Episode #5: Beyond Birth: Nurturing Pelvic Health Beyond Pregnancy

Welcome to the podcast where we dive deep into all things pelvic floor health! Join us as we explore the journey of our guest Natalie Headdings, a seasoned doula and exercise specialist, who discovered her passion for pelvic health through her work with postpartum mothers and Pilates teaching.

In this episode, our guest shares her inspiring journey from doula work to studying exercise science, weaving together her expertise in a holistic approach to pelvic health. From her experiences in clinical settings to her affection for pelvis models named Polly and Penelope, she brings a unique perspective to understanding the pelvic floor.

Together, we delve into the importance of pelvic floor anatomy and function, uncovering the mysteries of this vital area of the body. Whether you're a new mom, an exercise enthusiast, or simply curious about your body's inner workings, this episode offers valuable insights and practical tips for pelvic floor wellness.

Tune in as we empower you with knowledge and awareness to take charge of your pelvic health journey!

Here are the links that we spoke about within the show:

The Resource Doula Podcast by Natalie Headdings:  https://podcasts.apple.com/us/podcast/the-resource-doula/id1608653210

How to get in touch with Natalie & sign ups for Pre/Post Natal Fitness Specialist Certification:  https://www.trainernatalie.com/

Natalie's online  course:  Mindful Movement in Minutes:  https://www.moveinminutes.com/

Books by Katy Bowman for resources for minimal shoes, movement and more:  https://www.amazon.com/stores/Katy-Bowman/author/B0057HLJY2?ref=ap_rdr&isDramIntegrated=true&shoppingPortalEnabled=true

Affiliate links for Barefoot or Minimal Shoes
- Anya’s Reviews Shop: https://anyas-shop.com/?ref=trainernatalie
- Earth Runners: https://trainat.li/Earth-Runners (Code TRAINERNATALIE)
- Xero Shoes: https://trainat.li/xeroshoes 
- Vivobarefoot: https://trainat.li/vivobarefoot

Podcast Interviews about Barefoot shoes on The Resource Doula:
https://podcast.resourcedoula.com/1933625/10795758-why-minimal-footwear-with-anya-of-anya-s-reviews
https://podcast.resourcedoula.com/1933625/12416998-the-truth-about-feet-with-podiatrist-andy-bryant

Disclaimer:
The information shared on this podcast is for informational purposes only and is based on the opinions and experience of Lori Dorothy and their guests. The content should not be used as a substitute for professional medical advice. Diagnosis or a treatment. Always seek the advice of your healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you heard on this podcast         

Transcript

0:00

Welcome to let's get curious. The podcast for women and mothers seeking connection, support, and inspiration. We are friends, mothers, and therapists. Laurie, a physical therapist and Dorothy, a speech and language therapist. Together. We share our personal stories, including IVF birth experiences and navigating children's learning difficulties. Through our discussions, we uncover profound lessons for personal growth. Join us on this journey of curiosity, compassion and empowerment. Welcome to let's. Get curious.

Lori: 0:39

Well, welcome trainer Natalie. How are you today?

Natalie: 0:41

I am. Well, thank you so much for having

Lori: 0:44

I'm excited to have you on as I've been, you know, plugging along there on Instagram and letting everybody know of all the information that you're going to be sharing with us today. I value your experience. You're just all the years that you've been doing this as a doula exercise specialist. So I know you're going to bring us some really good and fun tips all about the pelvic floor. So with that, I would love for you to just tell us a little bit more about yourself and how you got into this line of work. Okay. Mm

Natalie: 1:16

the bat. I love it. So I started out, I would say, let's start in 2014. That's when I basically started this work. I became a doula during that time. I was also learning to teach Pilates at that time. And during my Great. Work as a doula during my Pilates teaching stent, I learned about issues that stem from childbirth and pregnancy, like incontinence and prolapse. I was able to attend and kind of assist a post baby class at the Pilates studio. I was working at

Lori: 1:51

hmm.

Natalie: 1:51

taught by a PT, a pelvic PT, and I learned about all of these things, diastasis and that. Exercise could be preventative and also restorative for these issues that happen. And so the wheels started turning and I started doing a little bit more research. I was in line to go to nursing school at the time, and I just, I quit nursing school. I was like, this is not what I want to do. I don't want to work with, with people who are sick. I want to work with people who want to get better, who are healthy, who. Need to move their bodies and know how to move their bodies and and want that for themselves. And so then I, I launched into a degree in exercise science and have knitted together. My dual work Pilates experience, exercise, science, background and clinical, clinical exercise, um, physiology as well. My experience in a in a. more medicalized clinic, wellness center, and that's kind of brought me to where I am today.

Lori: 2:51

And here you are with the love of the pelvis. Yes.

Natalie: 2:54

absolutely. Yes, I've acquired a couple pelvis models along the way. They all have names. So I have Polly and Penelope here with me today if we need some demos, if we are gonna share the video. Yes.

Lori: 3:08

other piece. I see this all the time seeing patients as a pelvic floor PT and after even women have given birth, I'll be like, do you know what the pelvic floor muscles even look like? And they're like, I have no clue. So we need to educate and show, you know, people what this area of our body looks like, because, um, I think a lot of times, unless you have, even if you do have a problem down there, you don't really understand the anatomy and all of its functions. Um, so with that then, why don't you take us into kind of just explaining the general pelvic floor anatomy, and function, and kind of give us an overview of that.

Natalie: 3:43

Okay. Yeah, that's a great place to start. Will people be able to see the video? Should I use a demo or just use Okay, I'll use my words as well. So here's the pelvis. And if you are not watching, you can put your hands on your hips and feel your pelvis, your hip bones there. So you have two sides of your pelvis. You have your two hip bones. In the back, you have your sacrum. and your tailbone at the bottom. Now your sacrum is mobile. It kind of tucks under, like think a dog tucking his tail between his legs, or coming back out, like a little bit of a booty pop, or arching your low back that direction. You also have in the front a pubic joint. A lot of times we refer to this as a pubic bone, but it is actually a joint. And if you have been pregnant and have pain with that joint, you are well familiar with where it is in your body. Um, so that kind of is the, the top view of the pelvis. If you're looking from the bottom, like if you're looking from the feet up. Or you're sitting down while listening to this, you can kind of rock back in and forth side to side and feel your sit bones underneath you. So, that's another landmark that you can use to identify your pelvic floor. So, the pelvic floor is a network. Of muscles, there's nerves down there. There's blood flow down there. There's ligaments. There's so many things packed in this like tiny little package, but it's really foundational and it's, it's the bottom of the core. So if you are sitting, then you can feel those sit bones underneath you. You've got the pubic joint in front and tailbone in the back, everything in that space, kind of what you're sitting on. Is considered your public floor. If you're standing, you can kind of think about, am I tucking? Am I untucking? How is my pelvis sitting in space right now? And imagine that the space right over your ankle bones, right? Underneath underneath your core is your pelvic floor. So something to think about there is it really is. The base of our core, and we can't talk about our core or core strength or core retraining without our pelvic floor. We're missing a crucial piece and I think that's part of the reason why We have so many issues and we've never been taught about our pelvic floor because we skim right over it

