I’m going to start with a family trip to a transport museum. It’s not a particularly happy memory but it gets better, I promise.

It was a grey, damp day and I was cold. I was well wrapped up but I was chilled to the bone. No energy. No interest. No words. A forced smile as my son and daughter delighted in the old planes and trains, zipping around the warehouse and pointing at the displays. Theirs was a world full of colour. Mine was dark and muted. My head was filled with pelvic organ prolapse and I was reminded of it with every movement — that bulge weighing me down in every sense.

The prolapse had happened a few years earlier, after the birth of my second child in 2015. My daughter had been born by caesarian section for breech and I was desperate for a vaginal birth this time around. I fought for it. I got it. It didn’t go especially well. After a long labour, my gorgeous boy with his white blond hair came crashing into our lives. He was fighting fit but I was straight to surgery after a 3rd degree tear.

This was the point at which I wish I’d had a greater understanding of my body. I had joined the 3 percent of women in the UK who tear from the vagina through the perineal muscle and into the anal sphincter. The midwives were full of sympathy. I still thought I’d ‘done it properly’. Eye. Roll.

We staggered through the next couple of weeks with feeding problems, sleepless nights (and days), I couldn’t sit down without a pillow…and then it happened. I had strained on the loo. I had lifted my toddler. I will probably never really know why it happened but my pelvic organs had prolapsed into my vagina.

I’ve been lucky in the sense that my symptoms are at the manageable end of the spectrum. I feel the bulge, my toileting is not what it once was, tampons and menstrual cups won’t stay in but I don’t have pain and I don’t have incontinence. I also got to see a pelvic physio early on, so I had someone to guide me through pelvic floor exercise and to lend an understanding ear as I tried to come to terms with the fact that things would not return to ‘normal’.

And that was it. For the next few years I got on with being a mum to two pre-schoolers, wandering in and out of Facebook groups, losing pessaries in car parks (don’t ask), fearful of movement and feeling somewhat broken. It wasn’t something I really talked about. It’s not something anyone talks about. And it’s not an easy thing to bring up in conversation. On one occasion I was working and suddenly needed to haul some heavy equipment. I couldn’t and I didn’t feel able to explain why. I felt weak and that’s not who I am. That’s how I felt in the museum too. A bit lost. And sad. And fearful.

I was constantly reading advice against running, jumping or lifting your kids. Against coughing or straining, or standing or breathing the wrong way. You can’t live life to the full when you’re living in fear of things getting worse.

I’m not sure when the turning point came. It may have been a chance conversation in a shopping centre when my son was 3. I bumped into a friend who revealed she also had a prolapse and recommended a physio. I decided to see what I could do to improve my situation.

I started seeing the physio. I also asked for an appointment with a specialist NHS nurse who went through my notes and gave me a better sense of what I was dealing with. I got more and more cross about the stigma and shame surrounding pelvic floor dysfunction so I tapped out an anonymous post on Instagram.

The kindness was overwhelming. Complete strangers understood completely and no one was dismissive or horrified. I carried on asking questions, sharing my experience, unloading and moving forward. Then I put my name on it because I felt like I couldn’t smash taboos with a paper bag on my head and even more people reached out.

I ended up meeting two women locally who also have pelvic organ prolapse. We rendezvoused in a cafe in actual real life and if you listen to the pod, you will know it has blossomed into our ‘Pop Club’ where we can laugh (or cry) at our predicaments and support each other.

Why Mums Don’t Jump is a community now. It has given me the confidence to get past the fear of losing my insides and build up my fitness from safe exercise programmes to pilates and even some running (with the ok from my physio), which I so wanted to do.

Making the podcast has been a hugely cathartic experience. I have shared my story and trawled the minds of so many of the wonderful experts who are working in this field. I am privileged to have heard the stories of some of the women affected by prolapse or other pelvic floor disorders who have spoken out so bravely. Some are on the pod. Others have written to say that hearing from those women has given them hope.

