minutes to start I don't know where you can see where I can see my end you probably can't but I've been caught out before where I started recording too early because it just says recording but doesn't come up for the minutes so yeah when Jim goes to edit the video I'm like well I don't know whether you can see me or not but you just have to wait for the time to start and then you can crop the first thirty seconds out yeah I don't want to get caught out like you did no you're kind Last time. I've got to upgrade to river. Are you? Yes. Yeah. Yeah. So this is obviously StreamYard, but I think we're going to swap over to Riverside because apparently that's meant to be. Yeah. That's meant to be good. Sorry, still waiting for the recording. I'm too anal. It's recording on my side. I can see that it's up to like. Yeah, then it starts coming up with like how long it's been recording for. So I've been caught out where, okay, so see, you have got the minute or the seconds now. Can you see that, Yorant? I can see it from the start, yeah. Maybe you can't see, yeah. So I see it a little bit differently from here, but it's started. We're now twelve seconds in, so it's Oh, so it takes. I come up recording. So then I've started and then I've had nothing. Oh, shit. It started to come up like we're twenty two seconds in now. So it's missed like nearly like thirty seconds off the start. So I'm like, I don't know whether you can see this. You're just going to have to wait and edit it out. Yeah, we're here. It's working. Yeah. All right. Hi, everyone, and welcome to another episode of the Stacey M Show. I'm here with the lovely Jen Dugart, who I've known for the past few years. And this episode is probably more for the female listeners. I think the males will probably benefit from it as well because they'll be able to just maybe understand and support their female partners through, you know, womanhood, in general but um it's yeah it's talking about uh essentially postpartum um once you have a baby and pull a bit floor and things look out for what's not normal and jen is an expert in this but I'll get jen to introduce uh herself so jen um fire away Thanks, Stacey. I'm so excited to be here. Thanks for having me. So I run a company called MumSafe and we're on a mission to make sure all women have access to safe and effective exercise at every stage of motherhood. So you summed it up. really well. It's about pelvic floors and what happens to your body after you've had a baby, but also what happens to your body in pregnancy. Could you prepare it better? Because we could. And also, I really liked your touching on the men being part of the conversation, because I think women's health is not always talked about by everyone. And we really do need men and women to get on board with this to improve the landscape for women and for mums. So Mumsafe is... It's off the back of me working, running a fitness business for mums, which I launched in two thousand and eight when my son was three months old and he turned seventeen in a week. So I've been in the pre and postnatal space for seventeen years, which makes me feel really old in my days now. Say again. very experienced um I spent a decade of my working life running mums and bubs group fitness in sydney's centennial park if anyone knows sydney I then created a pre and postnatal certification called safe return to exercise which educates exercise professionals in how to work with mums with best practice. And now MumSafe continues to deliver ongoing education to exercise professionals that work with mums and also allows mums themselves to connect with a trainer that they know that they can trust and is educated in this space because we're not all made the same. No. And I didn't even know this existed until I met you. So, like, I've had two kids. My oldest is nearly fourteen. And I can, I mean, my memory is not the best these days. And when I say, like, ninety nine percent, let's not go one hundred percent. I don't think any midwife, nurse, doctor, I even had like an obstetrician with, is that the right word? Is that what you have? Is that an obstetrician? Yeah, I had a moment there. With my second because of the horrific birth with my first. And she didn't mention anything. either about pelvic floor or what you can do to improve it or I guess you know possibly a bit naive but you know I didn't know it was a thing and you know we think things are just normal like okay that's meant to happen now that I'm old or now I have a child or whatever it might be and obviously we all have different births as well some are really easy some aren't You know, whether it's a C's or a natural birth, I'm sure that also affects the pelvic floor. So I suppose before we get to popping the baby part out, maybe before we even get to like the pregnancy part. So as I said, it's not necessarily just for pregnant females or postpartum. What could women do in general to help their pelvic floor before they even, you know, have a child or whether they decide to have children or not? yeah absolutely so one of the first things I picked up on that you said there stacy is um you were never informed, so we don't know what we don't know. And I think one of the biggest things with this space, and as a woman, if we go back to thinking about getting your period for the first time, unless you've got a mom or a parent that's really, really educated and open, and let's say like a lot of the parents of our generation were potentially not, you might've got some sanitary products thrown at you and you got sent on your way and you picked up some information at school or- Yeah, exactly. Dolly magazine. So this information about like being a woman is basically withheld from us our whole life. And we, yeah, we never know what is normal. And this word normal, like everything is normal, right? Because nothing is normal. nothing is normal, I guess. Like what, what are we, you know, what are we supposed to experience as a woman? So if I'm thinking about the conversation specifically around pelvic floor in the lead up to before you either become pregnant, choose to become pregnant, try to become pregnant. And one specific thing stands out to me. So there's a condition or a contraindication or a you know, called a hypertonic pelvic floor. And what that means is that the pelvic floor muscle is tight. And if you think about a tight muscle, if my bicep was tight and my bicep is is flexed so it's activated if my bicep is so tight that it can't release the whole way then we're going to have problems like I'm walking around with a clenched arm all day that's going to get very tight very sore and is not functional so if you think about your pelvic floor muscles some women have what we call a hypertonic overactive or too tight pelvic floor Now, what that means is that she's unable to release those pelvic floor muscles in order for it to function optimally. Now, some of the signs and symptoms that a woman might experience that has a hypertonic or two-type pelvic floor um one big one is recurring utis um another one could be painful sex another one could be lower back pain or hip pain or um you know what's something called vaginismus which is the involuntary spasming of of the vagina and these are all things that we often don't talk about and especially those recurring utis so you could be a young woman eighteen