Lori: 6:09

we

Natalie: 6:09

though it's Pretty much the center of the universe as, you know, in my world, right? And so we have to talk about it. We have to talk about the issues. I think it's becoming less taboo, thankfully, right now, but, um, still, I encounter people all the time who have no idea what the pelvic floor is. So, that's kind of the basis there, the muscles of the pelvic floor, they function much like a trampoline. So if you think of them kind of sitting at the bottom of your pelvis, holding up your pelvic organs, holding up everything inside, ideally they can ebb and flow. So they're not just static. They don't just hold still all day long. They lengthen and expand and kind of. Bulge isn't the right word, but they drop down. They lengthen that way. So not any pressure, we're not feeling pressure or bearing down, but they expand and open. And then they also do the reverse. They lift up and in and contract. So that's kind of the, the main movement of the pelvic floor, which should be in coordination with your So if we're talking about the entire core system as a whole, and I know I'm like getting beyond the pelvic floor here, but you can think about your, your diaphragm at the top of your core. And if you have your hands kind of around your broadband line, and you breathe in. Ideally, you can get some expansion in that ribcage. That's your diaphragm moving down and out. And in doing so, once it moves down and out, it increases the pressure inside your abdominal cavity. So, it's called intra abdominal pressure for the nerds in the crowd. As you breathe in and that diaphragm moves down, there's Uh, necessity for the pelvic floor to expand and absorb that pressure placed upon it. And so it releases or should as you inhale and then as you breathe out and your ribs kind of come back together, your diaphragm relaxes and goes back upward, then there's more wiggle room inside and the pelvic floor can lift. So an ideal breath cycle is when you inhale. Your diaphragm comes down, your pelvic floor releases and lengthens. You exhale, your diaphragm goes back up, and your pelvic floor contracts and lifts as well. So that's kind of like something to visualize and think about as we're talking about all of the topics we're going to discuss today and, and breathing. So,

Lori: 8:35

Yes. Well, I think that's a great overview and, you know, that's the piece where, same thing, you know, you guide somebody in taking a breath and a lot of times you just see them lift through the chest, right? We don't breathe, we have so many inverted breathing patterns, so a lot of times, at least in my experience, when I'm trying to, Retrain, say, a postpartum client, we have to go back to just the basics of breathing. And a lot of this stuff, too, could be boring work. Um, but, just as Natalie said, if you don't have that foundation, you can't build. and reverse the problems that you may be having, right, during pregnancy or postpartum. So what are some good habits, Nat, that individuals can just be doing, you know, whether they are looking to get pregnant before preconception, um, That they can be helping with their pelvic floor even just now. And even if they're not planning to have babies, right? I mean, this is an area, because as you said, it's like, this is the foundation, this is our core. And so many times we're taught that the six pack abs are, you know, that's what makes up your core. And,

Natalie: 9:40

Mm hmm.

Lori: 9:41

no.

Natalie: 9:42

There's so much more to it. There's so

Lori: 9:43

There's so much more to it, and this is why we have to get that education out there of the importance of the pelvic floor being essentially the core. And so, yeah. What are some good habits that we can start practicing today?

Natalie: 9:58

Okay. There's so many. There's so many. I'll start listing them. I can't even give you a number because there might be like 10 plus, but we'll start simple. The first thing that I would say is pay attention to your posture, pay attention to how you're standing and how you're sitting. If you are chronically standing with your pelvis tucked under, like that tailbone tucked between your legs and you're pushing your hips forward. I talk about this all the time, that alone can increases. Increase your chances of leakage, like whether you cough, sneeze, jump, run, and you find yourself leaking, whether you've had a baby or not. Um, and it also can increase the tension in the back of the pelvic floor. So remember, I said that, that sacrum moves. It tucks in and it opens back up. If we hold it consistently tucked, then the muscles in the back of the pelvic floor will be excess. It tight in excess and pull the tension kind of away from the front of the pelvic floor. So it doesn't have that resiliency or ability to catch a cough or sneeze or a jump right in time. And so we have an unbalanced pelvic floor and. Oftentimes this, this may surprise some of you, but oftentimes leaking is more so due to a too tight of a public floor or an unbalanced pelvic floor than it is a too loose of a public floor. And so just doing a bunch of kegels, if you are already in a non optimal. Position of length with those muscles is not going to solve the problem. It might actually make it worse. Um, so bringing that all back to posture, if you untuck your booty, so bring your hips back, release your glutes. You don't need your glutes just to stand. It's a joke. It's a joke to say it's a glute free exercise, right? So for those of us who have been gluten free, you can relate. Everything should be a glute free. Exercise when you're just standing or sitting. So if you're sitting, then pay attention to whether you're slouching back into the couch. And this isn't to say like, don't ever do that, but be mindful. If you are doing that more of the time than not, then your body is really smart, right? It follows the path of least resistance. It's not going to take more energy to release those muscles. If you're not asking it to, and so oftentimes we end up without tightness just because of how we're sitting all day long. So, untuck those booties. You can even sit on the floor. That's one of my absolute favorite things to encourage clients to do. Sit on the floor because it can get uncomfortable and then it requires you to move. So, the more Shapes and, and geometry, so to speak, that you can expose your pelvis to sitting in different positions on the floor, the more balanced those muscles are going to be. And that's just movement. It's not even adding any exercise yet. So that's a really good. Um, positional thing to try. Add a cushion underneath your hips. Right now I'm, I sit on the floor to record podcasts. So I'm sitting here on a cushion. Um, and that allows you to stay in kind of a more untucked neutral position without feeling like you're straining. Um, speaking of straining, use a squatty potty when you poop or find a stool.

Lori: 13:10

I have them all throughout the house here. Yeah,

Natalie: 13:17

I got the travel one. It fits right in my suitcase. It's incredible. Have you ever been in a hotel bathroom where there's not even a, there's a flimsy garbage can, you try to put it on its side for a squatty potty and it just fails. So invest squatty potty if you travel. Um, but by raising your feet up. Not by lifting your heels, because that actually might tighten your pelvic floor, believe it or not, if you're just lifting your heels off the floor when you're pooping, bringing the level of your entire foot up, brings the knees above the hips and Releases your public floor so that you can have a, a straight shot, right? Opens the shoot. So you can have a more efficient poop. You can evacuate your rectum. Well, chronic constipation, which we can talk about kind of some more of the causes and things about that, but, um, it can cause you to strain and put bear down and put unnecessary pressure on that pelvic floor, and it can lead to a lot of other public floor dysfunction over time. So if you are constipated, number one, I would. Address your diet and your water intake and your electrolytes and all of that, but do yourself a favor and raise those feet up when you are going to the bathroom. Um, yeah.

Lori: 14:35

I know, I have, I have a saying. All my friends, of course, every time I now go to a public bathroom, I think of you, and my whole saying, too, is cover, don't hover.

Natalie: 14:43

Mm hmm. Mm

Lori: 14:44

Because hovering, same thing, when we sit down to go even P, our pelvic floor has to relax so that the bladder can contract and push the P out. So when we're hovering right in the squat position, then the pelvic floor is also contracting to hold you into that squat, and then you're having to use more pressure to push the P out. So, Cover, don't hover, and that way the pelvic floor gets to completely relax and you get to fully empty, which can also then help too if you do suffer from, chronic, bladder infections.

Natalie: 15:14

Yes. Yeah.

Lori: 15:15

Yeah, urinary tract infections. So cover, don't hover. That's my, that's my tip to add to all of Natalie's amazing information.

Natalie: 15:23

I love it. I also will kind of piggyback on that too. No power peeing. A lot of times people will say, I'm going to, I'm going to go pee really quick. And my response always is now, Oh no, no, take your time. Don't go fast. Actually sit down and relax. Like I say that. In public at cafes to people all the time, because, if you are pushing your P out, then that can lead to unnecessary strain again on your public floor and more downward pressure. And when we talk about prolapse, which is that descent or non optimal movement of those public. Pelvic organs, right? We don't want to add any excess pressure downward if we can avoid it. So yeah, sit down, relax, take a deep breath, put your elbows on your knees

Lori: 16:08

take your time, and pee, and cover, cover if you need to.

Natalie: 16:12

yes. There are some instances where you might want to hover like a really gross outhouse

Lori: 16:17

Yes. There are some exceptions to the rule.

