Women’s health advocate Mary O’Dwyer is passionate about your floor. No – she isn’t interested in the shine of your floorboards nor the spring in your carpet. It’s your other floor. That one. Down Under.
Mary is a renowned Australian physiotherapist, author and creator of Pelvic Floor and Core Works, a health initiative dedicated to the maintenance and health of the pelvic floor – that sling of muscles that not only holds it all in, it births babies, keeps us continent and… pretty much makes us a woman.
Mary has been a champion of pelvic floor function for most of her expansive career. An astounding 75 per cent of Australian women experience some kind bladder leakage in their lifetime, and 50 per cent also experience some kind of pelvic organ prolapse, yet improving the condition of the female pelvic floor (PF) is surprisingly simple.
Prevention is a vital component of PF health, and in her latest book – Hold It Mama – Mary aims to enlighten pregnant and birthing women on how to actively prepare and heal the pelvic floor, both pre- and post-birth.
“The information in Hold It Mama provides mums (and those involved in birth) with practical evidenced-based information on how to care for the pelvic floor and core during pregnancy,” says Mary, “As well as ways to minimise trauma to the pelvic basin during birth.”
Mary says Hold It Mama has been popular with physios, midwives and fitness professionals, which is no surprise, as birthing is such a collaborative process between women and their healthcare providers – something the author strongly believes in.
Mary also believes that understanding how birth choices affect labour, birth and the pelvic floor allows mums to make wise choices (along with caregiver advice) for the safe delivery of their child, providing an optimal outcome for both mother and baby.
Not only does Mary provide detailed information on recovery after vaginal or caesarean birth, she also covers the treatment of abdominal muscle splitting, protecting the floor and core immediately post-baby, soft tissue techniques for scars, and how to prevent internal adhesions. She even covers such rather important topics as resuming intercourse and getting back into your pre-pregnancy jeans, with a series of exercise programs, from specific pelvic floor exercises to her ‘Shrink the Jellybelly’ program.
Mary’s driving reason behind writing Hold It Mama was simply her desire to give women the most up-to-date information on their pelvic floor, core and abdomen during pregnancy, birth and post-baby.
“This should be such a glorious time in a woman’s life and mums often don’t know where to turn for information to improve muscle pain or function,” says Mary.
“Some mums are too busy or embarrassed to seek treatment for post baby issues – for example, if sex hurts post-baby, it may be difficult to discuss this with a busy doctor, and such issues can seriously affect a couple’s relationship.”
In clinic, Mary spends time teaching mothers how to effectively prepare for birth, the best ways to labour and how to overcome any birth related issues. In Hold It Mama, she wanted to provide self-treatment skills and practical information for mums everywhere, and guide them in selecting the right caregivers when they need treatment and advice.
“The pelvic floor is a central part of a woman’s body, controlling sexuality, continence and core strength, so in an ideal world, all women will know how to care for this most precious area of their body by becoming their own pelvic floor experts.”
Mary believes that the choices a mother makes in preparing herself for birth – and how she births – are directly related to life-long pelvic floor health. Minimising floor and core strain is part of preventing pelvic organ prolapse and maintaining continence and sexuality throughout a woman’s lifetime, and Mary would love to see mothers and grandmothers passing on pelvic floor knowledge to their daughters.
“Various influences such as culture, family, friends, injury, self-talk and prior abuse impact on the way we feel about our bodies, especially the pelvic floor,” says Mary.
“When women feel comfortable with talking about pelvic floor health, they are more likely to pass this information along to their daughters (and sons).”
Today, women are sexually savvy with plenty of information on positions, pleasure and orgasms (which are great, incidentally, for PF health), yet Mary believes there’s still a lack of practical, functional pelvic floor knowledge to teach our daughters, not only regarding birth but everyday pelvic floor habits.
“I think back to my mother telling me she had absolutely no idea how her first baby would be birthed due to complete ignorance about her body,” says Mary.
When asked if the general health system in Australia is letting birthing women down, Mary says we are blessed to have such caring midwives and specialists birthing Australian children, regardless of the birth setting.
“But evidence shows that unnecessary birth interventions, poor birthing positions and the choice of birth setting and birth attendants have a significant impact on pelvic floor outcomes,” she says.
“Learning about birth, your caregivers and the hospital’s policies on birth interventions allow women to make clear choices, in conjunction with expert advice.”
Ways in which women can prepare the pelvic floor for birth include exercise, correct posture (to ensure optimal foetal positioning) and perineal massage. Mary says that stretching the perineum before birth reduces the risk of tearing for first time mothers, and practicising visualisations, along with effective breathing, gravity-assisted positions and urge-led pushing, also assists the pelvic floor during birth.
Post-birth healing is also a vital part of the birthing process for women’s health.
“Pregnancy and birth stretch the abdominal and pelvic floor muscles to their extreme outer range, so it makes sense to start the correct program post-birth,” says Mary.
“The pelvic floor muscles tighten with other core muscles to support the spine and keep us in a tall posture. They maintain bladder and bowel continence and support the pelvic organs from slipping down vaginally (prolapse). Exercising from the ‘inside out’ after childbirth will build a firm core foundation before starting back to other types of exercise.”
Mary’s first book – Hold It Sister – was revolutionary in terms of providing open and honest communiqué on an often ignored part of the female anatomy – and the book is now enjoying worldwide success. Now with Hold It Mama for pregnant women, Mary has provided a warm, supportive and tailored set of detailed instructions on pelvic floor health for birthing women and mums.
With Hold it Mama, Mary hopes her new ‘baby’ brings confidence and strength for the journey to birth, motherhood and beyond. She also hopes it helps create positive memories of birth.
“I feel proud I can make a difference to the lives of women – during pregnancy, birth and with regard to their ongoing physical health and vitality. I’m also really thrilled that the book was printed just before my daughter birthed her divine twin girls, earlier this year,” says Mary.
Perfect timing … and a perfect way to celebrate the figurative birth of a very important book for women.
Mary’s Top 5 Tips for a healthy pelvic floor pre- and post-birth:
- Sit tall to open up your abdomen and give baby room to settle into their optimal birthing position.
- Practice belly dancing hip circling movements.
- Do some type of exercise for 30 minutes most days of the week(unless otherwise advised). Swimming is the ideal exercise right up to labour.
- Prepare for birth and become educated about the effect of birthing interventions of the pelvic floor and your caregivers’ policies on interventions.
- Practice regular pelvic floor exercises for a strong floor to cope with the extra load of a heavy uterus.
- Number 6: read Hold It Mama!
Hold It Mama, $24.95 RRP, is available from all book stores from August 2011 or online at www.holditsister.com (ebook $14.95)