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Episode 03: How to choose your doula?
How to choose your doula? In today’s episode, I had the pleasure of interviewing Ann Fulcher, doula and head of the Hearts and Hands UCSD
Leslie December 15, 2021
What about postpartum?
Postpartum is no exception. I like to explain to my clients that over the course of 9 months, their bodies have gone through several adjustments and changes due, as we said before, to the baby and uterus growth. Once you give birth, despite the void created by your baby’s birth, your uterus takes some time to shrink to its original size, somewhere around 6 weeks or more in some cases.
So there’s no way you can simply “bounce back” to where your body was before your pregnancy in a few days or weeks (plus you’ll stay postpartum for your whole life, but that’s a discussion for another day).
Moreover, some hormones are still being released in your body for up to 5 months after giving birth, whether you breastfeed or not.
Relaxin, one of these hormones, is responsible for increasing the elasticity of your ligaments and soft tissues in all your joints. That’s why we usually see new moms complaining about their back for several months after giving birth.
If you breastfeed your baby, the breastfeeding position by itself can be the cause of chronic back pain.
Lots of moms struggle to find a comfortable position, especially at night when they are exhausted and just wish for a little more sleep. Be aware of how you position yourself. Nursing pillows are extremely helpful to relax the muscles in your arms, shoulders and back, and having a good and supporting nursing armchair is definitely a must.
Bad posture is also a culprit during postpartum. As I just mentioned, your body went through different adjustments during your pregnancy. And now, all of a sudden, it has to go through different changes again: uterus shrinking, breast growth, changes in hormones, lifting and holding baby all day long.
Plus there are several new tasks that go along with being a mom: lifting baby from her crib or the bath, picking things from the floor while holding her, etc. These can come at a cost on your back health. Again, if your core and back muscles are not prepared and trained in advance, your back may be screaming for help.
Pelvic floor dysfunction can also be one of the causes of back pain. Most women are not advised to spend time on their pelvic floor and ab rehab after pregnancy. And unfortunately, it should be the case in all circumstances. They are sent back to the gym after the 6 weeks check up with no warnings and no guidelines on how to safely go back. If you want to know more on the subject, you can check my blog post on 5 exercises for diastasis recti. A dysfunctional pelvic floor is usually linked to a dysfunctional core engagement. We usually see women not using their diaphragm and deep core muscles when working out and in their daily lives.
Of course, diastasis recti is also a cause of back pain by itself as you core muscles are not playing their protective and supportive role.
Do I have to add that lack of sleep is also playing its role? I guess it goes without saying!
How to be preventive?
Thankfully, all of this is not a fatality. There is a better way. If you get the right information from the get go you can easily come up with a routine to help you prevent and/or address back pain in pregnancy and after.
During your pregnancy:
- Watch your posture, always seek length in your back, avoid to round your back with your shoulders rounded forward, especially when you work out
- Do breathing exercises (I teach it in every single video) to make sure you use your diaphragm properly along with your deep core muscles and pelvic floor
- Watch your nutrition: increase beneficial nutrients to nourish and support your changing body and your baby’s growth
- Strengthen your back and core muscles following the advice in the above video
After your pregnancy:
- Again, posture is of high importance. Be aware of the changes in your body. When breastfeeding or nursing, sit in a comfortable position and try to relax your neck, shoulders, arms and back as much as possible, use a nursing pillow if available
- Do breathing exercises, and place your focus on your diaphragm, your deep core and your pelvic floor muscles. This can be done as soon as you’re ready and from day 1 after your gave birth
- Self-test for diastasis recti to know if you’re having some kind of separation between your rectus abdominis (your 6 pack muscles). You can check out this blog article
- Strengthen your core and start your postpartum recovery with safe, gentle and efficient exercises
8 exercises for back pain in pregnancy
Here is a step-by-step detailed guide of the exercises shown in the video:
1. Cat/cows:
The most common mistake here is that we usually perform this with our hands directly below our shoulders. To have the most natural breathing and avoid placing too much pressure against your pelvic floor, you should slide your hands slightly forward. This way you’ll place the focus more on your upper back (which intends to have the most mobility in the flexion/extension movement we’re taking it through) rather than on your lower back.
Start on a quadruped position. Slide your hands forward. Round your back all the way up in the angry cat position, vertebra per vertebra. Then, drop the back down, arching the back and pulling the tailbone up.
Repeat.
2. Thread the needle:
This one is one of my all times favorites when I feel tensions in my upper back.
Start in a quadruped position, with your hands directly below your shoulders. Bring your right hand across and through and your right shoulder to the mat. Stay there and breathe, relaxing the muscles in your upper back.
Repeat on the other side.
3. Child’s pose:
A classic one, but a good one when one is feeling her back. To make it more focused on the upper back, bring the knees to each side of the mat.
Start on your quadruped position. Bring the soles of your feet together and leave your knees on each side of the mat. Push your butt to your heels and reach forward with your hands. If you feel comfortable, you can place your forehead on the mat.
Stay there and breathe.
4. Side stretch:
We often see people doing side stretches by bending their spine to the side. It’s not the most efficient way of doing and it’s also making it more difficult to breathe correctly through the diaphragm.
Start in a crossed leg position. Bring your right hand to your left lower ribs. With your left hand, reach up to the sky, as much as you can. Each time you breathe out, try to reach further up.
Repeat on the other side.
5. Shoulder openings:
This exercise is really good for addressing posture with rounded shoulders. You can use a long elastic band (theraband) or not.
Start on your knees. Grab the band with your hands in front of you, at your shoulder level and shoulder width apart.
On an exhale, pull the band and bring your hands to the sides. Breathe in, come back to your starting position. Make sure to engage the pelvic floor up, feel your diaphragm moving up and engage your deep core muscles on each exhale.
Repeat.
6. Side raises:
This exercise is great to strengthen the top and back of your shoulders.
Start in a crossed leg position. Place the band below your butt. Grab each end of the band (you can do it without a band too). Breathe out, and bring one side up. Stabilize your shoulder throughout the whole movement. Make sure to engage the pelvic floor up, feel your diaphragm moving up and engage your deep core muscles on each exhale.
Repeat.
7. Overhead presses:
This one will improve your posture and strengthen your back muscles.
Start in a crossed leg position. Place the band below your butt. Grab each end of the band (you can do it without a band too). Put your elbows by your sides with your hands up and facing forward. On each exhale, bring one side up. Again, stabilize your shoulder throughout the movement. Make sure to engage the pelvic floor up, feel your diaphragm moving up and engage your deep core muscles on each exhale.
Repeat.
8. Rows:
A classic one for back strengthening and help with back pain in pregnancy.
Use a piece of furniture to secure your band (I use a chair and place a heavy ball on the seat. I then place the band around the legs). Face it and stay on your knees. Grab each end of the band in each hand. When breathing out, pull on one side. Again, stabilize your shoulder throughout the movement. Make sure to engage the pelvic floor up, feel your diaphragm moving up and engage your deep core muscles on each exhale.
Repeat.
