The dreaded Postpartum Poop

                                                 

The First Poop. 

We all know what I'm talking about right? That first poop after you give birth. It's terrifying. It's horrifying. It makes you sweaty with fear and dread that you are going to poop out your insides or rip open every stitch they just put in you. Or was this just me??

Maybe that was a little too much information for you but I'm just being honest. I'm pretty sure I was more traumatized by the idea of pooping after I delivered my first baby than I was from the actual delivery. I was so scared, in fact, that I had the nurse come in multiple times and talk me off the ledge over it. She didn't actually come into the bathroom with me while I did it or anything, but she had to give me some pep talks. And all the stool softener.

Reality was not as scary as my imagination. I took the stool softeners they gave me and tried to go as soon as I had the urge. I think I was still taking Tylenol so it didn't hurt that much, but the anticipation was rough.

Had I been a practicing Pelvic Health PT back in the day, I would have been on my game and been psyched about my first poop. However, I knew nothing. If you aren't sure what exactly that is, click here for more info.

My friend and I are both really into pelvic health and
have taught some fun yoga workshops about digestive health.
We are also very good at pooping now. Just saying. 

Here's what pooping should be like:

• No pain with pooping
• Soft but fully formed easy to pass stool
• No straining or "bracing" needed
• Pooping between 3 times a day to 3 times a week (basically enough so that you don't feel icky in your belly but not so much that it's consuming your day)

Here are some tips on how to make that first poop less scary for you than it was for me: 

1. Stay hydrated: Stay on top of your water intake (you'll be doing that anyway if you choose to breastfeed). Hydration is key to helping your poops move properly and be solid. Soft but solid is ideal!!
2. Take the stool softeners: If you are able, take the pills y'all. It helps soften your stool to make it easier to pass and therefore less painful. 
3. Practice your breathing: If you follow me at all on Facebook or Instagram you'll know I'm big on breathing. Breathing deeply using your diaphragm is key to pelvic floor health. Breathing in the bed after you deliver will help relax your nervous system. This will then relax your muscles. Your pelvic floor is made of muscles. See how it works? So breathe. In the bed, while sitting up on the edge of the bed, and especially while on the toilet. Just slow down, close your eyes, and take some good belly breaths to relax the pelvic floor.
4. Exhale, huff, blow out the candles: If you're confused, let me put it this way - don't strain! Straining on the toilet can make things like prolapse, diastasis recti (abdominal separation), pain, or swelling worse. You can avoid this by making sure you are breathing instead of holding your breath on the toilet. Imagine blowing out candles across the hospital room or make "huff" sounds with your mouth. That will help increase the pressure in your belly while also avoiding the strain.
5. Use a trashcan: Again, that sounds confusing. Have you heard of the squatty potty? Well, most hospitals don't have one in the room which means you have to get creative. Take the trashcan in the bathroom and turn it on its side, then put your feet on top of it. You've just made a squatty potty for free!
   
   There is science behind this. In a nutshell, it helps relax your pelvic floor muscles so your rectum is nice and straight. Stool can just head straight on out this way instead of having to move around a curve. It's much easier. Trust me. Here's a video if you want a visual. Don't worry I'm not actually pooping in the video I swear. 
6. Go when you feel it: When you feel the urge, go. Don't hold your poop. I know how it is with a newborn, I do, but holding your poop only confuses your sphincters and your brain and it makes it harder to go the next time. Plus, the longer it sits in there the more water gets absorbed and the harder your stool gets. Not ideal. Often you'll be most likely to poop after your first meal of the day so have breakfast, a glass of lemon water, and then try and poop!

Every body is different. As in, your body is different from my body and my body is different from my BFF's body. Every birth is different. Every postpartum experience is different. I know these tips won't work for everyone. Then again, not everyone is terrified of the first poop. But if you are, be mindful of these things to minimize discomfort. Better yet, see a Pelvic PT before you give birth. And then after you give birth. Go here to find one near you or come check out my website here for more information about Pelvic Health in Fayetteville, NC! 

Lacy Kells PT, DPT  

Owner of Fayetteville Pelvic Health & Wellness

http://www.fayettevillepelvichealth.com

lacykells@fayettevillepelvichealth.comFollow me on Facebook: Lacy Kells PT, DPT orInstagram @lacykellspt and on YouTube at Fayetteville Pelvic Health

Maternity Leave in Real Life

This blog is a guest post that I got permission to adapt from Instagram. My best friend Ashley is currently on maternity leave with her second son and shared some thoughts as she is home working hard to keep baby boy happy and healthy. I love her real talk and her thoughts as processes going back to work. Enjoy! 

Maternity Leave. What does it look like? Is it a vacation? 

It’s such a weird thing, you go to school working toward a career for so many years, you bust your butt to grow within that career and then before you know it it's time to expand your family. As a mom, a lot of that initial change falls to you. When you find out you’re pregnant, everything changes.

