Everyone’s walked down the grocery store aisle and seen “feminine hygiene” as an option. I’m sorry, but I have never met a single provider of women’s health care for sale on that aisle. Nope; what I find instead are powders, wipes, soaps, creams, scented pads and deodorized tampons, and a multitude of completely useless items no woman should waste her hard-earned money on.
Because of its life-altering nature, childbirth should not be entered into lightly. Neither should it be an event to be feared. While we can never predict what they journey may entail, we can empower ourselves with knowledge, create a plan, and work toward the kind of birth we want to look back on for the rest of our lives.
Whether going through pregnancy or postpartum, we are constantly in motion – externally and internally. Even when asleep our bodies are hard at work to create and sustain life. This makes it easy to become overwhelmed, exhausted, and emotionally drained. Because of this, self-care should be our first priority, not our last.
As 2017 approaches, we are looking for new ways to reach the women we serve. One of those ways is through a consistent team of contributing story sharers on our blog. Yes, story sharers. You don't have to be a 'writer', have your own blog or have anything published to contribute. We want real-life mamas sharing real-life things. Good things like the joys of motherhood; ways you have learned and grown as a woman; ways you have been empowered through your story or struggle. Hard things like depression and anxiety; miscarriage and loss; unmet expectations. Stories of the day to day and what that looks like...and how it changes. We're looking for women who would be willing to contribute 5-10 posts/YEAR. That's it! Sometimes we may ask for a specific topic, other times we will just share what it is that you're passionate about sharing. We want YOUR STORIES...your beautifully messy, imperfect stories. If you are interested, please contact our blog editor, Alisha, at email@example.com. We can't wait to hear from you!
Within every mother , there is a warrior. This warrior desires deeply to fight, to thrive and to live. But for a mom struggling with postpartum anxiety and other mood disorders, this warrior is imprisoned.
Their prison must be unlocked, so the doors of communication can open. The key to unlock that cell is support. The medium is education, and the vessel to utilize that medium is you.
The Motherhood Café Presents: Postpartum Body Image
Brandy Wilson, PT, DPT – doctor of physical therapy who has been practicing in the Lynchburg area for over 12 years, and focuses on pelvic health. Mom of 2, 9 and 6.
Trish McCoy Kessler, LPC – owner of Empower Counseling. Has been married for 10 years and has twin step daughters who are 17. Also a contractor with Prosperity Wellness, who treats eating disorders and body image issues in women and young girls. Loves working with women and empowering them to support each other in their journeys.
Erica: This is a sensitive topic that sneaks up on people and how emotional they can feel about these things. Our bodies go through a lot of changes during pregnancy and the postpartum period and so I just want you to feel comfortable with this discussion. At any point, we’d love you to chime in with your thoughts, experiences, or questions for our panelists. This morning is one that we’ve found in the past to be almost healing in its discussion. Sometimes we don’t realize the insecurities and feelings that we have where we are with our bodies and how we’re feeling as we transform from being a woman, to being a mother and a woman. Those changes are really difficult to talk about and to understand. This isn’t really a conversation that’s going to fix anything, but at the same time sometimes talking about it in a group and getting support and that you’re truly not alone in these feelings and people that you might look at and say, “she’s really got it together” to hear that we’re also got our baggage and insecurities and feelings about how we look, act, and feel about our bodies and our health in general. It’s helpful to know that we’re all struggling with things and hopefully that will make us that much more supportive of others to know everyone’s got their own stuff.
Erica: Health care disclaimer – local doctors and health care professionals are willing, advice is general . if you’re having a personal issue, please talk to your doctor and discuss your specific health care needs. Take anything you hear here with a grain of salt and discuss with your personal doctors.
Erica to Audience: We’re going to start with an audience participation questions: How would you describe your body before having children or pregnancy in one word?
Audience Answers: winter ready, strong, nice, energetic, curvaceous, mine, toned, prettier than I realized, curvy, cooperative.
