Anxiety in motherhood – why you’re feeling anxious, and how to make friends with it

Anxiety in motherhood – why you’re feeling anxious, and how to make friends with it

What is anxiety? What is its purpose?

Anxiety organises our responses to threats to our life, health and wellbeing. Focuses on our escape from danger. It encompasses feelings of unease, worry and fear – and this includes both the emotions and the physical sensationswe might experience when we are worried or nervous about something. This is related to the ‘fight or flight’ response – our normal biological reaction to feeling threatened. So, for example: pre-historic man used to have to go out and hunt for his dinner, and he may well have come across a sabre-toothed tiger on the lookout for its own, human-shaped, meal. Being alert and able to flee at any given moment was what enabled pre-historic man to survive. We still have this exact same fight-or-flight hormonal and physical response to perceived threats and danger. But the vast lucky majority of us are not under any physical threat, and our perception of ‘danger’ can escalate out of all proportion, leaving us feeling like crap, or gradually becoming scared of and avoiding the activities that we used to be carefree about, because everything is veiled with cloak of fear.  

Anya Hayes author and speaker
Challenge your thoughts. Don’t believe every thought you think, know that you have the power to either welcome thoughts in, or ask them to leave. Anxiety makes us view the world as very threatening. It’s important to aim for a healthy balance, between what’s real and what’s your anxiety simply making shit up. Imagine you’re in a maze with your child, having fun on a day out: then anxiety pushes us into believing its cul de sacs are safe and convinces us to stay there whimpering, waiting to be rescued.

Recent figures (2016) from the NHS show that anxiety is on the rise, particularly among young women.  As a mum, you’re more likely to suffer from anxiety if you have suffered miscarriages, or had a traumatic birth, or if you had problems with fertility. Or it may simply have come out of the blue, possibly a symptom of postnatal depression, or a result of being physically and emotionally depleted by your birthing and mothering experience and losing some of your resilience. Let’s have a look at some strategies for dealing with the physical effects of anxiety. Anxiety is a normal healthy reaction. It happens to everyone in times of danger or in worrying situations. When you are anxious, your body system speeds up. In certain circumstances this can be an advantage (e.g. if you are in danger). It means you are ready for action and enables you to respond quickly if necessary.

Anxiety and your body. When we feel anxious a chain of automatic responses happen in our bodies, which prepare us for action. This is called the ‘fight or flight’ response and can be traced back to our evolutionary past. Imagine the primitive caveman threatened by a wild animal. He needs to be prepared for vigorous action: either to fight or run away from the threat. We still possess this survival reaction although nowadays it is often triggered by situations that are not actually life threatening.

The physical symptoms of anxiety include: difficulty relaxing, butterflies in the stomach, shakiness, palpitations (heart beating quickly), difficulty breathing, feeling faint, tense muscles, excess sweating or blushing, needing to go to the toilet more often.

When a person anticipates or encounters a dangerous situation, a hormone called adrenaline is automatically released into the bloodstream. This causes a number of changes in our body which are designed to prepare us to respond to the danger (i.e. by fighting or running away). Our breathing rate increases because we need more oxygen in the body in preparation for increased physical activity. Our heart rate increases to pump the additional oxygen and adrenaline round the body quickly. With all this increased activity, our bodies heat up so we sweat more, which is how the body cools itself down when it is overheating. We need to go to the toilet more frequently and the function of this is to eliminate excess weight so that we can be ready for action. In other words, these changes are anxiety symptoms.

Anxiety symptoms are the body’s automatic response to being in a threatening situation, and are designed to prepare us to fight the perceived danger or run away from it. The problem is that sometimes the fight flight response switches on in situations that are not actually physically dangerous. When the fight flight response switches on in a normal situation, such as in the supermarket, or in a meeting with someone, it can become problematic.

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Disturbing thoughts

Very often when we have bouts of anxiety they experience disturbing thoughts. For example, we may think something terrible and catastrophic is going to happen, and can’t see beyond that reality. Many people are unaware that they are even having these thoughts until they have been consumed by them, which makes you feel more anxious or frightened. These thoughts are not useful or even true. So once you begin to recognise this type of thoughts you can learn to challenge them. THOUGHTS ARE NOT FACTS. Concentrating on what is actually happening right here, right now, rather than what you think might happen, will help break the charge of anxiety.

Top tips for making friends with anxiety

  1. Remember anxiety is a normal emotion, a purposeful emotion which ultimately aims to look after you and keep you/your child from harm. Look at your anxious thoughts, physical sensations and behaviour habits. Write them down. Understanding what anxiety looks like for you will help you tackle it.
  2. Breathe. Deep breathing is the number one way to switch off your anxiety. Is your anxiety a cat with bristled fur, ready to pounce? See how you can get your cat to curl up and purr blissfully instead. Practise calm, breathing and soften your body.
  3. Feel your fear, and do it anyway. Work out what kind of situations you tend to avoid or cause you fear. And try to actually go towards these situations. I’m not saying actually put yourself in danger obviously, but gently expose yourself to situations that normally you would allow yourself to run from without question. The idea is that you try to remain in the situation until your anxiety gives up and goes home. It’s not the easiest road, but it does work in the long term for reducing symptoms of anxiety by ultimately making you realise that ‘it’s not that bad actually’.