nineteen early twenties and for whatever reason you're you know you get a uti you go to the doctor you get antibiotics it goes away you get it again and you go before you know it you spent five ten years going from doctor to gynecologist back to a different gp just going what on earth is wrong with me maybe you are having painful sex as well but nobody has ever said to you have you ever seen a pelvic health physiotherapist or maybe this could be related to your pelvic floor you know add into that the fact that a lot of our young women are doing a lot of high intensity sports and there potentially is a correlation between women that are doing high intensity exercise and have hypotonic pelvic floors because we're winding up and winding up and winding up and no one's saying to us make sure you relax your pelvic floor or even educating you about what a pelvic floor is. So I've had countless women that are not necessarily mums hear this information and just go, oh my goodness, I've been that person on that merry-go-round for so many years. Because I heard what you said, I went to find a pelvic health physio. So not the same as a normal physio. So you'll either hear them referred to as women's health physio or pelvic health. And we're more sitting in the landscape of transitioning to pelvic health as the terminology. They go and see a pelvic health physiotherapist. They learn that their pelvic floor is too tight. They spend time with the physio learning how to downtrain pelvic floor and UTIs go away. And the reason they go away is because when you've got a hypertonic pelvic floor, you go to the toilet and you try and release all of the urine. And because the pelvic floor is too tight, it doesn't release fully. That urine then sits in the bladder, becomes susceptible to an infection, and that's how you get your recurring UTIs. So, yeah, I mean, it's so fucking simple. Like, why don't we get that education in high school? I don't know. That was what I remember. And we watched Degrassi High for sex ed at school. Literally what ours was at school is a little bit different now. I don't know what my girls have at their school, but um like even the physio thing like I've you know I'm not I didn't know that was a thing either is that I've definitely obviously learned more since like I've got to know you but you think it's just you know you go and prepare and do your I can't even think what it's called what do you do like when you've got to go off um when you put there from um what's the natal classes yeah yeah that's it you've got to see how long it's been since I've had a kid You know, even something simple in like an antenatal class as to, you know, I mean, you're pregnant by that stage, obviously, but, you know, even just something in that, like it just seems so simple. But as I said, we just assume that these things are normal and we do that with a lot of things as we get older, but yet that's normal, that pain's normal. It's because I've had kids that that's normal and it's, kind of getting it out there well it's like well it might not necessarily be normal and if it is normal then it doesn't have to be normal because we can change that like you don't have to to live that way and um and you know it's you're not living your optimal life if you're within a you like have a uti all the time like that's really painful it's going to you know restrict what you can you can do and if you've had that for like a long period of time then you know that's just something that could be treated obviously without the medication and so much sooner than, you know, it's like, okay, well, why do people not know about this? And I don't know what the answer is, whether there's more money in the middle, which I know that that's the case, whether people are uneducated, they don't care. I don't know where that sits. Yeah, there's so much to it. I mean, you know, imagine the young woman who's attempting to have sex for the first time and it's so painful and, again, she's, you know, potentially traumatized by what is happening to her. And the education piece, like, I always think that there must be, or there is, we all have Medicare, right? In Australia, at least. And therefore, the government is tracking our age. Therefore, why isn't there an email or a welcome to womanhood email that comes to us at the age of thirteen that gives us some education, or maybe eleven, depending on when we're going through puberty or statistics. And then another email that comes to us when we become pregnant to give us education and then postpartum. And then when we hit forty, forty five, why aren't we getting educated in perimenopause and then menopause? So it seems so, so simple to me to fix the gaps. But I guess at the moment it's conversations like this and people like yourself who are helping to raise the awareness and allow more people to listen to what we really should know. But we don't know what we don't know. Yeah, a hundred percent. And I suppose moving forward, so we kind of discussed like the pre, or even, okay, so we sort of have, so even before we move on to the pregnancy part, so are there exercises, let's say we don't have the tight pelvic floor and it's a normal pelvic floor, I know I just used the word normal again, but are there any exercises or is this something that women should be doing from the age of, I don't know, eighteen onwards or something in relation to You know, you hear like strengthening your pelvic floor. Is that something we should be doing? Should we be strengthening it? Is that restricting it? Like, is there anything that people can do or females can do kind of, you know, leading up to teens to womanhood, I suppose, with making sure that they're not going to have issues in the future? Yeah. Yeah, I think this is an interesting one, right? So essentially your pelvic floor and your abdominal wall, so your transverse abdominis and all that kind of that network of muscles are designed to automatically work when we move. So when I cough, jump, sneeze, walk, run, whatever, my pelvic floor and my inner core unit is supposed to work properly. Now, what I wouldn't, what I'd hesitate to do is go, okay, once you're over the age of age of or whatever age, you need to be doing pelvic floor exercises, which is an isolated muscle movement, or we're trying to do an isolated muscle movement. What I would rather encourage is say, if you are living a active life, your body will hopefully continue to we operate optimally. It's when we fall into patterns of, so I turned eighteen, I didn't go to uni, so I didn't keep moving. I gave up all the sport that I was doing when I was fifteen, sixteen, because it kind of didn't feel right. I now spend a lot of my time, I got a desk job, I now spend a lot of my time in that seated position. My hip flexors are shortened. My glutes are lengthened. That's when you might start to see pelvic floor becoming inhibited, things not working in the way that they worked when we were a kid, when we were running and jumping and moving. and doing all of those like mobile things. So the biggest thing that I would say, and this projects forward when it comes to, you know, entering your forties or, you know, over thirty five for women is we want to make, maintain as much or build and maintain as much muscle mass as possible. And we want to stay as mobile and as flexible and cardiovascularly