Erica to panel: do you feel that our culture supports women’s body images in general? Do you feel like we have a good idea of what the body is really supposed to look like?
Trish: I don’t think so. I think our culture has high expectations of what we should look like. Social media and advertisements make a false representation of what we should look like as a woman at any age and I think that’s a lot of pressure and it’s very unfair. I don’t think there’s a healthy view out there.
Erica: What about postpartum? Do you think that we have a realistic expectation for how we’re supposed to be when we’re caring for small children?
Trish: No, I don’t think so either. I think there again on TV and social media it’s all about how quick did she get her body back. That’s just unrealistic expectations. I think that the women on TV all have personal chefs and personal trainers. I think that they create a false representation of what a postpartum woman should look like.
Erica to Brandy: What do you think is the most surprising change that women have during postpartum?
Brandy: I think one of the things that I treat is the Diastasis issues – the abdominal don’t always go back to the way they were. Women will say that they have some ‘extra’ here or I tried a sit-up. One of the common exercises we’re taught is sit-ups and they can actually make Diastasis worse. We’ll try taping or show them manual exercises to strengthen the core. Folks come in to us having experienced when they sneeze or cough they leak or dribble some and they think ‘oh well I’ve had a baby, its normal’. Making sure everything’s working as well as it should.
Erica to Trish – What do you think some of the most common mental changes are after having a baby or pregnancy?
Trish: With the women I work with, they’re sometimes very anxious and depressed. They feel out of control. If it’s their first child, it’s the fear of the unknown, fear of body changes, and what to expect. We really work on some of these symptoms, loss of sleep and any distortions they have of what is realistic or what their bodies should be doing. I work with them to have a new normal of what it’s doing while they’re pregnant and after.
Erica: Why do you think that we’re so critical of our bodies? Why do we compare so much? Is it because of what we see all the time? Why do we have these expectations of how we’re supposed to look postpartum?
Trish: I think that the expectations and standards are just higher. I thought about my own mom – she’s not a size 2, but she’s the most beautiful woman I’ve ever seen. She always exemplifies self confidence and I never had this expectation, but as I got older and social media makes it harder than what it was years ago.
Erica: I sometimes am shocked at women’s experiences and what others have said to them postpartum. It hurts a little when your child says, “Oh, Mommy! You’re going to have another baby!” when you’re not. That’s a child and it’s innocent, but we’ve heard stories of amazingly insensitive things that have been said. It increases the feeling that you should hide yourself during that time.
Brandy: I myself have been struggling since my daughter. I’m a lot smaller now than I was a few months ago from exercising and being more cautious with food. You may have a long way to go, but it helps to remember where you’ve come from. Positive feedback from others is really helpful.
Erica asks the audience to share their experiences.
Audience: My husband reminded me that it took 9 months for my body to make these changes, so it’s not going to go back overnight.
Audience: I was shopping for a nursing bra at three stores and the clerks at two stores asked me when I was due. My son was right there with me and he’s 10 months old.
Erica to Audience: Have any of you ever felt “pressured” to get your body looking a certain way, either by your significant other or mother?
Audience: My sister kept asking me when I would be ready to go bridesmaid dress shopping. I said, “I’m ready now.”
Audience: I’ve had friends and family offer to buy me a gym membership to help me get my body back. I know they’re just trying to help but it was annoying.
Audience: I haven’t really had anyone say anything other than encouraging things to me, but I can relate to the social media aspect; especially with people trying to sell products. They show a picture of a women a week post partum and then again at 6 weeks postpartum and it’s a drastic difference. It puts those images in front of us and makes us think that’s what’s normal when it isn’t.
Erica: Images are really powerful. There is a sting that comes when someone is speaking to you directly, but the constant visual of what we’re supposed to look like is the thing that sticks with you. It’s difficult to adjust to your new body – it’s something that many women struggle with, no matter what their body looks like before or after.