You can also find plenty of other ways to soften your anxiety in The Supermum Myth. How is your anxiety today? xxx

Pilates for Pregnancy

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Mindfulness for pregnancy, birth… and motherhood

Mindfulness for pregnancy, birth… and motherhood

Mindfulness is definitely a buzzword, like many a new fad in the wellness industry we may have reached peak saturation in terms of hearing about this as a skill/method/technique. Which is a shame as I think it makes people roll their eyes when they hear the word, rather than prick up their ears. How do you feel about mindfulness? For me, it has been transformational in terms of my day to day length of tether. Sleep deprivation and the associated other demands on your body and mind through pregnancy and motherhood can leave you feeling scattered, tetchy, angry, Hulk Mum. Mindfulness offers a bit of a pause, a life buoy for those moments when you feel like you’ve fallen into a choppy sea of anxiety or anger.

Anya Hayes mindfulness for motherhood

What is Mindfulness?

Mindfulness is a mental discipline that enables us to respond differently to challenging circumstances, sensations, emotions and thoughts rather than follow our habitual reactions. Mindfulness is now widely considered to be an inherent quality of human consciousness  – what makes us human is our capacity to turn our attention and awareness to the present moment. Mindfulness can be cultivated through meditation practice and increases engagement with what our habits and behaviours are, allowing for a clearer understanding of how your thoughts and emotions can impact on our health and how much we enjoy our life.

Mindfulness-based approaches in healthcare began in the late 1970s the USA with Jon Kabat-Zinn’s pioneering Mindfulness-Based Stress Reduction (MBSR) programme at the University of Massachusetts. In the 1990s Mindfulness-based Cognitive Therapy (MBCT) was developed; drawing from CBT (Cognitive Behavioural Therapy) and MBSR, by Mark Williams at Oxford University, John Teasdale at Cambridge and Zindel Segal in Canada. MBCT is now a recognised and recommended way of reducing the risk of recurrence in depression and anxiety disorders (NICE 2009).

The definition of Mindfulness

‘The awareness that arises from paying attention, on purpose, in the present moment, and non- judgmentally’
Kabat-Zinn (2005)

Depression and anxiety are the most common mental health problems during pregnancy, with around 12% of women experiencing depression and 13% experiencing anxiety at some point – many women will experience both. Depression and anxiety also affect 15–20% of women in the first year after childbirth.

Information from NICE 2014 Female health: The Maternal Mental Health Alliance (MMHA), Using information supplied in 2013 by members of the Royal College of Psychiatrists’ perinatal faculty

How can Mindfulness help in pregnancy and motherhood?

  • MBCT is already established and recommended by NICE as an effective treatment for the prevention of recurrent depression
  • Research into the prevention of depression in pregnancy and the postnatal period has not yet identified an effective treatment (Dennis et al 2005)
  • Early research suggests mindfulness could be beneficial in the perinatal period

‘Participants showed increased childbirth self-efficacy and a trend towards lower pain catastrophizing and significantly lower depression symptoms post-course than controls; the difference grew in magnitude postpartum’

 Duncan, L et al (2014). Mind in Labor: Effects of mind/body training on childbirth appraisals and pain medication use during labor

‘A mindfulness-based course that combines mindfulness training with information and coping methods regarding pregnancy, childbirth and parenting concerns is more likely to optimise maternal well-being during this unique and important reproductive interval’

CM Guardino et al (2013) Randomised controlled pilot trial of mindfulness training for stress reduction during pregnancy

  • Practising mindfulness allows you to cultivate skills to enhance pain management, release stress, anxiety and other scrunchy emotions during the often turbulent transition to parenthood and, well,  everyday life with small people
  • You learn to truly pay attention to present moment experiences (sensations, thoughts, feelings), what you’re feeling right here, right now, deliberately and non-judgementally
  • Mindfulness help participants to see more clearly the patterns of the mind, helping to avoid an escalation of swirly negative thinking and the tendency to be functioning on autopilot
  • Mindfulness for childbirth and parenting has the potential to reduce the risk of postnatal depression and increase your ‘availability’ of attention for the baby. Offers you a buffer for those days when everything is a bit pharghhhnnngggg!  Literally offers you a bit of breathing space to process and respond rather than constantly react.
  • All the skills you learn through focusing on mindfulness are relevant throughout  pregnancy, through your childbirth experience and day to day parenting … and are transferrable life skills – for the whole of motherhood life.

