Prenatal Physio Changed my Birth Recovery
As I write this, I’m sitting with my seven-day-old infant on my chest, reflecting on the differences between his birth and that of my first-born. When my daughter was born in the spring of 2013, I had done a good deal of birth prep but little else. I was so worried about my birth that I gave very little thought to what comes after it. I struggled a lot to breastfeed and recover from my vaginal birth. I had cracked and bleeding nipples and was scared to feed. I dreaded the next feed knowing that the pain would curl my toes and reopen wounds. In order to feed, I had to be sitting a certain way, holding my baby in a specific position and brace myself for what was to come.
Back then, Alberta Health Services would send a nurse to your home to check in on you a few days after birth. We had an unmedicated vaginal delivery in a hospital with a doula and an amazing labour and delivery nurse (in fact, the nurse and I would later become friends). When the nurse came to my apartment, she assured me that nursing was going well. Apparently the pain, nipple damage and questions I raised didn’t worry her and I didn’t know any better. I was only two days postpartum and all my sitting upright seemed necessary as I struggled to feed. That was the last of my postpartum care until my 6 week appointment with the OBGYN, where I complained about lingering pain on my vulva and in my vagina. This pain was addressed by burning off some skin/nerve endings with acid and by clearing me for penetrative sex. Yay.
Fast forward to the summer of 2019 and my preparation for my second live birth. I had started working at Pine and was friends with a handful of amazing pelvic floor physiotherapists. Although I had learned a lot since the birth of my daughter, I wanted to take the Bump-to-Baby workshop that was offered by Jill. Unlike my first birth, I was not nervous about labour; I knew my body could birth. Truth be told, my body handled birth so efficiently the first time, I was planning a home birth because I doubted my ability to get to a hospital in time. So this time, my eye was on recovery. How could I make that better? That Bump-to-Baby class was a first-step.
I appreciated taking it at the end of my second trimester because it gave my brain time to absorb the information and change my prenatal preparations to align with my postpartum goals. I learned some helpful tips for labour and birth, and learned about what habits help with recovery as well as common mistakes that sabotage the healing process. I learned about the Rule of Five; that is, in recovery, spend five days in bed, five days around the bed, and five days in your home. More on this later. Soon after that workshop, I began going for private physio appointments. We talked about my birth history, did an external assessment of my pelvic floor, and practiced exercises to strengthen my body for birth. I had lower back pain from the pregnancy and some soreness in my hips. Through the exercises, I greatly reduced my lower back pain. And I did not even do the exercises all that diligently!
This birth went extremely quickly and involved non-stop contractions. My water broke at 01:15 and I called the midwife before waking my partner. I started a warm bath and hopped in straight away, but not before having a couple contractions. I could laugh through them so I thought this birth would go easier than my first. Let me tell you, it was not easier, it was just different. I asked my partner to do a couple specific chores that only a delusional labouring person would ask (like, can you make sure the dollhouse isn’t on the credenza). This was about 15 minutes since I called the midwife and was the last “break” I got from contractions.
Thanks to a few midnight construction zones, the midwife arrived at my home about half an hour after my water broke and by then, I was out of the unbearably small bathtub and the contractions were rolling from one into the next. I laboured on my living room floor for about another hour, using an exercise ball, a hot bean bag and the double-hip squeeze I’d learned in the Bump-to-Baby workshop. Honestly, I went from deep enduring pain, to hard unbearable pain.
In my head, I kept crying out for a moment of rest but the waves just kept coming. Suddenly, my body wanted to lay on its side and push. I pushed hard when I wanted and panted when it felt necessary. If I learned anything from my previous experiences, it was that in labour, my job is to listen to my body and just do whatever feels natural because it’s probably helping things move along. At 03:14 – just one minute shy of two hours – my baby was born.
Now my postpartum transformation could begin. Frankly, the most challenging part of recovery is having enough patience. Do you know how boring five days in bed is? Me neither, because I couldn’t stand it. I did manage to spend five days mostly just laying down but I needed to see more sunlight than my room offered! These five days were honestly so transformative. I saw how helpful they were to get feeding off to the best start. I was better connected to my body and could feel when I was overdoing it. If I felt any heaviness or pain… or really anything that didn’t feel like my normal prenatal self, I knew I was overdoing it.
The first day, that included trying to make myself some snacks. I could have done that myself. I could have powered through and felt that heaviness but I did not want to. My work with pelvic floor physiotherapists taught me that investing in my recovery now would mean that I could be back on my feet in full force sooner. I tried to just be on my feet when going from one horizontal surface to the next. The result was that feeding queues were spotted quickly, bowel movements happened without pain or stress, healing at the birth site felt speedy and, by day six, I was confident knowing my body was miles ahead of where it was 5 days postpartum in 2013. I even feel a little guilty at how well it’s going.
I recognize that I’m lucky to have a partner at home with me to facilitate this recovery. Not everyone has a partner or family around to help them. I tell my story in the hopes that people are able to prepare any support they can, including care with a physiotherapist who specializes in this transformative period of time. Postpartum doulas are also an unbelievably worthwhile investment, if you’re able. Birth is beautiful and my prenatal care has shown me that even postpartum recovery can be a beautiful time.