There’s a really powerful blog post that’s circulating now that’s about being in the picture with your children. Twenty years from now when your children are looking back at pictures, they’re looking to see you. They want to see what we looked like when we were parenting them as a three-year-old. It’s something that we need to remember – our children love us and they’re going to want to see us again in the future, too.
Erica to Brandy – Can you talk a little more about the things women come to you for help with?
Brandy: Diastasis is where your abdominal muscles stretch during pregnancy and the lining separates. If you’re noticing a hernia in that area, we can do corrective exercises and get those muscles back together and strengthen your core.
Erica: Is that something you notice right away or can it be fixed years after pregnancy?
Brandy: It can be fixed right away. If you’re having issues or a lot of pain right after delivery or if it’s years later, it’s certainly worth coming in and getting back on track.
Erica: Let’s talk about the difference types of incontinence women deal with. I read an article on the history of Poise pads and it talked about how more women are using them in their thirties and forties.
Brandy: There are two types of incontinence: urinary and fecal. With urinary there’s stress incontinence – when you’re sneezing, or lifting. There’s urge incontinence when there’s a very strong urge. It can hit you and there’s no delaying it. It’s the process of standing up to go to the bathroom and everything empties. There’s also mixed incontinence, which is when you experience a mix of both. We look at see what’s your bladder doing with a log of what you’re drinking and how often you’re going, talking a little on the normal bladder – your normal bladder holds about 2 cups of urine and going is about 6-8 times throughout the day and night, and we should be able to sleep all night without it waking us up to empty. You should be going every 2-4 hours. If you notice with your bladder log that you’re going more than normal, those are things where your bladder isn’t working as it should. There’s also fecal incontinence – certainly with ladies who have had a 3rd or 4th degree tear with delivery. It can happen immediately or 10 to 15 years after. It’s a matter of seeing what your muscles are doing, doing behavioral modifications to get you back on track.
Audience question: Is the frequency of urination that you mentioned the same for during pregnancy? I find myself waking several times a night to empty my bladder.
Brandy: That’s what’s normal not during pregnancy. During pregnancy it might be a little more. The baby pushing on the bladder can increase the sense of urgency. We see ladies during pregnancy who have a lot of pressure - it’s utilizing the taping to give support and help them through their pregnancy.
Erica to Trish: Let’s talk about some of the things you see women coming in for. What are the things you suggest women do? What are some things that are helpful for women to do at home of they’re not ready for therapy?
Trish: Some of the things you can do at home are to realize what your trigger symptoms are, what’s causing your anxiety or depression. There are relaxation techniques that you can do. You can do deep breathing, yoga. If you’re ready or feel like you need to, I work with women with addressing anxiety and identifying depression. Managing coping skills and making sure their support system is in place.
Erica: You’ve mentioned you work with women are experiencing eating disorders. What happens when someone who is dealing with eating disorders gets pregnant and then deals with postpartum. How is it different?
Trish: I think it’s more extreme – you never really get past eating disorders. If you have an eating disorder prior to becoming pregnant, reach out to your physician to help. Nutrition is so important during pregnancy.
Erica on audience question: How can we accept that our breasts really change during pregnancy and nursing? Is there anything you can do besides plastic surgery?
Brandy – Muscle-wise, you can do more of your pec-major and -minor exercises to help posture and give you support and stabilization.
Erica: Do not discount the importance of proper garment fitting. Most women are not wearing the right size bra. If you’ve gone through pregnancy and postpartum and you’re wearing the same bra or if you’re been wearing the same bra for years, it’s probably time to invest. It can make an amazing difference.
Erica: What surprised you about your own feelings postpartum?
Brandy: Prior to my first child, I had my plan. I was going to nurse. I was going to take my lunch break to nurse. I tried and he wouldn’t latch. I went to the lactation consultants. I was in tears, my husband was in tears. I wasn’t worried about my body, but I thought it was going to be a smooth transition.
