Latest from Goodto in Postnatal-health

What is postnatal depression and what treatment is available?

debraashtonwaters@gmail.com (Debra Waters) — Tue, 26 Apr 2022 10:17:00 +0000

Postnatal depression can happen to any new mum, regardless of whether they have suffered from depression in the past. While it can be a frightening experience, there is help and support available.

Every mother goes through matrescence - the process of becoming a mother - and it has a profound impact on who they are as a person, if women were more aware of it then perhaps it might make talking about how hard being a new mum is, a bit easier.

Whether plus size and pregnant or straight sized and pregnant, pregnancy and childbirth causes significant lifestyle changes (like trying to find mum friends), fluctuating hormones and a lack of sleep both while pregnant and after the birth of a child can negatively affect mood. Even if you've never suffered from depression you can develop it while you're pregnant – this is called prenatal depression. If you find yourself depressed after having a baby this is known as postnatal depression (or sometimes postpartum depression).

"Postnatal depression (PND) is a common experience affecting more than 1 in every 10 women within a year of giving birth," explains Stephen Buckley, Head of Information at mental health charity Mind. "Everyone will experience PND differently – and for different lengths of time."

In this article we look at postnatal depression, what signs to look out for and the best and quickest way to get treatment.

What is postnatal depression?

A type of depression, postnatal depression occurs within the first year of a woman giving birth. While PND is a mental health condition, it often has an organic cause. "Postnatal depression is not just a state of mind, but biological too," says Fiona Austin, a psychologist and health coach for wellbeing platform Mamma. "It's normal, it's biological, it's a gargantuan shift in our identity," she says. What PND isn't is the so-called 'baby blues' – temporary low mood and tearfulness that occurs a few days after childbirth and disappears within a couple of weeks. Postnatal depression goes on for longer than this and can be very debilitating.

It often comes as shock for women to realise that they're struggling with postnatal depression and they may feel ashamed to admit it. "PND is hugely common but often hidden – both consciously and unconsciously – by our survival mechanism to cope with the new baby," says Fiona. "I’ve had so many clients that have said 'I realise now I was hugely depressed… but just got on with things'. This can be the worst as you just don’t even know yourself what’s wrong."

These days, there's a lot more awareness and understanding surrounding postnatal depression than in previous decades, so sufferers don't have to battle through it alone or fear that their baby will be taken away if they admit to it.

Postnatal depression can make women feel desperate, sad and trapped. Credit: Getty

Postnatal depression symptoms

Persistent low mood, sadness, or depression
Irritability
Anxiety
Feelings of helplessness
Loss of enjoyment of life
Tearfulness
Lack of energy/tiredness
Trouble sleeping
Appetite changes
Withdrawing from friends and family
Difficulty bonding with your baby
Frightening thoughts that you might want to hurt yourself or your baby.

Feeling low, irritable, sad or helpless, feeling tired, sleeplessness, and experiencing a lack of enjoyment in your life or your baby are some of the signs of postnatal depression. Anxiety is also a symptom. Yet many of us might think this is a normal response to parenthood and so ignore our feelings of helplessness and depression.

"A new baby in the home can naturally bring about stress and anxiety as we strive to be the best parent possible," says Louise Broadbridge, aka The Honest Midwife and a speaker at The Baby Show at the NEC in Birmingham. "As a result, changes in behaviour can often be brushed aside as just part and parcel of parenthood."

Fiona warns that postnatal depression can also include anxiety. "Often they come hand-in-hand. But the latter can be left in the dark when supporting someone out of this debilitating and disconnected emotion," she says. "They both need to be addressed." Here are the signs of anxiety to watch out for.

If you're suffering from one or more of the above symptoms for more than two weeks in the year after giving birth, you could have postnatal depression.

Possible triggers of postnatal depression

Previous experiences of mental health problems, including a mental health problem when you're pregnant
Lack of support during pregnancy and after birth
Experiences of abuse
Difficult childhood experiences, such as neglect
Being in a situation where you felt pressured to have a baby, or not feeling like it was the right choice for you
Stressful living conditions, such as poor housing or money problems.

While postnatal depression can affect anyone some women are more vulnerable than others. This is usually a result of past mental health conditions or lifestyle factors. “There are a lot of reasons why someone might develop PND or other perinatal mental health problems," explains Stephen Buckley, a spokesperson for Mind. "A combination of factors is likely to be behind most experiences of PND and you might find you're more likely to get PND if you relate to a lot of these factors. But you could still get PND even if only one factor feels relatable or none at all," he says.

Even if none of these factors apply to you, don't feel like you can't ask for help. Sometimes, there are no obvious reasons for developing postnatal depression.

Edinburgh Postnatal Depression Scale

If you speak to a health professional, such as your GP or health visitor, to discuss how you are feeling they may ask you to complete the Edinburgh Postnatal Depression Scale (EPDS). This is a series of questions to identify PND and measure the severity of your symptoms. NICE guidelines recommend that this test is taken to determine how depressed you are and what sort of treatment you should be offered.

You can also take the Edinburgh Postnatal Depression Scale test online. However, it's not advisable to self-diagnose so always speak to your GP or health visitor about your results.

https://youtu.be/w0aaM9XzwTA

How long does postnatal depression last?

Postnatal depression usually lasts between a couple of weeks up until a year after giving birth. Sometimes, symptoms carry on for longer, especially if the condition is left untreated. How long postnatal depression lasts depends on the person, their circumstances and whether they've had any help or support. "PND is hormones and circumstance dependent," says psychologist Fiona Austin. "We're not meant to have children in isolation so one area that contributes greatly to reducing this new time is talking with other mums or a therapist," she advises.

While The Royal College of Psychiatrists reports that most women will get better without treatment after 3-4 months, it's believed that 1 in 4 mums will still be depressed by their child's first birthday. With this in mind, even if you think you'll get better on your own it won't do any harm to seek support sooner rather than later, in order to avoid PND lingering on.

Treatments for postnatal depression

Fortunately, there are a variety of treatments for postnatal depression. These include talking therapies such as psychotherapy, counselling and cognitive behavioural therapy (CBT), medication and support groups. Hormone therapy may also ease your symptoms. For example, pregnancy can affect the thyroid and hypothyroidism (an underactive thyroid) can impact mental health. So can that most precious of activities – sleep (particularly deep sleep). "This is the biggest sleep disruptor we’ll encounter in our lives," says Fiona. "Get sleep where you can. Sleep is a must."

Your first port of call should be your GP or health visitor. "A visit to your GP is important, just to chat about how you are feeling," says Louise. "This doesn't always result in a prescription but may open up opportunities for talking therapies or local groups who can offer support."

Don't worry that you'll be put on medication such as anti-depressants against your will. Depending on how bad your depression is your doctor will advise you but won't insist. If you're not sure about taking anti-depressants, Fiona suggests asking for a hormone, vitamin and mineral check-up first. "Sometimes it’s as simple as a hormone blast or a mineral deficiency post-pregnancy," she says. While this is true, if your tests come back normal and you're struggling there's no shame in taking medication to see you through this challenging period. If you're breastfeeding your baby certain anti-depressants are regarded as safe; however, if you're still unsure you can ask for alternatives or consider bottle-feeding.

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Support for postnatal depression

Getting support is key to coping with postnatal depression, so don't be afraid to reach out to your GP, health visitor, partner, family or friends. A charity such as the PND Awareness and Support Charity PaNDAS or a mental health organisation such as Mind can also provide advice.

"If possible, try to build a good support system, stay healthy, take time to relax. And seek support for your mental health when you need it," says Mind spokesperson Stephen Buckley, though he admits these things aren't always easy or possible to do.

While mum groups can be hugely supportive some may also, at times, be a bit competitive or other mums may not admit they're suffering too. "Sometimes mum groups can make it worse if there’s no vulnerability and honesty in the group," says psychologist Fiona Austin. "Pretending and competing that everyone is doing well when they’re not can make a bad situation worse."

If you suspect this about a group you're part of, Fiona recommends joining a group specifically set up for women with PND. "Groups with a counsellor or therapist present can be great as the mums can share and perhaps not get away with pretending everything is alright," she says. "These groups can also be great fun!" Your health visitor or GP surgery should have details of such groups. PaNDAS is also a great resource – the charity has a free helpline and can point you in the right direction for social media and Facebook groups and face-to-face groups in your area.

Talking to mums who've been through a similar experience can be very helpful. Credit: Getty

Can you reduce the risk of postnatal depression?

You may not be able to avoid postnatal depression, but there are ways to reduce the risk or manage symptoms. As well as being aware of the triggers, a good support system, therapy or a support group, and medication can help, as can self-help techniques. "Although there's no failsafe way of preventing postnatal depression there are things that you and your partner can do to minimise the risk or help yourself whilst suffering," says midwife Louise Broadbridge. "If starting a family is something you're considering, try to get as fit and healthy as possible. Our physical and mental wellbeing are very much connected. Starting your pregnancy in tip-top condition can help throughout and beyond," she says, as can exercising during your pregnancy.

As mentioned previously, some women who face certain challenges are more prone to postnatal depression. Triggers include mental health conditions, a history of trauma or abuse, a lack of support, or financial worries such as the rising cost of energy bills. "It's helpful to understand if you are at a higher risk of developing postnatal depression," continues Louise. "If you or women in your family have a history of depression following childbirth this does increase your risk."

Your medical history should be picked up in your antenatal appointments, which is an important reason not to miss any. "Your midwife will ask you about this history so appropriate support is arranged for you," says Louise. "It's also a good idea for you and your family to chat about the possibility of postnatal depression, the signs, and where you can go for support if needed. Writing these plans down before you need them may help you to seek help sooner if you can revisit your thoughts at a time when you may not be thinking as clearly," she advises.