What I love about mindfulness approaches

The thing that I personally find so effective about the mindful approach is that it works with YOU, with your body, your senses, your thoughts, it’s simply a way of tuning into your internal radio which is constantly playing. It works beautifully with movement such as Pilates, so for me it’s a natural link to what I already teach mums for working with their body – looking to have a similar focus on the mechanics of the mind as well. It’s simply offering you a kind of map to understanding your mind and being able to navigate without feeling so lost. Steering yourself as opposed to being blown by the winds of your mind without realising.

Are you interested in finding out more about how mindfulness can help you in pregnancy and birth, and can help you in your mothering day? Have a look in The Supermum Myth, there are plenty of mindfulness-based activities within, which will start to foster a deeper connection and awareness of your mental landscape. And in Pilates for Pregnancy I offer lots of mindfulness-based approaches for your BODY-MIND, including some hypnobirthing techniques for your birth experience.

I offer one-to-one coaching packages and workshops for pregnancy and early motherhood, helping you to be the calmer, confident mum you always knew you could be. Get in touch if you’d like to work with me.

How are you today?

Anya Hayes mindfulness for motherhood

Your pelvic floor – how to build pelvic floor rehab into your day to day

Your pelvic floor – how to build pelvic floor rehab into your day to day

I’m doing two FREE workshops next week: Your Confident Mothermorphosis for you beautiful bumps, and a pelvic floor restore workshop at Level Six Peckham next Thursday morning 6th December, babies welcome – come along if you can.
If you don’t already, you can follow me on Instagram @mothers.wellness.toolkit – I share there lots of postnatal healing and pelvic floor information, and Pelvic Floor Meditation live on Insta at 7.30pm on Mondays, which stays on my stories for 24 hours.
woman holding baby while sitting on fur bean bag
Photo by Daria Shevtsova on Pexels.com

But I’m a mum – I don’t have any time!

Remember there is never a “perfect time” to focus on your postnatal rehab. You have to build it in to the time you already have and try not to feel that it’s a “to do” pressure to feel the weight of. Doing 3 minutes here, 3 minutes there is much more valuable for your core health than trying to make time for an hour a week.
It doesn’t have to be a “full workout” to be effective. 7 minutes a day is valuable, remember. Build it up as and when you can. When pushing your buggy or baby wearing, take a moment regularly to breathe, really fully deeply breathe and soften your shoulders.

Your mum posture day to day

Check in at least once a day with how you are carrying yourself. Either stretch against the wall: stand against the wall facing perpendicularly away, place your hand onto the wall. The rotate away from the wall, straightening your arm. You should feel a stretch in your pecs. Or: lie on your back with your arms outstretched and draw snow angels in the floor.
Most importantly, think about your A, B, Cs: Alignment, Breathing, Centring, with your every day movement.
  • Alignment: release yourself into the ground at least once a day: lie down, breathe, soften, legs up the wall is ideal.
  • Align your ribcage directly over/in line with the pelvis whenever you can, to restore the natural momentum within your torso: diaphragm over the pelvic floor.

Breathing is your number one tool for healing

You carry it around with you daily. Use it, it’s free, you don’t have to do anything “extra”, plus it will calm and soothe your nervous system. Breathe. It’s SO important. Breathe well, and your pelvic floor health will benefit.
Remember – 5 deep breaths is all it takes to soften you out of fight or flight mode.
Remember when you’re picking up your baby/carseat/squatting down/getting up from the floor blow as you go: 
Breathe OUT to lift UP your pelvic floor when you pick up your baby, lift the carseat, sneeze, etc.
Lifting your baby in a carseat places more load on your pelvic floor than any sit up will.
Pelvic floor exercise will help heal any diastasis abdominal separation, it’s your deep abdominal wall that you want to strengthen, and this works together alongside the pelvic floor.
Don’t be afraid to move. But build your INNER STRENGTH adequately before you start high impact work such as running and HIIT.

Can I run while I’m leaking wee?

If you are running and also leaking, or feeling like you’re “falling out” – the simple answer is to stop running. Running while experiencing pelvic floor dysfunction is a bit like wallpapering a newly built wall before the plaster is dry. It’s temporary. Build the strength first, and then test it. Don’t test it simultaneously while you’re still building it, it’ll be like jumping into a boat which has a hole in it.
Download the Squeezy app without delay. 3 minutes, 3 times a day is all it will take to see some difference.
If you are experiencing urinary or faecal incontinence, DON’T IGNORE IT. DON’T LAUGH IT OFF. DON’T JUST REACH FOR A TENA PAD.