Erica: For the next part, we had one the moms here take some pictures of some of the other moms. These are some pictures of women here who were willing to be photographed in their postpartum bodies.
Audience Exercise: Make a list of 5 things you like and think are important about yourself. List 10 things that you value about people in your life that you’re closest to.
Erica: Mostly we just want you to look at those and see how many of them are about your physical appearance or are about other things. Whether it be their personality, or strength in character. Really look at what you value.
Trish: Erica, that’s one of the things when I work with women is to change their perceptions and identify all of the positive things. Sometimes we don’t take time for ourselves.
Erica: What do you think women should discuss more openly? How can we be more supportive?
Trish: Stop being so critical of ourselves and other women. Be a great role model for our children to help the next generation coming up to not be as critical.
Erica: Brandy, if women here are feeling like they want to get back in shape, to feel better about themselves. Where do they start?
Brandy: Start off with a walking program. Five minutes here and there add up and can make a difference.
Erica: At the beginning we talked about how we felt about our bodies before having children. Now, describe your body and yourself after you’ve had children. How would you describe yourself?
Audience: tired, phenomenal princesses of power, confident, proud, sensitive, beautiful, stronger.
Erica: To close, I would like each of you to take one last piece of paper and write a compliment to the woman on your right. It doesn’t need to be about her body; could be about her mothering, her smile, something you’ve noticed while we’ve sat here. Let’s not let a single woman sneak out of here unnoticed. You each are all beautiful.
The question then, is how?? How do we find the time? We reached out to author and blogger Jessica Turner. She is a full-time working mom of three, founder of The Mom Creative, and author of the book The Fringe Hours, where she addresses this exact topic with practical advice, worksheets and ideas to help any woman implement self care into their schedule.
We lay out our mats, grab blocks, bolsters and blankets and settle in to start class. It’s at this point that the rest of the world stops a bit. There are no cell phones, no TVs, no people other than the ones doing exactly what I’m doing. We focus on breath, we stretch, we downward dog and go through vinyasas. A few minutes in and there is no choice other than to focus on the exact move I am in, or I risk falling, injuring myself or hitting my neighbor—all things I’d like to avoid. I am there. And I am all in.
How you feed your infant is your choice. The Motherhood Collective supports your mental, physical, and emotional well-being. It is of utmost importance to us. In a world full of mixed messages, you need to be assured that you are the best mother for your child. You are innately able to care for your baby. You are strong. You are powerful.
Looking back, I wish so much that I had done something sooner because I barely remember that stage of my life, and as we as moms know, the early baby stage is so fleeting even if you are fully present. If I can leave you with anything, it is this. Please don't wait to get help. Please know that you are a good mom, an amazing mom. If you are going through something that you need help with, please get help as soon as possible, you will not be judged. If this is something that you did go through, and it has passed, please know that you did everything you could. Enjoy your now. You may not remember those scary and hard days in the beginning, but you can make memories starting today.
Applying these things to my fourth trimester helped tremendously during our transition to a family of six. I still had a few bad days, but they were few and far between. Because we had “been there” and “done that”, I knew my limitations and my husband knew when to step in and help me where I needed support.
Looking back, these were the longest days of my life and I look back on them with such sadness for how I wanted it to be and how it really could have been. Having come off of such a high from an amazing birth experience to having the furthest from ideal hospital stay was like being hit by a truck heading into Ezra’s first few weeks of life.
I’m a mental health professional and I hate the phrase “mental health.” Just like I hate the term “mental strength,” in case you had the joy of seeing that blurb go around Facebook last year. Why? Because it suggests polarity. If there is mental “strength” or “health,” then there must also be mental weakness, mental illness. For the record, mental strength (and by extension, mental weakness) are made up, pop-psychology, BS terms that mean nothing. I’ve consulted multiple versions of the DSM and those phrases are poppycock. That’s right, I said poppycock. Ok, all done there.