Postnatal depression can make women feel desperate, sad and trapped. Credit: Getty

Delegation and self-care

Fiona recommends delegating tasks if possible or at least sharing the emotional load so you don't become too tired or overwhelmed. "Don’t do everything yourself. Let your husband, mum or mum-in-law help. Let other members of family and friends help," she says. "If you don’t have family and friends join a group. Get therapy but don't try to cope alone."

Self-help techniques can can be effective at managing symptoms. This can be something as simple as taking time out to have a bath every evening (preferably with a 'Do not disturb' sign on the door!) or trying some natural remedies for anxiety. Or try postnatal yoga, postnatal exercise or self-visualisation techniques. "Why not revisit all the lovely hypnobirthing practice you may have done during pregnancy," suggests Louise. "Use these relaxation and visualisation skills in any situation to help keep things in check. Mindfulness is ever more popular and, again, can help to quieten the mind and encourage relaxation," she says.

The most important thing to remember throughout is that PND is common. It's not something to be ashamed of or to hide, says Louise, reassuringly. "Make sure you talk to those who love and care for you. Communicating how you feel is the first step to feeling better."

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Postpartum psychosis: causes, signs, risks and treatment

debraashtonwaters@gmail.com (Debra Waters) — Tue, 19 Apr 2022 14:26:00 +0000

Once referred to as a ‘temporary madness’, postpartum psychosis can be a terrifying experience for a new mum, and very concerning for the people around her. While it’s often regarded as an aspect of postnatal depression, it’s more extreme and requires urgent care.

Yet many of us aren’t aware it exists. While you could argue that ignorance is bliss, not knowing the signs and the treatment available makes sufferers more vulnerable. These days, it’s not unusual to discuss having had postnatal depression (also called PND or postpartum depression). Many celebrities including Adele and Reese Witherspoon have talked about battling PND. Even prenatal depression (being depressed during pregnancy) doesn’t carry the same stigma it once did. Yet a Google search reveals that few people – especially those in the public eye – share their postpartum psychosis stories.

Dr Jess Heron, CEO of Action on Postpartum Psychosis, says that because this illness isn't well known or understood, it makes raising awareness even more important. “Postpartum psychosis is a serious postnatal mental illness that can come on suddenly in the hours, days, weeks or sometimes months after giving birth,” she explains. This is why recognising the signs and symptoms – in yourself, a friend, or a loved one – is invaluable. Women also need to know that it's ok to reach out to healthcare providers – they won't be judged and their baby won't be taken away, which is a primary concern for them.

There is help out there. Here's what postpartum psychosis is, including symptoms, who's more at risk, and the treatment and support available.

What is postpartum psychosis?

“It’s difficult to say exactly what causes postpartum psychosis as there are so many factors involved, such as previous mental illness, hormones, birth trauma, exhaustion, genetics, but research is ongoing in this area,” says Dr Jess Heron. Experts have found a raised risk of having bipolar disorder and developing postpartum psychosis. Women with schizoaffective disorder or another psychotic illness are also more vulnerable. Aside from that, Jess told us, “Postpartum psychosis can affect anyone from any background, and it can occur completely out of the blue."

What we know for sure is that postpartum psychosis is always a medical emergency and needs dealing with as soon as possible. This might sound worrying but the good news, says Dr Heron, is that it’s “eminently treatable and has a good prognosis”.

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Postnatal psychosis vs postpartum depression

Postpartum psychosis is often thought to be part of postpartum depression. Although there are some similarities, they are two distinct illnesses. Dr Nagore Benito, consultant psychiatrist of the London Psychiatry Clinic, told us, “Postpartum psychosis is a serious mental illness that occurs in the period after giving birth and it's much less common than postnatal depression – it affects 1 in every 1000 mothers (0.1%) after giving birth.” Postnatal depression, on the other hand, affects around 1 in 10 women up to a year after giving birth. New fathers can also suffer from paternal postnatal depression. She adds that unlike postpartum depression, which can present several months after giving birth, it’s very rare for postpartum psychosis to appear months after having a child.

While anxiety or a low mood can be indicative of both, the symptoms of postpartum psychosis are more acute and severe. “Symptoms are varied and tend to change rapidly but be aware of drastic changes in mood (from being calm or happy to rapidly becoming highly irritable or very depressed), confusion (appearing disorientated and highly distracted, or feeling as if they’re in a dream world), finding it hard to sleep or not wanting to sleep, and a clear change in character, such as being more talkative, having extra energy or showing behaviour out of character,” says Dr Nagore Benito. “There are also symptoms that include hallucinations and paranoia.”

Symptoms of postnatal psychosis

An unusually elated mood, which possibly leads to mania (unusually high mood)
Agitation and irritability
Racing thoughts
Severe confusion
Not needing – or being able to – sleep
Psychotic symptoms such as hallucinations and/or delusions)
Paranoia or supernatural beliefs
Anxiety and depression can be part of postpartum psychosis, but only form a small part of the illness. “This is where potential misdiagnoses occur," warns Dr Benito. "As postpartum psychosis requires a different treatment approach to depression, it’s important to receive the correct diagnosis as quickly as possible."

Symptoms of postnatal depression

Depression
Anxiety
Low mood
Lack of energy
Negative thoughts
Loss of appetite

A note about the baby blues

“Baby blues affects more than half of new mothers and – unlike postnatal depression or postpartum psychosis – is not a condition that requires treatment,” says Dr Benito. “This usually starts a few days after giving birth and usually stops within the first two weeks. Women may experience mood fluctuations, feeling more teary or irritable and sometimes over-react to things." But, unlike PND, it goes away after a fortnight or so.

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How long does postpartum psychosis last?

“Postpartum psychosis can last for a few weeks. It evolves rapidly, within days, and requires urgent treatment,” says Dr Benito. Although mums may experience the most accurate postpartum psychosis symptoms for a few weeks, ongoing support may be required for several months or longer.

Untreated postpartum depression can be damaging, but postpartum psychosis is a medical emergency. One sobering fact is that, according to Action on Postpartum Psychosis, suicide is the leading cause of mothers dying after birth.

Who is at risk of postpartum psychosis?

It can tricky to determine who is more prone to this postpartum psychosis because it's relatively rare. “But it’s important to note that postpartum psychosis can happen to anyone. It doesn't matter how good their pregnancy is and how well they take care of themselves. Nobody is to blame for the onset of it,” says Dr Nagore Benito, consultant psychiatrist of the London Psychiatry Clinic

Because postpartum psychosis is a mental illness, developing it can be more of a possibility if you suffer – or have suffered – from certain mental health conditions. “Research shows that 1 in 5 women with a history of bipolar disorder experience postpartum psychosis following childbirth,” says Dr Heron. “However, many women who have previously experienced it, or who have a history of bipolar, can go on to give birth without becoming unwell again,” she says, reassuringly.

“We also know that it runs in families more than one might expect. It also more often affects first pregnancies than subsequent ones,” she told us.

Postpartum psychosis risk factors

Having a family history of mental health problems, particularly a family history of postpartum psychosis
Having a diagnosis of bipolar disorder or schizophrenia
Experiencing a traumatic birth or pregnancy
Previous experience of postpartum psychosis
Possible pregnancy-related complications such as pre-eclampsia
First pregnancies
A lack of sleep after giving birth can also be a trigger.

“There are factors which might mean you’re more likely to experience it, although these factors don’t mean you’ll definitely experience postpartum psychosis,’ adds Stephen Buckley, Head of Information at Mind.

Vulnerable women should seek extra help sooner rather than later. Credit: Getty

While there is no way of predicting that you will develop postpartum psychosis, these steps can be enormously helpful.

How to reduce the risk of postpartum psychosis

1. Ask for extra help

If any of the risk factors apply to you, don’t panic – it doesn’t mean that you’ll develop the illness. Forewarned is forearmed, though, so speak to your doctor or a mental health professional before you conceive, or as soon as you are pregnant. Stephen Buckley told us, “Talk to your doctor who can help you develop a plan for support. A perinatal psychiatrist will help you as well. They can discuss things like medication and talk about ways to reduce stress and triggers.”

2. If you have a mental health condition, tell your doctor

“Women with a previous history of mental illness related to bipolar and psychosis-related conditions ideally should let their psychiatrist or GP know that they want to get pregnant before starting to try to conceive, so a good discussion about medications, a plan to monitor their mental wellbeing, and having support can be put in place,” explains Dr Benito. If your pregnancy wasn’t planned, just let your doctor know when you discover you are pregnant.

3. Manage your stress

Although stress “is not a cause or risk factor of postpartum psychosis” says Dr Benito, stress isn’t good for anyone, so if you’re pregnant or have recently given birth, try to remove yourself from stressful situations as much as possible.

If you're in therapy, continue with this or ask your therapist to refer you to someone who specialises in perinatal mental health. Alternatively, speak to your midwife about finding a perinatal psychologist or pregnancy counsellor. A service such as Parenthood in Mind, for example, can help you from spiralling, as can medication.

4. Accept medical intervention

Because of the nature of postpartum psychosis, the majority of sufferers will need medical help. Don't try to manage this alone, or holistically.

“Medical intervention is necessary in most cases, particularly to pick up symptoms early on. Most cases require treatment with medication and sometimes in hospital due to the severity of the condition,” explains Dr Benito.

Rest assured, there is help out there for sufferers of postpartum psychosis

Seeking help when postpartum psychosis develops

Because of the extreme nature of postpartum psychosis, the best treatment is found in hospital, where mums are monitored until the worst is over. “The most appropriate treatment for anyone experiencing postpartum psychosis is admission to a Mother and Baby Unit (MBU), where women are able to recover without the added trauma of being separated from their baby,” explains Dr Heron. These units enable mum and baby to stay together whilst being supported by professionals and are the safest place for sufferers and their child. It's also key to a mother's recovery, as it's a fear of sufferers that their baby will be taken away. “MBUs provide specialist care, not just from a mental health point of view, but in terms of the physical care and facilities that women may need access to immediately following birth,” she adds.