You may not be telling people about the pregnancy yet, but it’s consuming all of your thoughts and plans. You wonder how this will change your family, yourself, your career progression. It’s a bittersweet source of anxiety at first.  Then you share your news, and somehow anything that happens in your career has a filter over it. Is this because I’m pregnant? Will my coworkers be mad at me for not pulling my weight? Will I lose out on opportunities because I chose to have a family??

Then you have the baby and it’s time for maternity leave. It’s a weird place to be, having worked so many years to be able to work every day in your field. Now you are at home, focused 24/7 on this tiny little person that has turned your life upside down. In so many ways it is SO. MUCH. HARDER. than daily work and in other ways it feels like you haven’t (can’t—sleep deprivation is real) use your brain anymore. 

We all know that maternity leave here in the US is pretty dreadful, I’m lucky that I can chose to take 3 months off, albeit unpaid. For me, I got only a super small percentage of my pay by filing short term disability (though can we all agree that having a baby is not a disability?!!?)

Lately,I’ve been thinking about this transition into motherhood. It’s so different the second time around. I love the newborn phase. Yes, it’s hard as hell. I’m tired, like super tired. And yet, my main responsibility and to-do list everyday is to take care of me and to take care of the baby. I can shift all my resources and energy to those goals.

I think the hardest part about motherhood for me was with my transition back to work. If I’m doing something, I’m going at it 100%, so with my return to work I didn’t want to halfway do it. I wanted to be just as on top of it as I was pre babies. And now I have this new focus of being a great mom whenever I’m home, which is hard when you are awake every 45 minutes the night before (yup, that's what my firstborn did for a while when I first went back to work). Nighttimes get more stressful because I’m always thinking about how it’s going to affect my performance at work the next day.  I’m short with my kid and my husband because of this stress and because I’m just. so. tired. By the end of the week I remember laying on my kitchen floor, staring at the ceiling too tired to make dinner, yet arguing with my husband because I didn’t want to order food in (it would mess up the budget (#realtalk here)).

What about you guys? What was easier for you? The early newborn days or later in the game when life got busier (like the return to work or other obligations??)

#momlife #realtalk #fourthtrimester #newborn #womeninhealthcare #momsinhealthcare #workingmom #sleeptraining #sleepdeprivation

Dr. Ashley Chandler is a Physical Therapist currently on maternity leave after the birth of her second son. She is a Certified Oncology Specialist and Certified Manual Therapist who is passionate about Oncology rehab and Lymphedema management. She is a wife and a mom to two awesome boys and a very fluffy Golden Doodle. Find her on Instagram @ashleychandleryoga or on Facebook at Ashley Chandler PT, DPT, CLT

I am a Lacy Kells, a Pelvic Health Physical Therapist with a passion for informing women (and men) on the completely amazing subject of Pelvic Health.

Owner, Fayetteville Pelvic Health and Wellness

http://www.fayettevillepelvichealth.com
lacykells@fayettevillepelvichealth.com

Follow me on Facebook: Lacy Kells PT, DPT or Instagram @lacykellspt and on YouTube  at Fayetteville Pelvic Health and Wellness. 

Exhale on the Effort! Why?? Watch to find out.

I often see women who are very active but are dealing with some pelvic floor issues despite feeling pretty strong. Very often, they are exercising regularly, lifting weights, doing things that they feel like should keep them from having pelvic floor issues yet they find themselves in the clinic for help.

Well, here's the thing. We can be strong and powerful yet still be compensating with our movements in a way that causes some dysfunction. Often, it's about pressure management through our core. Breathing properly can be such a big help in managing pressures through our abdomen so that we can prevent things like prolapse or leaking! While it's always more complicated that simply exhaling, sometimes it can be a good first step in getting yourself on track to stop leaking or prevent prolapse or worsening of your diastasis! I hope this video helps you get started and as always, find a pelvic PT asap to take a look and get you on track!




Lacy Kells PT, DPT
http://www.fayettevillepelvichealth.com


Owner of Fayetteville Pelvic Health & Wellness
lacykells@fayettevillepelvichealth.com

Follow me on Facebook: Lacy Kells PT, DPT or
Instagram @lacykellspt and on YouTube 

Real life motherhood from a real life awesome mom.

Night sweats, tearing, fecal leaking, milk letdown... All the things you may not have known about prior to having babies. Things that aren't talked about but that are real issues we deal with postpartum.

Postpartum anxiety and depression

My good friend and colleague Ashley Chandler recently delivered her second son. For some, that means a little less anxiety after having gone through this whole thing once before. However, that doesn't mean things are all peaches and cream. I asked her to make some videos about motherhood and how she is doing the second time around. I gave her no direction at all to see what issues felt most important to her and the first thing she wanted to talk about was postpartum depression and anxiety.



