Physio Octavia Hamilton: “There’s no one right way to do motherhood. So why are we only shown one type of mother?”
Tinto’s no-nonsense physiotherapist and podcast host shares the things she wishes she’d known before becoming a women’s health physio… and a mum.
I feel like women are cheated with the information we’re given to prepare for motherhood. Women need to be given the full picture, and yet far too often we’re shown just one side of the story.
After pregnancy and birth, I was so surprised by how different my body was and how little control I had over it. Everything from a weak pelvic floor and struggling to manage even one pelvic tilt to feeling like a concoction of breast milk and tears were constantly coming out of every orifice!
There’s a lot of outdated information on motherhood and it can be hard to access the good stuff. Advice needs to be broad, evidence-based and non-judgmental. There’s no one right way to do motherhood. So why are we only shown one type of mother?
The biggest preparation for pregnancy and birth should be psychological. As a physiotherapist, I am often asked if there are certain physical milestones that women should try to reach before getting pregnant with their first or (even more commonly) second child. But the truth is that understanding and mentally preparing for the processes and demands involved in pregnancy, birth and parenthood will have the biggest impact.
That said, if you’ve already taken the time to think about how you can best support your mental health during pregnancy and postpartum, then it is definitely worth preparing your body to cope with the load of pregnancy. This is particularly true if it’s your second, third or fourth time round as although the load might be the same, you’re working with a weaker system and against any issues you’ve experienced previously like Pelvic Girdle Pain. I would definitely advise maintaining good posture through gentle stretching of your hip flexors and lower back muscles and strengthening glutes, abdominals and your pelvic floor.
Remember: if your car broke down, you’d go to a mechanic. There’s no reason we shouldn’t provide our bodies with the right specialist help too.
Your training should be to keep your body healthy, pain-free and mobile, rather than to prepare for labour. But know that you can’t prepare for everything. I was really fit during my first pregnancy… and I certainly didn’t boss my birth!
If we can’t tell our vulvas from our vaginas, we’ve got no chance. Society does not educate women properly about their own bodies. So many women still don’t know how to correctly label their anatomy. The problem is that this creates shame and makes it very difficult for women to identify any problems and then articulate them to healthcare professionals.
In fact, I don’t think I’d ever looked at my vulva or vagina properly in a mirror before I had a baby. But after I’d given birth, I really wanted to see what was going on. And, although I hadn’t had a good look before, I knew immediately things were very different: swollen, bruised and the odd stitch! It was a strange experience, and I wish I’d known more. Getting familiar with your vulva and vagina is the best way to know if something isn’t quite right and to enable you to get the right treatment.
It’s all about early intervention. Women put up with a lot throughout motherhood. But chronic pain should be not be part of the story.
I see a lot of women suffering with Pelvic Girdle Pain (PGP) in particular. PGP is the term for pain in the pelvic area during and after pregnancy. The pain originates around the joints and is caused by changes in posture, the loosening effects of the relaxin hormones and changes in strength. Women with PGP tend to feel pain around the joints in the pelvis: the sacroiliac joints (two at the back of the pelvic) and the symphysis pubis (at the front). But it can also refer to pain in the lumbar spine (lower back), in the bum muscles and around your groin. Pelvic Girdle Pain can come on suddenly after a fall or slip, but usually it’s gradual, which means many women ignore it until it becomes pretty debilitating.
The problem is that the more pain you’re in, the less you want to move and the more you start to compensate. Later into your pregnancy, your muscles are really stretched and weakened and so your pain becomes even harder to treat.
So if you’re a new mum and you’re in a lot of pain — whatever that pain is — don’t suffer in silence. Go and speak to your doctor, ask to be referred to a specialist and get treated early. There’s so much that can be done.
Push your doctor, not your body. Normalising bodily dysfunction or pain is a really common practice when talking about the postpartum period. But saying that a prolapse or incontinence is normal is dangerous because it suggests that women should accept them as part of the package.
Instead, we should say it’s very possible that you might suffer from prolapse or incontinence after birth. But, crucially, you should absolutely seek medical advice as many symptoms can be resolved with physiotherapy.
The key is: if it doesn’t feel right, it probably isn’t right. Take incontinence, for example. There’s no exact time to wait before seeing your doctor. If you feel like you’re peeing, pooing or passing wind when you shouldn’t be, get checked out.
Some GPs are brilliant, but feel free to ask to be referred to a specialist too. A women’s health physio should be the first port of call. 80% of incontinence can be solved with physiotherapy.
Remember: if your car broke down, you’d go to a mechanic. There’s no reason we shouldn’t provide our bodies with the right specialist help too.
Once postpartum, always postpartum. We continually make women feel like their bodies should be doing more — even before having children. So guess what? We feel bad about our bodies and ourselves.
People are being much more honest these days, but there’s still an expectation that your tummy will whip back straight away, for example. The reality is that some women care about getting back to their pre-pregnancy weight and some don’t. The former shouldn’t be shamed for putting emphasis on wanting to “get their body back”, and the latter shouldn’t be pressured if it doesn’t interest them.
Either way, it’s not always within your control. Diastasis recti (the separation of the abdominal muscles), for example, can sometimes look like a soft protruding belly and can turn a belly button from in to out. However hard a woman trains, her tummy will always look like this without treatment. We need to take the pressure off ourselves, and make sure we get our bodies checked properly about eight weeks after birth and before we start any exercise.
Sometimes, even if you do all the right things, your skin might be stretched beyond repair and you might always have a bit of a saggy belly. And unfortunately, you’ll just have to accept that. This is the sacrifice we make to be mothers. All you can do is your best to love these changes… as hard as it might be.
Octavia is a Tinto expert, women’s health physiotherapist and also hosts the Tinto Talks podcast. You can contact her for advice through the Tinto app and hear more from her by downloading Tinto Talks wherever you get your podcasts.
