I was going to start this with a really corny dad-like joke but I just somehow found a thread regarding prolapse for women and realised how serious an issue this is and how much it affects women. So many women have babies and then that's it and that's fantastic! And I don't want to scare people into thinking well it's so common, I must have something too. If you are feeling great, that's great! We have our bodies for our whole life and we go to the toilet a lot, it makes sense that we create healthy habits. I think today there is much better awareness about pelvic floor issues and the importance of pelvic floor exercises during and after pregnancy than in the past, even recent past. At my mothers group, the maternal child health nurse told us to do squeezes while waiting at a red traffic light and that's all I really heard about anything. I give all my pregnant clients now the Pregnancy Guide (and some of my post-natal ones too), which is wonderful and has heaps of useful information. Doing your pelvic floor exercises might not be enough, have a read below about how to make your toilet habits count.
Lots of the info here comes from a wonderful book called Pelvic Floor Essentials, written by womens’ health physiotherapist Sue Croft. This is some of the information from this book that I feel compelled to share as well as my own experiences.
In 2011, a report commissioned by the continence foundation showed that the prevalence of incontinence in Australia was 4.8 million people (over the age of 15), 79% of these being women. Research also says that up to 50% of women who have children will suffer from prolapse in their lifetime – this is huge!! Conservative measures including pelvic floor muscle training and good toilet habits are important for life!
Today in Restore I said I am the queen of haemorrhoids! Actually it was a stupid thing to say, but it is an uncomfortable topic and it just came out. But I have had lots of issues with hemmorhoids and honestly it is painful and a bit depressing at times. Here's my very brief toileting history. For a long time I had issues with constipation and hemorrhoids. I used to be a long haul flight attendant (you have limited time to use the toilet; sometimes you simply cannot go when the urge arises, weird waking hours, lots of packaged and unhealthy foods and spending lots of time in a pressurised cabin so many cabin crew also have issues with having regular bowel movements). I also went through a stage where I used diet shakes to help control my weight and then developed a reliance on laxatives and suppositories to go to the toilet – all these things really placed havoc on my system. Following on from that ~ two pregnancies, two births and babies so I have certainly had my fair share of issues with digestion, constipation and hemmorhoids. I am now in a good place, developing good toilet habits has been essential in helping me become more regular. As well as the good toilet habits I have a pretty good diet, a healthy relationship with food and body image and I move my body regularly walking, swimming, doing Pilates and Yoga.
Do you strain to go the toilet? (Even for a wee) If you are a new mum, the answer is probably yes because you want to go to the toilet as quickly as possible. You don’t have time to be sitting on the toilet while your baby is crying for you! Or a toddler is watching you and probably pulling all the toilet paper off the roll! But, it is important to relax your pelvic floor and tummy muscles and allow your bladder to do the emptying rather than pushing and bearing down to get it out quickly. Sitting in the right position to do a wee is also important. Here is a pic from Sue Croft’s book, Pelvic Floor Essentials. Notice the neutral spine – that’s important. Hands can rest on the knees and feet flat on the floor. Do this is public toilets too, just put some toilet paper on the seat if you need to rather than doing the hover (well maybe not the gross ones.)
Now to the main part of the story; poo. Straining (especially while holding your breath) to go is kind of like having a mini baby!
It’s important to go to the toilet when the first urge arises. For most people that tends to be in the morning. For me, some hip circles and a big warm glass of lemon water can help to get things moving. Otherwise, a bit later in the morning coffee can be good too to help the bowels relax.
First things first, get into correct position, a bit different from the wee position as you have your feet raised so your knees are slightly higher than your hips, this resembles a natural squat which improves how efficiently we can eliminate waste. You keep the spine neutral, lean forward slightly, once again hands on knees. You can see in my photo, that I have a squatty potty – my daughter uses this as well. You don't want kids legs dangling down from the big toilet. You can go onto their website if you’re interested to find out more info and they have nice bamboo ones too. https://www.squattypottyaustralia.com Otherwise yoga blocks work well too, $5 from Kmart. Or apparently there is a folding stool from Kmart for $10.
Sue Croft recommends rather than pushing into your bottom think about gently bulging your lower tummy out or making a hissing sound like a snake, the hissing is especially useful for kids - but good for adults too. For me, I like to focus on my breathing; when you inhale ribs and belly expand and imagine breath moving down to your perineum and you will feel a gentle pressure on the pelvic floor (yes this is part one of the core breath!) then as you breathe out think about the gentle tummy bulge rather than pushing into your bottom so you can essentially "breathe your poo out" lol but true
For those suffering, aside from good toilet habits what else can you do? Well first of all, this information is not in place of medical advice. Your health professional is always your first point of call.
Moving and keeping active is important. Walking, swimming, Post natal Pilates and Yoga as well as dynamic stretching are all good ways to move in the post-natal period. Change the post to pre and they're all good options during pregnancy too. Try and include pelvic floor exercises or ensure your workout is pelvic floor safe. And of course listen to your body, stop exercising if you feel heavy or sore down there or things just don't feel right.
We all know a balanced diet with adequate fibre is important. Foods that are particularly helpful in making you (well me) go are apples, pears, beetroot, dried fruit - especially prunes, wild rice and there are plenty of others but these are my go-tos. Of course drinking lots of water is so important; good hydration is key.
A natural laxative is psyllium husk; you need to drink a lot of water with it to help “flush” the system out, rather than ‘clog’ the system.
Anyway, I hope this has been helpful. Please feel free to ask me any questions regarding this or discuss anything. This needs to be an area that is open for discussion and remember to see your doctor if you are worried. And if you're up for a laugh and a bit of grossing out, check out the video for potty squatty! It's weird but informative
For more information you can buy Sue Croft's book, Pelvic Floor Essentials from her website www.suecroftphysiotherapist.com.au or for specialised advice please see your doctor or find a womens health or continence physiotherapist