Remembering that trip to the museum breaks my heart a little but I honestly feel like a completely different woman today. That’s not because there’s a miracle cure. I still have POP. But it doesn’t rule my life. The single biggest driver in that has been sharing my story and finding that it resonates with so many other women. Despite what society has taught us, it is not our fault and it is nothing to be ashamed of. We need to find a way to talk more about our vulvas, our vaginas, our most intimate parts; about lumps and leaks and pelvic pain. We can ask for help. We can improve our situations. And we can feel less alone because we are really not!

Guest blog by Helen Ledwick from Why Mums Can’t Jump.

Is it true that women should reduce their pelvic floor exercise towards the end of pregnancy?

I was asked this question about pelvic floor exercise recently and I decided to reply with a blog response. Because, not only is the answer fairly involved, but I also think it’s important to share the many different ways you can take care of your pelvic floor health.

First, let’s talk about the correct way to ‘kegel’

Focus on your breath:

Pelvic floor exercises, also known as kegels, can be an important tool when done correctly. When I teach pelvic floor contraction in the pre and postnatal period, I focus very much on your breathing. During a kegel exercise, you should have equal focus on the release and the contraction of your pelvic floor, and the way you breathe whilst doing this exercise can make both movements more effective.

When you inhale, your pelvic floor should move down and ‘bloom’.

When you exhale, your pelvic floor should lift back up and naturally contract.

Exhale as you contract the muscles. Inhale as you release them.

If done incorrectly, these exercises could cause your pelvic floor to tighten and draw your tailbone towards your pubic bone, something which definitely won’t help while you are trying to get a baby through there! So, please remember to breathe, focus and take your time.

Use your torso:

You should also work on ensuring that, as you inhale, you are using your entire torso. Your breath should move between your sit bones, hip bones and the bottom of your ribcage. Then, as you exhale, you should first allow the natural recoil to happen and then, towards the end of the exhale, gently contract your pelvic floor.

This feeling is not a ‘lift and squeeze’ motion, it’s a gentle connection between the sit bones as you switch on the muscle without over-tightening or tensing it.

More ways to work these muscles

It is important to understand that kegel exercises aren’t the only way to look after your pelvic floor. The following factors can also play a big part in the aiding the smooth contraction and release of these important birthing muscles.

Mobility

Your pelvic floor needs to have a good amount of mobility to function effectively and allow your baby to move through more easily. A well-functioning pelvic floor is able to release as effectively as it contracts.

When it comes to looking at how your pelvic floor is functioning, you also need to consider your posture. Ensure that your pelvis stacks over your ankles, your ribcage stacks over your pelvis and your head stacks over your ribcage. This alignment will impact how well your pelvic floor supports you day to day.

Movement matters!

A well-functioning pelvic floor also needs to be moved! And there are many ways to work these muscles. In fact, going for a walk can be just as good for your pelvic floor as doing typical pelvic floor exercise like kegels.

To strengthen any muscle, you need to add weight and movement, which you can do with exercises such as squats, with coordinated breathing, and inner thigh strengthening, with coordinated breathing. But remember, you can’t strengthen a tight muscle, with these exercises you should, once again, focus as much on releasing the muscle as contracting it.

Encourage pelvic floor release

There are several exercises that can help you to smoothly release your pelvic floor:

Open like a flower:

As you inhale, visualise your pelvic floor opening like a flower.

Rotate:

On all fours, rock forwards and backwards, rotating the femur internally as you inhale

Cat:

On all fours, exhale to draw your tailbone to your pubic bone and your pubic bone to your chest. Then, inhale to release back to a flat back and feel the space between the sit bones.

Glut release:

You can roll on a tennis ball, or similar, to massage your glut muscles. The gluts – your bum muscles! – are connected to the pelvic floor via connective tissue called the fascial lines, and when we release the gluts, the pelvic floor releases too.

Stay active for labour and beyond.

When preparing for birth, your awareness of how to release your pelvic floor can certainly help during labour. But, not only that, it is also super important to prepare for the postnatal period and keep a level of strength in your pelvic floor, to do that, you need to stay as active as possible.

