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Prolapse and Exercise - so what is to know?

Prolapse and Exercise - so what is to know?

What is Vaginal Prolapse?

Usually our pelvic organs (bladder, uterus and bowel) are supported by a hammock of connective tissue and muscles. If this support system isn’t working as it should, it can lead to one or more of these organs descending into the vagina, which is called a ‘vaginal prolapse’. 

A prolapse can be categorized into different types – a front (or anterior) wall prolapse, which is the bladder or urethra coming down, a back (or posterior) wall prolapse, which is the rectum or small bowel coming down, or a uterine prolapse, which is the womb dropping down. It is still possible for the top of the vagina to drop down if someone has had a hysterectomy. 

It often seems to be assumed that it’s the uterus that most commonly drops down, but actually the front wall of the vagina is the most common type of prolapse to occur. 

Prolapses can also be divided into ‘stages’, depending on how far down the lowest part descends when you do a maximal downward strain:

  • A stage 1 prolapse means that the lowest part of the wall/organ is still more than 1cm inside the vagina 
  • A stage 2 prolapse means that the lowest part of the wall/organ is between 1cm inside and 1cm outside the vaginal opening. This stage of prolapse, when the organ descends to the opening, is often when women become aware of their prolapse for the first time. 
  • A stage 3 prolapse means that the lowest part of the wall/organ is more than 1cm outside the vaginal opening
  • A stage 4 prolapse means that essentially the whole organ has come outside the body – this is relatively rare. 

 

How do I know if I have a Vaginal Prolapse?

The symptoms of a vaginal prolapse are different in everyone, and it’s important to note that sometimes people with mild to moderate prolapses don’t have any symptoms. 

The most common symptoms are:

  • A bulging sensation (or being able to see a bulge) or a feeling of ‘something being there’ in the vagina
  • A feeling of not being able to completely empty the bladder or the bowel (usually because the prolapse is causing a sort of ‘pocketing’ making it difficult to evacuate).
  • Lower back or lower abdominal ‘dragging’ pain

Sometimes women can complain of a ‘heaviness’ or ‘pressure’, but this needs to be confirmed on diagnosis as this can also be a symptom of over-worked, tired pelvic floor muscles. 

Sometimes prolapse can be associated with discomfort with sex, and sometimes with bladder or bowel leakage, but again – this isn’t always the case and should be confirmed on a physical examination, because there are many people who have these symptoms without having a prolapse. 

The health professionals who work specifically in the area of Women’s Health are best placed to make this diagnosis – gynaecologists, Women’s Health & Continence Physiotherapists, or Continence Nurses. However, your GP is a good place to start and many GP’s will have a vast degree of experience in diagnosing and staging prolapses, and can then refer on to one of the aforementioned professionals for further management. 

 

How common is a Vaginal Prolapse?

Unfortunately, it’s very common for women to experience vaginal prolapse, mainly due to our anatomy. We are animals that stand upright, and have a large proportion of our body weight going through our pelvis, but we also need a wide pelvic opening to be able to birth very large offspring through!

That mix of a large pelvic opening with a heavy load on top of it is unfortunately not ideal for supporting pelvic organs.

Studies have shown that up to 50% of women who have given birth will have some degree of prolapse, with other research showing that 1 in 3 women will have a prolapse that extends at or beyond the vaginal entrance (ie a stage 2 or more prolapse). 

Unfortunately, there is a high proportion of women who will require surgery for either prolapse or stress urinary incontinence. Statistics show that 1 in 9 women will undergo one of these surgeries, which are not without risks and have relatively high recurrence rates. 

 

What factors increase your risk of Vaginal Prolapse?

The main risk factor for prolapse is having had one or more vaginal births, with specific risk factors including:

  • Forceps deliveries
  • Giving birth to a baby over 4kg (9 pounds)

Prolapse is not limited to only those who have delivered babies vaginally, however, with other risk factors including:

  • Pregnancy
  • Family history of prolapse
  • Increasing age
  • Increasing BMI
  • Constipation
  • Chronic Cough
  • Heavy lifting

The main reason that pregnancy and vaginal childbirth are risk factors is because of their effect on what is called the ‘levator hiatus’. This is the name for the space in the pelvis between the two sides of the pelvic floor, and is essentially ‘the gap into which things can fall’. 

Studies on women who have recently given birth show that this ‘gap’ in usually increased from normal for up to 4-12 months after having a baby. This is one of the main things that Women’s Health Physiotherapists will assess for when doing a vaginal examination at a postnatal assessment, because it helps to determine your individual risk for prolapse occurring or worsening with return to higher load or impact activities. 

This ‘gap’ would be increased more significantly, and more permanently, if the woman experienced a birth injury called a ‘levator avulsion’. This means one or both sides of the pelvic floor muscle having a partial or full tear away from the pelvis bone. This can also be assessed for with a vaginal examination. 

 

How is Vaginal Prolapse managed without surgery?

Pelvic Floor Muscle training, under the guidance of a physiotherapist with post graduate qualifications, is recommended as the first line of treatment for vaginal prolapse. 

We probably assume that this training is all about improving the strength of the pelvic floor muscles (measured out of 5), but studies have shown only a minimal link between a woman’s maximal squeeze pressure improving and prolapse improving. 

This makes sense, because a vaginal prolapse needs to be supported all throughout the day while you’re in an upright position, but we probably only maximally squeeze our pelvic floor muscles for 1% of the day – at times like in response to a big sneeze or lifting something that’s heavy. 

Instead, it is more likely that pelvic floor muscle training helps to decrease prolapse signs and symptoms because it improves the ‘stiffness’ and support of the area, and it decreases the ‘gap into which things can fall’ (the levator hiatus) both at rest and under load. 

Other management strategies would include:

  • Teaching women how to empty their bladder and bowels effectively and without straining
  • Determining if symptoms can be improved by incorporating rest periods in ‘anti-gravity’ positions throughout the day
  • Weight loss 
  • Exercise modification
  • Use of support pessaries

 

What is a Vaginal Support Pessary?

Vaginal pessaries are devices worn inside the vagina that help to give support to the vaginal walls. If fit properly, they should give symptom relief, be comfortable and should stop a prolapse from descending. 

They can be a huge help for women with prolapse who wish to remain active or become more active. Pelvic Floor Muscle Training, while essential in the overall management of prolapse, can take a long time for symptoms to improve. Pessaries could be used in a ‘stop gap’ role to prevent further descent, and possibly give feedback on what types of things cause descent to occur, while concurrently working on pelvic floor training.

