Be kind to yourself

Post partum diaries – pandemic edition. This is the third time I’ve done it and it does not get easier….

Here I am again. Three months post-partum, looking down at my squishy, flappy, stripey tummy, my wobbly arms and thighs, and staring back at my tired eyes and my frizzy, depleted hair (mostly on the floor). What’s happened to me? Who am I? How do I dress? How do I go to the toilet? Should I be exercising? Is it ok to feel bad? I’m so tired. Should I always feel good? What if I feel sad, am I a bad mum or a bad person? And, in this lockdown time, when we have limited, difficult or no access to the usual support networks, who or what can help me to feel « normal » again?

What is « normal » anyway?

If you take away one thing from this post, I hope it is this: when you go through pregnancy, when you give birth, you are a new version of you and that is cause for CELEBRATION!

And if you take one other thing: don’t be afraid to speak up. Don’t be afraid to ask for help, or to discuss the intimate details of the journey you are on. Get specialist support. There is nothing to be embarrassed about. You are certainly not alone.

With every pregnancy, every new baby, and labour experience, you change. Your body changes. It’s not the same body you had a year ago because you’ve since built and grown another human, and then ejected it. The evidence is in your arms. So don’t be unfair. Do not expect that your body has just forgotten about all that hard work overnight. You are not supposed to transform back to « pre pregnancy ». Think about it again. You will never be pre pregnancy again. You are forever post pregnancy, and that’s blinking brilliant. Well done.

By the way, here’s a confession: as I write this blog, I am also writing to myself. I’m writing to force myself to take my own advice. I have been hard on myself. I know it. But I keep doing it. I have never been body confident and whilst I’m insanely proud of my body for giving me three whole (and imho perfect) humans, I will always find plenty of things to complain about when I catch sight of my reflection. I know that immediately post partum is definitely not the time to start examining the finer details of ones physique (or lack thereof), but it doesn’t stop me from doing it. I have a silly habit of being disappointed in myself. Disappointed that I have not magically transformed into Jessica Ennis after doing 2 walks and a round of pelvic floor exercises. My expectations are high and self-confidence low, and that’s a bad combination. Especially just after giving birth.

I’ve hit the part of my post-partum journey where I really get cross with myself. Why? Because I don’t like my body. And I don’t have the energy to do anything about it. I am cross because that’s a terrible thing to think about a body that just gave me the three most precious gifts in my life. But, when it comes to body love, or loathing in my case, logic doesn’t get a look in. I need to retrain my mind to be more positive about my body. After all if I don’t love me, I can’t expect anyone else to do a better job! It’s time to be mindful.

I know I’m not alone. Some of my dear friends (who bear a closer resemblance to Jessica Ennis), are going through their own new baby new body journeys. Being able to share with them, in our little circles of post partum chatter, is both a huge relief and reassurance. How lucky I am to have friends near and far, on the journey and on either side, ready to lend an ear or a shoulder to cry on, share a personal story or – better yet – to force me to sit with a large glass of something cold and take a moment to regroup. One wonderful friend even sent me a series of pics of her (in her opinion) wobbly bits – despite regular exercise and careful diet – to reassure me that our bodies are what they are, and there is nothing to be embarrassed about.

As it happens, in our mum groups we’ve had some good laughs, learning terms like « queefing ». We’ve shared exercises and emotions, fears and tears. Women are amazingly supportive like that.

So now I’m cross with society, and the idealistic depiction of maternity and parenthood that we are sold. Those expectations. It’s not realistic. And it certainly doesn’t illustrate or raise awareness of the real repair work that’s going on when we’ve given birth, the work internally, mentally, and physically that’s not visible to the untrained eye. Why isn’t there more literature about this? Why are there only a few articles buried away addressing issues which affect every woman giving birth?

My body has changed, again, and I don’t know it properly yet. I don’t know how it works, or where it needs more attention. In order to best understand the new me, I need to engage some expert help, advisors who know about women’s bodies when they’ve given birth. Experts that can help you to differentiate what’s natural, normal and what requires special attention. Experts that can help you train your body so that it is ready for the next big hurdles… menopause, ageing…. But guess what – those (women) experts are few and far between. Quelle surprise.

Post natal care – where?

We live in a society that expects us to « bounce back ». It’s a society that often rates women generally on their looks alone, and in their maternity period, on a woman’s ability to return to a « normal » size in the shortest possible time after giving birth. We congratulate each other on how we look after giving birth, as if our outward appearance is more important than what’s going on inside. I am guilty of this, and conversations which centre on how fantastic someone looks considering they’ve just given birth. Why? So what? It’s a fine line between a nice confidence booster to a woman who – in all probability – is feeling low, and a reinforcing of all that is wrong with society.

Women who have given birth have been through one of the most traumatic experiences of their lives. Let’s not sugar coat it. We don’t applaud people coming out of major surgeries or after a terrible accident or traumatic experience for looking « normal » – in fact it would be strange if they did look normal, we expect people to look, well, traumatised. So why is giving birth different?