Although it sounds scary medication can be very effective, too, even for a short time. “Antipsychotic and mood-stabilising medications may also be appropriate,” says Dr Heron.

Peer support

What people are, perhaps, less aware of, is how invaluable support from other mums in similar situations is. Charities such as Action on Postpartum Psychosis not only offer advice, they act as a go-between so sufferers can share their experiences. “Peer support is really important,” says Dr Heron. “Speaking to other women who have been through it and, importantly, recovered, really does make a difference. It gives people the hope they need to get through it.” The network also provides support for partners and families.

Dr Heron continues: “This is why APP works closely with MBUs around the country. We provide in-unit peer support, and our community peer support is delivered both in person (through café groups) and online (through online forums and digital meet-ups) around the UK.” What’s more, this support doesn’t end after recovery. “It’s on a lifetime basis. That’s during recovery, relapses, through parenting and navigating menopause symptoms,” says Dr Heron.

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Advice for partners

Experiencing postpartum psychosis is hard on partners, too. As well as having to care of their sick partner, they may be taking care of a newborn, as well as other children. And they are probably working. Because of this, it’s important for them to realise that they are not alone. They, too, need taking care of. This sort of sudden illness can pull the rug from under a family’s feet so it's essential they ask for help.

“It's normal for mothers of postpartum psychosis and their partners to lack confidence with their parenting,” says Dr Nagore Benito, consultant psychiatrist of the London Psychiatry Clinic. "They need reassurance that this is the case for most new parents. Having those feelings does not make them bad parents or unable to look after their baby.”

Dr Benito advises sharing the experience with loved ones and to ask for practical help, such as shopping, cooking and babysitting. “It’s important to reduce stress levels and allow space for healing,” she advises – for both mum and her partner. Postnatal exercise and therapy can make a big difference. It’s very important that women and their partners do not think it's related to anything they have done, or that it's their fault, as this condition is highly related to purely biological factors that people do not have control of,” says Dr Benito.

Dr Jess Heron, CEO of Action on Postpartum Psychosis agrees: “While postpartum psychosis is a very serious illness, it’s very treatable. Our thriving peer support community is evidence of this. There is always hope – and there is a wonderful and supportive community waiting to welcome you.”

Find advice at:

Action on Postpartum Psychosis Mind mental health charity Royal College of Psychiatrists

What it is really like to live with postpartum psychosis

To understand what it’s really like to live with postpartum psychosis, we spoke to Zara, 31, who was diagnosed after the birth of her second child.

‘I started to experience symptoms around a week after the birth. Initially after becoming a mum for the second time I felt elated, so hyper and happy, like I could take on the world but then became unable to function. I was very severely depressed and started hallucinating, which involved smelling, hearing and seeing things that weren’t there.

‘I experienced postnatal depression after my first pregnancy, but this was different. At first my GP prescribed only antidepressants, putting it down to anxiety and hormones.

‘It was after a few months when I finally got to see a psychiatrist that he recognised that I had postpartum psychosis. He prescribed antidepressants and antipsychotics. It took three months for me to get properly diagnosed with postpartum psychosis, after the health visitor pushed for my appointment to be brought forward.

‘Unlike with postnatal depression, I had severe hallucinations, delusions and mood changes. I went from manic to a severe withdrawn depressed state that I’ve never experienced before. It also lasted much longer than postnatal depression.

‘The illness had a great impact on my family, they were at a loss of “what to do with me”. My partner’s mother thought I was being ridiculous and my partner was very worried and took on a lot.

‘My daughter was three at the time and I didn’t really engage with her like I used to, so that had an impact on her too. I couldn’t engage with my family and didn’t go outside for months. My partner tried to coax me out into the back garden and I went out for a second and came back in.

‘I managed to go to the park a few weeks after birth and spent a few minutes there and ran back home. I couldn’t even face going to baby clinic. With the depression I had after my daughter, I did new mum things like baby clinic, walks with her out in the pram. But with postpartum psychosis, I was afraid of everything for my son, didn’t trust anyone and totally isolated myself from everyone and everything.

‘My postpartum psychosis lasted longer than usual – around 18 months – and I don’t have many memories of my boy as a little baby, the illness robbed me of that. I did manage to feed, change him and hold him but it felt so alien.

‘I think if GPs had better training maybe and recognised what was happening, I would have been able to get seen quicker. I didn’t know about postpartum psychosis before having my children and neither did my family and as your the one in that state, you don’t really understand what’s going on, so more awareness is going to be a big help.’

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What is prenatal depression? Symptoms, signs and support

debraashtonwaters@gmail.com (Debra Waters) — Mon, 28 Feb 2022 14:55:00 +0000

Most of us will have heard of postnatal depression (PND) but what about prenatal depression? Also called antenatal or perinatal depression, this condition may come as a surprise to many.

There is a tendency to regard pregnancy as one of the happiest times in a woman's life, so easily forgetting that every mother goes through matrescence - the process of becoming a mother - and it has a profound impact on who they are as a person. Celebrities and social media fuel this belief further, with filtered photos of glowing pregnant women #livingtheirbestlife. True, pregnancy can be a wonderful, life-changing experience. But it can also be a period of uncertainty, worry, discomfort, and morning sickness. If a pregnant woman finds she's struggling mentally she may have prenatal depression.

"Prenatal depression is a type of clinical depression which occurs during pregnancy," says Dr Joanne Black, Chair of Faculty of Perinatal Psychiatry at the Royal College of Psychiatrists. "It's important that women have an awareness of this. Many don’t know that depression during pregnancy is relatively common, important and treatable," she says.

What is prenatal depression?

Pregnant women may not be aware that there's a specific depression attributed to pregnancy until they're actually suffering from it. But it's not uncommon. This is especially true if you've had depressive episodes in the past. "For many people who experience prenatal depression, studies have found that about half of people have a previous history of depression which re-emerges during pregnancy, although this is not pre-determined," explains Dr Orinayo Onabanjo, Lead Psychologist for pregnancy and postnatal online clinic Naytal.

Some of us may be more prone, but prenatal depression can affect anyone. "For others, this may be the first time they ever experience depression," says Dr Onabanjo. "Regardless of an individual's previous experiences of mental health, it affects about 7-15% of people during the period of pregnancy."

What determines prenatal depression from a few low days is time and severity. "Depression during pregnancy is more severe than 'baby blues' in the sense that it is more persistent in nature," says Dr Onabanjo. "Depression tends to persist for 3-4 weeks and beyond, and significantly impairs the individual's personal and interpersonal functioning," she explains.

There are other reasons why pregnant women may get depressed and lots of campaigns to help women feel less lonely such as the Mum Ribbon Movement. "Surging hormones, anxiety around finances and work commitments, relationship uncertainties, lack of sleep, worry about the birth, and previous experiences of pregnancy and birth can all cause some women to head into prenatal depression," says Baby and Parenting Expert Rachel Fitz-Desorgher. A difficult pregnancy or struggling to conceive in the first place, an unexpected pregnancy or ambivalence about being pregnant, a lack of support, physical illness, and trauma such as a bereavement can also trigger the condition. Being pregnant with twins or triplets can also raise some women's risk of prenatal depression. In one study, a third of women carrying twins reported major depression.

Women with prenatal depression may sleep more and withdraw from others. (Credit: Getty) (Image credit: TopVectors/Getty)

Prenatal depression symptoms

It's not unusual to have some of the following symptoms, on and 0ff, during pregnancy. Hormones can affect mood and make pregnant women weepy and snappy. Carrying a developing foetus can also make sleeping and eating the right foods tricker, and getting out and about more arduous. However, if you're pregnant and regularly experiencing symptoms, it's time to speak to your midwife or doctor.

Common symptoms include:

Depression
Anxiety
Irritability
Feelings of hopelessness
Frequent bouts of crying
Loss of interest in activities
Withdrawal from socialising
Excessive tiredness
Sleep disturbance
Changes to appetite (eating too much or too little)
In severe cases, women contemplate suicide. "Suicide is a leading cause of maternal death in pregnancy in the UK," says Rachel Fitz-Desorgher.

Nature vs nurture? Does lifestyle and environment or depression affect babies? (Credit: Getty) (Image credit: grivina/Getty)

Does depression during pregnancy affect the baby?

To date, studies have proved mixed as to whether perinatal depression (perinatal being the time both before and after birth) has a long-term effect on babies. This is because depression can be triggered for numerous reasons, including lifestyle and environmental factors.

For example, research undertaken by the University of Warwick found that 'mums-to-be living in war zones/areas of armed conflict were at heightened risk of giving birth to underweight babies.' While this could be, in part, due to stress and/or depression in pregnancy, it may also be due to limited or no access to maternal healthcare.

What research has indicated, so far, is that depression in pregnancy may impact the neurobehavioural development of the unborn baby as well as the environment within which the baby grows, says Dr Onabanjo. "Studies also show that maternal mood state can also affect foetal heart rate, sleep patterns and level of foetal activity within the womb," she explains. "This suggests that the baby is impacted by the mental state of their mothers. And existing research has linked prenatal depression to some children needing greater support with their cognitive and emotional development needs in childhood."

While this sounds alarming, Dr Onabanjo is quick to stress that this is by no means the result for every case. "Further research is needed to elucidate the nature of such links," she says. "Moreover, there is no guaranteed negative effects or suggestion that the impact is permanent." Rather than it being a straightforward case of nature or nuture, it's likely to be a combination of both. "It's difficult to know if it's the depression that increases the risk to the baby of lower birth weight, poor growth in infancy and reduced breastfeeding," says Rachel Fitz-Desorgher. "Or if it's the factors leading to, and resulting from, the depression, such as women not keeping antenatal appointments, poor diet and reduced self-care that are to blame."

It may also be reassuring to know that emotional distress – whether through depression or in response to life stressors – is a normal part of being human, says Dr Onabanjo. Sometimes it's impossible to avoid tumultuous times during pregnancy. "This is why we recommend that pregnant women focus on being as healthy as possible and seek help to improve their mental health," she says.