healthy as possible. So Pre-children, pre-starting to think about having a baby and going to a physio and making sure that your pelvic floor can release, and we can talk about that when we get to the actual pregnancy part, make sure you're meeting the minimum requirements of healthy exercise, which I think it's about one hundred and sixty minutes a week, which is not a lot. ideally we should be exercising every single day from a cardiovascular perspective and strength training at least three times a week and then be aware of signs and symptoms when you're younger that things may not be right and then that's when you address so if you've got tight a tight pelvic floor and you've got pain if you've got um if you're leaking when you're doing anything if you've got really painful periods like all of that stuff it's not normal to live with so try and be as active as you possibly can maintain exercise start strength training make sure you're doing some cardiovascular exercise and then pay attention to anything that you're like oh that doesn't feel right but a doctor's just said to me oh don't worry about it you're a woman it's normal you know heavy periods painful periods all that kind of thing so yeah it's more about the holistic version of health at that point and let's keep our bodies in the most optimally functional um capacity for our whole lives ideally but at least until we you know we we start to have babies yeah so I suppose we probably already touched on some of them or already for like the the next part we had But we had like what signs and symptoms should we wear when we're exercising in pregnancy and post, which is probably pretty well what we just discussed. I suppose because a lot of people that are listening are probably single mothers. I'm not saying that they all are. It could be single dads or just people who are short on time. I know I struggle because I just don't have time. I run run the businesses I have kids my kids have social lives more than me I've got to run them to school and sports and stuff so even if if you're not in that single space it can be difficult to to get that um exercise up especially if it hasn't really been your thing like I know that makes me sound really lazy um but how do you try to squeeze just some basic exercising whether you're short on time um we'll get probably just short on time like if you think you know like ten minutes a day or doing something like jumping up and down on a mini tramp thing or skipping or something is that kind of better than nothing well it depends if you're jumping up and down on your mini tramp and you're wetting yourself at the same time because that kind of relates Yeah, I mean, let's circle back at some time and talk about signs and symptoms in pregnancy and postpartum. Let's do this one first. In terms of squeezing and exercise, number one, I get it. One of the stories that I share is that my husband and I actually separated when my kids were really little and we actually spent three years apart. Now, on one hand, if you are in a situation where children are going between houses, and I know that that's not everyone's situation, I would say make the most of the time that they're not with you because it's hard when they're not with you, right? And not but, but and the upside to that is it is time that you can really focus on nurturing you as a human and potentially distracting yourself from the fact that they're not with you. Now, I also know know that is not everyone's circumstance sometimes mum has the children full time and that is really demanding and it's exhausting and it's all of those things so I think depending on the age of the children um and it is effort everything's going to take effort um and I also know like post post separation sometimes you just don't have that extra bit of effort to give, especially when it comes to yourself. What I would say though, is exercise and movements like a snowball effect. It's like, if you do less, you're going to feel like doing it less. But from the second that you go, I'm going to do this. And I know it's going to be really, really hard to get myself there and to do it over and over again. It's going to start to snowball in the other direction. So you're going to find it hard and it's going to get easier for it to become part of your daily life. I get up like, yeah, I mean, I just get up in the morning and I do it before everyone is up. Now my kids are older. I can do that and I can go out when they're younger. So there's a few things that I used to do when they were little is if you have the capacity, depending on your work situation is what I call like flipping your day. Could you get up and do an hour's work while they're asleep? You can't leave the house because they're They're there. But once you've dropped them at school or something like that, could you squeeze in that nine o'clock class or that nine thirty training session at a group in a group environment? I would absolutely advocate for mums, especially single mums, finding a group training environment to be in. because you then get this circle of support from other women in that healthy and active kind of environment. And your trainers, especially if they're trainers that are educated in working with mums, that not only are they educated on the physical ways that they should be looking after you best, but they're also educated on mental health, on emotional wellbeing, all of that thing as well. And they understand the the need to adjust your workout depending on your energy levels have you slept that night how are you feeling emotionally so when you're thinking about you know where to train and how to look for somebody you know yes you want someone who's got a pre and postnatal certification you also want someone who is educated in in that kind of space as well the last environment you want to go into is where you get punished for turning up late and you know someone's making you feel guilty because you couldn't fit your workout in it's like we know that life isn't that simple um one of the other solutions we have a lot of our mum safe trainers actually run online classes um we have one particular cohort they've got about eight eight different mum safe trainers and they run a huge schedule of classes across the week so you can be anywhere anytime you can either join them live or you can watch a replay So if you can't physically get out, but you want to build that community and you want to be part of something, then an online exercise solution could be a really good one for you. And going back to your question about is ten minutes good enough? Anything is better than nothing. And, you know, ten years ago I might have said, no, everyone needs to be strength training. They need to be in this type of exercise because this is the best. Maturity and experience, like do something you enjoy. Look, if you can be strength training, I'm always going to advocate for strength training because it sets you up for your whole life. But the biggest thing is, is that you are doing something that you can manage right now in the little bits of time that you can manage it. And yeah, let that be what you're doing. Even better, if as your kids grow up, you can do something with your kids. We've got a trainer on the Sunshine Coast who runs family sessions on a weekend. So you can, you know, there are trainers