You are not forgotten. You are not weak or less of a woman. You are beautiful. You are strong. You are remembered and honored. YOU have the toughest job in the world, for to contain such love with no child to pour that love upon…yes…that is the toughest job in the world. This Mother’s Day, I celebrate you.
My daughter has been learning to ride a big girl bike; it is hard, scary, and frustrating (For both of us.) Re-perched after a fall, she began to sing, "relax and pedal harder; relax and pedal harder when you're scared on a bike." I smiled and breathed deeply – those were just words Mama needed to hear.
As a culture, we tend to isolate and delegate the health and well-being of women and infants. We tend to make them "someone else's problem" instead of taking joint responsibility as individuals and as a community. Do we as friends, sisters, mothers, nurses, doulas, midwives, and more consider the comfort of the mother's environment, her quality of her story, her specific and unique desires? Do we consider her emotional, physical, and mental well-being during the labor process?
Welcome to one of our favorite topics! We were so pleased to have two health care providers willing to help us shed some light on common issues that are all too often kept in the dark. We welcomed Katie Page, CNM, and Dr. John Pierce, MD to our cafe' morning on February 8, 2016.
Our bodies go through a number of changes during pregnancy and birth. We spent some time talking about what to expect, what’s “normal” after baby and what are signs of possible problems. Too often women feel uncomfortable discussing these topics, but our sexual health is important, which is why we do this cafe' each year! Continue reading for a recap of our February cafe entitled: "Sex, Love and Other Things after Baby."
Q: Could you give us a brief description of what our most delicate, feminine parts of our bodies have gone through in the birth experience, etc.?
Katie shared an excellent graphic with us that detailed the variety of ways in which our vaginal area can be affected during and after birth. From minor swelling to 4th degree tears...some of the more severe tears were hard to even think about...but it showed that there are wide variations of 'normal', and healing will take different amounts of time for each woman. Also, our pelvic floor muscles will be weaker than before and need to strengthened.
Q: I’m curious as to your thoughts why a morning on this topic is even necessary? What have you seen women in the postnatal period (or later) struggle to grasp and understand regarding sex after having a baby?
John: It's a topic that needs discussing because women (and their partners!) need to understand, from a medical perspective, what is going on physically and emotionally in a woman's body after giving birth. He has actually walked in to a hospital room to find couples having sex after just having had a baby (!) ... while each woman's body is different and the timeframe will be different, that's definitely not recommended, and we need to understand why. Also, it's important relationally...for true intimacy and depth of relationship.
Katie: It's important physically, yes, but also mentally and emotionally...there are so many changes that happen in pregnancy and birth. Also, a birth experience, whether positive or negative, can dramatically impact sex.
Q: Our bodies physically undergo quite the transformation, but often women describe changes in their feelings about their partner and sex. What types of changes did your heart and mind undergo after becoming a mother? Did you feel the same? Different?
Katie: It was a big change, however, some of that is also cultural. We tend to be over-committed as a culture, and let things take over our whole life to the detriment of other areas of our life. I'm still ME. I'm a mother, but also all of these other things that I was before too...recognizing that this a new part of us, and a BIG PART of us, but not letting go of who we are as a person. That being said, there are lots of big emotions and big feelings that come and go after becoming a mother, and it is important to talk about them with your partner. It will take a lot of time, practice and patience, but it's worth it.
Q: Why is there a 6 week freeze on intercourse? What is going on in a woman’s body during this time?
John: It's different for everyone (although 2 days IS too short! see above). There is trauma, even in a good delivery. Muscles and nerves are stretched and nerves take longer to heal. To check how muscles are, you can 1) start to urinate then stop the stream or 2) put 1 or 2 fingers inside vagina and tighten, then release. This will help give you an idea of how well your muscles are healing (although the 6 week check is designed for your doctor to check on these things). If there has been a bad tear, it could be more than 6 weeks; if things are going smoothly, it could be as little as 3-4 weeks. Overall, take it slowly. There will probably be some vaginal dryness (use lubricant...even just some olive oil!) but there should not be pain.