Therefore, it's essential that mums-to-be attend medical appointments and ultrasounds throughout their pregnancy. Unfortunately, due to the isolating nature of perinatal depression, they may avoid going. "Both mental and physical health is really important for both mum and baby, so it's crucial that mums feel able to share their concerns about their poor mental health with their midwife, who will ask about it at every contact," says Dr Black.

If left untreated, prenatal depression can become postnatal depression after the birth. (Credit: Getty)

How long does it last?

There is no set answer for how long prenatal depression lasts. Some women will feel depressed for a relatively short period during their pregnancy; others for longer. "For instance, as the exhaustion and sickness of early pregnancy eases, so can some women's depression," says Rachel Fitz-Desorgher. Alternatively, some women may feel it more acutely in their final trimester when tiredness, discomfort, possible conditions such as pre-eclampsia and gestational diabetes, and the baby's imminent arrival may cause anxiety.

You would be forgiven for thinking that perinatal depression ends when sufferers give birth. This isn't always the case. "There is no guarantee that symptoms will go away once the baby is born as it depends on what factors may have contributed to the individual's depression during pregnancy in the first place," explains Dr Onabanjo. "Left untreated prenatal depression can extend well beyond the pregnancy and postnatal period and become more severe than what it was at the onset. Therefore, the most important things that help mitigate this are having a good support network and receiving support as early as possible," she advises.

Don't suffer in silence – there is support out there. (Credit: Getty) (Image credit: Vladimir Kononok/Getty)

Treatments for prenatal depression

Fortunately, there are treatments available for prenatal depression. However guilty or upset you may feel, please know that you won't shock health professionals – they will have seen cases before and are there for you.

Treatment for prenatal depression is similar to other forms of depression. "This is a combination of talking therapies, including counselling and cognitive behavioural therapy (CBT), self-help strategies and, where appropriate, pregnancy-safe medication," explains Rachel Fitz-Desorgher. You may be referred to online CBT, a counsellor, therapist, psychiatrist, or to a perinatal psychologist who deals specifically with pregnant women and new mums. There are also support groups available.

For women who are experiencing domestic abuse, there are resources available. "If mums-to-be are living with ongoing issues around domestic abuse they can speak with their midwife," says Dr Black. Alternatively, call Refuge on 0808 2000 247 or visit the Women's Aid website.

Your first port of call should be your GP or your midwife. They will decide on appropriate treatment, depending on the severity of your symptoms. "A referral can be made through your GP. However, if you are experiencing more moderate to severe levels of depression you can ask your midwife or obstetrician to refer you to the specialist mental health midwives at your chosen hospital, as well as your local perinatal mental health team, which specialises in supporting mums and their families in the community," explains Dr Onabanjo.

A small number of women who become very poorly with severe depression and invasive or suicidal thoughts will get specific care. Acutely unwell women, says Dr Onabanjo, may need a referral to an MBU (mother and baby unit) where inpatient support by a multidisciplinary team of specialists can support them on their journey to recovery.

Prenatal depression can be frightening and confusing but it's treatable. (Credit: Getty) (Image credit: Olli Turho/Getty)

Support for prenatal depression

If you are pregnant and feel depressed, or you know a pregnant woman who is struggling, reach out. While this is easier said than done it is the essential first step. "It can be very difficult for women to admit their feelings due to expectations to be happy about being pregnant. But it's really important that women get help to ensure treatment and support is put in place," says Rachel Fitz-Desorgher. "Once they have spoken to their GP, they can be signposted to support groups and healthcare professionals, and have their recovery monitored," she says.

You can also look at Tommy's and PANDAs Foundation. These excellent charitable organisations provide a wealth of information and resources about prenatal and postnatal depression.

Can you reduce the risk of prenatal depression?

It's impossible to know whether life will throw you a curveball while you're pregnant. Or if you will have an easy or difficult pregnancy. If you already suffer – or have suffered – from depression or another mental illness, you may have to accept that you are more vulnerable to prenatal depression. Look at it this way – forewarned is forearmed.

Dr Black has some sound advice for women with a history of mental health problems or trauma:

When planning a baby, if you know you are at risk of depression try to plan in advance. If you use antidepressants, please don’t abruptly stop as we know this often leads to a relapse. Your doctor or pharmacist can guide you with regard to the safety of medication in pregnancy.
If you're in – or waiting for – talking therapy for trauma or previous poor mental health, try to complete this prior to a planned pregnancy. Speak with your midwife about your mental health so she can help or make an onward referral.
Plan with your partner, friends and family about what support you might need.

Whether you've had previous mental health problems or not, our experts recommend these tips to all pregnant women:

Seeking help and support early is an important protective factor. Don't suffer in silence. The sooner you access treatment the stronger a position you'll be in.
Be aware of triggers that may affect your mental health. For example, if a heavy workload has caused burnout in the past, don't muddle through. Prioritise your wellbeing where possible.
Talk. "Just by acknowledging that all in the pregnancy garden is not rosy, women can begin to relax," says Rachel Fitz-Desorgher. "They start to realise that they are not alone."
Cultivate self-compassion practices. These can include rest and relaxation, plenty of sleep, pregnancy yoga, massage, mindfulness and meditation. If you use essential oils to relax, be aware that not all oils are safe to use in pregnancy. Neal's Yard offer a range of essentials oils that are safe.
Exercise. "Daily gentle exercise like walking or swimming has been shown to be great for managing depression of all kinds. Prenatal depression is no different," says Rachel. "Better still, get out for exercise when daylight is at its maximum – even in winter the middle of the day is brighter. This is because daylight on the eyes has a positive effect on the brain chemicals, which are disrupted in depression."
Avoid stimulants. Smoking, alcohol and caffeine may all have a detrimental effect on mother and baby.

(Rachel Fitz-Desorgher will be speaking at The Baby Show at London's Excel from 4-6 March)

Male postnatal depression: Symptoms and signs of depression in dads

Debra Waters — Mon, 28 Feb 2022 14:15:00 +0000

Having a newborn baby is supposed to be a time of great joy. But for some, it can also trigger postnatal depression. And it's not just new mums who suffer. Even though it's not talked about as much, dads can experience male postnatal depression.

Postnatal depression in women affects more than 1 in 10 mums in the UK. It is a relatively common response to the huge physical and emotional changes that occur after birth. While 'baby blues' are common in the first couple of weeks after childbirth – as hormones settle – PND lasts longer. Untreated, it can become a debilitating condition. Less well known is that some men suffer from depression after the birth of their children. Cases have risen in recent years, no doubt fuelled by the pandemic. One Swedish study reported that of 447 men interviewed, 27% of men had depressive symptoms above mild levels, yet fewer than 1 in 5 sought help.

In the UK, the guesstimate is about 1 in 10 new dads. "There is no official diagnosis of PND for men, but we do know that around 10% of fathers experience symptoms of what would be diagnosed as depression in the months after their child is born," says Dr Andrew Mayers, a psychologist at Bournemouth University and an expert in perinatal mental health.

What is male postnatal depression?

Pregnancy and giving birth can be exciting. It can also be, at times, worrying and even traumatic. Pregnant women and new mums have to deal with all sorts, from morning sickness, hot flushes and pre-eclampsia before the baby is born, to breastfeeding and lochia afterwards – as well as postnatal depression. "PND is essentially the same as any other depression, except that it occurs in the postnatal period," explains Dr Mayers.

But what about male postnatal depression? Men don't have to give birth, so why are they affected? The truth is that although male partners don't go through pregnancy and childbirth, they still have to adapt. "We all know that women have huge hormonal and physical changes to contend with but few of us realise that men do not escape as their testosterone, oestrogen, prolactin and cortisol levels can also change in response to becoming a dad," says baby and parenting expert Rachel Fitz-Desorgher.

Rachel continues: "Both men and women experience the enormous turmoil brought about by changes in income, a sometimes overwhelming and frightening sense of responsibility, and a feeling of loss of control. To cap it all there are the relentless disturbed nights. Needless to say, PND in either parent can cause immense strain to the relationship."

Annie Belasco, head of charity for PANDAS Foundation – which offers pre and postnatal depression advice and support – agrees. "Men can develop PND for many of the same reasons as a mother. This includes birth trauma, adaptation to life, sleep deprivation and other significant changes to their lives," she explains.

One of the main concerns about male postnatal depression is that men are less likely to admit to it. "Many men feel unable, through societal pressures, to tell anyone. So they bottle it up and put on a show of coping," says Rachel. She adds that they will also keep quiet to protect their exhausted partner. This may seem like an act of kindness, but it can cause serious problems later on.

A photo posted by on

Male postnatal depression symptoms

First and foremost, we know that PND is a form of depression. Typically, it can also include the following:

Low mood and/or a lack of motivation
Anxiety and/or panic attacks
Feelings of low self-worth and/or guilt
Poor concentration
Changes in appetite
Changes in activity (usually reduced, but can be agitation and restlessness)
Withdrawal from people
Poor sleep
Loss of identity
Hopelessness and crying
Thoughts about death

The majority of these symptoms are the same ones that women with PND experience. And like women, men – says Rachel Fitz-Desorgher – will also find it hard to sleep even when they have the opportunity to, may feel indifferent towards their baby just as a struggling new mum might, and may notice changes to their appetite and libido. "In addition, men are more likely to turn to alcohol and drug use, and resort to physical violence within the relationship when suffering from PND," warns Rachel. This makes it all the more essential that dads with male postnatal depression seek support.

This short video is from the perspective of both mums and dads who have felt depressed.

https://vimeo.com/488062034?embedded=true&source=vimeo_logo&owner=30724562

How long does male postnatal depression last?

While it can be a terrifying prospect to reach out and ask for help, it's better than coping alone. As with so many conditions, the sooner male postnatal depression is treated the better – in terms of both longevity and intensity.