Natalie: 16:20

I do know people who, like, carry, like, wipes with them and they'll wipe down the seat ahead of time really fast and then, yeah, so, there are options, there

Lori: 16:29

There are options. There are. So, okay, so posture. As you were saying, in terms of helping with good, habits for the pelvic floor, watching our breath, making sure that we're not constipated. What other tips do you want to add to that for good habits?

Natalie: 16:44

yeah, let go of your belly,

Lori: 16:46

Hmm.

Natalie: 16:46

go of the tension in your core. Oftentimes, I'll speak to women specifically because this is like, I call it Natalie Science, I don't know if it's backed by actual studies, but,

Lori: 16:57

Your experience, it says a lot.

Natalie: 16:59

yes, yeah, so, Oftentimes, we end up breathing like you were saying, Lori, in our chest, right? We inhale and our chest rises up and our belly goes in. I think that's mainly due to girls feeling like they have to hold their bellies tight for their entire life. Like we're told, suck it in, suck it in, suck it in, hold it tight. And for photos, the culture, whatever it may be, and we end up with a non optimal breathing pattern, which then affects how our core functions. So, let your belly go. And everybody can do this while you're listening, let your belly go, and then let it go again, because you're probably still holding tension. And that allows you to have a full range of motion of those muscles. So your core will actually get stronger. And if you're worried about aesthetics, it will look better eventually, right? Like if you think about holding a muscle tight at all times throughout the day, like if you were to hold your bicep tight all day long, how hard is it to Pull it, pull it straight again, right? It's going to be all cramped up. And how effective is that muscle? It's not, it's not going to be strong and resilient and able to. Lift or do things in case of an emergency, catch a ball thrown at your head by your kid, things like that. Same with your core. If you're consistently holding tension there, and I'll add to your glutes, relax your glutes. Oftentimes we're butt grippers without thinking about it. Um, then your core is not going to be as effective or as strong. or is resilient to catch you when you go to reach for something or catch that ball, right? And we may end up leaking because of that excessive just tension. There's no room for that beautiful ebb and flow of the breath if we're always holding tight. So yeah, let go of your belly. That's another one. I think my last one that I'll say is, um, check out your footwear. Look at your feet. There has been an actual study done. This is one of my favorite studies that the increase in height in heel height of a shoe

Lori: 18:57

Oh, yes.

Natalie: 18:58

higher instances of urinary incontinence. If we are constantly standing on ramps, lifting our heels up all the time, then we're not going to have the ankle range of motion. We're not going to have our feet work how they were designed. We're our feet need to. Spread out when they interact with the ground and be able to propel us forward and modern shoes, conventional shoes do not allow our feet to work how they need to. And so consider transitioning to minimal footwear or barefoot shoes, spend more time barefoot. As much as you can, um, the same, like, you know, barefoot and pregnant, like do that, do that. It's going to be the best thing that you do for your health, um, your pelvic floor, your overall posture, your ankle pain, your knee pain, your hip pain, your back pain, your neck pain, all of the above it. Your feet are really the foundation of everything. And so if they are strong, then the rest of your body is going to follow suit. So I oftentimes say the stiffer, the shoe, the weaker, the foot. So, the more support you have on your feet, the less they will actually work for you. So, um, I've got lots of resources as well. We can link in the, in the

Lori: 20:08

we will link those in the show notes. Well, and the other piece, you know, especially for our runners, who postpartum and stuff experience that leaking, the whole foot is about also absorbing ground reaction forces. So to your point, Natalie, if you're having, you're in this rigid shoe and you have a foot that's not functioning appropriately, it's just going to continue to lead to more leaking and stuff down the road. Well, and what you and I were talking the other day too, cause I was telling you how looking for, um, sport shoes for my kids and they play soccer and all those shoes are super, super narrow and it drives me crazy. And you were telling me, um, share that with everybody about the number of hours to be in toe spreaders. If you're in a narrow shoe,

Natalie: 20:51

I would do double the amount of time So if you go out for a night on the town, you're wearing high heels, which have a really nice squishy toe, right? Meaning it's pulling your toes together and not allowing them to be wide then if you're in those high heels or regular even running shoes that Or dress shoes, whatever it may be, cleats, playing soccer. If you're in that for an hour, then spend two hours in toe spreaders and doing foot rehab. It's that important. It's that important.

Lori: 21:21

so ladies, bunions, we know what we're talking about, tight shoes, narrow toe boxes will lead to bunions, as well as more leaking and not absorbing those ground reaction forces.

Natalie: 21:32

Yeah. It's all connected. It's

Lori: 21:34

all connected, yes it is, yes it is. So this question that I have for you Nat, may kind of be a little similar to the one that we just, said, but I just want to make sure that I'm not missing anything here. So, what can someone do prenatally to also help with their pelvic floor?

Natalie: 21:50

See you at Pelvic PT.

Lori: 21:53

And why would you say that? Yes, and why? If you can elaborate on that then.

Natalie: 21:58

I would say, like, the amount of modern conveniences that we have in our world, we're not deep squatting all day to, you know, pull vegetables out of the ground. We are not moving. As much as we should be as much as we're designed to we're sitting in a chair for work. We're sitting on the drive to and from work. We're sitting, um, to watch TV after work. Like all of that chronic sitting. It's an epidemic, right? And our hamstrings get tight. Our pelvic floor gets tight. Our low back is not as strong. So there's so many reasons to. start moving more and moving more mindfully, but also a pelvic PT can do an internal exam, and they can actually assess all of the muscles of your pelvic floor. I have, here's Penelope. She's got the muscles. So there's what, like 14, 15 different muscles down there, right? And pelvic floor PT is, if you consent to it, and if you want that, like you can do. An internal exam and figure out what is working, what is not, what is too tight, especially if you're hoping for a vaginal birth in the future, it, you're just setting yourself up for success. If you assess that now and then work towards, you know, keeping that balance throughout pregnancy and. And during your labor, because if we don't know what's going on with our bodies, and oftentimes we're very disconnected with that part of our bodies is where we hold a lot of trauma and and emotions as well. And we tend to disconnect, then we're not going to be as aware or in tune with what's happening throughout pregnancy and then, um, maybe run into some issues postpartum. So, I'm not not necessarily saying you can prevent everything, but you can really. You can really put a dent in, in some of those issues and you can hopefully prevent most of them if you're well aware of what your public floor is doing,

Lori: 23:49

Yes.

Natalie: 23:50

to birth. So,

Lori: 23:52

Yes. Women are always amazed, you know, after I do an internal exam on them, if they're just like, I had No clue this was happening in my body and a lot of times, like even for like the first week or two after we have that initial assessment, I might just go out and now be aware of these items that might be pertinent to them of where you're holding, what is your posture, when do you get the pain? you know, when are you holding your breath,

Natalie: 24:17

Yep.

Lori: 24:17

things. And so, and that's why this work, you know, it takes time because there has to be a level of awareness. If you can't, it's not about throwing exercises at something, right? Now it's like you have to understand what is happening, feel what's happening so that you then are in control and have the power to then go in and correct that stuff.

Natalie: 24:35

Yeah,

Lori: 24:36

So what would you then say, Nat, how does the pelvic floor change with pregnancy? And

Natalie: 24:43

It absorbs a lot more forces from inside, right? You have a growing baby, growing uterus. You've got excess weight on top of your pelvic floor. And the natural tendency is to want to shift those hips forward and, and kind of jut your hips out,

Lori: 24:59

do the pregnant walk,

Natalie: 25:00

Yeah,

Lori: 25:00

pregnant walk, yes.

