3 Signs your Pelvis is Still Birthing after Childbirth

March 26, 2016 in Childbirth, Pelvis, Post Partum, Pregnancy, Uncategorized

3 Signs your Pelvis is Still Birthing

 

Your pelvis may still be trying to birth your baby!  In my women’s health physical therapy practice I have discovered a very common pattern that a woman’s pelvis goes into to give birth. I’ve seen it in most every woman I’ve worked on in the last year since I became aware of it.  Only a hand full of women have not presented with this pattern. There is a certain way the pelvis opens up to help the baby get out.

 

This pattern can get stuck in a women’s pelvis, sometimes for years.   I first discovered this in my aunt who had a very traumatic birth with her first son who was 47 at the time.   So for 47 years her pelvis has been in an open birthing position.  One would think that the bones of the pelvis just go right back into place after the baby comes out.  In some women it does.  In others, which I’m finding is more and more common, it doesn’t.  The one thing I know that is keeping the pelvis from going back to its normal position is trauma!

 

Trauma can keep the pelvis stuck in the birthing position.   Until the trauma is released and the body and pelvis knows it’s safe then the pelvis can come back together to its normal position.   Trauma can be experienced at any time during the birthing process but most typically is occurs during the pushing phase when the pelvis is already open and ready to let the baby out.

 

Anytime a woman gets to the point where she wants to quit, doesn’t feel she can go on, feels out of control, or maybe gets threatened with a c-section a trauma response can happen in the body.

 

A typical trauma response in the body is to fight or flight the situation but since a birthing woman can’t do those two it does the only thing left which is to freeze. This freezing happens while the pelvis is in an opened, birthing position. Until the trauma is released the body tends to hold onto this pattern.

 

I can see how a woman may not recognize this trauma or that her pelvic is still birthing. After opening up so wide to get the baby out, all sense of normalcy, what was felt like before birth, is gone. There is no ground zero in your body once it’s birthed a baby. Also seeing and holding your baby in your arms for the first time is enough to distract anyone from what they’ve just gone through.   The reward of being with your baby seems to outweigh or override any negative feelings felt during the birthing process.

 

But I do know that women can feel a difference in their body after the pelvis has been helped back into its pre-pregnancy state. You must address both the physical position of the pelvis along with releasing any held emotions and trauma in the tissues.

There are 3 signs that I’ve discovered that are clues that your pelvis is still birthing. Let’s see if you have any of them.

 

#1. Your Pelvis is Tilted

The first sign your pelvis is still in a birthing pattern is when you lay down on your back on a hard surface (a soft bed may not the best surface to check this out on) is to check out how level are your hip bones, those little bumps on either side of your pelvis. Are they even? Or do you notice that your right side ilium, or hip bone, is higher than the left?

The typical birthing pattern is the right side will be higher than the left. When lying down on your back the pelvis will be tilted to the left as seen in this picture.

 

Position of pelvis after childbirth

Position of pelvis after childbirth

The reason for this is the sacrum gets jammed up and over to the right during the birth process.

 

Here is a normal posterior view of a sacrum prior to birth.

 

Normal position of sacrum in pelvis

Normal position of sacrum in pelvis

This is how the sacrum shifts to the right for birth.

Sacrum shifted to right

Sacrum shifted to right

This shifting of the sacrum to the right is also why so many women have right-sided low back pain after childbirth.   The sacroiliac joint gets jammed and the sacrum can’t move as freely as it should which is why the pain is created. Getting the sacrum back into proper place alleviates the pain.

There is a two-step process I do to help mobilize the sacrum back into midline again. I haven’t figured out how to help women do this on their own yet! Stay tuned….

 

#2. Sitting Unevenly or Uncomfortably

For the baby to be able to come out of the pelvis the sits bones or ischiums need to splay out to the side. Ideally they splay out evenly.   But depending on the baby’s pathway through the pelvis or the birthing position used, one ischium may be more splayed out to the side. Birthing in a side lying position can limit the mobility of the lower sided pelvis (on the bed) and cause more movement in the upper side (ceiling side). Birthing on your back with two separate people holding your legs at different angles can also potentially cause an imbalance in your pelvis.