Speak up

Ours is a society which idolises women that – at least from their appearance – have everything pulled together a few hours after giving birth. This includes members of the Royal family. AND YET for the non-royal amongst us, post natal care is woefully inadequate. Please don’t get me wrong: I’m eternally grateful to the wonderful NHS, to the midwives and doctors and nurses, and cleaners and receptionists, and catering team and anyone else who supported me in the run up to and birth of my precious babies. But once that baby is out, the reality of what we have just been through, the consequences, are rapidly brushed under the blood-stained bed sheets. These consequences are often a secret that you may only whisper to your GP if you are brave.

Let’s remember that at your 6-week check, if you don’t ask your doctor to do a thorough MOT, you could easily walk out without even being examined. Many women are too shy to ask to be checked over comprehensively. And if you are examined, and / or indicate that « something isn’t quite right » down there, or your stomach feels like it’s not strong enough to keep your core stable, your muscles have pulled apart, you might be offered the possibility of an appointment to see a specialist physio in, you know, 2 years, by which time you might have given up on your body and self-confidence.

By contrast, in France, la rééducation périnéal is a standard élement of the post partum experience for every birthing woman, paid for by le gouvernment because, when it comes to birthing children, someone smart in the République recognised that it’s worth a little investment in the women-folk. Especially if you want to grow your population or have sex again. #jussayin

We ain’t equal yet

I have no doubt that there are women that really do spring back from giving birth, that suffer minimal or no internal or external repercussions, that have the support and the means to get straight back to what they were doing before giving birth. There are women that have no choice but to do that. But those women (not mentioning any names HRH K-Mid) are few and far between.

In fact, almost every woman I have the pleasure of knowing has some sort of story about their maternity journey that is alarming, or painful, or anything but idealistic. I’m talking bleeds, prolapses, leaking, painful intercourse, impossibly sore nipples, lack of milk, too much milk, infections, pelvic girdle pain, back issues, scar discomfort, extreme hair loss, depression, fear and anxiety,…. not to put you off (hopefully by now you know women are superheroes so these are but small hurdles to overcome)… but these are still all serious issues. Issues which aren’t always visible, and which may not be taken seriously. I’ve heard a few older ladies tell me when they sneeze and wet themselves:

« oh, that’s normal. That’s what happens when you have a baby »

Well it may well be what happens, but it’s not « normal ». It’s sadly a common problem, but it’s exactly what a pelvic health therapist can help you to manage.

According to this Dec 2017 Guardian article citing an American study by the Society for Colon and Rectal Surgeries, 40% of post partum women have a prolapse. Basically 1 in every 2 women. And yet here in the UK, there are woefully few qualified women’s physiotherapists who are equipped to help women address post natal body function. To my understanding, almost only a handful of around 700 (there are 33 million + women in the UK). So for the 700,000 or so births per year in the UK, you’ve probably got a ratio of 1 qualified women’s physio for every 1,000 or so mamas giving birth, of which 500 would benefit from therapy. If you opt for a pelvic surgery, there’s a risk that the surgeries associated with prolapse fail, especially without diligent physiotherapy immediately following surgery.

If men gave birth… LOL

Let’s take a moment to reflect here: – if men were giving birth, would post partum physiotherapy be a « luxury », available from a niche community of underpaid specialists only to those with the means and curious or scared enough to speak up? Would the menfolk accept having padded pants and willy-protectors for the rest of their lives? Would they pull on a giant tummy-support swimming costume, with a saggy boob booster, and accept they can’t ever let it all hang out? Would they just smile and acknowledge they may never have sex again, for fear of it hurting their penis? No. Not in a million years. So why should we? I was horrified to learn that my women’s therapist was not taking client’s covered by a big insurance company any more because, after overheads and fixed costs, she would take home just £15 for her time. As she noted, she respectfully felt her time was worth more than that. And I wholeheartedly agree.

During this pandemic I’ve seen a lot of positive posting from women’s health specialists, on Instagram in particular, and I want to shout out to a few who are offering amazing advice, support and guidance for free – they are no doubt aware that this is a particularly difficult season to navigate, and despite what appears to be a general lack of funding and support (eg from health insurance companies), they are putting us ladies first. @physiomumuk, @clarebournephysio, @luluadams, @bumpsandburpees, @theobygynmum, @mothers.wellness.toolkit @enphysio_forwomen are just a few I’ve been following and want to thank for putting tools out there for women to become better informed on these difficult topics, and in these strange, lockdown times.

I can’t believe in 2020 it’s still difficult to get access to this information. Considering that most women give birth twice, I would have thought that in an age of information at our fingertips, there would be much more available.

Pre pregnancy no more

In conclusion …. Please don’t judge your new body by reference to your old « pre-pregnancy » body, your old clothes or photos of your old self. Go and get your new body some new clothes. Go! (Online shopping naturally) #Covid19

Maybe say adieu to some underwear, some once staple items may now be a thing of the past. And let’s be honest that’s probably not a bad thing.

Find yourself a women’s physio. Even if you feel pretty much ok, don’t forget that in later years, through menopause, our bodies decrease in oestrogen production, our bone density starts to deteriorate. If you want to be a swinging sixty type (who doesn’t!) then some of the work needs to start now. Get into good habits. Statistically we are going to outlive the menfolk – let’s do it with energy and strength!

Embrace the changes because those are all yours to embrace. To remind you what your body has given you. And to remind you what power, what resilience, and what magical wizardry (or should it be witchcraft?) you embody.