Natalie: 25:02

Yes, so if you find yourself doing that, then see if you can adjust and bring your hips back. You might notice that you look less pregnant because your belly and your baby are sitting more inside of you rather than in front of you, which by doing that you can also reduce the severity of diastasis, that separation that happens down the center of your abs. You can breathe better. You can get a deeper breath. Most of the time if I have somebody who's very pregnant and they've been standing In that, you know, classic pregnancy posture with the hips way forward, the upper back way behind and they get a, they complain of shortness of breath. Once we get them back into that more stacked and aligned posture, they're like, oh, my gosh, I can breathe again. I have room in my diaphragm. Like, I can get that deep breath and I've been wanting. And so that's, I would say, like. I guess I'm going back to the, what they can do, but the pelvic floor also is affected by relaxin and increased amounts of progesterone during pregnancy, which makes things a little more loosey goosey, which is the technical term.

Lori: 26:08

Yes.

Natalie: 26:09

So you have a lot more laxity in your joints during pregnancy. And that also affects your connective tissues as well, as far as like. The, the linear Alba, which is the center connective tissue, you were pelvic floor muscles. And so the tendency may be to tighten. Your pelvic floor or clench because your pelvis itself feels more loose, but thinking about, okay, I don't want to tighten my pelvic floor. I don't want to get it excess. Tension, because it needs to relax to have a baby, right? Our uterus pushes our baby out. Our public floor does not. It needs to get out of the way. And so. All of the people prepping for labor with, like, a million kegels,

Lori: 26:54

Oh!

Natalie: 26:55

themselves. Right? So. Yeah.

Lori: 26:57

yes.

Natalie: 26:58

Yes, the pelvic floor, it absorbs more pressure and tension during pregnancy, it may get tighter, um, but to combat that you want to strengthen your glutes, your hamstrings, all of your surrounding hip muscles, so that it doesn't feel like it has to take on that excess laxity and pressure alone. Um. We also have more weight in the boobs, right? Our boobs grow getting ready for breastfeeding if you choose to go that route. So that forward, like, rounded posture of the shoulders oftentimes happens as well. Um, and I'm, I know I keep getting off topic, but going up from the pelvic floor, right? If we are, avoiding that rounded shoulder posture. We're usually pulling our whole shoulders back and pushing our rib cage up, which also affects the pelvic floor because then your diaphragm and that, and that pelvic floor cannot have that same communication that we talked about at the beginning, that, that beautiful ebb and flow of moving up and down with each other. So it. Increases attention, decreases the function, and oftentimes it leads to dysfunction of, leaking, maybe potential prolapse or pain. There's a lot of pain that is associated with pregnancy that's considered normal, but that can oftentimes be avoided by strength. So, um, yeah, does that answer the question

Lori: 28:21

It totally does. Yes, it does. Well, and you know, and just to build off of, I mean, you know, it's, it's, you're saying like off topic, but it really is still all topic because the body is all connected. Right. And so to kind of piggyback off of your rounded posture, when we were in that rounded posture. Our whole thoracic spine is not in a functional position to give us full turning and twisting and rotation. And so that then leads to abnormal pelvis positions, which then leads to the pressure that we were talking about. So it's all connected. And so, you know, as Natalie was saying, you know, to go and see. Um, uh, a pelvic floor PT, when you're working also with the pelvic floor PT, it isn't just about them assessing just the pelvis and the pelvic musculature. It is also they should be looking at posture because you could be stuck in your mid back, right between those shoulder blades. That could be. You know, affecting down below and vice versa. So the whole chain is, is connected. And it's amazing when you start, um, opening somebody up. So to our breastfeeding moms, and even if you're bottle feeding, we tend to get into these rounded postures, we're holding the baby in front, we're propped up with, you know, pillows, which the Again, puts us more in this rounded flex posture. And again, it is, it's hard to take that deep breath and we're just feeding into those, um, postural weaknesses that might've been there, you know, prior or even, you know, your whole life. And so everything just gets compounded more and more sometimes after pregnancy because of the laxity from the hormones and posture that we're not aware of and, um, inverted breathing patterns. So looking at the whole picture, the whole body is, is so important. Um, so, and anything else you want to elaborate on that, that piece now or do you feel we covered that?

Natalie: 30:11

I think I think we covered it pretty well.

Lori: 30:13

changes, mm hmm.

Natalie: 30:15

Changes. Embrace the changes.

Lori: 30:18

Embrace the changes. How about, um, just, you know, ways Sleep, right? Sleep becomes really, really challenging, especially as, as we grow the baby and everything. So is there any fun tips that you have about kind of supporting the pregnant mom through sleeping postures, standing postures, anything like that that can obviously affect the pelvic floor as well?

Natalie: 30:41

Yeah, the standing posture is the same, like for everyone, essentially, bring that booty back, bring your ribs down, take a deep breath, see if it goes lower, that's a really good way to test if you're in a more optimal position, if you're breathing all in your chest, then, you know, you're probably in a less optimal position, sleeping postures are difficult because everybody is so different, right? And, um, lots of pillows, if you can prop yourself up, um, Ideally, you still shouldn't be getting up throughout the night multiple times to pee. That might be like a little bit of a yellow flag, um, to address with your pelvic, you know, PT and, and figure out, like, maybe I have some urgency, maybe I have some, um, incontinence that I'm not addressing. Um, it gets harder and harder as you get. further along in your pregnancy because that bladder has, you know, very little room. Um, but making sure that you are well hydrated and keeping up on electrolytes, I think is huge because your pelvic floor, if you are not hydrated, if you're like shortening or reducing your water intake before sleep on purpose, so you don't have to get up in the middle of the night, your concentration of your urine goes up. Right. The, the, it gets less water down. And so that is actually a bladder irritant and could cause you to leak or cause you to feel like, oh, my gosh, I have to pee right now. Um, so it's, it's a fine balance. Of course. Um, I'm also a huge advocate for magnesium. Most people in. The world in the U. S. at least are magnesium deficient. So, if you're not sleeping well, if you're uncomfortable, then that's something you can talk to your provider about as well. It's increasing your magnesium intake. Um, but yeah, find whatever, find whatever position is most comfortable for you. Sometimes people like to do that core breath where they really inhale, expand and exhale, just lift their pelvic floor slightly, um, right before they go to sleep. It's a calming breath. It can help. Relax your whole nervous system. So that's a good time to prep and practice that breathing as well.

Lori: 32:45

Yes, well, and I like that you were saying too, in the sense of, um, irritants for the bladder. So also just being aware, and this does not even have to do with pregnancy alone, but Uh, caffeine, carbonated drinks, as well as alcohol are irritants to the bladder. So if you're finding yourself, again, leaking or just peeing more frequently, check and see how much of that you're consuming throughout your day, because it will be, uh, an irritant. And you know, like you were saying, you shouldn't be waking up many times throughout the night to go to the bathroom. And I want to kind of piggyback off that as well, because, you know, when we talk about, I think everybody's pretty well versed, um, in the sense of like the leaking. Right, so like the stress, um, uh, incontinence that we go through, but then we also, um, have the urge. And when we're giving, and so, and as, as rehab providers, we kind of have to treat those a little differently. The stress is more about, yeah, are we too weak, or are we too tight in those, in that pelvic floor musculature? Where the urge incontinence is actually more of a brain bladder connection. And so if we're always kind of doing that, like, oh, we're getting ready for a road trip, and you even do this to the kids, make sure we pee before we go. So if you're peeing when you don't have to pee all the time, it's telling the body that we need to go pee when you really don't, uh, which then leads more to that urge incontinence. And then same thing, you might be laying there, you know, in bed and have a, um, a feeling that you need to get up and, and go pee. And I would say, Be aware of that, but then push it off for a little bit because you don't want to get into that cycle where every time you have that urge, you're, you're training your body and your bladder, I got to go pee now, I got to go pee now. Um, because it's harder to kind of come back from that. It's rehab able, but it takes a lot of time and trusting that you're not going to leak. And I think what, what I thought was really cool when I was learning all this stuff, You know, when you have the urge to go pee, it's okay to push that urge off. And then the urge will come back, and you can probably push it off one more time, but then probably by like the third or fourth urge, you're like, okay, no, now it's really time to go. So it's okay to push pee off. It's not okay to push poo off. So when you have the urge to go poo, Go poo,

Natalie: 34:57

it

Lori: 34:58

take it, because, and especially if you already suffer from constipation, right? So when we push off that urge, the body just kind of shuts it down altogether, and that urge most likely will not come back, and, and then just lead to more constipation down the road. So, just getting into some fun pelvic floor tips, because again, a lot of times, you know, people don't, we, they just don't understand how this all works. So, um,

Natalie: 35:24

thing I'll add to that actually if you count Your 1, 1, 000, 2, 1, 000, like slow seconds when you are peeing, ideally, like a full bladder is about 10 to 12 seconds long. So if you feel like, Oh my gosh, I have to pee and you put off the urge and you're like, okay, I'm actually going to go to the bathroom. Start counting every single time you pee to see if your bladder is truly full. And that can be a really good indicator to help you figure out, Oh, like, okay, maybe I've. I've gone too soon in the past and trained my bladder to think that it's full when it's only halfway full, something like that.

