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Beyond the Birthing Plan: A Conversation on Maternal Health with Oceanside Physical Therapy

It’s been about a month since I visited Oceanside Physical Therapy for my first prenatal consultation. With less than four weeks left until my due date, I have two things on my mind: maternal health and a birthing plan. The news is all a splash these days over the rise of maternal mortality during childbirth in the U.S., thanks to NPR’s recent investigative piece. So nine months pregnant, I’m swollen, weary, and all fired up to shift the birth plan focus from baby to mama.

Oceanside Physical Therapy, Stratham, NH

Cristin Zaimes, PT and Owner, warmly welcomes me into the office and leads me to a tranquil studio space spilling over with natural light, cushioned yoga mats, and cozy bolster pillows. With the kids at home, this is my time and I don’t feel an ounce of guilt. I’ve been rushing to countless prenatal appointments in the past few months and this is one I’ve been chomping at the bit to attend. At my last appointment I learned some simple but effective breathing techniques to strengthen my pelvic floor and I’m eager for more. I share my goals for this appointment with Cristin and she smiles reassuringly–as a mom herself, she totally gets it.

Okay, so I’m scheduled for my third C-Section. How do I prepare?

Her advice is simple: just breathe. Getting familiar with your body, your pelvic floor, birthing muscles, and breathing capacity is the best and most effective preparation for any delivery, she explains. Most women have been taught to tense up when they feel pain, labor, or push when our bodies should be doing the opposite. We should be relaxing each muscle with breath and intentional release. This can reduce the risk of strain on our laboring bodies and will ease tension.

Cristin also recommends visualization and mental calming exercises to decrease stress. Particularly with cesareans, these mindful efforts can help get the brain and body into a place of genuine readiness for a surgical delivery.

If I was delivering vaginally, would I do anything differently?

Cristin pauses for a moment. “Yes and no,” she says. “You would be pushing, so you’d need to think about comfortable positions that would relieve tension. If your partner is willing, massaging pressured areas of the body can go a long way too.”

“The jury is still out on perineal massage,” Cristin continues. “It may help some women, but is not necessarily required for making a vaginal delivery easier.”

What are some best practices for better laboring?

Getting your bowel and bladder movements regulated beforehand. “You want to have as much room to move as possible”, Cristin shares. “This means internally, too”. It’s not uncommon for women to experience leakage during delivery or full-on movements. Those muscles are all working together towards the same cause, after all.

Cristin also notes that a healthy gut and balanced nutritional care go a long way for better labor and delivery. Not only can it help strengthen mama, but passing on those nutrients to baby early on is equally as important.

What can I be doing to care for myself after delivery?

Cristin is quick to return to pelvic floor care: “find your pelvic floor again.” After delivery of any kind, nerves are stretched and things are going to feel different, Cristin cautions. But resting was also at the top of Cristin’s list. Just like an athlete recovering from surgery or an injury, our bodies need to heal and that can take a good four to six weeks.

Practicing breathing exercises again in the 48 hours after delivery can help too. Just get comfortable and supported with baby. With a Cesarean, massaging the tissue area after two weeks can help heal the area and reduce nerve damage.

Let’s talk warning signs and symptoms. What should I be looking out for?

Too much bleeding, dizziness, or sharp pains are actual warning signs. Cristin always encourages her clients to email or call with any concerns. Self-advocacy is crucial these days. Contrary to popular belief, it’s not ‘anything goes’ after delivery. There are clues that our bodies provide, we just have to pay attention.

Be on the lookout for muscle changes, too. If you go to sit up after delivery and notice a dome or bulge on your abdomen, you could be experiencing Diastis Recti.

Any last words of wisdom, resources, or insights?

Postnatal care is just as important as prenatal care! Cristin recommends coming in for a PT appointment within two to four weeks following delivery. This proactive approach can help tremendously, especially if you’ve had a c-section or an episiotomy. Oceanside offers a free, weekly mom and baby Restore the Core class that makes it easier for new moms to practice self-care.

Bottom line: it’s never selfish to make maternal health part of your birthing plan. 

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