"Babies can bring joy but they can also rock the foundation of their parents’ lives and the sooner mums and dads seek help and support, the sooner they can start to feel emotionally stronger and start to enjoy life as a family," says Rachel Fitz-Desorgher.

Time is of the essence here. "How long PND lasts is down to how soon help is sought," says Rachel. "Left untreated, symptoms might drag on for years," she warns.

Support for male postnatal depression

Fortunately, says Annie, more men are becoming aware and educated around perinatal mental health. As a result, they are seeking answers and support for male postnatal depression. "They're not risking their symptoms being brushed off or undermined," she says, which is good news.

And there's a lot of support out there. The charities Tommy's and PANDAS provide a wealth of advice and resources, and Dr Mayers information on fathers' mental health is very useful. Dr Mayers is also working with the NHS to help men with PND.

"With our campaigning work and research evidence, we persuaded NHS England to include methods to screen new fathers for mental health, where their partner has been referred to support services," he says. The NHS recognises male postnatal depression so dads don't need to feel embarrassed or afraid to discuss their worries with a health professional.

"First port of call should be the GP who can get the ball rolling fast, keep support in place, and also monitor how well treatment is working," confirms Rachel Fitz-Desorgher. "And the role of support groups should not be underestimated – just knowing that you are not alone and that other dads have experienced PND can be hugely helpful," she says. For example, PANDAS offers PANDAS Dads. "It's an online community for just men who are fathers or carers who may be suffering with pre or postnatal depression or anxiety," explains Anne. "This is a safe, moderated place for fathers to share their experiences with other dads."

While some men may wonder if treatment differs from female PND, the medical response remains largely the same, although breastfeeding mothers may be less inclined to take medication. "While many medications are probably safe in breastfeeding, many mothers feel that it is not safe," says Dr Mayers. As a result, some women will feel they have to choose between drug treatment and breastfeeding – a dilemma men won't have to face.

But, as a general rule, male postnatal depression gets the same clinical treatment as female PND. Help includes talking cures and lifestyle changes to improve mood. "Treatment is the same for men and women and can reduce symptoms within a few months," confirms Rachel. "So, a mixture of self-help, talking therapies, cognitive behavioural therapy (CBT) and, where appropriate, medication."

Talking to other dads can help, as can therapy. (Credit: Getty)

Can you reduce the risk of male postnatal depression?

For most new parents, there are ways to lower the risk of developing postnatal depression or to prevent it from spiralling out of control. These include leaning on friends, family or health professionals, spending time outdoors and exercising, eating well, and getting as much rest or sleep as possible.

Reducing expectations can also be hugely beneficial. "Not putting unrealistic pressure on yourself is a great place to start," says Rachel Fitz-Desorgher. "Just by acknowledging that babies cannot be made to sleep or wait for cuddles, or to learn night from day before they are developmentally ready, can help both parents to stop feeling like they have failed when their baby behaves erratically," she advises.

Some women will be more prone to PND because they have a history of depression or substance abuse. Or they had a traumatic life event or illness during pregnancy, a difficult birth, or their baby had – or has – health problems. These circumstances can also apply to fathers who develop male postnatal depression, plus there's the challenge of getting men to talk about their feelings in the first place – something women usually find easier to do.

"One of the key factors in PND with fathers is encouraging men to speak about emotions and mental health and seek help," says Dr Mayers. "Men can be typically reticent when doing either of those things, for physical and mental health. We need to make it easier for men to speak up. Increasingly, we are seeing male role models speak up, especially in sports such as professional football. This helps legitimise it," he says.

A traumatic birth can also trigger male postnatal depression, adds Dr Mayers. Witnessing a partner in danger or pain can be very distressing for men. Then there are life challenges such as financial worries and separation. Another aspect to take into consideration is society's tendency to dismiss the load fathers carry. Raising a family is still regarded as women's work. While this is essential for new mothers – who, more often than not, carry the burden – it's also important that we don't ignore the male experience. "It's crucial that we treat men equally in the parenting journey from conception through to birth and beyond," says Annie. "This can reduce anxiety and the unknown path ahead as a father."

This is particularly true of first-time dads, she says, or men who have a pre-existing mental illness. Age counts, too, adds Rachel – studies show that like younger women, younger men more likely to be affected by male postnatal depression than older dads.

Caring for a new mum with PND can be exhausting, so it's perhaps not surprising that a woman's fragile state of mind can have a knock-on affect on their nearest and dearest. "It is more likely for men to become unwell with PND if their maternal partner has symptoms or a diagnosis," says Annie. So, if you know a mum who's suffering it could help enormously to ask her partner how he's doing, too. If he's struggling and you can offer advice, he's in a much better position to support mum and baby.

(Rachel Fitz-Desorgher will be speaking at The Baby Show at London’s Excel from 4-6 March)

First period after a baby: What to expect from your first postpartum period

Debra Waters — Thu, 01 Apr 2021 11:05:50 +0000

Your first period after a baby may come as a bit of a surprise but it's a natural part of the postpartum journey.

What new mums experience will differ, so don't be alarmed if your period comes more quickly or takes longer to arrive.

Before your first postpartum period, in the first day after childbirth, you will experience lochia. This is completely natural. However, if you are at all concerned by postpartum bleeding, don't hesitate to contact your GP or health visitor.

Here, two health experts explain what you can expect from your first postpartum period.

Will your first period after baby be heavy?

The first period after a baby will come after lochia. It could be different from what you're used to – you may find it's heavier or you may have cramps even if you didn't suffer from painful periods before childbirth. 'Your first period can be quite heavy and return in full force as the uterine lining sheds, along with blood clots from the birth itself,' says holistic health coach Mellissa Laycy. 'This is quite normal.'

'For some women it will be heavier than they had pre-pregnancy. For others the first one maybe lighter,' explains Marie Louise, aka The Modern Midwife and author of The Modern Midwife's Guide to Pregnancy, Birth and Beyond. 'Breastfeeding women may get spotting as the first sign of their period, which is very light bleeding.'

How long does a first postpartum period last?

When your first postpartum period starts and how long it lasts depends on a number of factors, such as the length of time you experience lochia and whether you're partially or fully breastfeeding. 'This does vary, like all periods do, and breastfeeding will also impact the length of bleeding,' says Marie Louise.

Mellissa agrees: 'Everybody is different, so the exact time frame varies from woman to woman; however, one of the biggest determining factors is breastfeeding. Generally, a lot of women find that their period doesn’t actually return until after they have finished nursing, although this shouldn’t be taken as the gospel truth. If you have decided to bottle feed, then your period may return anywhere from 5-6 weeks after giving birth.'

Women will experience lochia before their first postpartum period. (Credit: Getty)

Can you use a tampon for your first period after a baby?

'Usually, pads are recommend for the first period. This is for comfort (if you have had a vaginal birth) and hygiene,' explains Marie Louise. 'You can also better monitor what you are losing – you'll be able to see the amount of blood, colour, and whether there are clots.' This also applies to lochia.

Marie Louise adds: 'Some breastfeeding women may not get a period for more than six months.' By this point many women will feel ready to use internal protection. 'They may want to use tampons or a moon cup after a day or two of monitoring their bleeding. It’s a choice and women know their bodies so it’s important they feel comfortable,' she says.

'Having said that, hygiene is really important for postnatal women regardless of birth type. As postnatal refers to the first eight weeks following birth if you bleed within this time I’d recommend pads and regular changes, and to avoid tampons.'

Your lochia flow will get lighter over time. (Credit: Getty)

How can you tell if it is a first period after a baby or lochia?

All women bleed after giving birth. This is known as lochia and it's the body's way of removing blood, mucous and placental tissue from the womb. Lochia starts soon after birth – regardless of whether you've had a vaginal birth or a Caesarean – and usually lasts between 2-6 weeks, but can go on for longer. It starts off as relatively heavy and, over time, becomes lighter in flow.

Lochia flow becomes more moderate after a day or so and will get lighter as the days go on until it's more like spotting. It will change colour, too – beginning as red or brownish-red, then going darker brown or pinkish red.

'Lochia starts to change colour toward the end – it (often) becomes a dark brown colour.,' explains Marie Louise. Blood from your first postpartum period will look different. 'When your period starts, it tends to be a brighter colour. There's usually a few weeks between lochia stopping and your period starting.'

What to expect from a first postpartum period, according to a midwife

'This varies depending on each woman, her cycle and whether she has conditions such as endometriosis,' explains Marie Louise. 'Either way, all women experience changes to the endometrial lining. This can affect your first postpartum period in various ways,' she explains.

While most women will have lochia and their first postpartum period without any problems, there are signs to watch out for. 'If any bleeding is very heavy, very painful, is offensive smelling or there are clots that last a week, you should report these to your GP,' she advises. 'If you have any other concerns, you know your body. It’s important to get checked out if you feel something isn’t right.'

Be aware that you can become pregnant again as early as three weeks after childbirth, even if your periods haven't re-started. Avoid sex until lochia has finished, as it can put you at risk of an infection.

Postnatal exercise: 5 ways to exercise after having a baby

daniella.gray@futurenet.com (Daniella Gray) — Wed, 24 Mar 2021 10:00:00 +0000

Postnatal exercise is an empowering step for new mums who are looking to boost their physical and mental health, as well as some time for themselves while caring for their baby.

Caring for a newborn is testing and tiring for mums, and when you’re ready to start doing some physical activity, such as running with a pram or beside your baby beside you while you do some pelvic floor exercises can be a great way to boost your fitness and get some much-needed headspace. Resting, recovering and repairing is key during the postpartum period, so it’s important not to rush into exercise.

Typical NHS protocol, according to its exercising after having a baby guidelines, involves providing a postnatal check between six and eight weeks post-birth, and during the examination, your doctor will assess your blood pressure, check the healing process and address any other relevant aspects. Prenatal and postnatal fitness expert Hollie Grant tells us: “This is an appointment for mother and baby, however it does tend to focus on the baby's health and often the mother isn’t checked. If you have had a vaginal birth, it’s worth having any stitches checked over, and ask to be checked for diastasis recti. If you have had a caesarean, give yourself a little longer to recover and ask for your scar to be given the all clear.”