out there that understand you can't, like most of our mom safe trainers, you know, you just bring the kids to the class with you. So yeah. Yeah. That's what I was going to, I know I used to, when I didn't go you know we don't you might leave um asu just put like the kids in the pram and walk and yeah I was very fortunate that my kids did that I know some babies I was very lucky with my babies like they they weren't you know um tricky yeah I was like difficult I know that's a word but like I was quite lucky so I could easily put them in the pram and go for like a half hour walk or something so that was um yeah also something you could do and as you said when they get older you can incorporate that stuff. I know that when I did CrossFit, there was like CrossFit for kids. So if they were kind of, they would do their thing and then like I would go do my thing and then kind of like watch you in action. So yeah, there's definitely things out there. I suppose like you just don't need the guilt. Like I recorded a podcast last week where I get sick and tired of tracking shit. Like, I even took my Apple Watch off. I'm like, I don't need my ring to yell at me that I haven't done my ten thousand steps today. So, you know, as you said, anything is better than nothing, but still don't be hard on yourself if you have a week or two off or whatever. It's just obviously know that the more you move, the better it's going to be for you, which obviously makes sense, but it's a mental thing that you need to kind of overcome as well I think um the letting go of perfection and letting go of if I can't get it right I don't do it at all I know that you're in a season of life at the moment that is tricky um for whatever circumstance and like you said release the guilt like if you you know whatever you do is great and it doesn't mean that if you didn't do it today you can't do it tomorrow yeah hundred percent it was a five minute walk then it was a five minute walk it's better than yep it's like I've got my chair so I stand like if you have the capacity to have a standing desk but that's another option right like I mean I don't have little kids there's not that many mums of little kids that are spending a whole lot of time sitting down so yeah that's an exercise in itself right yeah you know yeah um what was do we cover everything in that one the next one I had um the signs and symptoms we should be aware of I think that's quite important so we we kind of talked about the signs and symptoms of a hypertonic pelvic floor prenatally um it's really important to understand the hypertonic pelvic floor as well in pregnancy because if we go back to thinking like the pelvic floor muscle if it's tight you know what it's very hard for a tight pelvic floor muscle to open in order for a baby to pass out, like to come through the vagina. So we want to make sure that your pelvic floor is both contracting and is able to relax nicely in the lead up to that birth process. It's actually Birth Trauma Awareness Week here in Australia at the moment. So very front of mind is how can we prevent women from having traumatic birth experiences? So this is less of a symptom, but there is research that suggests that if the perineal length, which is the back of the vagina towards your anus, is short in pregnancy um so less than three centimeters then this is a risk factor for potential perineal tears during pregnancy um sorry during childbirth so you know getting our pregnant women to see a pelvic health physiotherapist in pregnancy with or without symptoms is really important but if you do have any signs and symptoms of leaking dragging heaviness through the pelvis um feeling like anything is bulging down into the walls of your vagina that could be a sign of a prolapse and we want to make sure that all of these things are are assessed by a pelvic health physio so you know doing those things in pregnancy and then again postpartum are you leaking are you feeling heavy are you is your pelvis like you know we could have pelvic pain so you've got any kind of pelvic pain we want to get you to a pelvic health physio as well um you know We could talk about abdominal wall, like do you have a lot of doming or peaking or a large gap in between your rectus? So all of these things are things that we want to be aware of in pregnancy and then postpartum, go back to see a pelvic health physio, have a six-week checkup because your six-week checkup that your doctor does is not enough to return you to exercise safely and effectively. And then when you work with a trainer in an exercise environment, what do they ask you when you come in to that gym? you know, is the CrossFit gym running mums and bubs classes actually doing a pre-screening that is relevant to what you've been through as a pregnant woman giving birth and then postpartum? Because the majority of gyms are not even doing pre-screening or no, I shouldn't say the majority. Some gyms are not even doing pre-screening, let alone screenings that are specific to pregnant and postpartum women. Yeah, I know that definitely. So, um, I know when I'd signed up to just different gyms, like your twenty four hour gyms, that was definitely nothing that was on the checklist application form or whatever. I know that when I was doing CrossFit, so CrossFit's obviously pretty hard on your body. There's a lot of cardio, there's a lot of weights and it wasn't uncommon. I mean, the guys that were there were really, really great, but it wouldn't be uncommon for females in the group to leak um while they're trying to do like what they're jumping rope like doing double unders or something or like deadlifts or and it was just that's that was normal that's what's yeah you're squeezing down and but I said the respect of that was that the guys it wasn't like they were grossly bad and trying to make them feel bad. So from that perspective, it was good, but it definitely wasn't uncommon. Or people should not be able to do things because they didn't want to do that. And it was obvious that they were not wanting to do that deadlift or try to do double unders or whatever, because they were scared that they were going to leak. But again, that wasn't a question I was asked when Yeah, there's a few things in that. So number one, you can have really great coaches that know nothing about working with mums. Yeah. And or they think they know they don't actually have not actually done any deeper education in that space. um the other one that stood out for me was um I actually trained on crossfit gym as well crossfit have done a really good job of normalizing um things that have things that happen to women in like postpartum leaking being one however we need to take it beyond normalizing so what they've done is create a safe space that people can acknowledge what's happened to them but that's when it kind of drops off so you're not embarrassed because it happens to people um no one made you feel bad because it happened to you all of that is good what we're now missing is the bit that says and I wonder why that happened I wonder if we can um support you to get to a point where that doesn't happen and did you know it is common to leak when you're lifting or you've had a baby but it's not normal for that to be what you just accept for the rest of your life so you know is it a pelvic floor thing is your pelvic floor not