 

 

What exercise should I avoid if I have a Vaginal Prolapse?

Now this is an interesting one… and if you’re after a list of Do’s and Do Not’s, I’m sorry… it’s not coming from me!

Let’s start with what the recommendations are for exercise for general health. The Australian Government’s “Physical Activity Guidelines for Adults” states that we should participate in:

Cardio exercise:

  • >150 minutes of moderate intensity activity/week
  • OR 75 minutes of vigorous activity/week (or a mixture)

Resistance exercise:

  • >2 days/week 
  • >1 set of 8-12 reps per area
  • Maximum health benefits are gained when you would struggle to do another set

And recommendations for Bone Density and prevention/management of Osteoporosis:

  • Regularly doing a combination of resistance training and moderate to high impact weight-bearing activities

But historically (and I’m not talking that far in the past either) the recommendations for anyone diagnosed with, or at risk of, vaginal prolapse were:

  • Minimise weights
  • Keep all exercise low impact

But although well-intentioned, how evidence-based was this blanket recommendation?  And by giving this advice, are we compromising overall health (in particular our heart and bones) for the health of the vagina? 

Recent studies have looked a lot more into the pressures created in the abdomen, and more specifically in the vagina, during different types of exercise and although we can extrapolate some general information, the main message that comes out is “It’s not what you do, it’s how you do it”. 

If you give the same exercise to a variety of different women, then their individual anatomy, injuries, technique etc will mean that the way they perform that exercise results in a wide variety of different effects to their pelvic floor muscles and vaginal walls. 

It’s highly recommended that in order to tell a woman what exercise they should and shouldn’t do, we should understand:

  1. Their individual risk profile for prolapse occurring or worsening
  2. Whether a certain exercise is likely to be on the higher or lower end of the ‘risk’ spectrum

 

How do I know which risk category I fall into for Vaginal Prolapse?

A Pelvic Health Physiotherapist is a physio who has done a huge amount of extra training in Women’s Health and Pelvic Floor Health. They can do vaginal examinations to check a number of things such as:

  • The Pelvic Floor Muscle function
  • The structural support of the vaginal walls both at rest and on straining (and very important to assess this in standing too!)

There’s a specific test that we can do called ‘GH+PB’, which measures the amount of movement of the tissues at the opening of the vagina when you strain. This measurement, taken externally, has been proven to be a good indicator of what’s happening internally to the size of the space into which our organs could potentially descend. The larger the GH+PB measurement is (in cm) the higher the risk is that a prolapse could occur or worsen when the area is put under strain. 

Some important points to note:

  • It’s important to check if you currently have a prolapse (it’s not always symptomatic) but it’s just as important to pick up those who don’t currently have a prolapse but are at high risk of it developing
  • Pelvic floor muscle exercises are important but there’s a lot more to it than just getting the best maximal squeeze possible, especially for endurance activities like running and playing a game of sport (because when you think about it… how much help is a grade 5/5 squeeze going to be during a run if you’re not squeezing maximally while you’re running?)

 

Which exercises are likely to be higher risk?

There are lots of unknowns here, and we don’t know what the ‘safe’ level of intra-abdominal pressure is for preventing prolapse. We also don’t know, without individual assessment, how different women respond to the same exercise. 

But we can understand generally which exercises tend to come out as creating higher intra-abdominal pressure and perhaps these can be the ones that are more closely tested and monitored. 

Things we can assume about strength and resistance exercise:

 

  • Standing exercises have higher pressure than sitting, and both of these have higher pressures than lying down. On this note – abdominal crunches and lying down abdominal exercises usually come out as one of the ‘lowest risk’ exercises in the studies that have been done, although traditionally these have been amongst those that were the most highly cautioned against. 
  • Increasing weights and resistance increases intra-abdominal or intra-vaginal pressure

Things we can assume about aerobic exercise (note that this is probably the hardest type of exercise to investigate, but there is some exciting current research happening in this area):

 

  • Running, jogging, skipping etc are likely to be high risk due to the fact that they have an endurance nature to them, they’re always done in upright positions, and there are ground reaction forces involved.

Things we can assume about Crossfit-style exercise:

 

  • In low risk women (those who are young and have never had children), there is unlikely to be a negative impact on prolapse between those who choose to do Crossfit compared to those who choose to do ‘gentle’ exercise (but there are likely to be many benefits in other areas of health)
  • There is limited/no research on prolapse risk in women who are considered ‘high risk’

Things we can assume about pilates exercise:

 

  • Most pilates mat and reformer exercises are considered low risk and are unlikely to increase intra-abdominal or intra-vaginal pressures significantly (many are performed in lying down and with relatively low resistance)
  • There are lots of benefits to pilates but in isolation it doesn’t meet the guidelines mentioned previously about Disease Control and Prevention and needs to be considered in conjunction with other forms of exercise. 

 

How can a Women’s Health Physio give you individualized information about the type of exercise you should consider?

A Women’s Health Physio should be able to put all of this together and come up with a plan that suits you regarding an exercise regime. 

They might assess you and find that you’re very low risk for prolapse occurrence or worsening, and then you can work out together whether any monitoring needs to occur as you increase your load and intensity in your workouts. 

They might assess you and find that you’re currently in a high risk category and they can help you to work on a pelvic floor program (and possibly a pessary fitting) to allow you to gradually return to the exercise you love with close monitoring. 

They might assess you and find that you fit somewhere in the middle. Perhaps there are certain things that either make your prolapse symptomatic, or that cause vaginal wall descent without you realizing. Rather than advising you to stop exercising completely, they should be able to help you to come up with regressions or variations of these movements, and perhaps supplement them with other forms of exercise that you enjoy to allow you to still meet the health guidelines. 

 

Some final points to remember about Prolapse and Exercise…

  • Exercise is vital to overall health, and women unfortunately often decrease exercise due to fear of worsening a prolapse. 
  • Remember that a large number of exercises that were previously suggested to be ‘not pelvic floor safe’ don’t actually have much evidence to back that up (and might be really good for overall health)
  • Individual assessment and reassessment is key – and remember that you can’t assess prolapse or risk of prolapse with only an external examination. So if you’ve only had a real time ultrasound screening assessment on your abdomen, this isn’t able to be used to determine your risk profile. 

