Kegels (not how we were once taught!)

The process is to tighten the pelvic muscles as though you are trying to stop the flow of urine or hold back gas. However, it is not recommended that you practice this by actually stopping the flow of urine while you are on the toilet. There is concern that this could lead to a urinary tract infection. It may help to imagine that you are sitting on a marble (do not use a real marble) and using your pelvic muscles to lift it off the chair. Think about squeezing the muscles closest to your vagina and anus.

While it can be challenging to learn how to contract your pelvic floor muscles without using your abdominal, buttock, or thigh muscles, it is important to learn to do so in order for the exercises to be effective. This will get easier with time and practice.

Once you have figured out how to isolate the right muscles, you can begin to strengthen them. To do this:

●Contract – Squeeze your pelvic floor muscles.

●Hold – Keep contracting the muscles for 8 to 10 seconds. In the beginning, you may not be able to hold the contraction for this long, but over time, you will build up strength.

●Relax – Relax your pelvic floor fully. This step is as important as contracting the muscles.

Over time, try to hold the muscle contraction harder and for a longer time before relaxing. As with other forms of exercise, you will become stronger with practice, and you will need to keep up your routine in order to notice long- term effects.

You can do these exercises in any position (standing, sitting, or lying down) and work them into your daily routine in a way that is convenient for you.

A typical regimen involves doing this exercise (to contract your pelvic floor muscles, hold, then relax) 8 to 12 times per session, for three sessions every day, if possible. This routine should continue for at least 15 to 20 weeks. Healing and strengthening takes time and it is important to stay patient and keep working on it.

We always recommend following up with a pelvic floor physical therapist; these are amazing professionals who can teach you how to do these exercises effectively. If you need a referral just let us know.

"Elevator" kegel exercises:

• Visualize your midsection as an apartment tower. Using your pelvic floor muscles, draw upwards to the first floor and hold for five seconds.

• While continuing to hold, draw upwards to the second floor and hold for five seconds.

• Release and repeat several times per day. Sitting on a pillow, ball or Sissel disc will help increase your ability to contract.

Slow Hold

• Sit or lie comfortably with your legs wide apart.

• Close your eyes and imagine that you want to “hold on” and stop yourself from passing urine or wind.

• Squeeze the muscles around your front passage (vagina) and back passage (anus) as strongly as possible and hold tightly for three seconds. By doing this you should feel the pelvic floor muscles lift up inside. Relax for at least five seconds.

• Repeat this “squeeze and lift” movement up to 10 times, holding the contraction for three to five seconds or as long as 10 to 15 seconds if you are able. Ensure that the squeeze stays strong and you can feel the “let go.”

• Rest for one minute before you proceed to the next exercise.

Quick Squeeze:

• Squeeze and lift the pelvic floor muscles as strongly and quickly as possible. Don’t try to hold on to the contraction; just squeeze and let go.

• Gradually increase the speed of each contraction and the number of repetitions before the muscle tires. Allow a three-second rest in between each exercise.

• Repeat 10 times. Do this several times a day.

Squeeze and Hold:

• Squeeze the pelvic floor muscles and hold for a slow count of five to start, working your way up to 10. Relax and rest for 10 seconds.

• Repeat five to 10 times. Do this several times a day.

**To prevent further damage to pelvic floor muscles, avoid:

• straining with a bowel movement or being constipated

• repeated heavy lifting

• repetitive coughing or sneezing.

** During these exercises you should NOT:

• feel any downward movement as you contract the muscles.

• tighten your thighs or buttocks.

• hold your breath.

If you had stitches after having your baby this is a great article on perineal scar tissue massage

While you want to strengthen your muscles often previous clients reach out after they started having intercourse with their partner again and it’s painful. Again, we highly recommend seeing a pelvic floor therapist! These exercises are helpful learning to relax your pelvic floor.

How to relax your pelvic floor muscles

POSTPARTUM MOOD

Being a mom definitely has it's ups and downs and sometimes we just sit and cry when baby cries because, well, that's all that's left. Some women slowly drift deeper and deeper into a place that becomes isolating and you feel like each day is a battle of emotional turbulence. We have prepared a few ideas to hopefully steer you in a healthy direction.