strong enough to contract to keep you continent is it a pressure thing is the pressure um in your abdominal wall too big for for your pelvic floor to cope with, therefore you're leaking. Like there's a, there's a host of things that could be the reason. It could be, could we give you a different lifting strategy? So could you exhale on effort and you can deadlift to a decent weight, ninety, a hundred kilos using that strategy. A lot of CrossFit gyms don't teach it because it's hold breath, hold brace. And then what they miss there is you should be, activating up, not bearing down. But could we give you a different lifting strategy so that you can still lift with your skipping? Let's stop jumping two feet on the ground. Can you skip one foot to the other foot? That instantly takes pressure off your pelvic floor. I don't have a bunch of pelvic floor issues, but I do not enjoy at certain times of the month double unders or skipping. But I can switch it to like one leg to the other leg to take that pressure off my bladder, off my pelvic floor. So, you know, I think a lot of women sometimes they don't seek help because they're worried about being told what they can't do. If you work with the right trainer, it's about figuring out where you're at, understanding your body right now, knowing your goals and then figuring out what you can do in a way that supports your body. And that's the difference between a really great trainer that's educated versus a trainer that either ignores it or guesses about what they can do. And that guesswork will either be like, oh, just keep going. It's not hurting. Do it. Or they'll be really, really conservative and you'll get frustrated because you're not doing the things that you want to be doing. Yeah. And I suppose even if they're the gym isn't that way inclined you know if you listen to this you can be educated to know that you know there are options for you but then as you said on your website you have a pile of people um that are available who are trained so you know it'd be unfortunate there's not somebody in your area but at least you can at least be educated and go okay so know maybe yes um if I skip a little bit different I know that it's not how it's meant to be done because it's meant to be with two feet but you know what if that works it works how is it meant to be done right like it's very one-dimensional for us to say exercise should only be done in this way it's like there's no one way right that's the point And your coach or your trainer or your any gym environment should be able to adjust your session for where you're at. And if they can't, then there's two actions. Number one, you go to the MomSafe website and you find a trainer that can. Number two, especially if it sits in the pre and postnatal space, you're like, hey, I really love training here. Do you have certifications in pre and postnatal? If you don't, well, they could come and do safe return to exercise, which is our pre and postnatal certification. so you know it's not it's not about you know I want all of the coaches like I wish that pre and postnatal education was um you know whether it's included at the cert three and four level I don't know maybe we're not ready for it at that point but there needs to be some education in our initial certifications as trainers and coaches to go there's this whole population and it's seventy seven percent of women over the age of fifteen in australia will become mothers and further research tells us that over fifty percent of people using gyms and fitness facilities are women. So if you think seventy seven percent of over fifty percent of the people using your gyms, I think it works out at being like forty two point five percent of the people using our gyms and fitness facilities are moms. Then we as consumers can go back to the gym and go, hey, if you've not done it, I don't want to leave you. Can you please go do a pre and postnatal certification so that you're more educated or you just go and train somewhere that knows how to do it already? Yeah. The next one we had is, is pelvic floor just taught for mums? So I think we have covered that in that it's not just necessarily for mums, it's females. And men have a pelvic floor. was going to bring that up and then they don't have as many holes down there so it's maybe not as um relevant like you're less like so women can have what we call a prolapse which is where any one of the organs of the pelvis so the blood of the uterus and the rectum can fall into the walls of the vagina and in the worst case scenario sit on the outside but men still have pelvic floors um you know men still lift heavy they bear down we want to make sure that they can they can use their pelvic floor well the pelvic floor also for them you know it's it works in conjunction with their abdominal wall so we want that pelvic floor to be working well for men as well so yeah understanding as well that you know you know links could happen or supporting them to not make them feel bad or you know just there's just stuff that happens and they just you know especially as they get older yeah yeah muscles to be still be working you know and it can correlate to sexual function as well so it's good to be aware of yeah um we kind of already touched on this one as well I just want to raise something before I forget because I didn't raise it before but I've got the two questions left um so I don't think it's been in the media for a little while I'm pretty sure it's relevant to this conversation whereas people were getting like the mesh and remember that and then you know I think it was found that whatever mesh whatever company was using I think was causing health issues I'm not quite sure whether it was as extreme as cancer or or something like that I know it wasn't very well and I just might be payouts and stuff Yeah. That, and again, maybe it's not a thing anymore because of those court cases. I'm not sure. I don't really read the news. But I just remember that being a big thing quite some time ago. So suppose if, you know, the mesh thing has been suggested to you, assuming it's still a thing, know that you may not have to go to that extreme and it may be something as simple as going to the physio who is trained in pelvic floor to help you come up with exercises that way. So I guess it's just knowing that there's other options out there, but I just wanted to raise the mesh thing just because I remember that being quite a serious issue a few years ago. But did you have any? Yeah, it was a big case. The company was Johnson & Johnson. Yeah, women that had prolapse were then given mesh to, or mesh was used in the surgery to, I guess, fix the symptoms, fix the problem. What then happened is that mesh apparently shouldn't have been in the human body and the mesh contracted. And when it started to contract, you know, obviously the tissues and everything were growing around it, which is what's supposed to happen. But that caused a lot of pain for women. They would report or some people would report when they had sex, their partners could feel the mesh contracting. grating volume and it would put a lot of women into severe pain problem then it's very hard to remove something that is so embedded into the tissue so you know as far as yes there was a big case there were payouts as far as I know that product is not being used anymore um