If you’d like to see a specialist physiotherapist in Western Australia, there’s online Directory for both private and public referrals:

Also, if you live in Perth or Mandurah, we have compiled a list of post-graduate trained physiotherapists who are particularly good with pregnancy, postpartum and exercise – see the FitRight website!

And remember – the whole aim of FitRight is to keep you moving, even if you do have a vaginal prolapse. Chances are that multiple women if every one of our classes are managing a prolapse and the instructors will be aware of this and know how to modify the classes to suit individual needs. 

Whether you’re pregnant, early postnatal, a Mum of young children or heading into peri-menopause, we have classes to suit you!

 

Article was written by Taryn Watson owner of FIT Right. She holds a 

Those bits that affect just under 1% of pregnancies that no one really talks about....

Those bits that affect just under 1% of pregnancies that no one really talks about....

We have all heard of a placenta but many have never heard about the condition PLACENTA PREVIA. It may sound like a horrible breakfast cereal but to those pregnancies which it affects its an awful reality.

It occurs when a baby's placenta partially or totally covers the mother's cervix — the outlet for the uterus. Placenta previa can cause severe bleeding during pregnancy and delivery. If you have placenta previa, you might bleed throughout your pregnancy and during your delivery. With it afffecting approximately 0.5% of pregnancies, it is the most common cause of bleeding in the third trimester.

 

So you may ask why is this a problem in a pregnancy? Well as the cervix thins and dialates- (getting ready for labour) and the placenta is attached the blood vessels tear and result in bleeding. The lower uterus is less able to contract and restrict (stop) the bleeding in this area resulting in uncontrolled bleeding.

The advanced age of a mother, a smoker or multiple babies are the main risk factors for this to occur. But also a woman who has had multiple pregnancies, a previous previa, previous uterine or cervical surgery or a cocaine user.

With Placenta Previa there are three catergories: marginal, partial or complete. Most diagnosed in the second trimester resolve themselves especially if they are not major. (84% complete and 98% of marginal will have resolved by 28 weeks).

Most woman diagnosed with this will endure an ultrasound with some getting put on bed rest ,for extreme cases, or Pelvic Rest (NO hanky panky). The biggest risk comes from the onset of labour. Many with moderate to severe previa will have to undergo a routine cesarean also if there is blood loss, foetal distress or evidence for preterm labour. 

So Placenta Previa is no walk in the park and there is no direct correlation between anything in particular-some pregnancies it just happens even if you didn't have it previously.

For 1 in 8 it is not so easy to fall pregnant they instead have to endure rounds of hormone stimulation, injections and so much more.

For 1 in 8 it is not so easy to fall pregnant they instead have to endure rounds of hormone stimulation, injections and so much more.

Cassie Silver is one of those 1 in 8 who is struggling to conceive naturally. While some go down the negative spiral of ‘Why me’ and blaming lots on the universe she has chosen to put a positive spin on her experience and share hers plus many others journeys through her podcast: ‘What To Expect When You’re Injecting‘.


I haven’t
created a human yet, but the journey has made me a better one.
 

“I’m grateful this is happening to me”, are words I never thought I would say when it comes to reflecting on my journey so far in trying to conceive. Why would anyone want to go through the pain, grief and uncertainty that comes with IVF? Is it the need for attention as the woman putting her body and soul through so much? Or the quest for validation that I am working harder that other to become a mother? The truth is, I wouldn’t change the cards I have been dealt because it’s the journey so far has completely changed my outlook on life. I had the fairy-tale picture in my mind when I married my best friend years ago and came off the pill. I started talking about baby names, character traits and even forecasted what horoscope they would be and aligned the moon and starts perfectly. Just like my type A personality, I had planned to fall pregnant after my 30th birthday, soon after our wedding. Fast forward a few years and we’ve had multiple IVF and FET cycles without any success. So- in a nutshell. While we haven’t made a human yet, it’s made me a better one.

 

Living with PCOS, a high follicle count, the inability to ovulate, blocked tubes and my husband’s poor sperm motility means IVF is our best chance to have a family. I have been no stranger to the world of swaps, smears and stirrups; suffering from abnormal cells and having many laparoscopy procedures since I was 18 years old. But, unlike any challenge or milestone I have faced in life, making a family is the only hurdle I have no control over and feel I am failing at. I have spent more than a decade working in the Australian mediaindustry as a television journalist, producer, presenter and now the owner of a successful production business.  I am no stranger to the spotlight as a media identity in Perth and I’ve always made I my mission to life an authentic life. I have interviewed incredible individuals and travelled the world as a journalist, sharing their stories of success and struggle. While I have always been transparent, I never thought I would be sharing my own. If someone tells me I can’t do something, I fight for it even harder; I am a high achiever, I mean we collected 29 eggs at our last collection!

 

What started as a bruised ego is now a bruised belly, but Iwouldn’t change the cards I have been dealt. This journey has already made me a better friend, daughter, sister, colleague and wife. Ultimately, this is going to make me a better mother. A mother with a deep understanding of the value of empathy and the awareness of other people’s shit instead of suffocating in my own. I have cried through the park on my runs and walks as I fly by prams and mother’s groups feeling alone and lost. But it’s been the ability to change my internal language patterns and recognise self-sabotaging behaviour that’s made all the difference. Instead of wanting to run headfirst into prams and yell “F U”, I look at them and smile and say “that will be me very soon”. Yes, many strangers think I am a little creepy, but I am the only one who can control my emotions attached to infertility. I used to wish there was a different button to click other than “like” as people posted their baby announcements on social media. Maybe a “just a thumbs up” emoji will suffice my level of happiness for this Facebook acquaintance. Once again, there exciting news shouldn’t create a reaction of jealousy or anger, it should fuel hopefulness. I have run out of responses to comments like “everything happens for a reason” or “maybe a holiday will do you both some good.” For anyone who hasn’t experienced infertility, sometimes silence is the best support. One thing Ive learnt, is I may feel lonely- but I am not alone. Whether it’s an early miscarriage, unsuccessful implantation or the embryo didn’t survive thawing, I have experienced the loss and grief which comes from all of them and I’ve learnt not to measure it.