Postpartum depression and anxiety are not things that we choose to suffer from. They are chemical and/or hormonal imbalances that can make us feel awful, sad, insane, angry, scared, worried, even suicidal. They aren't things we can just sleep away (though sleep deprivation does play into these issues). They are legitimate problems that moms can suffer from in the postpartum period, and it's not always recognized. Very often moms don't realize they may be dealing with these issues until they are past them. And let's be honest, that is no way to live out the early postpartum days. Below is the video she made describing her experience with depression and anxiety. For more videos check out our website or find us on YouTube.

Hopefully your provider has given you a little handout to go through that screens for depression. I must have taken it in the early days after I had my first child, but I can tell you right now it didn't pick up on how bad I was suffering. I think, in retrospect, it was probably more anxiety clouding my brain, but I know I had a bit of both even so.



If you don't know if you've filled out the scale to screen for depression, here is one example.  It's quick but if you have 10 or more points you may want to ask your doc about it. Anxiety is another issue. Here is a scale that you can take if you thing you may have postpartum anxiety. Mild to moderate is 21-41 points and severe is 42 and up.



If you have even a tiny bit of doubt that you aren't okay, ask your obstetrician. Tell your PT. Call your mother or your girlfriends or your priest. Just don't suffer in silence. These issues are SO common, yet we all feel shame over discussing it. Admitting your aren't okay feels so vulnerable so many women hide it. It's too bad, because there is help out there. Whether it's meds or therapy, hormone balancing or exercise, diet or essential oils, there is lots out there to help make you feel better, healthier, stronger. And by all means, get evaluated by a PT so that your new body works as well as it can. Feeling depressed over time because you are limited by incontinence, pelvic pain, prolapse, diastasis recti is no way to live either. Check out  https://www.fayettevillepelvichealth.com/blog for more information about what we offer as Pelvic Health physical therapists.










Lacy Kells PT, DPT
http://www.fayettevillepelvichealth.com


Owner of Fayetteville Pelvic Health & Wellness
lacykells@fayettevillepelvichealth.com

Follow me on Facebook: Lacy Kells PT, DPT or
Instagram @lacykellspt and on YouTube 

Standing quad stretch

What exactly is a C-section?

6 years ago I had a scheduled Cesarean birth. Baby B was breech and I just didn't want to risk complications, so we had our twin daughters on our OB's lunch hour. All went well as far as I knew, but back then, I didn't ask many questions. I didn't know what to ask really. I certainly didn't care about how the cesarean was done, I just cared about two healthy babies and a good recovery. Knowing what I now know as a Pelvic PT, I still would have opted for the C-section, but I would have done some rehab as well afterward.


I have included a video I made on C-section birth and how it's done using felt and it's SUPER cool so check it out. The physician cuts through skin, fat, fascia, separates the muscles, cuts through the peritoneum (connective tissue in your abdomen), uterus and amniotic sac all before getting to baby. That's a lot of layers to heal! And every layer has the potential to develop more scar tissue than is ideal. I mean, some scar tissue is essential of course, but if things aren't moving well or if there's excessive amounts, we can run into issues.


For me, it's back pain. When my scar gets sticky and bound down, my abdominal wall does not work as well as it could, and my low back muscles start to freak out and overwork themselves. That, then, leads to low back pain at the very best. At worst, it's pain in my back, butt, and leg.


If you are wondering why this would happen if they don't cut through muscles, it's because muscles, fascia, bones are all connected. If one layer of tissue can't move properly, nothing else can work at its best. The solution? Honestly, it's PT. I'm not just saying that because I am a PT. It's that pelvic health physical therapists know exactly how to assess you and your movement. So after a big abdominal surgery, we know what is safe for you to work on right away, what things you can start to work on as time goes on, and what to teach you for the future so you can continue to live your best life. Pelvic PT is not just about the pelvic floor. Yes, that's a component, but you do NOT have to have had a vaginal delivery to see a Pelvic PT. We are also experts in the rest of your body!


So, if you have pain and have a history of a C-section birth, find a PT.
If you are scheduled for a Cesarean section, find a PT to prepare.
If you are worried about a Cesarean, find a PT.
If you just had a C-section, find a PT.


Do yourself a big favor and take your health and wellness into your own hands. There are Physical Therapists out there who don't need a referral, so you won't have to fight for your right to see one of us. There are so many physicians out there who are more than happy to send you to a PT if you ask. So use your momma bear voice and your mom smarts and find one near you! If you want more info about what we do and more about my own practice, check out my website!












Lacy Kells PT, DPT
http://www.fayettevillepelvichealth.com


Owner of Fayetteville Pelvic Health & Wellness
lacykells@fayettevillepelvichealth.com

Follow me on Facebook: Lacy Kells PT, DPT or
Instagram @lacykellspt