal assessment and treatment of the pelvic floor. 

Our pelvic floor specialist osteopath is expertly trained and experienced in helping to prepare the pregnant patient for birth and assisting with light bladder leakage, pelvic girdle, lower back and pelvic pain associated with pelvic floor dysfunction during pregnancy. 

I’m suffering with light bladder leakage while pregnant, can pelvic floor treatment help?

Yes. Research and professional experience has shown that pelvic floor treatment and rehabilitation can prevent and improve the symptoms of light bladder leakage while pregnant. 

Why would I see a pelvic floor therapist (osteopath) while pregnant? 

You can see a pelvic floor trained osteopath if you are experiencing back, hip or pelvic pain or requiring advice on specific exercise and movement practices.

If you are suffering with any light bladder leakage or prolapse concerns

If you are wanting assistance with preparing yourself and your pelvic floor for birth.  

You need your pelvic floor to be working appropriately during pregnancy, during the birth and after the birth of your little one. Learning how to contract and connect with your pelvic floor and breathe prior to the postpartum period, when it has just stretched over 3 times its normal length with a vaginal birth or you’ve had cesarean birth; helps to facilitate a faster and better recovery post birth. 

Eastern Osteopathy has a pelvic floor trained osteopath who has extensive experience in assisting pregnant patients with pelvic floor assessment and treatment.

Can I have Pelvic floor treatment if I have no specific concern?

You need your pelvic floor to be working appropriately during pregnancy, during the birth and after the birth of your little one. Learning how to contract and connect with your pelvic floor and breath prior to the postpartum period when it has just stretched over 3 times its normal length with a vaginal birth or you’ve had cesarean birth helps to facilitate a faster and better recovery post birth.

Seeing our pelvic floor trained osteopath can assist with helping you connect with your pelvic floor and education on specific pregnancy safe exercises. 

I have abdominal separation and I'm pregnant. Is this ok?

It is estimated that up to 100% of pregnant patients by the third trimester will have abdominal separation (diastasis recti abdominis), this is normal and helps to create space from the growing baby. 

At Eastern Osteopathy, we have osteopaths who are specifically trained in the treatment and rehabilitation of abdominal separation, we believe despite it being normal there are breathing and movement strategies we believe a pregnant patient can integrate into their life to minimise the impact this separation has on their core system, pelvic floor and pelvic and lower back pain. 

Pregnancy and Exercise

Exercise during pregnancy should be done and is safe, in a healthy, uncomplicated pregnancy. In fact, performing the recommended type and amount of physical activity during pregnancy achieves health benefits for mother and baby including reducing risk of pre-eclampsia, pregnancy induced hypertension, a reduction in instrumental delivery and unplanned caesarean section birth, and may help to reduce the severity of lower back and pelvic girdle pain.

According to the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) evidence-based guidelines for physical activity in pregnant women, it is recommended that in a normal pregnancy woman participate in 150-300 minutes of moderate intensity or if previously exercising can continue 75-150 minutes of vigorous intensity exercise per week.
This can be completed over a minimum of three days per week, however, being active every day (ideally 30 minutes per day, less if previously inactive) is encouraged and doing some physical activity is better than none.

Training should be a combination of aerobic (brisk walking, cycling, swimming, dancing, exercise classes) and strength (body weight, light weight or resistance band) exercises and exercise intensity will vary depending how physically active you were or we not pre-pregnancy. Women who were active prior to conceiving can continue with their usual activities for as long as they feel comfortable but are advised to check with a health professional if they would like to continue with vigorous intensity or high impact sports and exercise.

Additionally, some exercises may need to be modified as your pregnancy progresses due to biomechanical changes and pain i.e. after 16 weeks it is best to avoid exercises lying on your back.

Exercise is not recommended in all circumstances. The following are cases in which exercise is not recommended;

• Incompetent cervix

• Ruptured membranes, preterm labour

• Premature labour

• Persistent second or third trimester bleeding

• Placenta previa

• Pre-eclampsia

• Evidence of intrauterine growth restriction

• Multiple gestation (triplets or higher number)

• Poorly controlled Type 1 diabetes, hypertension or thyroid disease

• Other serious cardiovascular, respiratory or systemic disorder
  

Stop and seek advice from a health professional if you experience any of the following while being physically active:

• Chest pain

• Persistent excessive shortness of breath – that does not resolve with rest

• Severe headache

• Persistent dizziness / feeling faint – that does not resolve with rest

• Regular painful uterine contractions

• Vaginal bleeding

• Amniotic fluid loss

• Calf pain, swelling or redness

• Sudden swelling of the ankles, hands or face

• Decreased foetal movement

Still unsure what physical activity you can or cannot be doing during pregnancy speak with your health care provider before starting an exercising program.