In this article, we’ve consulted with the experts to provide essential guidelines, explore the numerous benefits and answer questions such as when it’s safe to start running after giving birth.

What are the benefits of postnatal exercise?

Postnatal exercise can feel like the last thing you want to do when you’re a busy mum, but it can be hugely beneficial. "Postnatal exercise should be low impact and build up slowly while the body recovers from pregnancy and birth," says postnatal exercise specialist Grace Lillywhite.

Increases your fitness: Postnatal exercise can enhance fitness by promoting cardiovascular health. Try to build activity into your day by taking the stairs instead of the lift and getting outside to walk, where possible.
Reduces the risk of postpartum depression: According to the NHS, one in 10 become depressed in the year after having a baby, so doing some gentle exercise – even if it's a walk around the block with the buggy – can boost your mood.
Improves pelvic floor function: The muscles in your pelvic floor and abdominals may have lengthened and separated during pregnancy, so exercises that gradually rehabilitate those areas are beneficial. "Just carrying the weight of the baby puts a level of strain on them and then birth – whether vaginal or abdominal – will also impact how they function. In the very early days, rest is really important so that you don’t over strain the pelvic floor muscles while they are recovering but low impact movement is one of the best things you can do for your pelvic floor," explains Grace.
Relieves tension: Your muscles can tighten in your back and shoulders, so check with your women's health physio for a proper assessment, as back pain, in particular, can be radiating out from scarring (episiotomy, vaginal or c-section). Grace tells us: "Being a parent is a hard physical job and hopefully your baby will be growing every day. Unfortunately, this isn't so great for your body and new parents can end up with a lot of tension in the neck, shoulders, lower back and more. Mobility work will help to relieve this tension in order for you to build strength, and you can’t strengthen muscles that are over-tight."

Best postnatal exercises

The best postnatal exercises tend to be gentle and low-impact while you’re recovering from birth. Our advice is to start with very low impact core and pelvic floor work before anything else. Hollie suggests these five moves for the postpartum period.

Bend and extend

Pre and postnatal exercise expert Hollie Grant demonstrating bend and extend (Image credit: Hollie Grant)

This move is great for strengthening your posterior chain (back, glutes and hamstrings), says Hollie. Do 12 to 14 reps – with good technique – for two sets.

Stand with your feet hip-width apart, knees soft, pelvis neutral, spine neutral and hands in prayer position.
On the inhale, hinge at the hips, bowing forward as low as is comfortable (no lower than hip height). Keep the knees soft and the spine neutral as you do so.
As you exhale, press the heels into the ground, and using your glutes and hamstrings slowly come back to start position.

Cactus

Pre and postnatal exercise expert Hollie Grant demonstrating cactus (Image credit: Hollie Grant)

This move targets your rotator cuff (a group of muscles and tendons that surround the shoulder joint) and spine extensors (that allow us to bend and lift). Do 12 to 14 reps on each side for two sets.

Stand with your feet hip-width apart, knees soft, pelvis neutral, spine neutral and arms raised up to shoulder height, elbows bent to 90 degrees, palms facing forwards like you’re waving.
Inhale and rotate the arms so the forearm is parallel to the floor and the palms face down.
Exhale to rotate the arms back to their start position.

Side bent leg

Pre and postnatal exercise expert Hollie Grant demonstrating side bent leg (Image credit: Hollie Grant)

The side bent leg move targets your hip abductors (located on the outside of your hips) and pelvic stabilisers. Do 14 to 16 reps on each leg.

Start lying on your left-hand side, knees and hips bent to 90 degrees (tabletop position), spine neutral and head supported.
As you exhale, keeping the right knee and hip at 90 degrees, lift the right leg up to hip height. Your shin should be parallel to the ground.
Inhale slowly to lower your leg back to the start position with control.

Superman

Pre and postnatal exercise expert Hollie Grant demonstrating superman (Image credit: Hollie Grant)

The superman move targets your posterior chain, which includes your back, glutes and rear deltoids. Do 12 to 14 reps each side for one set.

Start on hands and knees, spine neutral, pelvic floor engaged.
Imagining you have a glass of water on your back that you don’t want to spill, exhale to reach your left arm forwards up to shoulder height, and extend your right leg backwards to hip height.
As you inhale, bring the left hand and right knee to touch under your tummy – remembering that imaginary glass of water.

Zips

Pre and postnatal exercise expert Hollie Grant demonstrating zips (Image credit: Hollie Grant)

Zips target the core, mainly your pelvic floor and transverse abdominis (abdomen). Do 12 to 14 reps for three sets.

Start on all fours with a spine neutral, and abdominals and pelvic floor relaxed.
Imagining there's a zip running from your tailbone between your legs, up your tummy and ending at your breastbone.
As you exhale, imagine you're zipping up that zip, first engaging the back passage, then the front, followed by the transverse abdominis. Inhale to unzip in reverse.

How soon after birth can you go running?

It will vary from person to person, but generally, you should be able to return to running after 12 weeks. Again, it’s important to take things slowly if you’re keen to start running after giving birth. It’s a high-impact activity and there are a few things you need to be able to do and a few muscles that need to be strengthened before you start running. “In those early couple of weeks you need to be focusing on pelvic floor exercises, gentle core exercises and walking,” says Hollie.

Once your pelvic floor muscles become stronger, you can start doing more advanced exercises by utilising different positions, holding your contractions for longer or increasing the number of pulses. Then, Hollie suggests adding in some lower impact exercise to build up the intensity of the exercise without the impact, such as squats, lunges and glute bridges.

Before you get to the running stage, there are a few things to check so you know you’re ready. Hollie tells us: “For example, you aren’t showing any signs of pelvic floor or faecal incontinence, [that means] you’re not feeling heaviness in your vagina which could be a prolapse.” If you’re not worried that you have excessive diastasis, you’re able to do your pelvic floor exercises without discomfort and walk for 30 minutes, you may be OK to start running. “I would start small, shorter distances, not so fast. You could even think about running and walking and gradually building up,” Hollie advises. When you feel comfortable and ready, you might also look into running with a pram so you can exercise with your baby on board. It’s important to make sure you have the correct one though – find out what we thought about the Buggy Jogger Summit X3, a stylish running buggy designed to make it easier to enjoy an active lifestyle with little one.

How soon after birth can you do tummy exercises?

Before you start doing tummy exercises, it’s advised that new mothers give their bodies full rest within the first week of giving birth, and two to three weeks if you’ve had a caesarean. Hollie calls this the recovery phrase and recommends doing some breathwork exercises to bring some stimulation back to your core muscles: "Breath work is vital for healing, reducing stress levels and improving pelvic floor function.”

The next step is to start healing your pelvic floor and strengthening the muscles in it. For women who have had a vaginal birth, your pelvic floor passage would have stretched to allow the passage of the baby. Some people experience pelvic floor trauma, such as tearing too. Hollie explains: “Equally, if you’ve had any tearing during birth, pelvic floor exercises bring blood to the area which can help with healing, and if you’ve given birth via caesarean, you’ve still had nine to 10 months of carrying a baby, which is really demanding on the pelvic floor.” Some people will feel ready before six weeks to start doing functional movement exercises but we recommend waiting for the check-up so that you can speak to your doctor.

We spoke to the following experts:

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Bowel problems after pregnancy and childbirth are common but should not be ignored, here's why

Rachael Martin — Thu, 04 Jun 2020 14:00:00 +0000

Bowel problems after pregnancy and childbirth are common but should not be ignored. Understanding the issue and getting the right treatment or advice on how to manage your symptoms is important.

Your body will go through so many changes in both pregnancy and after childbirth, and a common change many women will experience after giving birth is bowel problems.

A study by Warwick Medical School revealed that one in five women develop anal incontinence at some stage after having a vaginal birth, and both of the experts we consulted for this article emphasised how common bowel issues are after pregnancy and childbirth.

Miss Shazia Malik, Consultant Obstetrician and Gynaecologist at The Portland Hospital, told us: “The postpartum period brings a whirlwind of changes, not just emotionally and physically in terms of external appearance but also internally, affecting bodily functions such as digestion. Many new mothers experience various bowel problems after giving birth, which, while common, can add stress to the already challenging postpartum period. Understanding these issues and knowing how to manage them can significantly ease this transition.”

Dr Malik shared her advice and expertise on common bowel problems after pregnancy and how to manage them for this article, along with highly experienced GP Dr Semiya Aziz.

The information in this article is for general purposes only and does not take the place of medical advice. It is essential to be guided by your GP and take note of official NHS advice. You should immediately seek medical attention if symptoms worsen or you are concerned about your health. If you are unsure or concerned about bowel problems after pregnancy, or experience persistent or severe symptoms, then it is crucial to seek personalised advice from a doctor as soon as possible.

What are common bowel problems after pregnancy?

Bowel problems are quite common after pregnancy. The body undergoes significant changes during and after birth, which can affect the digestive system and bowel movements.

New mothers may experience a range of bowel issues, and bowel problems that commonly occur after pregnancy may include:

Changes in bowel habits
Constipation
Diarrhea
Piles (haemorrhoids)
Faecal incontinence (leakage of stool)
Difficulty in emptying the bowels

"These conditions are typically temporary but can be uncomfortable," says Dr Malik.

Pregnancy charity Tommy’s says, "Some women may also have problems controlling their bowels (known as anal or bowel incontinence). This is more likely to happen after a third- or fourth-degree tear. Most women who have a third- or fourth-degree tear heal completely and have no lasting complications."

"Don't be embarrassed to talk to your midwife, health visitor or GP about any incontinence problems. They can help you get the right care, such as bladder and bowel training, physiotherapy or surgery if needed."

What causes bowel problems after pregnancy and childbirth?