 

I have more patience for people in general and take time to listen to their problems instead of finding solutions. Someone wise once told me, “when you’re heard, you start to heal” and I truly believe in the magic behind the phrase. My marriage is stronger than it was when we decided to come off the pill and give natural conception a good crack. We both understand eachothers love language and appreciate what we have more than what we don’t. We have had the Carrie and Big from Sex & The City chat about, “will it just be us two?” and are we ok with that? I now have more honest and open conversations with my family instead of being a hero and projecting a persona of success. Going through IVF and running my own business has taught me the value of balance and priorities, I learnt how to say NO. My friendships have a focus on quality not quantity, a bit like my outlook now at egg collection. I have removed people from my life I probably wouldn’t have had the guts to do a few years ago and created new connections instead. Not only has my rollercoaster ride through infertility been a chance to overcome a horrific fear of needles, but it’s also allowed me to evaluate how I see my own self-worth and esteem as a woman. I have gratitude’s written on my bathroom wall which remind me every day that my body is doing incredible things, the process is incredible, I am worthy, and my journey is remarkable. There is nothing wrong with being your own cheerleader and it gives you a new meaning behind the word empathy too. It’s redefined my definition of failure and allowed me to use my media skills in a completely new light as the host of new podcast “What ToExpect When You’re Injecting”. I wanted to marry my skills and struggle together by producing an authentic and uncensored podcast, “What To Expect When You’re Injecting”, a candid and personal discussion on IVF and infertility. This project is allowing me to turn pain into purpose and fill my life with contribution and connection. So, for those on the journey, try to find the silver lining in it; somewhere, somehow. IVF has made me a better person, and while many would never wish is upon anyone, this is the only time I can truly believe in the saying “everything happens for a reason”, regardless of loss, heartache and pain. While some may say I’ll be able to translate the gratitude I have right now into motherhood; the truth is, I may never be a mother, so for now my greatest achievement is to be a good human regardless of if I make my own or not.


Check out @injecting_to_be_expecting

Written by @cassiesilver
What To Expect When You’re Injecting is available on Spotify and Apple Podcasts.

 

 

So you are off to the Hospital to deliver you baby… what are the essential items to pack into the bag?

So you are off to the Hospital to deliver you baby… what are the essential items to pack into the bag?

Packing your pregnancy bag is a job you will either do too early or too late. It's never too early to gather together all the essentials you'll need during labour and birth, and for after your baby is born. Even if you're not planning to have your baby in a hospital or birth centre, you may need to go in unexpectedly, so try to have a bag packed by the time you're about 36 weeks pregnant.

Create a checklist and get ticking :)

 

What Mum needs for her hospital pregnancy bag:

  • Maternity bras
  • Nighties including an old one or a large t-shirt to wear in labour. It will probably get a bit messy, so don't buy anything special or tight to wear in hospital.
  • Dressing gown. This will be useful if you end up pacing hospital corridors in early labour. You'll probably also want one on the postnatal ward. Hospitals can be very warm, so a lightweight one may be better. A dark colour or busy pattern will help hide any stains.
  • Casual day clothes: include a pair of leggings that have supportive belly band with non intrusive seams. It helps with the repair of this area.
  • Slippers/shoes: Backless slippers that are easy to get on and off. Thongs work well, too.
  • Breast pads
  • Maternity pads plus lots and lots of undies
  • Heat packs. Many hospitals have a limited number of heat packs but are happy for you to bring your own. Check first, though, that your hospital allows microwaved heat packs (some have banned them), and has a microwave available so you can heat the packs.
  • Toothbrush, Toothpaste, Makeup, Hairbrush, Deodorant, Shampoo, Conditioner plus Hairbands, clips or a headband. If you have long hair, you may want it tied up or clipped back. And if your hair is shorter, you can keep it off your face with a soft headband especially during labour.
  • Lip balm: your lips can dry out quickly on a warm labour ward and from the air conditioner on the ward.
  • Any medications you have been taking (please bring the medication to the hospital to show your admitting doctor and arrange for this medication to be returned home)
  • Your Medicare card, details of your health insurance (if you have private insurance) and any hospital paperwork you need. Your birth plan (if you have one) and antenatal card, if you were given one.
  • Storage containers for glasses, contact lenses, hearing aids, or dentures. Note that your glasses may fog up when you're in the throes of labour, and you won’t be able to wear contacts if you're having a caesarean.
  • Things to help you relax or pass the time, such as books, magazines, games, knitting or a tablet. You may also want to download some fun and distracting apps on your phone to keep you occupied during early labour.
  • Music device, Phone and charger
  • Snacks and drinks for during and after the birth. Most women are able to eat and drink during labour and those early few days of breastfeeding when you can eat anything in sight. The hospital will have food and drink available, but you may prefer to pack a few things that you know you like. Great ideas are: Fruit, unsalted nuts, chips, muesli bars, honey sandwiches or and popcorn are all good options.

 

Some optional extras depending on the type of birth and/or what you have put into your birthing plan:

 

  • Massage oil or lotion if you'd like to be massaged during labour. You may also like to borrow or invest in a massage roller or similar aid, so your birth partner can massage you for longer.
  • Birth ball. This can help you find different positions of labour, and may also help you manage the pain of contractions. Check whether the hospital has the right size for you. If not, take your own. Remember to bring a pump so your birth partner can inflate it for you.
  • Oil burner, if you'd like to use aromatherapy oils. Check with your hospital because most have won't allow open flames, but you may be able to use an electric burner.

What baby needs:

 

  • Baby clothes and a blanket to take your baby home in
  • Newborn nappies and extra wipes (especially if you like a certain variety)
  • Dummy or pacifier if you choose to use one
  • Formula, bottles, teats and sterilising equipment, if you plan to formula feed
  • Olive, apricot, almond oil for coating baby's bottom before the first nappy goes to make cleaning easier
An exercise in Fertility: the ability to fall Pregnant

An exercise in Fertility: the ability to fall Pregnant

For some this is true: Don't drink the water you'll get pregnant! For a growing number the ability to fall pregnant is a long and ardious process with many roller coaster rides of emotions and pregnancy test kits. The angst felt by woman who see their friends/relatives/work mates fall pregnant within a drop of a hat is indescribable. They keep saying to themselves: 'When will it be my turn?'

Just because you haven't conceived doesn't mean you cant or wont be able to fall pregnant naturally- sure there are some medical reasons that might inhibit it but one thing is for certain you need to put your body in the best healthy state possible.

Did you know: 

~Around four per cent of all children born in Australia are the result of IVF -- that's the equivalent one child in every average sized classroom.