Here are supplement recommendations for postpartum emotional balancing:

Fish Oil-1000mg / 3 times daily

B Complex daily Folate-800mcg daily Zinc-8mg daily

Vitamin D-2000IU daily Magnesium - 1,000 mg daily

And then there's this:

1. First off it is best to evaluate your diet. Reduce processed and refined carbohydrates. Healthy carbs (such as vegetables and fruits and complex carbs) increase serotonin levels in the brain.

2. Watch those blood sugars. It's easy to skip meals when taking care of a newborn but you are now out of the "honeymoon" phase where you are on bed rest and your are being taken care of. Blood sugars fall, stress hormones are released. As during your pregnancy, protein continues to stabilize blood sugars.

3. Avoid caffeine. This alkaloid found in coffee, tea, chocolate, sodas and many medications produces an effect similar to the stress response in our bodies. As little as two servings can worsen anxiety.

4. Not that we think you are partaking, but more than the occasional "good for your heart" glass of alcohol can aggravate depression and deplete your body of important vitamins and minerals.

5. Getting enough magnesium? Studies suggest that low magnesium can trigger anxiety. Food sources include: Almonds, cashews, and green vegetables

This blog covers all this in more detail as well as having a recipe for postpartum tea that supports mood and emotional stability https://www.euphoricherbals.com/blogs/news/11-natural-solutions-for-postpartum-depression

Take the opportunity to sleep. We are obviously aware of how interrupted a mother's sleep can be. However, this schedule also depletes our adrenals and increases the likelihood of anxiety. Make a schedule for yourself to have someone take kiddo watch and allow yourself to take a nap!

Journaling can also give an outlet to emotions. Write down what is happening when anxiety or sadness overwhelms you and then following that with a word or phrase of encouragement. This way you can identify your emotion and speak truth over it!

***Counseling and therapy (this is the most important first step, so want to save it for last so it is most fresh on your mind! Counseling can be a critical touch-point for you during your immediate postpartum, as well as the weeks and months continue to pass. Therapy is a wonderful form of self-care and a great way to get help processing through the many emotions of becoming a mother (whether this is your first baby or your 5th!)

Do NOT hesitate to reach out for more help or resources! That’s what we are here for!

Just know that you are amazing and are doing better than you think!!

ADDITIONAL RESOURCES:

Postpartum Support International Call or Text our HelpLine You are not alone and you are not to blame. PSI is here to help. Call 1-800-944-4773 (4PPD) English and Spanish Text 503-894-9453

Available 24 hours a day, you will be asked to leave a confidential message and a trained and caring volunteer will return your call or text. They will listen, answer questions, offer encouragement and connect you with local resources as needed.

National Postpartum Depression Hotline: 1-800-PPD-MOMS (1800-773-6667)

If medication is needed or desired, here is a list of resources you can contact to discuss that with them:

Dr Deborah Fuller (214) 887-6100 (we can send a referral and get you in sooner if need be)

Chrissy Davis, WHNP-BC Embody Health www.embodyhealthtx.com

***IF AT ANYTIME YOU FIND YOURSELF HAVING THOUGHTS ABOUT HARMING YOURSELF OR OTHERS, IMMEDIATELY LET YOUR HEALTH CARE PROVIDER, COUNSELOR/THERAPIST/YOUR MIDWIVES KNOW.***

FAMILY PLANNING

Nothing would excite us more than having you getting pregnant again but we you to be the one to determine when or if you want more babies.

Many of our clients ask about non-hormonal birth control methods. Here are our favorite resources:

Taking charge of your fertility

Caya Diaphragm

Oura Ring

Temp Drop

If you are interested in a hormonal birth control we are able to call you in a low dose progesterone pill. This is recommended for the first year while breastfeeding as it is slightly less effective as a combo birth control pill. It also needs to be taken at the same time daily.

If you are interested in other birth control methods we can discuss them at your next appointment. If you would like another form of hormonal birth control pills, an IUD, Nexplanon Implant or are considering a tubal ligation we can send a refer to our consulting physician. We also have referrals for vasectomies as well. Our goal is that you are well educated and feel good about your family planning methods.

Birth Certificate

By now you should have received a verification of birth facts and approved it. Once you receive your baby’s social security card in the mail you can order their birth certificate here.

Superbills & Insurance Claim

Please email hello@dfwcommunitybirths.com or start a message with “admin” on your portal if you need a superbill after your final appointment or you need us to submit a claim to your insurance.