Dr Malik explains that several factors contribute to postpartum bowel problems. "The physical strain of childbirth, particularly with vaginal deliveries, can affect the muscles and nerves around the anus and rectum, leading to issues like hemorrhoids and constipation," she says. "Hormonal changes, adjustments in diet and fluid intake, and the effects of pain medication or anesthesia used during delivery can also impact bowel function. If you have a caesarean birth, it’s not unusual for the bowel to take a couple of days to get back to normal – so lots of fluids and gentle laxatives can be very helpful. Certain painkillers are more likely to cause constipation – particularly those with codeine, so take these for as short a time as your healing process will allow."

Dr Aziz adds, "For many women childbirth can be a very traumatic experience, particularly a vaginal delivery. This can lead to the stretching and weakening of the pelvic floor muscles, contributing to bowel problems which may lead to issues such as faecal incontinence and difficulty controlling bowel movements."

How common is constipation after birth?

Constipation is one of the most common bowel issues after childbirth and Dr Aziz says that it can be an "extremely common" issue, "in the days and weeks following delivery."

Constipation after birth can be caused by, "pain medications, reduced physical activity, and the body's recovery process," says Dr Malik. "It’s common to get a little dehydrated during labour, especially if it’s a long one, so along with this and the release of stress hormones during this time and after delivery (especially your first baby) can contribute to constipation."

Dr Malik adds that, "the fear of pain during bowel movements, especially after a perineal tear or episiotomy, can also contribute to constipation." Pregnancy charity Tommy’s reassures that it’s normal to feel worried when you first go to the loo after giving birth, "You are not alone if you are feeling a bit anxious about your first poo after birth. Many women get anxious about this, especially if they had stitches or a tear. You probably won’t have a poo for a few days after birth. If you had stitches, it’s very unlikely that you’ll break them, open the cut or tear again."

The NHS states,"You probably won't have a poo for a few days after the birth, but it's important not to let yourself get constipated." They advise: "Eat plenty of fresh fruit, vegetables, salad, wholegrain cereals and wholemeal bread, and drink plenty of water."

The NHS also reassures, "If you've had stitches, it's very unlikely you'll break them, or open up the cut or tear again." However the NHS also advise that you talk to your midwife or GP if you have constipation that won't go away, or, "if poo is leaking or you're pooing when you don't mean to."

Can you develop IBS after pregnancy?

Dr Aziz explains that there are no direct studies to indicate an association of IBS with pregnancy or childbirth, however she adds that pregnancy and childbirth can exacerbate symptoms of irritable bowel syndrome (IBS) in some women: "This is commonly due to hormonal changes or any stresses that may occur during the pregnancy or after birth, such as when looking after a newborn."

Dr Mailk reiterates that, "irritable bowel syndrome (IBS) is not directly caused by pregnancy or childbirth," but also adds that, "stress and hormonal changes associated with pregnancy can potentially trigger its onset in some women or exacerbate existing symptoms."

Does breastfeeding affect a mother's bowel movements?

Both doctors confirmed that breastfeeding can commonly affect a mother's bowel movements.

"Breastfeeding can influence bowel movements due to hormonal changes that affect the digestive system. Some mothers may experience constipation, while others find their bowel movements return to normal more quickly," says Dr Malik.

Dr Aziz expands, "This is due to a release of the hormone oxytocin during breastfeeding sessions, which may stimulate uterine contractions and occasionally lead to bowel movements. Hydration and the consumption of a nutritious diet while breastfeeding can also support healthy bowel function."

What to do if you're experiencing bowel problems after pregnancy

It is important to discuss any bowel changes with your healthcare professional. They will be able to assess the condition and provide appropriate advice on managing and treating your symptoms.

Remember, postpartum bowel problems are very common and lots of people who have given birth will have experienced similar issues - so the doctors, midwives and health visitors have seen it all - and they’re there to help. Don’t be afraid to ask them any questions and share any concerns you may have. Pregnancy charity Tommy’s reiterates, "Don’t be shy about asking your midwife or health visitor any questions you may have about what’s happening. No matter what the issue, they have lots of experience in helping women after giving birth and are there to help you."

How to ease symptoms of bowel problems after pregnancy

Dr Aziz and Dr Mailk explained to us that managing postpartum bowel problems involves a combination of diet, hydration, and gentle activity.

"Increasing fibre intake through fruits, vegetables, and whole grains can help alleviate constipation," says Dr Mailk. "Staying well-hydrated is crucial, especially for breastfeeding mothers. Gentle exercise, as approved by a healthcare provider, can also stimulate bowel movements."

Dr Aziz adds, "practising pelvic floor exercises (Kegels) may help to alleviate bowel symptoms."

For easing constipation or piles the NHS recommends, "Eat plenty of fresh fruit, vegetables, salad, wholegrain cereals and wholemeal bread, and drink plenty of water. This should make pooing easier and less painful." You can also speak to your GP about getting some haemorrhoid cream to help ease discomfort.

Dr Malik advises a 'slow and gentle' approach to recovery after birth, "The postpartum period lasts 42 days, so it’s important to give yourself time both physically and mentally to recover and adjust – slow and gentle works best. Try and make sure that you have time to keep yourself well nourished and hydrated – and keep enough supplies at home especially if you don’t have help at hand. Taking probiotics both in pregnancy and after your birth can be very helpful with bowel issues."

You should also speak to your GP or midwife about any postpartum bowel problems as they will be able to advise on the best course of treatment for you and offer personalised advice on how to soothe your symptoms.

How long does it take for bowels to return to normal after pregnancy?

"The time it takes for bowel functions to return to normal varies among new mothers but typically resolves within a few weeks after childbirth," says Dr Mailk. Dr Aziz explains, "It is difficult to put a timeframe as to when bowel function will return back to normal after pregnancy. It will vary on many factors including the delivery method, normalisation of hormonal levels and lifestyle measures undertaken, however gradual improvements begin to occur in the weeks following childbirth, as the body slowly begins to recover from pregnancy and childbirth."

Dr Mailk advises, "If problems persist, consulting a healthcare provider is advisable" and the NHS advises, "If a physical problem is bothering you, ask a GP or health visitor for help at any time. They can advise you and refer you to a specialist if necessary."

Should I be worried about postpartum bowel problems?

Bowel problems after pregnancy and childbirth are common but should not be ignored. Speaking to your GP or midwife about any postpartum bowel problems you experience is advised because they will be able to asses the issue and offer personalised advice based on your circumstances

Dr Mailk says, "While most bowel issues resolve on their own or with minor adjustments, prolonged problems should not be ignored. Persistent or severe symptoms could indicate an underlying condition that requires medical evaluation and treatment."

Dr Aziz agrees and advises, "A degree of irregularity or discomfort in the postpartum period can be expected however prolonged or severe bowel problems should always be discussed with the healthcare professional. Symptoms such as severe, prolonged or persistent pain, bleeding, or fecal incontinence, will require an urgent medical assessment with appropriate management and treatment."

Dr Mailk also adds, "Understanding potential bowel changes, implementing simple lifestyle changes, and seeking medical advice when necessary, can help ease symptoms. Please do speak to a medical professional if you are concerned about symptoms you experience postpartum."

The information on GoodTo.com does not constitute medical or other health advice or diagnosis and should not be used as such. Although GoodtoKnow consults medical experts to create and fact-check content, this information is for general purposes only and does not take the place of medical advice. Always seek the guidance of a qualified health professional or seek urgent medical attention if needed.

Our experts

Placenta encapsulation and eating your placenta - is it safe and what are the benefits?

Sibelle Mehmet — Thu, 01 Aug 2019 10:22:00 +0000

Placenta is a natural part of every woman’s pregnancy – but can it benefit you once your baby is here?

The placenta is the first organ that forms when you get pregnant – before any of your baby’s organs – and grows alongside your baby. The placenta is expelled from the uterus after your child is born.

In recent years there have been cases of women eating placenta raw, incorporating placenta in to their meals, and in Hilary Duff’s case turning her placenta into a smoothie.

Clinically, this is known as plancetophagy. Plancetophagy is not a new concept – women throughout history have been known to consume their placentas, and many animals such as dears and giraffe consume it too.

What are the health benefits of eating your placenta?

With celebrities such as Chrissy Teigen, Kim Kardashian and Love Island’s Jess Shears endorsing placenta pills on Instagram, the health benefits associated with placenta encapsulation have been questioned.

Some women believe that having your placenta ground into powder and turned into pills has many health benefits because it contains the nutrients and vitamins transferred from mother to baby throughout the pregnancy.

Placenta specialist and founder of Placenta Mamas, Kimberley Knight says: 'The most common benefits reported include increased milk supply, reduced lochia (postpartum bleeding), reduced stress, increased energy and stabilised hormones during the post-partum period.'

We've rounded up a list of health benefits reported by mothers who have consumed their placenta:

Supply new mothers with iron, amino acids and essential fats
Supply new mothers with vitamin B6 and vitamin E
reduce post birth bleeding
encourage a quick and healthy milk supply
balance hormones
reduce stress levels
prevent baby blues and postnatal depression
boost energy levels
prevent developing insomnia
improve the appearance of skin/hair/nails

A photo posted by on

How safe is eating your placenta?

While some mums rave about eating placenta, there is little scientific evidence on the benefits and safety of placenta pills.

Scientists from Society of Obstetricians and Gynaecologists of Canada in May 2019 issued a warning against placenta encapsulation stating: ‘Despite the growing trend...there is no documented evidence of benefit for improved iron stores, mood or lactation.’

There is a huge risk that the preparations made to the placenta before consumption may not have completely destroyed infectious bacteria and viruses the placenta may contain. The SOGC also found that improper sterilisation of the placenta could lead to serious health risks for a mother and her new born baby. The report stated: ‘There is potential for transmission of bacterial, viral, or fungal pathogens to both mother and baby or close contacts.’