Katie: There are some exercises that you can do to help...what John already mentioned are good things to do; if there is pain involved, you are not ready for sex. The 6 week check up is checking so much more than just the vagina; it's testing for soreness or issues in a host of other surrounding muscle groups as well. Kegels are good, but need to make sure you're both contracting AND relaxing...you need to be able to do both. Also, focus on good GENERAL health. When you feel better about yourself, you'll feel better about sex. Don't expect the baby weight to disappear in those 6 weeks, but give yourself some grace; be patient. Take time and space to take care of yourself, and you'll be more content and happy, which will have a positive impact on sex.
Q: What is 'normal' when it comes to having sex/frequency after baby? (note: when polled, the average time for the audience to have sex after baby was 'before 6 months'.)
Katie: There is such a wide range of normal! For some couples, sex everyday was normal before, but for others, sex once/month could be healthy and functional. Don't compare. If you and your partner are both comfortable, it's healthy. We as women tend to need to be aroused first, while for men, they think about it first and are then aroused. Add in abdominal/vaginal changes, and it's a lot! Talk about expectations and desires...both of you need to work together to find what works for your specific relationship.
John: Be aware of 'creeping separateness'. Where you slowly are drifting apart but don't really realize it. It will take time to figure out, but work at it as a team and together. It's important to continue to date one another and set aside time to talk as a couple about plans/dreams/desires for yourself, your relationship and your family.
Q: So many say that the “best” foreplay is seeing their partner doing the dishes! But seriously, what types of foreplay would you recommend? Is foreplay even necessary?
John: Referred to the phrase, "Men are like a frying pan, women are like a crockpot." In essence, if things are going well outside the bedroom for a woman, things won't get well inside the bedroom either. (editor's note: it was at this moment that we all wanted to record Dr. Pierce's insights and play them in the background of our homes.) Men NEED to talk about expectations too! Learn each other's 'love languages'...how does the other one best receive love? Is it by doing the dishes for them? Then do them! Is it by saying 'I'll take care of the kids, you go take a bath'? Then do that! Recognize that this is a season, and there may not be a lot of time for foreplay, but if you can try to put each other's needs first when you are able, the sex will come a lot easier. Also, lube. Again the lube...it can be your best friend during this season!
Q: How have you personally maintained and found time for a healthy sex life? Any tricks of the trade? Has anyone ever shared any particular pearls of wisdom that stick with you?
Katie: When they're a newborn and can't roll yet, it's a lot easier...just put them somewhere safe: the floor, their crib, wherever, and you're good to go! :) For a while...schedule it. We schedule everything else in our lives, why NOT this?! After a while, you'll start just finding the time and it will become a new rhythm. (although, she noted, our short maternity leaves do not help in this area...we barely have time to adjust!) Schedule parental 'nights off' for each other, split up chores and tasks...use an adult chore chart! Also, if it's scheduled in, it helps your partner to know and anticipate taking over some parental duties so that you can prepare.
John: We need margin for time and space. Focus on your family; personally he and his wife made a clear boundary: the parents were prioritized and it was not all about the kids. Also, use 'code words' for sex, so you can talk and plan when you have a few minutes, even if the kids are around! Example: I'd like to go to a restaurant. Fast food, not gourmet. (get it? wink, wink.) Or having a cue, like him coming home to a lit candle means that you're thinking about it and in the mood...but also realizing that sometimes the best-laid plans can still go awry, and the baby will start crying, need to nurse, etc. Remember that it's not just the act of SEX, but how we promote acts of LOVE.
And that is a great way to end! If you have additional questions or feel you'd like more info on something we touched on here, please feel free to contact our blog editor at firstname.lastname@example.org and we'll help you find the answers you need!