what I think the biggest conversation here is an absolutely devastating for the women that that happened to this whole conversation hopefully can get us to a point where prevention is better than a cure so if you understand your pelvic floor in pregnancy you've been taught how to do a proper pelvic floor activation you've seen a pelvic health physio they've made sure you're doing it well then you've had really good birth preparation to make sure that you can relax your pelvic floor you've checked your perineal length you've you've learned good pushing strategies, you understand, you know, a cascade of interventions. So maybe you try, if you can avoid induction, and then, you know, we hopefully avoid avoiding forceps delivery and all of those things that can create, you know, both pelvic floor trauma and potentially prolapse. Then on the flip side, you're returning to exercise safely and effectively, you're not bearing down too soon, you're not lifting heavy too soon, you're you know, we call it train to the weakest link. And it's if your pelvic floor can't cope with the exercise you're doing, maybe we need either a different strategy or a different exercise. And, you know, if women are bearing down, bearing down, bearing down, that could create an exercise induced prolapse down the track. So Couple of things. Number one, if let's do all of those things. So hopefully we can get to the point where we don't have a prolapse. That would be the most obvious, right? Number two, if you have been diagnosed with a prolapse by a doctor or a surgeon, sorry, by a doctor or gynecologist, and then you've been sent to a surgeon. and no one has suggested a pelvic health physiotherapist in the middle, that is your next port of call before you go to surgery. Because, yes, there are conservative treatments that we could potentially try, pelvic floor retraining. We could use a pessary, which is a silicone device that's inserted into the walls of the vagina and it lifts the pelvic floor, the organs of the pelvis off the pelvic floor. They could all be things that we could do before we go down that road of surgery. So, yes. Yeah, even when you're saying, like, we go back to the delivery side with, like, forceps and stuff. Like, I remember, so my second was a Caesar because of the first. But, like, I even, like, kind of vaguely remember the midwife. So it was a random doctor. Like, I didn't have a, there was just a random doctor at the hospital. I never saw that person again. But I even remember, like, the midwives, assuming they were midwives, if not nurses, and the doctor yelling at each other about, like, how they wanted Lil to come out. It was like, right, we have to cut. No, it's got to be a tear. I think she ended up having the ventouse or something like that as a side thing. So even I just said, I don't remember a hell of a lot, but I remember just like being yelling at each other. And the doctor left a room for a minute. And the midwife is coming to me saying like, you know, I'm pretty sure she was like wanting One of them wanted to cut and the other one wanted to tear. I remember that just being an issue. I remember the midwife coming over to me, telling me which one that she wanted. And when it's your first kid, you're in a shit ton of pain. You've got two different people yelling at you what to do. Like even if you had an option to say I don't want either, it's, you know, even if the opposite happens to what you want or it's a traumatic birth, which Lil kind of was as well, You know, know that, you know, you're not going to have control over that probably. It's happened. Like as long as a baby comes out happy and healthy, that's probably like the overall goal. If you can have control over it, great. Maybe if you had an obstetrician, that might be more communication with how you want it to go. But, you know, just, you know, don't feel bad about it if that hasn't happened. You know, there are still options that we've discussed that you can, you know, do post-separation, post-separation. again that wasn't anything I knew about but I don't think I was any in any shape to know what I wanted number one thank you for sharing that because and it's it's interesting the perspective that I think is more a societal thing that we're taught as women that if you have a healthy baby then that is the main thing but at what cost yeah so if we recap you know, maybe this isn't the time or the place to open the lid on your birth experience. But number one, the practitioners really need to be on board with their beliefs and their values before walking into a delivery suite and trying to make a woman who has not been pre-educated. Well, let's take a step back further. If we think you're going to need either an episiotomy or tear, what would you prefer? These are the options and this is the pros and against. And what would you as a birthing person like in the delivery suite should that happen? Because that's the way it should be working, not practitioners. And number two, you know, I would say that would be cause for a report complaint. Like I had two caregivers that were supposed to be working together to support me through this process that had their own agendas and they put me in the middle of it, each one trying to come to me with their opinion not okay yeah and then you have a big labor like it's not like I could make a reasonable decision like I I don't care about pros and cons back then because I like I just wouldn't have been in the right state of mind right and as a woman I'm just in in that in that situation like how do you put your full trust into people that are arguing with each other it's a battle of wills between them and then afterwards you know, yes, there are things that we can do and yes, we can support you. But from an emotional and a mental health and all of that kind of perspective, what I would really encourage people to do is if you believe your birth was traumatic, then you get support for that. It's not what other people have told you. Like you could have someone that seems to have a very straightforward birth on the outset that actually felt like their birth was traumatic and that's what we need to respond to as carers and again if we move it into the exercise space working with an exercise professional that doesn't understand or hasn't asked you about your birth experience in that pre-exercise screening is potentially not the right place, again, to be trusting your body. Because you've gone from this traumatic experience during a birth, and now you're trusting your body on the other side to an exercise professional. we all need to be better educated and able to support you not have our own agendas at play and a lot of pts that are not educated it's well how much weight do you want to lose how hard can I push you um and he's he's like there's no excuses and that is the last thing that the majority of moms need especially if they've had a traumatic birth experience yeah it definitely um Yeah, I feel like we need to have like a massive posters at the hospitals or something, or hospitals were even educated in this stuff. Wouldn't it really? Yeah. Well, my youngest is twelve this year and. I might have gone to college. Oh, no, an obstetrician, sorry. No, we say that with love. They don't know it. Some of them do. Many of them don't. It's like they're so specialised and their