Pregnancy, childbirth and caring for young children all place huge demands on women’s bodies. Up to 50% of women experience pain in the skeletal system during pregnancy (most commonly in the pelvic area) and for many women this persists throughout their children’s early years. Other women get through pregnancy relatively pain-free but develop pain from the repeated strains of lifting and bending while caring for their children.
My passion for helping women optimise their physical health during their childbearing years comes from having provided physiotherapy to hundreds of injured mums over the years. In 2008 I took this interest further and I completed a Masters of Health Science on the ergonomic factors that might contribute to mothers of young children developing pain. My research showed that the physical work of caring for children is highly demanding because children are a challenging load to lift (they are mostly moving, are unpredictable, and are often in awkward postures that make them difficult to grip) and because childcare tasks involve repeated reaching and bending, requiring you to sustain awkward postures. This means that to face these childcare lifting scenarios safely, mothers need to have good strength and fitness and a high level of self-awareness.
So how can women prepare themselves for the physically demanding job of being a mum?
Preparing the body for this important work starts pre-pregnancy. If you are able to enter your pregnancy with good strength and fitness and self-care routines then you are more likely to be able to maintain these during pregnancy. Once pregnant, women face different challenges to their physical health and fitness at different stages of pregnancy.
In the first 3 months the biggest challenge for most women is managing nausea and fatigue. These symptoms make many women unable to do any exercise as they struggle just to cope with normal routines. However, even if you are struggling to do your normal level of exercise it can be extremely helpful to start some good habits that will benefit you later on.
It is never too early to start to do pelvic floor exercises. The pelvic floor is the layer of muscle stretching from the pubic bone in the front to the tailbone at the back and forming the floor of the pelvis. It is the main support structure for the pelvic organs (bladder, uterus, bowel). A good guide to successfully exercising these muscles can be found at http://www.continence.org.nz./
It is also important to try and get some gentle cardiovascular exercise, for example monitoring your energy levels and including a 15–20 minute walk at the time of day you feel most well.
To help maintain your flexibility and your movement awareness, a gentle yoga or stretching routine that you can do at home can be useful, or just finding time to do some basic deep abdominal activation exercises. This all helps to reduce the de-conditioning that could result from 3 months of inactivity. Pacing your day to allow you the energy to exercise gently – whatever you can manage – is well worth it.
After the initial 3 months many women regain energy and this is the time to make the most of being able to do some strength and conditioning work and start exercising regularly again. Build back into it gently at first and be cautious about overdoing it. Pregnancy-specific workouts that develop your general strength and core condition will definitely pay off once you’re a busy mum.
In the last 3 months of pregnancy most women have to adapt their routines as they change shape and again face reducing energy levels. This can also be the time when aches and pains become more prominent and some women need expert treatment and advice to help keep them mobile and minimise pain, and so that they can be confident going into birth.
Post-natally, it’s time to get the abdominals and the pelvic floor muscles up and working again. It is vital to quickly restore the muscle support to the back and pelvis. Making time to get into a post-natal exercise routine should be a priority – even if initially it is only working your deep support muscles and doing very light exercise. But don’t expect too much too soon – the body has to heal and recover and more vigorous activities like running need to be built up to over months, not weeks.
As well as getting the support muscles working, women need to take care of themselves in other ways:
pace their day and have regular breaks to rest and relax
prioritise their own safety when lifting and carrying
make the most of any practical support available
set up the home as a comfortable workspace
seek professional help early if they start to develop pain or problems
This months article comes from a brilliant local physiotherapist Renee Vincent from Total Mums & Total Physio in St Lukes. Total Mums is a physio service specialising in treating pregnant women and mothers of young children. Renee is also very pro-massage.
For more information about Total Mums go to www.totalmums.co.nz