PELVIC FLOORS ARE FOR LIFE

Your pelvic floor will not magically get better on its own. It needs attention and care, and then it will work loyally and diligently for you in return.
THINK TENNER NOT TENA: imagine lifting a ten pound note up into your vagina. Hold it for 5 seconds, then drop it down.
Other resources to have a look at: Pilates by Georgia is a physio and Pilates teacher, and on facebook she shares free workouts which are postnatal pelvic floor friendly.
Her website is Home | Pilates By Georgia where you can do a 2-week trial for free or you can pay a subscription for her workouts, some of which are really short and really easy to squeeze in (if you’ll excuse the pun).
Perinatal anxiety – what it is, and tips for how to manage it

Perinatal anxiety – what it is, and tips for how to manage it

Perinatal Anxiety

Pregnancy The Naked Truth by Anya Hayes
Pregnancy The Naked Truth by Anya Hayes

What is it, and why am I feeling it?

We’ve all heard of ‘postnatal depression’ and it looms large in your imagination as a scary ‘thing’ that might happen after the baby arrives. Increasingly being recognised, though, is the fact that heightened levels of anxiety or low feelings during pregnancy can increase the risk of developing postnatal depression. And perinatal anxiety is more commonly being diagnosed as a standalone condition, separate from postnatal depression. ‘Perinatal’ is the period which encompasses pregnancy and the first year into early motherhood. 

Figures released in 2015 by the Royal College of Midwives suggest that up to 20% of women experience perinatal mental illness during pregnancy and in the first year of their babies’ lives. It’s particularly common if you’ve struggled with fertility issues, or have had recurrent miscarriages. The new pregnancy guidelines published by NICE for healthcare professionals suggest that there should be ‘screening questions’ asked at regular pregnancy checks, to look out for warning signs, and support should be offered where needed.

Anxiety is the natural response to times of change: it is a normal human reaction, your brain is hardwired to perceive threats and respond to those threats by asking you to run the hell out of there, or fight, or freeze like a rabbit. When you’re pregnant, your future suddenly looks different, and your brain is physiologically changing to equip you for motherhood, which means that the area of your brain responsible for your fight or flight, the amygdala, actually grows during pregnancy, ensuring that you are more alert for dangers that could affect your baby. A wonderful and miraculous brain adaptation to ensure the survival of the human species… but less handy for modern motherhood when it’s work-related emails, financial worries or the stress of your commute which may be triggering this response day to day, rather than a predator in the bushes.

When anxiety comes out of balance in your emotional “team”, and begins to speak more loudly in your internal dialogue is where it can cause problems. Perinatal anxiety is an issue only where it reaches beyond regular normal ‘worry’, and into something that affects and influences your day to day behaviour and decisions – you’d have to be slightly unusual to sail through pregnancy without ever freaking out about your growing baby, your life ahead, the birth, the fact that you’ve run out of chocolate digestives … No, this is where normal worry tips into something that starts to control your life in a negative way and needs to be managed.

The Maternal Mental Health Alliance describes perinatal depression and anxiety as including constant symptoms such as ‘tumble-dryer mind’, insomnia, feeling tense and irritable, social paranoia, shakiness, blurred sight, racing heart and breathlessness. If you recognise these symptoms in yourself, make sure you chat to your midwife or GP, and please, you’re not alone and there is no shame in seeking help, so don’t suffer in silence.

‘I was surprised by how I seemed to change from being relatively easy going to suddenly very fearful and jittery about everything. I spoke to my midwife about it and apparently it’s quite normal. My GP referred me for a course of CBT (cognitive behavioural therapy) to try and deal with it before it became serious.’
Rosie, mum of 2

What can I do about it?

Question your thoughts – anxiety thrives in the space between your thoughts and your emotional response to them. So, tell yourself that THOUGHTS ARE NOT FACTS if your mind has gone into overthinking overdrive. Journal, when your thoughts seem to be overpowering your brain’s ability to temper their force. And meditate. Offer your thoughts a chance to shine – give them centre stage, and try to observe their acting as if on stage, removed with a curious distance, rather than listen within the emotional whirl.

Share the load and talk to someone about it. It takes confidence to speak up, but try not to feel scared to admit to feeling less than ecstatic if it’s clear that you’re feeling low or anxious most of the time. Even if you’re not able to confide in your partner or open up to your midwife, acknowledge to yourself that you’re feeling this way and try to incorporate managing techniques into your pregnancy – take a regular yoga or mindfulness class, or allow yourself some pampering time – or, simply take five deep breaths. Your breath is the surest way out of fight or flight, as deep breathing physically triggering the balancing parasympathetic nervous system to calm and soothe you. Anything that reduces tension in the body will help you to calm the mind. If you feel happy to, ask to be referred for counselling, which can give you some tools to keep your mental health on an upward trajectory.

‘I did worry about how parenthood would affect me. I’m not a fan of uncertainty and in lots of ways your first pregnancy is one of the most uncertain times of your life!’
Natalie, mum of two

Could it be serious?

If left unchecked and out of balance, perinatal depression can unfold into postnatal depression and really impact on your enjoyment of motherhood, so it’s really worth investigating and taking steps to improve your understanding of anxiety and learning how to soothe yourself into calm.