medical industry is amazing and they're so specialised in their field that sometimes it's a very hard ask for them to go outside of the box and consider the whole woman rather than the birth at that time. Yeah. Yeah. We've kind of already covered this one as well. What should we look for in a trainer for an exercise environment? So we've pretty well just covered that in that. I feel like if you have a checklist, I'd love to go and make it like a checklist available or something for people to, you know, even if it's a simple thing, hey, are you trained to deal with, you know, women who have had babies or are in pelvic floor? might be an awkward thing to raise. Or maybe if you're a PT listening to this, maybe advertise the fact that you are trained or you are becoming trained or something. I think that would make a big difference for people. But is there anything else that you could think of about trying to find a gym or a trainer if you are wanting to get back into that exercise environment? Absolutely. So there's a couple of questions. So if you were approaching a gym or a personal trainer, number one would be, do you hold any pre and postnatal certifications? Number two would be if you do, how long did it take you to complete it? Because there's definitely some like one hour courses out there that talk about pelvic floor that are not really going to cut it. So we have in the fitness industry at the moment, CECs, we're moving to PDPs. very soon. But if it's not more than ten to thirteen CECs, it's probably not a comprehensive certification. So asking them what certification they've done, how long ago did they do it? Because they could have done it ten years ago and a lot of the research has changed in the last ten years. So For a mum safe trainer, all mum safe trainers have to hold at least one comprehensive pre and postnatal certification done in the last three years at the time that they became a mum safe trainer. And then we continue that ongoing education and working with women and mums as they move forward. The third thing I would be looking for is what is their pre-screening process? And I know that we've looked at it, but General pre-screenings have three questions on them. Question number one is, have you had a baby in the last twelve months? We've not really talked about it today, but postpartum is forever. From the day that you had your baby to the day that you're no longer with us, you are postpartum. So if that question is on your pre-exercise screening, that's the only way that they're screening you for being postpartum, they don't get it. Yeah, because you can be five and still struggling with the things, you know, from pregnancy and birth. The second question is, have you had your six-week checkup? The six-week checkup is a mark of the end of your postnatal medical care. It's not a clearance to return to exercise. It's going, cool, you're normal to move out of our medical system, but it's not you're normal to go back to the exercise that you're doing beforehand. And then the third question is, do you feel okay? what new mom knows if they feel okay anyway. But the other thing to understand is things like pelvic floor weakness, any kind of abdominal wall, a wet like weakness or contraindications are not necessarily painful. So you could have a postpartum mom who says she feels okay, but she's leaking every time she's training. It's not, there's no pain trigger there. So she's not going to stop. So if we go back to asking your, your trainer is, or observing the pre-exercise screening process you go through if they're the only three questions that are on that form then they are not educated like the kinds of questions that should be on there are you know, when did you have your baby? And when did you have your previous babies? Like how many children do you have? When were they born? Because you could have a relatively straightforward birth of the last one, really complicated birth before that. And if we don't understand that, we don't understand you. Did you have a vaginal delivery? If you had a vaginal delivery, how long were you pushing for? Did you have any tearing? Did you have an episiotomy? Did you have a C-section? If you had a C-section, were you pushing before you had a C-section or was it a planned C-section? All of these things, then postpartum, like, you know, was it a fast delivery? Because anything under the three hours, her pelvic floor stretched really quickly, and that's not great for pelvic floor either. So these are signs and symptoms that we as trainers need to understand and be aware of in order to program training for you. And there's a whole host of other, you know, pre-exercise, postpartum questions that we want to ask. If people want, so there's this gap between the six-week checkup and returning to exercise. If anyone listening wanted to get more educated in that, they can go to mumsafemovement.com. And halfway down the page, there's a free five-phase program called Safe Return to Exercise for New Mums, which is designed to bridge the gap between having a baby, and returning to exercise. So we talk about mental health, we talk about your birth experience, we talk about your body, and then we talk about what to look at in a personal trainer. So they can sign up for that, and that will give them those five phases. It's really easy to absorb. It's all videos with subtitles on in case you're breastfeeding in the middle of the night and you want to watch. That's a really good resource for your mums. Yeah, I reckon the only thing I've ever filled out would be name, email, address, and, like, emergency contact. It makes me so angry, I guess. And it's like, even if I want to ask those questions, you've got to assume that people told you. Like, your doctor told you at the time of birth. Like, I know with Lil, I had a three V tear. I know that she wasn't breathing when she came out because I know that I I was induced and they said that wasn't going to work and it did work and it all happened and I was left in my room for hours before everyone believed me that I was even in labor. Like, so you had that side of things. So I kind of, like, I know I had the three B thing and everything was like, yeah, no, well, everything else is normal. I'm like, dude, like, I was, like, fully dilated six hours before you came into my room, like, and you just left me. And then, like, Josie was, like, a plain Caesar because of Lil and – but, yeah – You know, I don't know any of the intricacies other than that. So you have to even assume that you're going to know the information for that too. Yeah, like if you came into my gym and you told me that you'd had a three B tear, I know that tears come in grades one, two, three, A, B, C and grade four, right? Grade four potentially or grade four could include the anal sphincter. So I know that you've had a pretty severe or I hate these words, severe like pain. when I'm providing exercise to you. So my next question as a trainer is, were you referred to a pelvic health physiotherapist after your birth? Cool. So that is where I stop. Okay. I would like to train you. I want to train you safely and effectively. It's really important to me that we make sure that you get the best possible care. This is the pelvic health physiotherapist that I work with. Make an appointment with them. When you've had your appointment, give them