Lori: 36:00

Love that. Love that. Well, and because a lot of times too, people won't drink water because they then don't want to go pee and you're just adding them to dehydration, right? Again, pregnancy or not, birth or not. And that just leads to other problems down the road. Yes. I mean, we

Natalie: 36:18

Yes, but there's another fun tip that I love talking about. It's like a bio hack. It's like a body hack If you have the urge to pee and you're like in the middle of the grocery store You feel like you can't hold it feel like you're gonna wet your pants, right then do some slow mindful calf raises Squeeze those calves really nice and tight Lift up, you can add in that exhale and pelvic floor lift as you come up, inhale to lower, do about five or ten of them. If you're in a place where that is not acceptable, you can do it also sitting. You can also just scrunch your toes, like make a toe fist with your toes. There's actually, there's a nerve, right, that goes through your calf and it When compressed shuts off that signal or helps to shut off that signal from your bladder to your brain and so it can bide you like a little bit of extra time to get to the bathroom without leaking.

Lori: 37:13

And without rushing, right, without, because that's the other thing, you don't want to start, even if you would, okay, I do have to go, you can still use this technique that Natalie's talking about, walk calmly to the bathroom, and then relieve yourself, and not always be in this state of panic and anxiety. Mm hmm.

Natalie: 37:30

And the other thing too with that is oftentimes like, it's like the key in the door syndrome, right, where you're coming home from work, you didn't pee before you left, and you're like, Oh my gosh, I have to pee as soon as you put the key in the door, you leak. And so that's a trigger. And it's a very real thing with urgency, right? And so, um, So I oftentimes have clients if they're dealing with this, like they go home a different route. They hum a song while they're opening the door. They walk backwards into the bathroom because the sight of a toilet just makes them bleak. And so whatever you need to do to be really creative at distracting your brain is excellent. Like come up with whatever works best for you, but know that, know that these things are treatable. Like it's figureoutable. It's rehab able. Yep.

Lori: 38:15

Yes, it is. So as we're, okay, so now we've kind of taken us through preconception, the changes that happen in the pelvic floor during pregnancy. Now comes time for birth. And the laboring. So if you can elaborate a bit on kind of that process of what happens with the pelvic floor, um, through that, and what are just some considerations that we could be doing for the pushing and the breathing, to help get through that, wonderful but yet exhausting phase.

Natalie: 38:45

Yeah. Labor is like a Spartan race. You never really know what are obstacle you're going to come in contact with. Um, from even before the labor, I'm going to back it up just a little bit from about like 36 weeks on. I encourage clients to change their core breath strategy and do what we call like a reverse Kegel. So instead of inhaling and expanding, exhaling and engaging the pelvic floor, We simply inhale in and expand, excuse me, and then as you exhale, you keep that expansion in your pelvic floor. So you're training to relax regardless of the exhale or the inhale. Like I said before, your uterus pushes out your baby, your pelvic floor does not. So it needs to relax and get out of the way. So the more you can train and encourage your pelvic floor to let go, hopefully the more smoothly and more efficient your pushing phase will be. The more movement during labor, if at all possible, if you can get up, move around, be on all fours, do a lunging position, slow dance, wiggle your hips on a ball, be in the bathtub. The more movement, the better. Motion is lotion when it comes to exercise and when it comes to Um, if you think about like belly dance movements, that was originally designed to help get babies out, move your hips, practice that before you go into labor. So you were familiar with those movements and then do them during, Oh, I'll reset. Do them during your labor experience. Um, something else to think about is when you are vocalizing, when you're making sounds, there's a really cool, if you Google vocal cords versus pelvic floor, you'll get a bunch of images that show the similarities between your. Your vocal cords and how your pelvic floor looks. Those muscles are very similar. There is a connection. It's not that odd. It's just the other end of the tube, right?

Lori: 40:46

that's

Natalie: 40:47

So the higher pitch sounds that we have, and if we're, if we're squealing, if we're yelling, if we're screaming higher, higher pitched, um, then our vocal cords go tighter. Our pelvic floor goes tighter. So the lower, Okay. Deeper growls, the primal sounds that you can do the, like, as, as low as you can go. Some people say like, I was making sounds that I didn't even know my body could make, right? Vocalizing during labor. Keep it low. Some people are quiet. That's fine. But if you are going to make noise, keep it low. That can also help relax your pelvic floor and keep it open and supple and ready to allow a baby to come through. Um, As far as specifically pushing, ideally. You don't. Ideally, you let your body do its thing and you respond intuitively. This is more challenging for first time parents, right? It's also more challenging if you have an epidural, because you can't feel as much. You can't feel where baby is exactly. Um, so When you have that urgency to push, follow it, sometimes it can relieve some of the pressure and pain. Um, a lot of times specifically in the hospital setting, women are coached to take a deep breath and hold it, curl around their baby and push as hard as they can, like they're having a bowel movement. It kills me to hear that. That's not the most efficient way to push out a baby. Oftentimes they're also on their backs. Now there's nothing necessarily inherently wrong with pushing out a baby on your back, but it's going to make it more challenging. Some people are way comfortable on their back. I've had clients who come back to me after taking my class and they're like, okay, I thought I was not going to push on my back, but then it was the most comfortable. You do you boo. That's

Lori: 42:35

Mm hmm.

Natalie: 42:36

my thing, but if we think about how that sacrum moves, we're coming back to that theme again, right? If we're flat on a bed or on the floor, pushes that tailbone up and it creates a smaller opening for the baby to come out. So, By any way, if you can just roll to your side slightly and give your sacrum room to expand and open up or hands and knees, you have plenty of room for that sacrum to get out of the way, that tailbone to get out of the way, then that is going to be optimal. The other thing to think about is when you're pushing, like you can practice this here. Here with me. So one hand on your lower belly like underneath your belly button one hand on your upper belly like right underneath your ribcage Okay, take a breath in and then start blowing the air out like you're blowing a pinwheel or blowing bubbles, right? So you're breathing all that air out. Keep going. Keep going. Keep going. Keep going. Keep going. Keep going. Keep going What you should feel under that top hand is kind of a compressive feeling like it's pulling down and away from your hand from your belly button to your perineum kind of poofs out. Right? That is ideal for pushing. So that breath, you're, you're getting that pressure from the. air and from the lungs to start that effort downward. But then the bottom of your belly and your pelvic floor are relaxed and they can absorb that force and allow that baby to come through. So that's a really good way to push without holding your breath and running out of air and being on your back and doing the hardest crunch of your life. Right. I think it's so funny. We're like telling pregnant women, don't lay on your back and don't do crunches. And then what do, what do a lot of providers have them do when they're giving birth? Lay on their back, do the hardest crunch ever, and hold their breath. That just doesn't make sense to me at all. So if you can be in a, a more But natural position more upright. You're working with gravity. You're allowing your sacrum freedom and you're pushing intuitively. You could also think about like, um, the example I love to give is like a toddler pooping behind the couch,

Lori: 44:44

Yeah. Mm hmm.