For more tips, pregnancy information and advice, have a look at Pilates for Pregnancy, or Pregnancy The Naked Truth.

sleeping baby
Photo by Bryan Schneider on Pexels.com

Have you struggled with anxiety during pregnancy or into motherhood? Get in touch if you’d like to chat about ways through. xxx

 

Abdominal Massage – why it’s so important for your postnatal recovery

Abdominal Massage – why it’s so important for your postnatal recovery

If I could have known the power of JUST ONE THING postnatally first time round, it would have been the immensely healing and restorative power of abdominal massage. Particularly post-caesarean, but arguably essential as a general post-pregnancy recovery tool. All new mums should be given the gift of understanding how much power you have in your own hands to stimulate your healing, to foster your sense of self-compassion, to begin to reconnect to your belly again now that your baby has evacuated the premises.

Anya Hayes pregnant bump

In many cultures, there is a confinement period for new mothers: in China women “do the month” and are tended to by their relatives and community for a month in order to look after their physical recovery. In Malaysian villages, women are massaged and wrapped with sashes infused with healing essential oils, to ensure that their body and heart are protected and repair after being so opened, physically and emotionally, by the experience of giving birth. These practices offer a time when the new mother is looked after, nourished and helped to heal, her breastmilk production is stimulated, the blood circulation to her organs is enhanced. There are practices such as in the Closing the Bones ceremony, which hails from Ecuador, where the mother is offered a sacred space to connect to her body again after the epic adventure of pregnancy, her bones are literally closed, her hips rocked and massaged to rebuild her pelvic strength and integrity, the massage helping to heal and close the abdominal stretch of the rectus muscle.

And what do we do here in the west? We go straight home from our birthing experience, shaken to our core albeit hopefully elated, and hope to get into our “pre-pregnancy jeans” as son as we can, and eat biscuts on the sofa receiving a thousand visitors, without any real time to soften and rest, to lie naked with your baby and allow your body and hormones to play into the very vulnerable and fragile domino effect of their natural recovery process. And then two years down the line we accept our pelvic pain, incontinence or back ache as an “inevitable” part of motherhood.

Part of your recovery is being able to let go and release tension, physical tension, AND mental, emotional, visceral. Connecting to your tummy through massage is an extremely powerful way to do so. As women, we often have little love for our tummy, there is a world of complex emotional responses when we think about our bellies  and particularly post-pregnancy with societal expectations of “getting your body back” (IT NEVER WENT ANYWHERE!). We regularly sucking the muscles in tight and create extra tension after birth. Simply not breathing widely, fully and deeply can impact your healing as breathing is so inextricably linked to pelvic floor optimum function and release.

Self-massage allows you to reconnect to these muscles, to help them to let go, allowing you to move your whole body easier. Massage will enable you to release tightness in your breathing process which will enable the diaphragm to release fully into your belly, triggering a full open pelvic floor release and lift. Stimulating your blood flow which will help to reduce swelling, which will bring back sensation, which will make you FEEL BETTER. Massage can help to ensure that adhesions don’t form: this is scar tissue forming in the fascia between your muscles which can stick your organs together like glue. There are so many layers of healing that go on post birth but particularly post-caesarean that it is, in my view, absolutely outrageous that we are not told about the benefits of abdominal massage post-section, as it can help to prevent myriad aches, pains and worries in the future. Not only that, there is strong research that massage can help improve bowel movements, which in turn helps alleviate pressure on your pelvic floor, scar and abdominal separation.

And the best part of all, massage is soothing and healing. It is sensual. It fosters a sense of self love and forgiveness. And it’s free! What’s not to love about that?

You can read more postnatal tips in my Pilates for Pregnancy book, which is out now. I’d love to hear your questions about pregnancy or postnatal strength and healing. Get in touch! xxx

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Pregnancy and Postnatal mindfulness and core strength workshops

Pregnancy and Postnatal mindfulness and core strength workshops

I’m excited to be adding two monthly workshops to the schedule in the new year. I’d love to hear your thoughts, and if you’re in south London, come along!

For mums to be

Your Confident Mothermorphosis

A workshop introducing a toolkit of tips to help you release anxiety and soothe your body as you enter the next phase of your life. This workshop uses techniques from Pilates and mindfulness-based cognitive therapy (MBCT) to connect to your body and calm your mind and spirit, enhance your feelings of self-compassion and confidence in the journey ahead. Including a guided meditation and breathing techniques which will equip you well both for your birth experience and into early motherhood.