permission to share the outcome with me. I will then make sure that the exercise I'm giving you is not going to do further damage so you can exercise for a long period of time. Like that is like the most simple process that many trainers just don't know. Yeah, definitely have never. The fact that you knew it was a three B tear, like not just saying, oh, it was a tear. It was whatever you, those words. Because the new four was basically front to back. And I just, that's basically the only part I was, I must've teared. I mustn't have been cut then. So, but yeah, that's, but there was nothing. about it, it was just, it was through me. I'm like, okay. And you're trying to, if they've done a pre and post health certification, they should know that three B means you need to see a public health physio. Yeah. No, it's wrong. It's so wrong. And I'm so passionate about our industry doing better. And I'm so frustrated that in many places we don't, which is where the education, again, conversations like this to the consumer, to the mums, to the women is the most powerful place to sit in right now. Like, you know, I want the government to give us, give all women pelvic health as part of their Medicare package when they have a baby. How amazing would that be? But until that time, how do we have more conversations like this to make sure that you and no one else says, why did nobody tell me? Yeah. A hundred percent. So is there anything else down there that when we had wasn't normal to like after a baby, which we've answered that pretty well. So just really note that. Is there anything else that you want to mention before we wrap up today other than I think I've made you really, really cranky? No, I'm not cranky. I'm really, it reminds me. So every time I deliver a safe return to exercise certification and every time I have a conversation like this, it reminds me why I do what I do. And I truly believe, like, so I was in a conference a few weeks ago and there's these different schools of thought in the medical industry and in the fitness industry, like, and in allied health. So you've got medical, allied health, fitness industry. And there's a cohort of those industries that think that if we educate women more about what could go wrong, that we're going to create fear. So we're better off not educating them so that they don't get scared so that, so that what like and it's like but what we're missing is education creates empowerment yep I've not met one woman that's you know obviously you know the way that we talk to people and the way that we educate them we need to be very aware of that because we don't want to create fear but what we want to create is empowerment through education so you're going to have a baby you have a pelvic floor these are the things that we know could happen just like with the pain relief conversation these are the ways that we can help you to prepare your body in the best possible way these are the ways that we can support you during the birth process these are the way that's that we're going to support your postpartum and if any of those things happen you're educated so you can make conscious choices or you've already made those choices ahead of time especially in a circumstance like yours So that you do have a look back and say, why did nobody tell me? Because the majority of women, when confronted with a problem with education, go into, cool, I know myself, I know my options, and I'm going to make a decision from a confident and an empowered place. And even if that's decision, so for example, I've worked with a client before who had a hypotonic pelvic floor. She'd had a traumatic first delivery, She knew at thirty eight weeks her pelvic floor was still tight. She wanted a vaginal delivery. Yep. She knew that with a hypotonic pelvic floor and a traumatic delivery beforehand, that the potential of that second delivery was going to be hard and that she would have more work to do afterwards. But she made that choice. She didn't go into that. Eyes shut coming out going. Oh my god. I've got all this pelvic floor trauma and birth trauma No one told me she came out going I knew what I was getting myself into I made that decision for X Y&Z and now I'm in a much better place emotionally psychology psychologically to Deal with what comes next so, you know, it's not about creating fear it's really about educating ourselves and what I would say is is demand the education for yourself if it's not being offered to you. Yeah. I think the fear is there anyway, right? Like, I know I used to watch, like, One Born Every Minute and Sixteen and Prank. Like, you know, you're watching that trashy stuff. Like, there's fear in there anyway. And, I mean, is it fear of the unknown? Is it actual fear or is it fear of the unknown? Probably both. I don't even think I even... I know I was like towards the end of my pregnancy. I'm like, crap, I'm going to get this kid out. Like I haven't thought that far ahead. Like, you know, it's, yeah, I don't know. Even with that, imagine if someone had said, um, You're going to go and see a pelvic health physio. What they're going to do is they're going to assess your pelvic floor. They're going to make sure you've got a nice pelvic floor contraction. Then they're going to make sure that you can release your pelvic floor. We can use real-time ultrasound to actually externally look at pelvic floor, and you can see it on a screen. Then what we're going to do is we're going to spend some time teaching you how to bear down in a safe and effective way. or in the most optimal way to have a baby. And these are the things that we're going to make sure that you're equipped with if those things don't go to plan. So you've now got options and you're educated and your eyes are wide open. So that, yes, you know what, going into birth, it's a situation we've never been in. Most women are going to have some level of anxiety around that. But are we supporting that or are we just going, well, let's not think about it and we'll deal with that when we get to it and then we leave women on the other side feeling Like they were shut out of their own birthing conversation. Yeah, I've been going with the latter for that in the majority of cases, I reckon. Exactly. Women are fucking amazing. We just need to be, you know, considered that and given the education every step of the way so that we can make educated choices for ourselves. A hundred percent. Well, this will be going everywhere because I know a number of people who are pregnant already, including my beautician, so I'm probably going to see her. Don't watch this. But thank you so much, Jen, for today. I know, I mean, it's a bit too late for me to, you know, I've had kids, so I've been there and done that. But to know that they're often even, yeah. Yeah. So thank you just so much again for today. We'll make sure Jen's links and bio and everything. below in the show notes or on YouTube, depending on where you're listening or watching it. But yeah, thanks again, Jen. And yeah, thanks for tuning in. And please make sure you share this with anybody who is maybe expecting or you are expecting or you want to send this to your personal trainer. Please share it far and wide because it's definitely something that's just not discussed anywhere near what it should. Thanks for creating the space, Stacey. Thanks, Jen. Cheers.