~The success rates of IVF significantly drops from 35 per cent in patients under 30 years old to just eight per cent for women over 40 years of age.

~A quarter of Australian women undergoing IVF are over the age of 40.

This leaves many to ask how can I place my body in the best possible space to fall pregnant?

We have compiled some tips, foods and ideas to help you on your way:


  1. Healthy weight

Being overweight or underweight can affect your chances of conceiving. Too much or too little body fat can make you have irregular periods or stop them completely, which can affect your ability to conceive.

+Your weight is healthy if your body mass index is between 20 and 25.

+Women whose BMI is more than 30 or under 19 may have problems conceiving.

+If your partner's BMI is more than 30, his fertility is likely to be lower than normal.

     2. Exercise

Studies of the effects of exercise on fertility have found that vigorous exercise reduces the risk of ovulation problems and that moderate exercise decreases the risk of miscarriage and increases the chance of having a baby among women who undergo ART(Assisted Reproductive Technology.

Polycystic ovary syndrome (PCOS) is a complex condition which is associated with infertility. Women with PCOS often have irregular or no periods because they rarely ovulate. For overweight and obese women with PCOS regular exercise can increase the frequency of ovulation which leads to more regular menstrual cycles. As ovulation becomes more frequent, the chance of conceiving increases. While studies show that exercise boosts female fertility it is important to note that a large amount of very high intensity exercise may actually reduce fertility and the chance of having a baby with ART. So, it’s a good idea to avoid very high intensity exercise while trying for a baby.

     3. Smoking and Drugs

There is also a link between smoking and poorer quality sperm, although the effect on male fertility isn't certain. But stopping smoking will improve your partner's general health.

There's no clear evidence of a link between caffeine, which is found in drinks such as coffee, tea and cola, and fertility problems. Though it is recommended to keep the caffeine at a lower level. There is also some prescription drugs and illicit substances that will interfere with the ability to fall pregnant.

     4. Food

+Following a low-carb diet may improve hormone levels associated with fertility, especially among women with PCOS.

+To boost fertility levels, avoid foods high in trans fats. Eat foods rich in healthy fats instead, such as extra virgin olive oil.

+Some studies suggest that eating more calories at breakfast and less at your evening meal can improve fertility.

+Taking an antioxidant supplement or eating antioxidant-rich foods can improve fertility rates, especially among men with infertility.

+Eating a diet high in refined carbs can raise insulin levels, which may increase the risk of infertility and make it harder to get pregnant.

+Eating more protein from vegetable sources, instead of animal sources, may improve fertility levels in women.

+Replacing low-fat dairy products with high-fat versions may help improve fertility and increase your chances of getting pregnant.

+Consuming iron supplements and non-heme iron from plant-based food sources may decrease the risk of ovulatory infertility.

    5. Relax

The last piece of the puzzle that we are sharing is the impact that the stress or worry will have on conception. We know of several examples of woman who were so stressed/anxious/uptight about the whole process and when they gave up and stopped trying so hard- guess what they FELL PREGNANT!

As your stress levels increase, your chances of getting pregnant decrease. This is likely due to the hormonal changes that occur when you feel stressed. Having a stressful job and working long hours can also increase the time it takes you to become pregnant.

In fact, stress, anxiety and depression affect around 30% of women who attend fertility clinics.

Receiving support and counselling may reduce anxiety and depression levels, therefore increasing your chances of becoming pregnant.

Our next article on fertility is going to be on the small percent of woman who conceive fine in the first pregnancy and then struggle with their second (second infertility). This actually accounts for a whopping 50% of infertility cases.

The above information has been collated from a range of sources and research papers.

Have you read the NEWS?? Exercise in pregnancy and breastmilk reduce the risks

Have you read the NEWS?? Exercise in pregnancy and breastmilk reduce the risks

A new study finds even moderate exercise during pregnancy increases a compound in breast milk that reduces a baby's lifelong risks of serious health issues such as diabetes, obesity and heart disease.

 

A new study led by researchers at The Ohio State University Wexner Medical Center and College of Medicine finds even moderate exercise during pregnancy increases a compound in breast milk that reduces a baby's lifelong risks of serious health issues such as diabetes, obesity and heart disease.

They already know that exercising during pregnancy is beneficial to the unborn baby but they wanted to also understand the WHY. When they did their original study they found that the health benefits from fit mums transferred to the pups, proving that they were, in fact, passed through breast milk and not simply inherited genetic traits.

Researchers followed about 150 pregnant and postpartum women using activity trackers and found that those who had more steps per day had an increased amount of a compound known as 3SL in their breast milk, which they believe is responsible for these health benefits.

They are now trying to see if they can extract this 3SL so that maybe they can add it to baby formula to help Mums who were maybe on bed rest or can’t breastfeed.

Dorothy M. Davis states: “Exercise is also great for your overall health during and after pregnancy, so anything you can do to get moving is going to benefit both you and your baby."

So there you have it even more reason to get out and get moving with your bump on board!

 

Information from the study was published in ScienceDaily.com

Do I really need Maternity leggings?

Do I really need Maternity leggings?

Comfort and support are the most important features when it comes to maternity clothing and leggings are no different. All of our pregnancy leggings have been specially designed to allow for the growth of the bump and belly while providing absolute support and comfort. Featuring a high waistband that can be worn during pregnancy, or folded down for extra support postpartum

Many woman experience different disorders while they are pregnant, but some of the symptoms are the same such as pelvic pain, swelling, stiff hips and the added strain on the lower back. Therefore finding the right maternity leggings to help relieve and minimise these types of symptoms is essential for comfort during and after pregnancy. Our specially designed maternity leggings have been constructed to support you in all the right places. By keeping the weight off your pelvis and reducing the pressure on your muscles and ligaments around the bottom half of your body that is growing so much!

So what do they do?

They offer:

  • Light compression to the legs, hips and if they are over the bump; the belly and lower back as well.
  • Support under the belly to take some weight off your hips and pelvis by providing a layer of support, they can help to lift up and alleviate the pressure on the pelvis.
  • Help to assist in keeping your weight in the right spots to put your body back into natural alignment.

 

You can wear them under the bump in early pregnancy, then over the bump later in pregnancy. MUMMACTIV pregnancy and postpartum leggings can be worn under or over because: 
  • Over-the-bump leggings have a light compression panel above the waistline that stretches and pulls up over the bump.
  • Under-the-bump leggings have a vee at the front of the waistline so the bump can sit in the middle.