Natalie: 44:49

They're in privacy. So that's also something to consider when giving birth, having the room dark, having only people who you are comfortable with seeing you poop. Be there. That's a really good standard to draw the line. So your mother in law or whoever's uncle doesn't join you in the birth room. Right? Um, and then, And then allowing yourself to use force, but be intentional with how you direct it down. So, that toddler, right, if you have that image in your head, usually they take a little breath, and they hold it for a time, but then they let it go, and they grunt. So, it sounds like this. Right? And so, that's kind of a good, Way to think about directing that pressure, using that force from that air and then letting it go. Um, but sending that energy downward rather than sending it all out upward, like through your mouth. Okay, so that's something to, to think about as well when you're pushing. Most second, third, fourth time moms say took fewer pushes, right? I hardly had to push your body knows what it's doing. If you were in a coma and you were in labor, it would push out a baby just fine on its own. So that's something else to remember and, and keep track of. Like my body knows what to do. I just need to work with it. Um, the other thing I'll

Lori: 46:10

a foreign concept to everybody, right? Yeah. Mm hmm. We always think more. We think more is better. More is better. More is better. And it's like, just go with the flow. Go with the flow. Hard when you're in pain. Yeah. But a reminder of letting it go. Well, and I like to always give the visual to, even if I'm doing, um, post rehab work, visuals, right? Picture like a flower blossoming, an opening. Um, even jellyfishes. I don't know if you've ever like watched them in the water, right? There's like that, yes, there's that contraction, but then there's also the opening. So as you're trying to push that baby out, picture, because all the visualization work too, with the mind is huge outside of, even if it is maybe hard to get that breath or remember what Natalie said during this podcast, just even visualizing opening, opening, opening. Will help.

Natalie: 47:00

Yeah, the last thing I'll say

Lori: 47:02

Mm hmm.

Natalie: 47:02

You can give yourself even more like centimeters matter when it comes to a head coming out of your vagina, right? So if you can give yourself the most freedom of movement and space in your pelvis,

Lori: 47:15

Mm hmm.

Natalie: 47:16

the thing I will tell you to research and look up is closed knee pushing. So remember the sacrum tucks under if you are. Lying flat on your back. Oftentimes what we imagine for birth is the knees spread wide, right? That spread eagle position. What that actually does is Close the pelvic outlet even smaller. It brings the sit bones closer together and allows Less room and more tightness of that pelvic floor. So it's opposite of what we think. Hollywood has made us believe that that's the best opening position. Even providers will say that, like, get your knees as wide and close to your ears as possible because it's going to open your pelvis. It actually is opening the top. It's opening where the baby comes in to begin with, but it's closing down that outlet. So if you can get off your back, ideally hands and knees, upright, squat. Or a half kneel position and then actually bring your knees closer than your ankles. It will open up those bony parts of your pelvis and allow more freedom of movement and, and help to expand your pelvic floor. So if I was to tell anybody, like one thing to prep for, for labor, get your pelvic floor familiar with letting go. And look up closed knee pushing positions and advocate for yourself to do those during labor.

Lori: 48:39

Love that. Is there anything, Nat, that they can also be doing to the perineum prior to birth and labor?

Natalie: 48:47

Yeah, so it's a controversial topic, perineal massage.

Lori: 48:51

Mm hmm. And if you can maybe explain, sorry to interrupt you, but maybe if you could even explain what the perineum is and then, yeah, we could explain what we're talking about.

Natalie: 49:00

I've got Violet the vulva here. Perfect.

Lori: 49:02

I love it. We're using all the props today.

Natalie: 49:05

So the perineum is a space between your vagina and your anus. So that tissue at the bottom of your vaginal opening, the bottom of your vulva, right? Um, that stretches and opens and oftentimes can tear during delivery. So there has been a lot of talk about massaging that perineum prior to birth, getting it prepared. There's a lot of different approaches that you can take to this. Um, It's not. Like a massage where you're letting getting knots out. It's not necessarily, um, you're going to treat it now and then it'll be loose and floppy and amazing during labor. It is a more so mind body connection that if you are okay with it, and if you are feeling good with it, you can apply some pressure. And of course, with lube, some oil use, whatever, right? You can do like a, um, like a U shaped. Pressure massage at the bottom of your perineum, you can do it to yourself or have your partner do it for you. But the idea is that you apply slight pressure and you breathe through it and you allow your public floor to relax and let go. And then you find the next position of pressure. And so you have that muscle memory of what it's like to have pressure in your perineum and release and surrender to that pressure. I've had clients have very good success with this and feel like, yeah, that was like, really helpful. And I didn't tear and all of that. I've also had clients say, maybe they have history of sexual abuse. Maybe they have like, a very big disconnect with their body. Maybe they just feel uncomfortable with that. Then it actually causes them to tighten up. And so it's not as. Effective, right? It's not going to be helpful to allow your public floor to release. They found other releases more beneficial, like the post to your public floor when, where you sit on a tennis ball underneath your sit bone, things like that. So there's also a product called the epi no, which is. Not really sold in the US, but the idea is that, in other countries, they used progressively larger gourds and they would insert the gourd to the vagina and relax around it and then increase kind of like a dilator

Lori: 51:17

Yeah. Yeah.

Natalie: 51:19

so you can use pelvic floor wands, you can use dilators. All hopefully with the supervision of your pelvic floor, PT and guidance to see if you even need that, be encouraged that the cocktail of labor hormones that you get naturally from your body will make that tissue. Like, my midwife friend says, chewed bubble gum, like, it's so elastic and open and, and so you don't have to necessarily worry if you are touching your perineum now, and you're like, how on earth. Is a baby going to come out

Lori: 51:51

Mm hmm.

Natalie: 51:52

They encourage that that tissue is not the same as what it is in labor. You will get. More hormones, more laxity to it. So yes, there's oftentimes benefit to perineal massage. It can be great if that works for you, but a lot of times clients choose to not do it because they're, you know, uncomfortable with it, or it feels foreign to them and they still have success and, and avoid tearing as well. And the other thing. To note on this is tearing isn't necessarily the worst thing in the world. Sometimes the body needs to open a little bit and release that pressure to be able to birth your baby vaginally. And that's not a bad thing. Like a lot of times I hear tearing is like the number one fear of first time pregnant moms. It is usually better than an episiotomy where they cut manually a natural tear. It doesn't necessarily always have to be stitched up, it heals much better that those natural tear torn edges come together easier than a straight,

Lori: 52:57

hmm.

Natalie: 52:57

you know, scissor cut. So, something else to remember and keep in

Lori: 53:02

Yeah. Well, and I think it's just a great reminder of just remembering really what you are in control of is trying to keep yourself as relaxed as possible. Right? Relaxed as possible. Yes, and so, okay, we've walked now through the birth and the labor, and now we are postpartum, Nat. And so, wow, yay, we made it! And so, how would you suggest building back the pelvic floor, postpartum wise?

Natalie: 53:28

Yeah, rest first. Sleep when you need to. That is gonna be the most valuable thing in your recovery. I'm not like a lot of other exercise specialists who are like, Go harder, go faster, go stronger. It's not the time for that. And rest is gonna do you really well. The other thing that is Related sort of off topic, but related is. Nourish your body with good, good warm foods postpartum. It's really crucial that you give your body things that are easy to digest. No cold foods. If you look to all other cultures in the world, they have a period of like 30 ish. To 40 days after birth of eating warm foods where the mother is resting and really taking care of herself or someone else is taking care of her. So she can take care of her baby. Well, I recognize that's not possible for everyone in every situation. The more nourishment you can give your body. Now, your tissues rebuild with nutrients from food, right?