*Exercise intensity ratings are based on ratings of perceived exertion on a scale of 1-10 where 1 is not moving and 10 is maximal effort. Activities in the range 3-7 indicate moderate-vigorous intensity and are considered safe and are recommended for health benefits in pregnant women. This can also be judged by the ‘talk test’ in which a conversation can be held during moderate intensity activities but difficult during vigorous activities.

Brown, W.J., Hayman, M, Haakstad, L.A.H., Mielke, G.I. et al. (2020). Evidence-based physical activity guidelines for pregnant women. Report for the Australian Government Department of Health. Canberra: Australian Government Department of Health.

Kate's Tips for Pooping in the Postpartum Period

Now let me tell you something I found out the hard way… NO ONE tells you that having a vaginal birth can feel like the baby is coming out of your bum. Anyone with me??

Postnatally, there are lots of conversations about looking after your vagina; regarding tissue tearing, episiotomy and surgical repairs. Today however, we are doing a 180 and talking about the rectum, and, you guessed it... poop. It certainly makes sense that this area might be tender, and if you have had the privilege of seeing a vaginal birth in person or via photos or video, you can see how the rectum has been pulled and stretched away from its usual position. As unpleasant as this may sound, we do actually need for this to occur, as it helps make room for the little (or in my case - not so little) one, to exit. 

Personally, I had more pain rectally after giving birth than I did vaginally. I actually had no redness, swelling or stitches associated with my magic vagina, but did I have rectal pain? HELL YES! And let me tell you, I was more than a little scared to go poop. However, I knew that prolonging the act was definitely not going to help in the long term. 

So today I'm giving you my top tips for pooping directly after you give birth. 

• This is a biggy.. please don’t delay the poop! It might seem scary, but the longer you wait and the more you suppress the urge to eliminate waste, the more backed up you will get. As the stool backs up, it ends up being stored in the descending colon, and in doing so water is removed from your poop making it harder and harder. This will make it more painful and even harder to pass. If you feel the urge, please be brave and poop. 

• When it's time to go, remember to use the squatty potty. The posture the squatty potty encourages helps to relax the pelvic floor muscle (puborectalis), which straightens your back passage and allows poop to exit with ease. Adding a low tone sound like mooooo, zoooooo or rooooooo can aid in this process by encouraging your abdominal muscles and diaphragm to contract, increasing the pressure around the rectum and stimulating the parasympathetic nervous system.

• Still nervous about doing a poop? Take a small pillow with you, placing it on your lower belly (this is even more important if you’ve had a cesarean section) and adding some pressure. The act of pooping requires tension (intra abdominal pressure IAP) to be created by our diaphragm and abdominal muscles , the pressure from the pillow can help regulate the IAP normally created by our stomach muscles. Plus it takes pressure off your fresh scar. 

• A great way of stimulating the parasympathetic and dampening the sympathetic nervous system is with relaxed diaphragmatic breathing. If you are not sure how to do this, check out this video. When we stimulate our parasympathetic nervous system, it gets our digestive system moving and stimulates our rectum to contract while inhibiting our internal anal sphincter, i.e. the back passage opens. The parasympathetic nervous system is all about rest and digest. This type of breathing will also massage the bowel with the rhythmic motion of your breath. Plus, as a bonus, diaphragmatic breathing will also start building an awareness of your breath and pelvic floor muscles. Did you know that when contracting your pelvic floor muscles you increase blood flow to the area which also aids in healing and recovery?

• As I’m sure you know, things can be a little tender downstairs after a vaginal birth. If you can handle the pain after giving birth, try to avoid medication containing codeine, as it will clog you up even more. There are other alternatives such as panadol for pain relief, and the use of ice to numb the area. Using ice as a cold compress also aids in your recovery by adding compression to your first aid steps. 

• If you are having trouble with passing stool and need help with softening the waste, magnesium oxide can be a great way to achieve this. However, before taking magnesium please consult with your maternity health team. 

• Your first meal after giving birth should be nutrient rich and easy to digest. Why hello Bone broth, this yummy nourishing substance can be a great way to keep you hydrated during the labour, plus it will help to give you loads of energy (trust me when I say you will need it) during the birth, and again once you have your new bubba in your arms. This liquid gold is rich in collagen (did I mention collagen can help repair any tissue damage during the labour), gelatin and lots of minerals which are thought to have many medicinal properties, one of which is strengthening the gut lining and improving our immune system. YAY! This is exactly why people offer to cook chicken soup when we are sick. When I say cook I don't mean reheat from a can. I mean the type of soup our nannas cooked when we were young. Not sure on how to cook a bone broth? Check out Chloe’s blog. You can consume the bone broth on it’s own or use it as a base for your yummy soup.