With over the bump leggings when the compression panel is folded over (doubling the layer) and you wear it under the belly they give you even more bump support so the weight of your organs and bump isn't sitting on top of your hips as much.

They are essentially a belly band attached to pants. Many woman buy a belly band during pregnancy or for postpartum. Whereas, maternity leggings already have the belly band attached as a panel above the waist. Because the band is longit can be folded over during pregnancy to really provide support like a belly band, then after-baby, fold it down to help push your tummy in and support it.

 

Had or having a C-section?

 

When maternity leggings are for you...The compression panel scoops low at the front to provide the ultimate in comfort for any c-section scars. After a c section you don’t want to wear any clothing with seams that sit on the scar simply because they will irritate you. We've had customers regularly commenting that our leggings are the only pants they could wear post-baby after a c-section because of the way the seam cuts down and doesn't aggravate or irritate the scar.



Can you smell that?

Can you smell that?

The sense of smell is very important. Did you know that this sense often gets affected due to depression? Many observe during pregnancy that their sense of smell heightens often making nausea worse so why is it that many suffer a loss of smell in the postanatal stage due to postnatal depression or other mental illness post baby?

"Personally, my husband did not believe me that my sense of smell had gotten so bad due to my postnatal depression and anxiety. Unfortunately now many smells go unnoticed or the degree of the smell needs to be greater in order to sense it..."

So here is why?

Depression, schizophrenia and seasonal affective disorder all suppress the sense of smell. The olfactory bulbs is the part of the brain that gives us our sense of smell. Researchers have found that the more severely depressed a person was, the smaller their olfactory bulb.  Therefore this suggests that depression may cloud, but not damage, a person's sense of smell. The reduced brain response to odours found in depressed persons may be tied to problems in two closely connected parts of the brain that play an important role in processing emotional information and smell, known as the orbitofrontal cortex and amygdala.

The effects were present whether or not an individual was taking antidepressant drugs.

It has also been noted that once the depression has been successfully treated the sense of smell/response to smells returned back to their normal levels.

Pregnancy and CoVid19 so what's the latest

Pregnancy and CoVid19 so what's the latest

Pregnancy is a special time full of excitement and anticipation. But for expectant mothers facing the outbreak of the coronavirus disease (COVID-19), fear, anxiety and uncertainty are clouding this otherwise happy time. To learn more about how women can protect themselves and their little one, we spoke with Franka Cadée, President of the International Confederation of Midwives.

COVID-19 is a new virus and research into it is ongoing. We will update this article as new information becomes available.

 

Is it safe to continue prenatal check-ups?

Many expectant mothers are fearful of going to appointments while they are taking precautions, such as staying home and practicing physical distancing when outside. “You do see a lot of adaptation happening at the moment in the world where midwives are doing clinics or certain appointments by phone, so that the actual looking at the baby and the growth of the baby appointment can be short,” says Cadée. “I expect that pregnant women will find they’re seeing their healthcare professional less, to protect them and the healthcare professional from getting infected and that they will be seen live when it’s necessary.” Modifications may also be tailored for individual patients depending on their respective conditions, for example lower vs. higher-risk pregnancies.

Cadée advises mothers to find out what options are available to them from their healthcare professional and in their communities. “The person who’s taking care of you is perfectly geared to you and your own needs, so your midwife or obstetrician will know best.”

After your child is born, it is also important to continue receiving professional support and guidance, including routine immunizations. Speak to your healthcare provider about the safest way to have these appointments, for you and your baby.

 

If I have coronavirus disease (COVID-19) will I pass it to my baby?

We still do not know if the virus can be transmitted from a mother to her baby during pregnancy. “The COVID-19 virus has not been found in vaginal fluid, in cord blood or breastmilk,” says Cadée, although information is still emerging. To date, COVID-19 has also not been detected in amniotic fluid or the placenta.

The best thing you can do is to take all necessary precautions to prevent yourself from contracting the COVID-19 virus. However, if you’re pregnant or have just given birth and feel ill, then you should seek medical care promptly and follow instructions from your health care provider. 

I was planning on giving birth in a hospital or healthcare clinic. Is this still a good option?

“Women should ask their midwife [or health care professional] what they feel is the safest place for them and how precautions are being taken from situation to situation,” recommends Cadée. “It depends on the woman, on her situation and on the healthcare system.” 

“You would hope that most healthcare facilities have different facilities where those with the COVID-19 virus go in one entrance and the others in another. But in some situations that’s totally not possible,” says Cadée. “In certain high-income countries like in the Netherlands where I come from, we have a system whereby home birth is integrated within the system. So home birth within the system is safe and you are seeing more women give birth at home [but this is certainly not the case in most countries]. And even certain hotels are being used in the Netherlands by midwives for women to be able to give birth in the hotel which is made safe for a woman to give birth, so she doesn’t have to go to the hospital. But that is very much within that local context.” 

For the safest option for you, it important to speak to the healthcare professional who is supporting you throughout your pregnancy and birth.

 

Can my partner or family member be nearby when I give birth?

While policies vary by country, Cadée believes women should have someone nearby to support them, as long as the proper precautions are taken, such as wearing a mask while in the delivery room and washing their hands. “We are finding that in certain countries people are not being allowed to be with women, and that is worrying me. I can understand that you want to reduce the number of people with a woman while she is giving birth because you’re trying to reduce contact, and that is very very logical, but let’s make sure that a woman has someone, one person, with her while she’s giving birth – her partner, her sister, her mother, [or the closest person of her choice]. And please keep the babies with the mothers.”

“We have to be compassionate and understand each situation as it is and that the healthcare professionals together with the family members are doing their best, using their common sense and listening to each other. I think that’s very important: that we try to work as a community.”

 

I’m feeling incredibly anxious about giving birth. What should I do to cope?

Having a plan in place for your birth can help ease feelings of anxiety by giving you more of a sense of control, but recognizing that the current situation means there may be less predictability depending where you live. “This should include who to phone when the labour begins, who will provide support during labour and where. Establish what restrictions will be in place for hospital birth regarding support people and family members,” advises Cadée.

She also recommends doing simple things at home to relax, “like [stretching] exercises, breathing exercises and giving your midwife a call if you need to.” Focus on taking care of yourself as much as you possibly can. “Eat well, drink well, put your hands on your belly and enjoy being pregnant.”