If the pelvis remains in this birthing position, sitting may seem different. It can feel uneven, or awkward.   This is not from swelling or tenderness in your perineum, as that can cause discomfort and or pain. If you don’t have pain but sitting still feels weird, it’s because your bones are in a different position than before your birth.

#3. Feeling Ungrounded or Discombobulated

One of the things I ask the moms that I find with birthing pelvis’ is “What are you feeling in your body and in your life?” The most common reply is “ungrounded, not myself or discombobulated”

When we realize the pelvis is our energetic foundation for our body and life, when it is open and unbalanced we don’t have a solid foundation. In one of my clients it felt like energetically she was walking around with her energy just flowing out full blast, like both faucets handles turned on and water spilling out with no container to hold it.  When you can’t hold and contain your energy within you, if can feel a little unsettling. Most new moms may attribute this to figuring out how to care for a newborn, not that she has no energetic container.

 

So if you find you have one, two or all of these signs you now know what’s going on. Your pelvis is stuck in a birthing position and needs help coming back together.

 

 

 

 

 

 

Hemorrhoids, Fissures and Tears, OH MY!

February 9, 2016 in Childbirth, Pelvic Floor, Post Partum, Pregnancy

Hemorrhoids, Fissures and Tears, OH MY!

Let’s talk about something! It’s not a pleasant subject. It’s the nasty little triad of issues one might face after having a vaginal birth.  I’m talking about the after effects and trauma that can happen to your bottom. It’s rarely discussed before a birth and I believe there is a reason for that.   The physical injury to the pelvic floor area from a vaginal birth can cause significant damage that leads to some rather unpleasant, uncomfortable and down right painful issues some women have to face.   I’m talking about hemorrhoids, fissures and tears that occur in the perineum during, for hemorrhoids, and after birth for all three. There are some things you need to know to help you deal with these uncomfortable issues if you find you have developed these.

HEMORRHOIDS

Let’s start with hemorrhoids!

Hemorrhoids are a swelling and inflammation of veins in or around the anus and lower part of the rectum. They can be painful and itchy. Hemorrhoids are very common in pregnancy as the increased weight from carrying the baby causes greater pressures on the pelvic floor. Also prenatal vitamins and hormones cause a slowing down of your colon and swelling of your veins, two factors contributing to constipation that can lead to hemorrhoids.

So to avoid hemorrhoids you’ll want to avoid constipation and the bearing down that usually goes along with it.

The first step is to avoid being constipated.

Diet has a huge implication on constipation. (Please consult a nutritionist for greater help with your diet) By eating more fiber rich foods you can help keep things moving in your colon. Raw veggies are a great way to increase fiber or adding flax seeds to your foods can help too. Be careful in adding too much fiber at first if things aren’t moving well especially if you aren’t doing this next thing.

That is, drinking enough water. Increasing your water intake, especially when you are breastfeeding, will bring more water to help keep things flowing through your colon. Moving your body will also do the same.

The next step it to use good toileting habits. When you sit on the toilet, you want to make sure you keep your back straight and lean forward. Avoid sitting slumped on the toilet. It can help to have your knees higher than your hips. There is the squotty potty chair you can purchase to help with this or you can use two yoga blocks, toilet paper rolls or a big fat can of tomatoes and put your feet upon.

To relax your pelvic floor you can try making different sounds to see which sound bulges your pelvic floor downward more easily. Take a deep breath and say “Grrr!” or “Shhhh” and see which one lengthens your pelvic floor. Use that sound during your next bowel movement to help move things down and out so your pelvic floor stays relaxed!

Once a hemorrhoid is in place you need to decrease any excess pressure on this tissue in order for it to heal. With all the bearing down that happens in birth the rectal tissues need to learn to come back up in and inside again. That can only happen when you avoid bearing down during a bowel movement after your birth. It’s important to allow your stool to pass on it’s own without you having to force it out. Any forcefulness will only exacerbate your hemorrhoids.