For mums

Pelvic floor and core restore

Pilates for postnatal rehabilitation. This workshop focuses on breathing, alignment and pelvic floor awareness, releasing tension and finding your deep inner strength – suitable if you’re suffering from diastasis recti. Find out how to connect to your centre in your day to day activities rather than make time for “pelvic floor exercise”. Rebuild your foundations to feel more energised in your mothering day. We’ll finish with a short (baby-friendly) guided meditation to leave you relaxed and uplifted.
How do you feel about your pregnancy and early motherhood experience? I’d love to hear. Get in touch and tell me your story xxx
073A9336
My book Pilates for Pregnancy is available now
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The Supermum Myth Anya Hayes
The Supermum Myth
Diastasis recti – how to strengthen your separated abdominals post-birth

Diastasis recti – how to strengthen your separated abdominals post-birth

Around the second trimester, depending on the size of your bump, you will have experienced some degree of abdominal separation: diastasis recti. The rectus abdominis muscle is your “six-pack” muscle. It runs down your front, from your breastbone to your pubic bone: two segments running vertically parallel and intersected by a fibrous band, the linea alba.

In a brilliant design feature of the human body’s adaptability, as your bump grew, the linea alba stretches to allow your baby more space. The two bands of muscle stretch away from the centre. This is most likely to begin at the navel as that is where your baby usually requires most room.

This is a normal structural adaptation, you can’t necessarily prevent it, and neither would you want to – it is a design specially created for your baby’s comfort and growing power. Around 30% of women experience this abdominal separation in the 2ndtrimester, with a further 66% separating in the third trimester. Some research says that 100% of women have some level of diastasis of the rectus abdominis by the third trimester (Gilliard and Brown 1996, Diane Lee 2013). Look at those stats again: 100% of women have this happen at some point to some degree during pregnancy.

The extent of your abdominal separation depends on a number of factors:

  • Your abdominal tone pre-pregnancy
  • If you carried more than one baby
  • If you’ve had more than one baby
  • If you gain a lot of weight, or if carried a big baby for your height, your baby will have had less space and needed to “pop further out”
  • Age plays a part: it can be worse if you’re over 35
  • Lack of regular exercise
  • Postural load – are you stooping/lifting constantly without care for your technique and form?

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Mind the gap

Until quite recently we’ve talked in fearful terms about THE GAP, and the need to “close the gap” postnatally. But actually we now know that it’s not the width of the gap that is the issue: it’s whether or not there is deep tone of the supporting muscles underneath that matters. You could have a 3-finger gap, but as long as your core muscles are firing properly and you can manage your intra-abdominal pressure – the pressure in the space between your respiratory system (your diaphragm) and your reproductive system, placing load out into your belly or down into your pelvic floor – this gap is considered to be “functional”, i.e. not a problem. You may never “close the gap” completely, but as long as you have tone supporting the linea alba, this is ok. So: a problematic diastasis recti is one where there is soft squishy tissue rather than tensile active tissue underneath the linea alba “gap”, therefore not truly supporting your core in movement and leaving you vulnerable to injury and pelvic floor issues.

Diastasis used to be considered a purely cosmetic issue, merely a cause of the “mum tum” or “postnatal pooch” – and dismissed roundly by GPs as a result “ah well you’ve had a baby what do you expect?”. But this is heartbreaking for me to hear of so many women fobbed off when they inquire about DR. There is a direct correlation between a diastasis lacking tone, and the impact and load placed on your pelvic floor and your spine. In essence: if you have a serious gap, you my also experience back pain and/or symptoms of pelvic floor dysfunction.

Diastasis has an effect on the strength and action of your oblique (waist) muscles, and mayhave an impact on the ability of your abdominals to control the pelvis and spine – this in turn could possibly be a cause of back and pelvic pain, if the integrity of your core support isn’t given some scaffolding with strength and conditioning exercises (such as Pilates).

You might have noticed when you were pregnant that when you got out of bed or even up from sitting, there was a strange doming in your stomach, a bit like an alien pushing out, or a Toblerone triangle. As a rule of thumb, you don’t want to see that doming any more. We don’t want to be in a position where you’re putting your muscles under pressure and encouraging it to happen. If you see it when you lift yourself out of bed or off the floor, try rolling over onto your side and pushing yourself up with your hands, rather than using your abdominals.

Continue to avoid ‘regular’ exercises – even if you get the “all clear to exercise” from the GP at your six week check up, unless they have actually palpated your abdominals to check for a DR, please don’t rush back into traditional ab exercises, oblique strengtheners (twisting curl ups and side planks), or any loaded rotation and definitely avoid getting back into running or any other high impact exercise just yet. Erring on the side of caution is always the best policy – despite what some celebrity trainers might suggest on their glossy Instagram feeds.

Excessive abdominal training when a diastasis is present, particularly with twisting movements such as oblique curl ups, can cause a downward pressure in the abdomen through the pelvic floor, which will pull the already weakened linea alba further out to the sides.

Diastasis recti doesn’t always resolve itself on its own, the first 8 weeks are where the main natural healing takes place, and if yours is still a problem gap after this point it needs conscious training and dedicated deep core healing work.

You can hear me chatting about diastasis recti on BBC Radio here. Any questions about postnatal healing – get in touch!