You might be interested in our pregnancy Pilates classes  

3 tips to improve pelvic floor health

I encourage my clients to see isolated pelvic floor exercises (sometimes called kegels) as a piece of the puzzle. It is important to look at pelvic health as part of as a bigger picture.  You can improve pelvic floor function by addressing the following issues:

1. your breathing patterns

We take around 20,000 breaths every day. Breathing creates Intra-Abdominal Pressure (IAP), which can cause you to bear down on your pelvic floor. This means the way you breathe is instrumental to your pelvic floor health. Your breathing can be affected by many different things including back pain, scars/adhesions and posture. We need to  look at how you are using your whole body as well as the pelvic floor on it’s own.

Your pelvic floor works alongside your diaphragm as the top and bottom of a container that creates your centre. When you inhale your pelvic floor descends and releases. This creates space for all of your organs as they move downwards underneath the diaphragm. The muscles and fascia of both the pelvic floor and abdominals elongate on the inhale. How much depends on your breathing pattern. It is important to use the whole of your ‘breathing apparatus’ so you are not just breathing down into your belly and causing a huge increase in intra-abdominal pressure. The ribcage needs to expand up and outwards too so that the pressure created is evenly spread through the torso. When you exhale the pelvic floor recoils back up again. This can be co-ordinated with movement to create an unconscious pelvic floor contraction. Everything starts with your breath!

2. your posture

Everything in your body is connected by a wonderful web of fascia or connective tissue. You can find out more about fascia here https://www.youtube.com/watch?v=-uzQMn87Hg0

We can’t look at the pelvic floor as an individual structure, we need to look at it as part of the whole body (again!). This will allow us to find a holistic approach towards how it functions. Your pelvic floor is directly impacted by what is above it (your organs, your ribcage, your skull) and what is below (your legs and your feet). When our head stacks over our ribcage, our ribcage stacks over our pelvis and the pelvis stacks over the ankles our pelvic floor is able to function as it should. When everything is out of alignment it makes it much more challenging for the pelvic floor to work at optimum function. The position of your feet, the relationship between your hips and your knees, your ankle mobility and your rib cage position all have a direct impact on optimum function.

A Note on Sitting!

Many of us spend a lot of their day sitting and it is important to think about that too. Can you move your laptop so that you sometimes work from a standing position? Can you have a ‘meeting on the move’ where you go for a walk instead of being desk-bound. Sitting, particularly when your are slumped on the back of the sit bones, can draw the tailbone towards the pubic bone. This will shorten and tighten the muscles of the pelvic floor. If you can try to be more active day to day it is beneficial for your body as a whole. Simply sitting on top of your sit bones and stacking the ribs and head above the pelvis rather than slumping will help. While I’ve got you, stand up and get moving for 10 seconds RIGHT NOW!! A sedentary lifestyle is the enemy!

3. your toilet habits

Straining when you go to the toilet creates IAP which is something we want to avoid creating too much of when looking at pelvic health. If you are constipated you are likely to be creating a large increase in IAP when you go to the toilet. You can address this by increasing your water intake, the amount of fibre in your diet, the amount you move and using a squatty potty (or equivalent) https://www.squattypotty.co.uk/.

When humans came up with toilets, we didn’t think through the biomechanics necessary to do a nice easy poo! We were designed to poo while squatting (think about your toddler when they go in their nappy!).  This allows the puborectalis to fully relax and the anorectal angle to straighten which immediately improves bowel function. It makes it easier to empty the bowel at this angle. Changing the angle of your legs when you are on the toilet (you can also use a toddler step or even a pile of books under each foot) is a great zero effort step to reducing the IAP created.

I hope you found that useful. Keep following @centredmumspilates on Instagram for updates on my blog posts and lots of videos coming soon!

You may be interested in our Your Core Matters course for exercises and more top tips!

https://centredmums.com/postnatal/your-core-matters/