Also when dealing with hemorrhoids after birth, I find you also have to address the soft tissue in your vaginal and anal openings.   We’ll cover how to do this later in this article.

Around the anal opening is a sphincter muscle. It’s very common for this muscle to have small “knots” in it from the birth, especially if you tore. These knots don’t allow the muscles to expand evenly to allow your stool to come out. When a hemorrhoid is present, most likely there is a restriction or “knot” in these tissues that can prevent the hemorrhoid from healing. They can also lead to an even greater problem and that is a fissure!

FISSURES

A fissure is a open tear inside the rectal tissues.   Fissures have to be one of THE most painful conditions to recover from after birth.   The problem with this condition is the tear has a hard time healing because it gets reopened every time you have a bowel movement.   It makes having a bowel movement EXTREMELY painful! Some women, who have a fissure, report having chills, breaking out into a sweat and even their whole body shaking after having a bowel movement. The pain afterwards can last for hours. When dealing with a fissure for any length of time the anticipation of a bowel movement can bring fear and greater tightness to the pelvic floor area, which creates a vicious cycle that is hard to break. It’s no fun at all!

There is one thing that has helped my clients when dealing with a fissure and that is to massage their perineum and anal sphincter prior to a bowel movement. Usually there is increased tension in the anal sphincter that is on the opposite side of where the fissure lies. When you release this knot prior to a bowel movement it can lessen the pressures placed on the fissure and allow it to heal a little bit easier.   Stay tuned to learn how to massage your anal sphincter area.

 

TEARING IN YOUR PERINEUM

The third issue that is closely related to hemorrhoids and fissures is tearing in your perineum. Unfortunately tearing from birth is very common for women. Scar tissue forms to help heal a tear. Scar tissue is not as flexible as normal tissue and restricts the tissue mobility in the area. This can inhibit a stools flow out the anal sphincter and contribute to the development and prevent the healing of hemorrhoids and fissures. Mobilizing this scar tissue can help soften the tissues and allow easier flow with less pressures, helping both issues heal.

 

Caring for your Perineum After Birth

So what’s a new mama to do to help her perineum after birth?

Massage this area!

What do you do?  It’s simple!

Take your thumb pad and place it just inside your vaginal opening. Your knuckle should stay on the outside. Place your index finger on your anal sphincter. Start on one side as far as you can go and pinch the two fingers together and see if it feels soft and mushy or hard and resistant to compression. You want your tissues to be soft and supple. Work your way along toward the opposite side and see where the tissues are resistant to compression.   Where there is resistance you can apply pressure by gently compressing the area between your fingers while breathing into the area at the same time. Hold this pressure until you feel the tissues soften and release.

Scar tissue can create thickening and resistance to mobility.   Compression and pressure can help release this but sometimes scar tissue needs more. If you find scar tissue that is not releasing to pressure there can be an emotion stuck in there. Honoring that feeling and releasing whatever emotion is there is needed before it can let go. To read more about how scar tissue and emotions are connected check out this blog post.

Pinching between the anal opening and the vagina works on the upper half of the anal sphincter. For the lower part take your index finger and apply pressure around the sphincter from 3 to 9:00 if you think of it as a clock face. Check to see if you feel any spot more resistant than the others. If you do gently apply pressure with your finger in a downward motion and just hold it until you feel the spot release.

Massaging this area before every bowel movement can allow the tissues to expand more easily for your stool. This can help keep some of the excess pressure off your fissure area and potentially help it heal. Decreasing any resistant or thickened tissues helps to normalize the tissues so your stool flows through more easily.

There’s so much more to all of this that if you don’t find relief from doing the above, please go see a women’s health physical therapist or a holistic pelvic care specialist to get some help. You can find a practitioner near you by checking out these websites:   MoveForwardPT.com or WildFeminine.com

 

 

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