My new book Pilates for Pregnancy is available now

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Post birth healing tips

Post birth healing tips

In the first few days and weeks after giving birth you’ll probably feel bruised and sore, whatever birth experience you’ve had. We’re preoccupied with “snapping back into shape” straight after having a baby, and if we buy into this bounce back mentality, the days and weeks after baby can come as a huge shock when celebrities make it look so easy.

The first three months is a time of huge transition and change. It will take this whole time, at least, for your emotions and body to begin to settle into a sense of familiar vaguely confident “normality”. It is totally to be expected that you might feel discombobulated and chaotic. Think of it as starting a new job: you’d imagine that the first few months would be a steep learning curve and to feel way out of your comfort zone. It’s no different for your new job as a mother/mum of two/three.

Some women feel like a superhero, with such a sense of triumph and euphoria that anything seems possible – it can be hard to imagine that you have to take it easy on yourself and rest while you’re riding this high. But equally you may fall into the camp of women who feel like they are depleted and exhausted by the birth and the early days. That was certainly me first time round, and if this is you, please don’t push yourself to hold up a façade of “normal”. Rest. Cuddle your tiny newborn to get the oxytocin flowing and soothe both of your nervous systems, your breathing helps to regulate your baby’s breathing. Snuggle with lots of calming skin to skin in those early days. It takes time to complete your metamorphosis into motherhood, and “normal” takes on a different appearance from now on.

sleeping baby
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Your uterus contracts back to its original size in the days after giving birth, and these contractions feel quite similar to early labour contractions. They can be stimulated particularly by breastfeeding, and it’s more intense if it’s not your first baby. Establishing breastfeeding is hard, mentally and physically, and is painful initially even if your baby takes to it easily, despite what your health visitor might suggest. You are also very hormonal. So you will be feeling tender and emotional.

Breathing techniques are so valuable for getting you through these intense early days. If it’s your second or subsequent baby, you might be less hit by the enormity of the physical challenge as it’s familiar territory, but you have the added emotional challenge of introducing your new baby into your household of other children and changing the status quo, possibly dealing with demands from your firstborn of “taking the baby back where we got him now” (true story). All of this brings with it lots of joy but also upheaval and mixed emotions. So, revisit deep breathing exercises to soothe your nervous system, every day.

Breathing and pelvic floor awareness exercises are suitable from 24 hours after your birth, whenever you feel ready.

Tearing, and episiotomy care and recovery

It can take up to a month for tears or cuts to heal and for episiotomy stitches to dissolve (small tears with no stitches usually heal faster than this). In that time you’ll probably be in some pain. Having an episiotomy or suffering a tear carries the risk of scarring. Make sure you take painkillers if you need to, and at a time that feels right for you when the area is no longer tender, internal massage is a great way of stimulating the healing process and breaking down the scar tissue, making sure there is minimal effect on your pelvic floor sensation on the long term.

  • Bathing in warm water and/or using a cushion (a special inflatable cushion can make sitting down more comfortable) can help.
  • If you’re still uncomfortable after a few weeks, make sure you speak to your midwife, health visitor or GP.

Here are some tips for this early healing period:

  • Keep the cut/tear and surrounding area clean.
  • After going to the toilet pour a jug of warm water over your perineum to rinse it. It’s ok to add some drops of tea-tree/witch hazel and lavender to this as well.
  • Going for a wee can be painful: it might help if you pee in the bath (just before getting out), or in a warm shower.
  • You might be scared to poo because you’re worried about pressure on the stitches. This fear causes a lot of extra discomfort and emotional distress. You can ask your midwife, GP or health visitor about medication to help you poo more easily. But again, deep breathing should be employed first and foremost.
  • After having a poo, make sure you wipe front to back, away from your vagina, to keep the stitches clean.
  • Place an ice-pack or ice-cubes, soaked in tea tree/lavender/witch hazel wrapped in a towel or cloth, onto the affected area, to relieve the pain. Or you can now buy ready made sprays which contain soothing and healing ingredients, such as Spritz for Bitz – which can also be used for caesarean wound healing (and for your baby’s nappy rash).
  • Restart pelvic floor awareness exercises as soon as you can after birth.  They enhance blood circulation, and aid the healing process.

For more postnatal tips, see the Fourth Trimester chapter in my Pilates for Pregnancy book, which so far has 10 5-star reviews! Thank you so much if you’ve enjoyed and reviewed it, I really appreciate the feedback.

Do you have any questions about postnatal recovery? I’m currently writing Postnatal Pilates, which will publish with Bloomsbury next year. Please send me your questions I’d love to try and help xxx

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How to restore your pelvic floor, in less than 3 minutes a day

How to restore your pelvic floor, in less than 3 minutes a day

One of the things that new mums tell me almost more than than anything else, is that they wish they had fully understood how important pelvic floor health was, and they wish they had taken the time to focus on it a bit before baby came – as let’s face it, once baby is out and you need to do the work more than ever before, it’s when you have the least brain space to think about it.