 

What questions should I be asking my healthcare professional?

Cadée underlines the importance of establishing a trusting relationship with your healthcare provider. “All of those questions that have to do with you and your health, I would ask them freely. If you have an open relationship with your healthcare provider – with your midwife, with your obstetrician – they will discuss these things with you and answer you openly. It is your absolute right to know these things because it’s your body and your baby.”

“Midwives are responding to increased demands on their services as are doctors and nurses, and so may take a little longer to respond,” Cadée notes. She suggests establishing a system of how and when to communicate with your healthcare professional. For example, organize routine around appointments, and how to get in touch for urgent care. It may also be helpful to talk to care providers in advance about obtaining a copy of your health records including record of prenatal care, in case of any disruption or change in services.

When it comes to your plan for giving birth, it is important to ask as many questions as you need to. Cadée suggests the following:

  • Am I at risk of coronavirus disease (COVID-19) in this space? Has someone else been here with the COVID-19 virus?
  • How do you separate people with the COVID-19 virus from people who have not?
  • Is there enough protective clothing for the healthcare professionals?
  • Am I allowed to take someone with me? If not, why not?
  • Am I allowed to keep my baby with me? If not, why not?
  • Am I able to breastfeed my baby? If not, why not?
  • Am I allowed to give birth vaginally or do you give Caesarean section sooner? If so, why is that? 

 

What should women pack to go into hospital given the coronavirus disease (COVID-19) outbreak?

“I don’t think women need to take anything extra, but they should take precautions well into account,” advises Cadée.

She expects some hospitals may ask women to go home more quickly than normal if they’re healthy. “Again, that will be different from area to area, from woman to woman, from hospital to hospital,” she says, recommending expecting mothers to “ask their midwife or their obstetrician for advice that’s really tailor made for them.”

 

Once I have given birth, what can I do to protect my newborn from the COVID-19 virus?

The best thing you can do is to keep it simple: stick to just your family and don’t ask for visitors right now. “Also make sure that your children (if you have other children) that they’re not with other children. Get your family to wash their hands and take good care of themselves,” says Cadée.

Although it’s a difficult time, Cadée recommends trying to see the positive side of having this time to bond as a family. “Sometimes it can be very busy for young mothers and fathers to have so many visitors. Enjoy the quietness of your [immediate] family together for this time. It’s quite special to be able to bond with your baby alone, discover that new human being and enjoy that.”

 

I am an expecting mother. What should I be doing to keep myself safe during the COVID-19 virus outbreak?

As far as the research shows, pregnant women are not at a higher risk of contracting the COVID-19 virus than any other group of people. That being said, due to changes in their bodies and immune systems, pregnant women in the last months of pregnancy can by badly affected by some respiratory infections, and so it’s important to take precautions. “I know that for pregnant women it can be really hard – of course they’re caring for themselves and for their baby and sometimes have other children as well – but as far as we know, pregnant women are not at more risk than other people are, and for that reason they need to do the same things as everyone else,” explains Cadée. She advises practicing the following physical distancing measures:

  • Avoid contact with anyone displaying symptoms of coronavirus disease (COVID-19).
  • Avoid public transport when possible.
  • Work from home, where possible.
  • Avoid large and small gatherings in public spaces, particularly in closed or confined spaces.
  • Avoid physical gatherings with friends and family.
  • Use telephone, texting or online services to contact your midwife, obstetrician and other essential services.

Additional protective measures include frequent hand washing with soap and water, regular cleaning and disinfection of frequently touched surfaces at home, self-monitoring of any signs or symptoms consistent with COVID-19 and seeking early care from a health care provider.

 

Can I safely breastfeed my baby?

“As far as we know, it is perfectly safe to continue breastfeeding,” says Cadée. “All the research shows, the COVID-19 virus is not transmitted through breastmilk, so the mother can breastfeed – it’s the best thing she can do for her baby.”

If you suspect you may have the COVID-19 virus, it is important to seek medical care early and follow instructions from your health care provider. Mothers well enough to breastfeed should take precautions, including wearing a mask if available, washing hands before and after contact, and cleaning/disinfecting surfaces. If you are too ill to breastfeed, express milk and give it to your child via a clean cup and/or spoon – all while following the same precautions.

 

What should I do if I live in a crowded space?

Many women around the world live in close proximity to lots of other people, making physical distancing much more challenging. In such places, “I would really ask the whole community to take care of their pregnant women,” urges Cadée. She recommends that people keep their distance from pregnant women as much as possible and that certain toilets be designated for them.

And don’t forget the importance of handwashing in the community. “Handwashing is not said for nothing. COVID-19 and soap don’t like each other. It’s a simple measure that can do a lot of good,” she says. “I really hope that whatever situation people face, that the community and the healthcare professionals think of a system whereby it is as safe and secure for pregnant women, who after all are giving birth to our future. That needs to be treasured!”

 

 

This article is from Unicef.org

https://www.unicef.org/coronavirus/navigating-pregnancy-during-coronavirus-disease-covid-19-pandemic?utm_source=facebook&utm_medium=organic&utm_campaign=coronavirus&utm_content=pregnancy-page-post-2

 

 

 

 

 

 

 

 

 

 

 

Help...Antenatal classes online

Help...Antenatal classes online

Many pregnant Mums are facing the news that their antenatal classes have been cancelled at their delivery hospital. If you are a first time Mum or a Mum with a large gap in between these classes offer a great base. They give pregnant Mums an information bank on what to expect in delivery, options for birth, bathing, sleeping, changing nappies and a whole heap of practical tips and tricks when navigating the birth, delivery and early few days.

Many hospitals and birthing rooms have had to cancel these for the near future due to CON-VID19. Not having this access can increase the anxiety, fear etc for the expecting Mum.

 

We have done a bit of a run around and here are some paid/unpaid courses that we have found:

 Nourish www.nourishbaby.com.au $100 for Guide to healthy pregnancy, Guide to positive labour and feeding success. There are other options.
Hypnobirthing Australia www.hypnobirthingaustralia.com.au $499 for 3 hour private session. $199 online course
Baby Centre www.babycentre.com/childbirth-class FREE and has 7 chapter modules
About Birth www.aboutbirth.com.au $85 6 months unlimited access. 55 individual videos, 14 resource downloads.
Mama Lee Midwife www.mamaleemidwife.com.au $129 for 6 week membership- 4 classes on labour, packing a bag etc
Birth Beat www.birthbeat.com $397 for 12 months access to 9 modules

 

Why HIIT Is A Great Option For Time Poor Mums

Why HIIT Is A Great Option For Time Poor Mums

How would you feel if I told you, that you could do a 15 minute workout anywhere at any time at any stage of your fitness journey that could burn a large amount of calories and did not require equipment?