Similarly in 2017, a report published by Centres for Disease Control and Prevention documented a case of a new born baby developing group B streptococcus after a mother breast-fed her baby while consuming placenta pills.

While some scientific studies have not wholly supported the benefits of placenta encapsulation, they have not completely dispelled the health benefits of the practice either.

Below we have listed the different ways of eating placenta. Though, bear in mind some hospitals may not allow you to take your placenta away, so it is important to check their policy before you make your decision.

A photo posted by on

How does placenta encapsulation work?

Around 70-80 per cent of women who eat their placenta opt to send their placenta away to be encapsulated - in other words, turned into placenta pills.

Former Atomic Kitten star Natasha Hamilton chose this option, sharing a picture of her pills online after the birth of her fourth child Ella, and other celebs including Coleen Rooney and January Jones have revealed that they’ve also encapsulated their placenta.

Mothers are advised to transfer their placenta to a placenta company as soon as possible after birth - though, it can be stored in a fridge for up to three days below 4°C. The placenta should be stored in a clean and leak-proof container immediately after the umbilical cord is cut and inspected by your midwife or doctor. It should be kept in a fridge at home or stored in a cooler box with ice.

After your chosen placenta specialist receives your placenta, it will be firstly steamed, then dried using a food dehydrator for eight to 10 hours and turned into a powder. The powder is sealed in vegetable capsules, which can be taken orally throughout the first few months after birth. Typically the placenta encapsulation process is complete 24-48 hours after the placenta company receives your placenta.

A placenta will make around 75 - 200 capsules, although this depends on the size of your baby, placenta and placenta pills. According to the Placenta Remedies Network, the average number of capsules from a placenta delivered at 40-42 weeks is 120 capsules.

Placenta capsules are usually consumed two to four times a day during the first 6 weeks. Placenta pills should be stored somewhere cool and dark. Do not store your pills in the refrigerator as this can effect their benefits. Though, they can be transferred to the freezer after one year to keep for use during the menopause as they help with hormone imbalances later in life.

Placenta expert Kimberley Knight emphasises the importance of choosing a certified placenta specialist certified by the IPEN to carry out your placenta encapsulation.

She advises: 'The Placenta Remedies Network in the UK provides a website so that you can search for qualified specialists who adhere to strict health and safety guidelines approved by Environmental Health and who know the contraindications for placenta consumption.'

All members of the Placenta Remedies Network are fully certified in food safety, hazard analysis and infection control to ensure your placenta is prepared in a safe environment.

How much does placenta encapsulation cost?

Professional services for placenta encapsulation are popping up over Britain and in the United States. Some companies offering the process in the UK are Placenta Plus, Placenta Practice, and Placenta Tree.

The standard cost for placenta encapsulation ranges anywhere from £150 to £500 per placenta. Usually prices include picking up your placenta from hospital or home, transporting and chilling your placenta correctly, and delivering your capsules back to you when they're ready.

As mentioned previously, some hospitals may not allow you to take your placenta away so check with your midwife beforehand.

Placenta smoothie

A BBC One documentary brought the debate about women consuming their placenta raw after childbirth to life, by showing a woman blending hers into a fruit-based smoothie.

Childbirth: All Or Nothing, which aired in 2015, featured Kati Edwards, who had recently given birth, whipping up a seemingly unremarkable blend of berries, banana and coconut milk, before adding the key ingredient – a small portion of her placenta.

Whilst the squeamish amongst us might feel queasy at the thought of consuming a by-product of childbirth, Kati appeared unfazed as she sipped the mixture.

Sharing the thought process behind her unusual beverage, she explained: ‘It’s just to replenish my body of the nutrients it’s lost… I thought it was a bit weird when I first heard about it but when I started reading up about why you might do it it becomes much more normal.’

Consuming your placenta in raw smoothie form is not an uncommon practice. A search on YouTube shows hundreds of videos of other new-mums sharing their placenta smoothie recipes online.

Credit: Getty

Cooking placenta

Although many mums prefer placenta pills as they don’t have to deal with the raw tissue with themselves, you can use your placenta fresh (provided you do so as soon as possible) or preserve your placenta in the freezer until you are ready to consume it.

You can use it in a meal – some women add theirs to stews or sauces to make it more palatable, or blend it into a drink. TV presenter Hugh Fearnley-Whittingstall once incorporated the placenta in a pate recipe on his show TV Dinners for a family of a new born baby.

Placenta face cream

Some beauty conscious mums are indulging in the new phenomenon of placenta face cream. Former TOWIE cast member Amy Childs after the birth of her daughter in April 2017, took to social media to share a snap of her placenta pills as well as her placenta face cream made by the company Placenta Plus.

Ranging from £45- £75 per pot, the placenta face cream promises to hydrate dry skin and prevent ageing.

Did you consume your placenta after childbirth? And if not, would you try placenta encapsulation or any other option in the future?

Postnatal depression and breastfeeding

Beth Ivory — Sat, 04 Feb 2017 16:14:00 +0000

There's no simple rule about whether or not breastfeeding is the right choice for someone with postnatal depression. It's a complicated relationship and every mother who is suffering with postnatal depression needs to evaluate her situation individually.

The benefits of breastfeeding your baby are very well documented, but if you're finding it particularly hard and you believe it's having a negative effect on your mental health, you need to decide if it would be in yours - and your baby's - best interest for you to give up.

Talk to your health visitor or GP about your decision. They will be able to offer you advice and support, but ultimately only you can know what's best for you and your baby.

This is all very well, but when you're facing some of the most challenging times of your life, as well as struggling with depression the 'best thing to do' is not always clear. If you're coping with postnatal depression and think giving up breastfeeding might help the situation, read our positive and negative aspects and see if it helps you decide.

Positive reasons to breastfeed with postnatal depression

If you manage to breastfeed it may help your confidence as a mother, something that women who suffer with PND can struggle with
Breastfeeding can make you feel calm and soothed
Breastfeeding can help foster the bond between you and your baby - something sufferers of PND can find difficult
Breastfeeding can help you realise how much your baby needs you - this could be a comfort to a mother with PND

Negative aspects of breastfeeding with postnatal depression

If you are struggling with feeding, it can knock your confidence in your abilities as a mother
If you are finding feeding particularly difficult, you may form negative associations with your baby and get you very stressed
You may interpret your baby feeding as an overwhelming dependence on you which is compounding your postnatal depression symptoms

Anti-depressants and postnatal depression

Anybody on anti-depressants for postnatal depression should speak to their GP about suitable medication if they are breastfeeding.

Mums' advice GoodtoKnow mum Juliette O'DonnellO'Donnell believes breastfeeding while suffering with postnatal depression literally saved her life.

'I didn't feel like a proper mum and couldn't connect with Sean. He wouldn't be comforted by me, he didn't look like me, I felt no bond with him. But the one thing only I could do for him was breastfeed. This stopped me doing something to harm myself as I knew he needed me.'

How to exercise your pelvic floor

GoodtoKnow — Wed, 03 Feb 2016 10:25:00 +0000

You've probably heard of pelvic floor exercises (also known as kegel exercise) before - but are you doing them properly, or as often as you should be?

Your pelvic floor is a sling of muscles that run from your pubic bone to the base of your spine. It provides support for your bladder and bowel, and gives you control when you go to the toilet.

Exercising your pelvic floor is just like exercising any other part of your body - except no one knows you're doing it unless you tell them! It's essential for building and maintaining strong muscles and preventing health problems in the future - so what should you be doing, how often, and why?

Why do you need to exercise your pelvic floor?

If your pelvic floor is weakened, you may experience incontinence, and while this can happen in both men and women, especially as we age, it's particularly common in women after having children. People with weak pelvic floor muscles often leak urine when they cough, laugh or sneeze, or during activities like exercise (this is known as stress incontinence).

Exercising your pelvic floor strengthens these muscles, and can also help restore lost sensitivity during sex - another common symptom of pregnancy and birth.

Pelvic floor muscles that are severely weak or damaged can eventually lead to prolapses, so it's important to keep them toned and healthy so that they give you the correct support.

How to exercise your pelvic floor

The NHS explains how to do a basic pelvic floor exercise in the following way:

Close up your anus as if you're trying to prevent a bowel movement
At the same time, draw in your vagina as if you're gripping a tampon, and your urethra as if to stop the flow of urine
At first, do this exercise quickly, tightening and releasing the muscles immediately
Then do it slowly, holding the contractions for as long as you can before you relax: try to count to 10
Try to do three sets of eight squeezes every day: to help you remember, you could do a set at each meal

When exercising your pelvic floor, you should not pull your stomach muscles in excessively, squeeze your legs or buttocks together, or hold your breath. It's not easy when you first start, but you need to isolate those core pelvic muscles to get the full benefit of the exercise.

To identify the right muscles, you might find it helpful to try the movement whilst you are urinating. However, you should also not practice pelvic floor exercises when you are using the toilet on a regular basis, as this may cause problems with the bladder and bowel emptying.

Varying the length and intensity of your exercises will give your muscles stamina and strenghten them as the weeks go by. According to the NHS, you'll need to do the exercises regularly for at least three months to reach maximum strength.

Pelvic floor toners

If you're finding it hard to exercise your pelvic floor independently, you may find it helpful to use a pelvic toning device. There are two main options: weight-based and electronic toners.

Weight-based toners are generally cone-shaped and contain weights of various sizes. They are designed to be inserted into the vagina like a tampon to train the correct muscles and can be worn whilst walking - although you should only use them for around 20 minutes a day.

Electronic toners stimulate and exercise your pelvic floor muscles using an internal probe which gives off a range of electronic signals, creating a similar effect to if you were exercising the muscles yourself. Electronic pelvic floor toners are typically the more expensive option, generally costing over £100, but women who have not had success with the weights or independent exercises often consider them worth the investment.

If you have a weak pelvic floor and are unsure of the right exercise for you, speak to your GP, who will be able to advise on the best course of action.