Pelvic floor health should be something that we seamlessly coordinate into our day, like brushing our teeth. You no doubt dedicate at least 4 minutes of your day, every day, to your pearly whites. The idea of not doing that would be fairly grim for the long term. So, why is it so hard for us to factor in pelvic floor health if it could be within that time frame? It’s not a time issue, is it? It’s a human self-sabotage issue.

woman in grey pants holding black and purple stroller
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For a start, pelvic floor health is intertwined with how you breathe, move, and carry yourself day to day. So, ultimately no amount of occasional hopeful squeezing will be effective if your body held in bad posture most of the time or if you’re not breathing consciously, as your pelvic floor works in a finely choreographed balance with your diaphragm and other abdominal muscles. It’s not really worth sitting and squeezing once or twice a month, but placing loads of pressure on your pelvic floor through your postural habits day to day and not addressing that. We need to be curious about our  bodies and take our strength and health into our own hands.

What you do and how you move day to day impacts so much more on your muscles than one hour in a fitness class a week or the occasional “pelvic floor exercise”.

Your pelvic floor health is crucial for your mental health into your old age. Incontinence brings with it issues of fear of exercise, embarrassment, depression. Prolapse can make you feel like an old woman, can cause discomfort and anxiety. But working your pelvic floor CAN MAKE A DIFFERENCE to your pelvic floor dysfunction symptoms, and prevent incontinence or pelvic organ prolapse postnatally.

So first: think about your alignment, then breathing. THEN, connect.

It’s as easy as A, B, C. 

  • Stand or sit tall with your ribcage stacked above your pelvis: your heart centre balanced directly above your womb centre.
  • Breathe in through the nose, deeply, wide, full, low: imagine a “360” breath around all sides of your torso opening wide out through the ribs and down to your low belly. Allow your lower belly – and pelvic floor – to fully soften.
  • Sigh your breath out through the mouth as if you’re fogging a window in front of you.
  • Draw up into your back passage as if you’re trying to stop breaking wind, then pull the engagement forward and up. Hold for up to 10 seconds – no tension in your jaw, buttocks, inner thighs – then fully release with a deep wide breath in.
  • Repeat 10 times.
  • Then – sigh out, then lift up and pulse squeeze 10 times quickly. Then breathe in to release.
  • Do this 3 times a day.

So remember your A, B, Cs

Elaine Miller, also known as @Gussetgrippers, Women’s health physio and stand up comedian is spreading the hashtag  We won’t pee with 10 10 3.

10 lift and hold. 10 pulses. Three times a day.

woman carrying baby boy wearing white tank top infront of white curtain inside the room
Photo by bruce mars on Pexels.com

Honestly that’s less than 3 minutes of your day. How can we sex it up to make it something you don’t continue to avoid?

I’d love to hear from you – get in touch and let me know your thoughts, I’m really keen to find ways to get women to engage with their pelvic floor health, so let me know what your barriers to focusing on it are. It’s boring? You’re not sure how to do it? You never remember? Let’s work on this together.

#wewontpeewith10103

 

World Mental Health Day – how are you?

World Mental Health Day – how are you?

It’s World Mental Health Day today. You wouldn’t feel ashamed to tell anyone you had sprained your ankle or had a sore throat. Yet we still layer our mental health with taboo and cultural patterns of secrecy and stiff upper lip.

woman carrying baby near grass
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❇️According to figures from the World Health Organization – depression and anxiety are set to become the world’s 2nd biggest health burden by 2020. That’s basically now. A crisis matching heart disease for its effects on society. And yet, if we are allowed to begin to SEE our mental health in the way we’re encouraged to see our physical, perhaps we can help ourselves move away from this crisis by empowering ourselves and – crucially – noticing in others and coming from a place of support and understanding.

❇️ Everyone has physical health. Everyone has mental health. You might experience blips in each of these, throughout your life. And for each, it’s about learning the tools to keep them optimum in your day to day. It’s ok – normal – not to be ok all the time. It’s how you handle it long term that affects your mental health. You can control what you take on board in your mental challenges just as you can your physical. And you can aim to work on your mind as on your body. If you have an injury, go to phsyio. If you have a mental health crisis, find some way of counselling your way through to heal.

❇️ Lengthen your spine through Pilates, stretch your brain through mindfulness. A star jump here, a gratitude list there. Medicate and/or meditate. There should be no shame.

Happy world mental health day. How are you today? What do you do to maintain your mental health?

My essential mental health toolkit is:

❤️ Green space

❤️ Movement

❤️Meditation

❤️ Gratitude

❤️Being OK with not feeling OK all the time

❤️ Connection – seeking support rather than hibernating in hermit land (which is often what my mental health gremlin tells me to to do when feeling low).

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Look at some wonderful sources of wisdom, Emma @thepsychologymum, Suzy @suzyreading, Zoe @motherkind.co. You’re not alone ❤️