Well the training method called HIIT offers you exactly all of that.

Hiit Style training is a great introduction if your looking to come back into fitness or it’s a great challenge if you’re a seasoned exerciser.

Here are the benefits of Hiit Style Training –

I have put them in order of what I know are the biggest concerns mum's have when thinking about Hiit Style training -

1 – I’m not fit enough to do Hiit 

 Perfect for all fitness levels.

If you’re a mum and you're just thinking about where to start with the whole exercising thing as you want to start feeling good again, Hiit training can help. You start with a 15 minute workout and you will notice in a short amount of time you can increase the length of these.

HIIT workouts offer experienced or fit gym goers a new challenge, and beginners a quicker way to see results. You are constantly pushing yourself out of your comfort zone with the shortened rest phases.

2-  I don’t want to train at a gym

You can do it anywhere

HIIT is such a simple concept of work phase and rest phase, you can take it anywhere with you – to the kids park, the gym floor, the beach, your lounge room or a hotel room on holiday. And you can choose the exercises that you have enough space to complete! 

3 -  I have no time to think about exercising even though I know I should

 Time efficient

 HIIT is great if you have a limited amount of time to work out. You don’t need to spend hours in the gym to reap the benefits of regular exercise and Hiit helps play a huge part in this.

  1. 4. I don’t own any equipment

 No equipment required

HIIT workouts are so great as no equipment is required. All you need is a little bit of space. HIIT workouts can focus just your own body weight, so any workout that gets your heart rate up quickly such as plyometric, high knees, and jumping jacks can be implemented into a HIIT workout. particular muscle group – and of course if you have any injures regressions of all movements are available and still great to use.

 

5.. Will this help me  lose this baby weight  

Burns calories and helps with fat loss

The harder you exercise the harder your body has to work to fire up those muscles. Hiit is challenging for the body as you are pushing yourself through each working phase.

 

6 . I am more interested in making sure I can run with my kids

Great for cardio conditioning

During the high intensity periods (working phase) of exercise, HIIT takes you into an anaerobic training zone (where your body's demand for oxygen exceeds the oxygen supply available).

With consistent training in this zone, you will be able to out run your kids and be able to show them up in no time.

 Article written by Cass Wilson, Mum of two who runs and co-owns HIIT That Group Fitness  in Perth. 

She is on a mission to help women to take better care of their bodies, and give them the confidence to get stronger both physically and mentally as their embark on their journey as a new mum. She has a special interest in pre and postnatal woman and is passionate about educating them on how to lift weights and exercise correctly,

 

What Is An Irritable Uterus And Is It A Problem In Pregnancy?

What Is An Irritable Uterus And Is It A Problem In Pregnancy?

What is an irritable uterus?

Some women develop frequent, regular contractions that don’t produce any change in the cervix. This condition is often called irritable uterus (IU). IU contractions are much like Braxton-Hicks, but they can be stronger, occur more frequently, and don’t respond to rest or hydration. These contractions are not necessarily normal, but they also aren’t necessarily harmful.

INTERESTING FACT:

In 1851, a Dr. McKenzie wrote a piece in the London Journal of Medicine describing the condition. He started by remarking on the dueling titles of the time— hysteralgia and irritable uterus. The latter coined by a Dr. Gooch in 1831 

In the early 1800’s, “irritable uterus” was actually used to describe a condition in non-pregnant women and unrelated to contractions!

 

The HEALTHLINE.COM states that:

"There have not been many studies done on IU and pregnancy. In 1995, researchers explored the link between IU and preterm labor and published their findings in the American Journal of Obstetrics and GynecologyTrusted Source. They uncovered that 18.7 percent of women with uterine irritability experienced preterm labor, compared to 11 percent of women without this complication.

In other words: Irritable uterus contractions might be annoying or even scary at times, but they are unlikely to significantly increase the chances of your baby coming too early."

What causes an irritable uterus?

It is unclear as to what causes it and isn’t necessarily the same in all women.

Some of the causes include anything from dehydration to stress to untreated infections, like a urinary tract infection. Unfortunately, you may never learn the cause of your irritable uterus contractions.

 

What Are The Symptoms Of Irritable Uterus? 

 

Irritable uterus can feel similar to Braxton Hicks contractions but the contractions occur more frequently, are more painful, and tend to be more regular in length and frequency. Due to the intensity of the contractions many women mistake them for real labour. The contractions can also be accompanied by a feeling of pressure and/or pain in the back. Unlike Braxton Hicks, irritable uterus contractions worsen with increased activity. Irritable uterus can also feel like a constant tight belly, which can become worse when standing or walking. The tight belly can last for over an hour at a time. -

To deal with the symptoms you may want to try:

  1. Keep your bladder empty; a full bladder can create further irritation
  2. Stay hydrated
  3. Reduce your stress levels
  4. Get plenty of sleep
  5. Avoid lifting heavy items
  6. Lie on your left hand side
  7. Eat small meals, more frequently
  8. Avoid caffeine
  9. Take magnesium supplements (but check with your care provider first). 

 Our Pregnancy/Postpartum leggings have also been reported to help avoid the irritable uterus as there are no constricting seams through the uterus area. (This is a reported claim and not a research/investigated link)

References

1. Roberts WE, Perry KG Jr, Naef RW, Washburne JF, Morrison JC. The irritable uterus: a risk factor for preterm birth? J Obstet Gynecol. 1995 Jan;172(1 Pt 1):138-42.
2. Kehinde S. Okunade, Ayodeji A. Oluwole, and Maymunah A. Adegbesan-Omilabu. A Study on the Association between Low Maternal Serum Magnesium Level and Preterm Labour. Advances in Medicine. Volume 2014, Article ID 704875, 6 pages
http://dx.doi.org/10.1155/2014/704875
3. Irritable Uterus and Irritable Uterus Contractions: Causes, Symptoms, Treatment. http://www.healthline.com/health/pregnancy/are-your-contractions-normal

See more at: https://www.bellybelly.com.au/pregnancy/irritable-uterus-during-pregnancy/