Health
Busting pelvic floor myths By Eliza Henry-Jones WHEN I am eight months pregnant, I can still simultaneously manage to sneeze and not pee. This, in late pregnancy, is regarded as a sort of miracle. "Enjoy those muscles while you've got them!" a family friend advises me. Other friends tell me that I'll definitely wet myself the first time I ride my horse after having a baby. I am, quite rightly, terrified. Pelvic weakness is too often normalised following pregnancy and birth - particularly traumatic, vaginal births. But we have much more control over our recoveries than we think.
assumed that my body would spring back within a matter of weeks after birth. "Education is a big part of an appointment," Jen tells me. "We screen for any issues that may be there and that screening includes comprehensive birth history, prior obstetric history and also encompasses fluid and dietary intake that can influence bowels touching on lots of sticky subjects!" Jen laughs. One myth that Jen encounters regularly is that there is no point visiting a physiotherapist before the typical six-week postpartum check-up.
I spoke to Jen Vardy, a mother of four and physiotherapist with a keen interest in women's health, about the misconceptions surrounding pelvic floor health and what we can do to keep ourselves strong.
While it's unlikely that a physiotherapist will do an internal examination earlier than six weeks due to the risk of infection, it is an opportunity for concerns to be addressed, an initial program planned out and mums getting information on pelvic floor health and perhaps beginning some gentle exercises.
The first thing we talk about is time. Our bodies take a while to heal. Often, our bodies can still be healing up to two years after giving birth. This shocks me. I had, like so many other mums,
"During the six week post-natal check, with either your GP or your obstetrician, the focus is widespread baby, feeding, PND risk and mental health screening, scar or stitches.
"It usually does not include a check of your pelvic floor. I think that's why it's important that we start to normalise a pelvic floor check for all women post-natally." Examinations with a physiotherapist after the six-week mark can generally be either internal or external. "There is an option to assess pelvic floor using a real-time ultrasound but that doesn't convey information about muscle tone and strength. We can see if someone is activating or not, but can't assess the strength of the muscles," Jen explains. "Another thing you miss is if there has been any tissue stretch or potential for prolapse. But the ultrasound is an avenue if someone doesn't feel comfortable having an internal. "
"This is some of the feedback we can give to mums during an internal exam," Jen explains. "Whether they're correctly using those muscles." Another misconception that Jen frequently encounters is the idea that muscles will just improve on their own. "Natural recovery will see them improve. However, why don't we encourage all women to get as strong as they can?" Jen points out. Jen finds the work she does incredibly rewarding.
Alarmingly, most women don't know how to activate their pelvic floor muscles - a vital skill for any sort of pelvic floor strengthening.
"I love working with pre-natal women, to maintain fitness, to deal with issues like pelvic girdle pain and lower back pain that may occur during pregnancy and that also gives me the opportunity to plant to seed to strengthen pelvic floor before baby arrives," Jen says.
Jen tells me about recent research that found between 60% and 70% of women will incorrectly activate their pelvic floor when given written instructions on how to do it.
"What the body's going through is such a massive thing and we're so lucky to be able to go through this journey and while it can put our body under pressure, it's an amazing thing."
Gut bacteria linked to anxiety in kids GUT bacteria might predict a child's risk of future anxiety, according to a new study. Researchers believe children with a lower amount of Prevotella when they are one-year-old are more likely to have anxiety-like behaviours, including shyness, when they turn two. More than 200 children took part in the Barwon Infant Study that tested their poo samples at one-month, six and 12 months of age as well as their behaviours at two years. They found those with lower instances of the bacteria at 12 months of age were more likely to be shy, sad and showed indications they may be a 16 AUTUMN 2020
higher risk of going on to develop childhood anxiety. Study leader Professor Peter Vuillermin, from Deakin, Barwon Health and MCRI, said the study found less Prevotella in children who had recently taken antibiotics. "Growing evidence supports the idea that antibiotics, poor diet and other factors in the modern world are leading to the loss of our traditional gut bacteria, and in turn, health problems," he said. "There is intense interest in the relationship between gut bacteria and brain development, but most of the evidence has come from experiments in mice. This is one of the first human
studies to compare the composition of baby's gut bacteria to subsequent behavioural outcomes."
category for anxiety we can offer an early intervention," Dr Amy Loughman said.
In previous cross-sectional studies Prevotella abundance has been associated with both autism and Parkinson's disease.
"This might be a supplement of Prevotella or other bacteria, or it could be in the form of behavioural and family support to bolster their psychosocial environment. But we need to get more research behind us before we can reach that point."
The research team now hope to build further evidence to consider Prevotella as a gut bacteria key to both identifying health risk, and potentially, as an intervention to improve health outcomes. "One day we could get to the point where we can look at a child's poo at 12 months, and if they are showing levels of bacteria that put them into a high-risk
In the meantime, parents are encouraged to follow Australian dietary guidelines and feed children a diet high in fibre, including plenty of fresh fruits and vegetables, and to work with their doctor to minimise the use of antibiotics. www.knoxmonashkids.com.au