Lori: 54:30

Yes,

Natalie: 54:30

oftentimes we forget that. Like, we think about the physical recovery

Lori: 54:34

Mm

Natalie: 54:34

as separate from eating. Now, if we eat, I'm a huge proponent of eating animal foods. And I know that's not everybody's, everybody's jam. Um, but the more you do research on it, there's really no replacement. And Slow cooked meats are awesome, bone broths, rebuilding minerals, like all of those things are hugely important. I would recommend everybody read Lily Nichols book, um. But if we, if we take out the animal foods and the cholesterol, we need to make those sex hormones, then our recovery is oftentimes less great. Um, and so some people who are like vegetarians or vegans, they will actually opt to eat meat during pregnancy and postpartum, because it's been shown by the research to be the most crucial time of building, like, you're literally building a human, right? And an organ, the placenta, and so it's, it's really important to do that. So if you want. Faster, more efficient, better tissue healing, eat lots of things with collagen, meat products, good quality dairy products, all of that. And I know that sounds weird coming from an exercise person, but if you don't have the foundation and the building blocks to. your tissue quality, then it's going to be harder to do it through exercise. So you're just aiding yourself as much as you can, setting yourself up for success if you're nourishing your body well. So as far as exercise, you can start the core breath 24 hours postpartum. Ideally you're horizontal as much as you can be in the first week, if not a couple of weeks, you then can add in maybe a glute bridge where you lift your glutes up. or your hips up off the bed or the couch or the floor, coordinating that with the breathing. Then you roll to your side. Think about kind of how a baby moves, right? They start on their back, then they roll to their side. It's developmentally

Lori: 56:29

Yes, it is.

Natalie: 56:30

as well. You start to do maybe a leg lift while you're breastfeeding on your side. If you can do, if you can coordinate that, building up your hips and the coordination of your core with your hip muscles, because those are going to be tired and sore. Right? Um, then you start to go a little bit more upright. Maybe you do some hands and knees stuff. You roll to your belly, you press up, you do some core activation and hands and knees, maybe like a bird dog kind of movement. Then you go up to sitting and you see if you can lift one leg at a time without totally losing stability. Maybe you do some arm movements. Your, your shoulders are going to be tight. You activate, you do some rows or you do some. Like band pull aparts to just get the back of your shoulders to wake up and the front of your your shoulders your pecs to release Then you start to add in maybe a squat really mindfully you can do it while you're holding your baby Then you add in a leg lift in standing and then you start to do a lunge and then you start to increase the speed and the load and the the different types of movement that you do but that will carry you for pretty much the first eight weeks, you're slowly moving from your back all the way up to standing in a split stance in a lunge. So, it's not a specific reps and sets, but I don't think it needs to be. I think it needs to be, you need to listen to your own body, but that's the way to progress. If you are a runner or a jumper, you want to. Go back into high impact activity. The current research is showing don't go back until you number one are building up to it, but at least three months postpartum, if not six months, it takes about a year to recover from childbirth. If not longer, it took at least 10 months to make the baby. Right.

Lori: 58:14

You're not getting back. Yeah. Three weeks out running or anything like that. Yep. Well, we always try to talk about the the fourth trimester at least as well, right? Give yourself that fourth trimester to heal and get sleep and get adequate nutrition and you'll come out of it stronger. Mm hmm. Mm

Natalie: 58:32

first 40 days, if you've heard the same, the first 40 days sets you up for the next 40 years and oftentimes postpartum hormones breastfeeding hormones can give you a glimpse of perimenopause postmenopause, which is very interesting. Like, you have the vaginal dryness sometimes with breastfeeding, you have, um. The night sweats, you have a lot of the similar symptoms, so it's a glimpse in the future. So if you can nourish your body really, really well during that postpartum time, hopefully your perimenopause menopause time will be that much smoother. It's kind of an interesting perspective, long term perspective. Mm hmm.

Lori: 59:07

it's hard to always kind of keep that in sight, right? But yeah, a great tip. What about, bathroom habits? Postpartum.

Natalie: 59:16

Use a squatty potty.

Lori: 59:19

Kind of everything kind of circles back right to the prenatal and just day to day yeah day to day living one because I know you know a lot of times like we're swollen right we're swollen down there and so same thing it's hard to tell like how much you're pushing and are you pushing and having those sensations so again just practicing I think all those breathing exercises that you hadn't mentioned even going into labor of just relaxing and Relaxing. Yes. And let gravity

Natalie: 59:45

out, breathe your poop out. Ha,

Lori: 59:47

out. Yes.

Natalie: 59:48

ha.

Lori: 59:50

Very true. And now, is there anything that you want to add about prolapses?

Natalie: 59:56

I have a lot to say about prolapse. I won't go on too long of a tangent, but, um, there was some research that showed that about 80 percent of women in the first few weeks postpartum had some degree of prolapse following a vaginal birth. It just makes sense, right? Prolapses is the descent or movement downward of those pelvic organs. And if we have pushed a baby out, downward, then, and there's laxity in our connective tissues, then it just goes to make sense that we would have some slippage, for lack of a better word, of those, of those organs. So that's just another reason, like 80%, that's really high stat, right? If you. Can stay horizontal, do the gentle bridges, encourage your body to heal. If you are doing too much in those first, in that first week, then it can prolong that prolapse for, for longer and, and increase your recovery time. So do yourself a favor of like. Really being mindful, really breathing well, you can wrap your pelvis and your lower abdomen with a postpartum wrap. Um, the belly zinc one is the one that I recommend,

Lori: 1:01:04

it's a great one.

Natalie: 1:01:05

Yeah, it's adjustable and it doesn't, it's not a waist trainer. It doesn't squeeze from the middle of the toothpaste tube. It supports gently from the bottom.

Lori: 1:01:15

So you can then get a normal breath is what you're saying, right? You can. Yeah, it doesn't impede. Yeah. Breathing. Mm hmm.

Natalie: 1:01:21

it just assists in that, that muscle function and helps you feel okay. I'm taking care of it's like a gentle hug. Right? Um, so prolapse, it's also not a death sentence. Like it's a very scary thing, but more education, more awareness about it leads us to understand and be able to advocate for ourselves and see a pelvic floor PT. As soon as you are able, generally they won't go internal until. Past that 6 week mark, right? You're on pelvic rest until 6 weeks postpartum, most of the time, if not 8, but get booked with a pelvic PT during pregnancy for about 8 weeks past your due date. That's what I would recommend if you're on the books, right? Most pelvic, good pelvic PTs are pretty busy. So, if you can get on the books, you can at least move that, that appointment around. And then it's 1 less mental load piece that you don't have to think about after you have a baby, um, but. Yeah, being mindful of not straining on the toilet,

Lori: 1:02:15

Mm hmm.

Natalie: 1:02:16

mindful of not holding your breath, and, and bracing when you're lifting things, um, in those first few weeks is, is key. So,

Lori: 1:02:25

Yes, and I, you know, usually we go back right to our OBs and they check us to make sure we're healing okay, and then they'll give us, like, you know, the go ahead. Um, but, you know, what I want to elaborate on there is they're mainly checking to see how you are healing inside. They're not really checking, do you have a prolapse? If so, what should we be, watching? Maybe, again, go out to pelvic floor PT, you know, to get looked at and assessed. They're not checking for diastasis, recti. They're just looking to see, are you healed? So to your point, it's great to just follow up with a pelvic floor PT. And then you have that gauge of where are you now post baby? And what do we have to, keep an eye on. And, you know, even when it comes to, to prolapses, Yes, there are, there's always a time and a place for surgery, but just like anything, we need to give the body time to heal. You know, I was just listening, actually to a, another, pelvic floor professional that I follow and she had a, a prolapse and it took her two years, to fix it. And there's also pessaries, right? There are pessaries that you can be fit with if it is something that's annoying you, that it's kind of fits like a diaphragm and can, support those organs while you're getting. Um, your rehab taken care of.