• Look after your gut MICROBIOME - these are the bugs that live in our gut - with the greatest concentration being in our large bowel, they are very much involved with the health and function of the bowel, and the quality and ease of our poop! Pregnancy and birth interventions can cause lots of disruptions to our microbiome, so it’s important to support and rebalance the microbiome postnatally (in fact it’s super important to optimise it the whole way through pregnancy learn more about that here.

• We need both PRE & PRObiotics to restore & maintain our microbiome - this can get confusing - let me explain; PREbiotics feed the good bugs and PRObiotics are the good bugs. PREbiotics are found food in plant foods (a rich and diverse plant-based diet creates a rich and diverse gut microbiome) and PRObiotics are found in fermented foods and drinks (yoghurt, kefir, kombucha, sauerkraut etc) or supplements can be used. 

Supplemental PRObiotics are amazing to use postnatally for gut health. They help with motility, reducing inflammation, repairing tissue, regulating stool composition (keeping them soft!) etc. BUT (and this is a big but!) not all probiotics are created equal, you need to consider specific strains, mechanism of action (what they do in the body) and also quality of manufacture. We recommend Qiara - it has lots of great research, many of the beneficial mechanisms of action and it’s a quality Australian made product, it’s actually a breastmilk strain (meaning it was originally isolated from healthy human breast milk). As well as having many proven benefits for gut health and the gut microbiome - it also helps breast milk microbiome, breastfeeding outcomes and infant gut, microbiome & immune development. As far as PRObiotics go - it’s one of the best. I wish every mum and baby could have it. 

• When choosing food from a menu in a hospital, or if you have a friend or family member who has organised a food roster (these can be the best!), just remember to be fussy and ask for nutrient rich, organic whole foods that rot and make up the colours of the rainbow. Having a 1kg tray of lasagne delivered to your door, as yummy as it sounds, may not be the best for your digestive system. Chicken soup with a side order of sauerkraut can be an awesome request.

• Most importantly, when eating, take your time to chew, chew, chew your food. Chewing breaks our food down and promotes the production of gastric enzymes. Gastric enzymes are responsible for breaking our food down to an appropriate size for the small intestine to start removing nutrients. The act of chewing, filling our stomach and dumping into the small intestine stimulates a nerve pathway that causes our colon, and it’s natural peristaltic motion, to start. This peristalsis gently propels our stool through the large intestine. Way to go chewing, filling and dumping (pun intended)!

• Water, water, water! Always have a water bottle on hand and take it everywhere. Being hydrated is absolutely essential if you plan to breastfeed. It is vital to be hydrated for the production of your milk. Did you also know that dehydration can be a major cause of constipation? Since you are taking your bottle everywhere, when you have had a poop or a wee, rather than wiping the area with dry toilet paper, try using a soft damp cloth, especially if you have stitches, hemorrhoids or fissures.

• Whether you have, small graze or a minor perineal tear, an epsiotomy or a larger tear involving the external anal sphincter; it’s likely your perineal area ( the space between your vagina and anus) will be tender and need some ice and compression for 24-48hrs. Keep the area dry and clean. When drying after a shower, remember to dab the area dry. 

• Sleep. When you can, get some sleep. Hahaha… I know that this idea is good in theory but quite hard to achieve in practice. However, it is super important that you look after yourself and get sleep when you can. Try to limit screen time - especially at the 2 am feed... as tempting as it is to pick up your phone, DON’T! The blue light can affect your melatonin levels, therefore making it much harder to go back to sleep. 

• Move. This may seem like a hard task, but starting with small walks like checking the mail can be a great way to stimulate your GUT to get moving. 

At Eastern Osteopathy we believe that having good quality poop and optimising your gastrointestinal tract (GIT) health should be part of all new mamas postnatal health plans. Doing so will not just have a positive impact on your git, it will have a positive impact on your immune system, your mental health, the function of your pelvic floor and then there are the health benefits to your new baby. 

Pelvic Floor Series: Anatomy of the Pelvic Floor

Kate and Liz are coming together for a pelvic floor series to share a few short videos and articles about the pelvic floor. In this video Kate goes through the anatomy of the pelvic floor.

Stop, breathe and think about your career with Michelle Redfern, founder of advancing women

As a part of our recent expert zoom series, Kate got together with Michelle Redfern, founder of Advancing Women and diversity consultant, to discuss how to stop, breathe and think about your career. This was an amazing interview for anyone who is reconsidering their career or looking for a new job in the current climate. Michelle is a wealth of knowledge, working in advisory positions on issues of equality, inclusion and gender diversity in business and sport.

The resources Michelle referenced in the video can be found here.

For more information on Michelle Redfern and advice on your career, visit Michelle's website and Instagram page.