Natalie: 1:03:38

Yeah, they can be an excellent tool to

Lori: 1:03:39

Mm hmm.

Natalie: 1:03:40

get those muscles back into the place they need to so they

Lori: 1:03:42

Mm hmm. Mm

Natalie: 1:03:45

in Alaska, right? A lot of moms are like, I need to be able to hike up this mountain with my child on my back and if they have prolapse symptoms while they're hiking, but not at any other time, it decreases that quality of life. And so they may choose to get a pessary just for the

Lori: 1:04:00

Mm hmm.

Natalie: 1:04:01

and use it occasionally. For And that relieves their symptoms, helps them get stronger, and helps them feel better mentally, right? Because they're doing the thing that they love,

Lori: 1:04:10

Yes.

Natalie: 1:04:11

um, avoiding feeling. All the icky things that the symptoms like lower back pain or pressure downward on your perineum all all of that.

Lori: 1:04:20

of those. And what about carrying the baby?

Natalie: 1:04:24

Oh, yeah

Lori: 1:04:25

Cause that kind of, that feeds into our posture, right, wrong posture, wrong, pressure leads to more pro, well could prolapse as well as leaking and those types of things. So any tidbits about baby carriers, how to carry your baby, what to be mindful of during that time.

Natalie: 1:04:41

yeah get a carrier that fits you well to begin with That supports you well, I don't really recommend baby wearing for, like, the 1st, 10 days, because you shouldn't be up and about and trying to get more things done with both hands during those 1st, 10 days. Anyways. And ideally, if you're the more time you can spend horizontal, the better, which we talked about. Um, but. that same stacked untucked

Lori: 1:05:07

Mm hmm.

Natalie: 1:05:09

will challenge your core more so yay bonus core workout, but also take the pressure off of your low back. If you have a lot of pressure, if you have a lot of pain in your shoulders, your carrier probably isn't the appropriate carrier for you or your child, um, Cassidy over at let's talk baby wearing is 1 of my top resources for sending people because she. Reviews pretty much every type of carrier and talks about

Lori: 1:05:33

Oh, wonderful.

Natalie: 1:05:34

how to adjust it. So, yeah, I, um, I love her resources and she's very, very helpful. So find somebody who can help you fit 1. A lot of times you can also try friends on prior to buying your own, so it can save you some headache of like, searching for the right 1. Um, but, yeah, in those 1st, few weeks, see if your partner can carry the baby for you where the baby, um, but make sure that your posture is. Is great. And there's two when they're carrying the baby, does that help answer the

Lori: 1:06:06

It does. It does. It's all those things, you know, it's easy to, you know, put them on the hip, right? To get that support while you're doing something at the stove and trying to, to multitask. But it can just lead to more, more dysfunction and more pain and, and just longer, longer rehab for sure. Mm hmm. It definitely does. And I just want to circle back to make sure that everybody is understanding this too. So, as you're saying, we can get into just some nice easy core breath after baby. Can you just review for us one more time what core breath is and how it looks?

Natalie: 1:06:41

Yeah, absolutely. So it's an inhale through your nose, nice and gentle, expanding your rib cage, your belly and your pelvic floor. So everything expands and opens as you breathe in. And then as you exhale, You can add in a rounded lip, exhale, like you're blowing bubbles through a wand, blowing a kiss, whatever it may be, slowly breathe out. You can add in a little pelvic floor lift, like pick up a blueberry with your vagina. Think about maybe a Kegel, but you're lifting up towards the crown of your head rather than just squeezing locally. As you're breathing out naturally, your deep core will activate and wrap around you and make you feel stable and secure. And that is a foundation and basis for. Pretty much every exercise and it will help retrain your brain and your body connection to know that when you get up out of a chair, when you catch a ball, when you throw a ball, when you pick something up off the floor, your core is already there to support you. It should have an anticipatory action, so it should turn on prior to whatever task it is that you're going to do. Oftentimes we run into like, Oh, my back hurts when I put on my sock.

Lori: 1:07:47

Mm hmm.

Natalie: 1:07:48

because the timing is off. So if you can retrain with that breath, slowly introduce movements, slowly then introduce more load or weight and speed and reps, then you'll get stronger and retrain that, that whole system.

Lori: 1:08:03

Right. And you know, and that's the thing to remember, ladies, is that you don't need to go back necessarily into the gym. Your whole house and new lifestyle with the baby is your gym. The baby's going to gain weight. You're going to be lifting heavier. You know, always get into that practice. I tell people you're lifting up the laundry, inhale down, exhale up. You're lifting that baby out of the crib. Same thing. Get that breath before and exhale. And so that it becomes this reflexive, natural breathing pattern. Yeah. And now, are there any other resources that you can recommend that will give people just maybe some ideas of some, natural movement that they can do throughout their day and, again, just kind of continue on this, yeah, this path?

Natalie: 1:08:44

For natural movement, I love Katie Bowman. She has written numerous books. She has a podcast. And she has She's not really on social media because she practices what she preaches, but she has a lot of information on her site. I also like MoveNat, M O V E N A T, for ideas of, of more natural movement, like crawling and jumping and hanging and things like that. I have my own course, which is called Mindful Movement in Mere Minutes. It's on my site, you can find it at trainernatalie. com or moveinminutes. com. And I go through. A lot of what we talked about, the breathing, the posture, specific muscle releases, how to squat, how to lift, how to do, do all of the, typical lifts that you would experience in a normal workout with good form, with mindfulness, with the breathing. And then there's some workouts in there as well. So yeah, that's a, that's a

Lori: 1:09:37

Wonderful, wonderful. Well, and I, I encourage your, your class again, even if you are not down the path of baby, because this is just movement that we need also as humans. So, treat yourself. Christmas is coming, right? Christmas is coming, a birthday is coming, an anniversary, something is coming. So, yes, treat yourself, well.

Natalie: 1:09:58

your body is worth it. Your body is worth that investment.

Lori: 1:10:01

That's right, that's right. Well, Nat, this was amazing, so informative. Any last bits you want to add in before we close?

Natalie: 1:10:10

Oh, man, put me on the spot again. Laurie. Um,

Lori: 1:10:14

Just making sure, because you're a wealth of information.

Natalie: 1:10:17

I think, something that has been a theme with my clients lately, is building back trust with our bodies and you have to trust your body and your body has to trust you to heal. But you are the only expert on your body. So you can take every course you want. You can read all the books that you want. You can do whatever pro exercise program, but you're really going to truly heal when you build that trust with your body, which looks like showing up for yourself in whatever way that makes sense to you. Gentle, gentle. Most of the time, nourish your body. Well, let your body trust you again and start to trust your body again. And that that is the way to healing and feeling better.

Lori: 1:11:00

I love it. I love it. Well, again, Nat, thank you so much. For those of you out there, everything that we talked about today will be linked into the show notes. Also remember that Natalie has her own podcast called the Resource Doula. So again, a slew of information. I know you also bring on some other birth professionals. So please go ahead and check out her podcast as well. And, I am sure we will be You know, circling back and doing this more in the future together, Nat, I, I love your work and I love you. So thank you.

Natalie: 1:11:30

thank you, Lori. Thanks so much for having me. It was a pleasure.

Lori: 1:11:33

Yay! Well, we will see you all soon!

Natalie: 1:11:36

Bye.

1:11:38

The information shared on this podcast is for informational purposes only and is based on the opinions and experience of Lori Dorothy and their guests. The content should not be used as a substitute for professional medical advice. Diagnosis or a treatment. Always seek the advice of your healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you heard on this podcast