Thursday, 21 September 2017

Guest post: My Birth Story and the Return to Exercise - by Erin Wright

Each woman has a unique pregnancy, a unique birth experience, unique children, and unique parenting styles. I was always told this, but I never truly understood until having my son Arlo.

My pregnancy was fantastic. I breezed through the first trimester with no nausea, had an excellent second trimester where I felt full of energy and traveled across Canada with family.  During my third trimester I finished my Master’s Degree and I walked across the stage at convocation a week before Arlo was born. I had great energy levels throughout my pregnancy and even worked at a fitness facility where I was doing close shifts until 11pm until I was 39 weeks pregnant. I stayed as active throughout my pregnancy and felt confident doing cardio, lifting weights and teaching spin until the day before Arlo was born. One friend I worked with called me the “pregnancy unicorn” and I understood all too well that my experience was unique to me and to this pregnancy.

As you might imagine, my labour and delivery story is also unique. I will describe my story, but it’s not to scare you. By telling my birth experience, I want to share with you how I was able to recover and get back into exercise.

I was in labour for almost 24 hours (from start to finish). I was positive for Group B Streptococcus (a normal bacteria found in the vaginal tract, but requiring antibiotics in labour) and was told to head into the labour and delivery unit if my water broke. My contractions started at about 5:00am on the Wednesday and stopped at 9:00am. I went for a walk with my husband and after getting to the end of the block, I thought I had wet my pants. I ended up calling the labour and delivery room and essentially said “I know it’s possible I peed my pants but my water could have broke as well”. It wasn’t the usual “gush” you hear about. My water did break and I was induced around 1:30pm that afternoon.  I did get an epidural. My contractions were coupling (coming two at a time with no breaks) and with little sleep the night before I couldn’t relax. After receiving the epidural, Arlo’s heart rate fell and at one point we thought I was going in for an emergency cesarean section. Arlo’s heart rate dropped one last time and the doctors needed to get him out immediately. I was told to push (I maybe had time for 6 pushes) and heard the words forceps and episiotomy. In the midst of the emotion, all my husband and I were concerned about was the safe arrival of our unborn child. While I did have a vaginal birth, I sustained 4th degree tears.

Arlo Jasper Vriend was born at 4:01am on Thursday November 24, 2016. Thankfully, we heard Arlo’s little cry a minute after he was born and he was placed in my arms five minutes after delivery. I required stitching that lasted about 45 minutes and was told “this is about as bad as it gets when it comes to tearing”. I was terrified. Not only did I have a newborn child but I was unsure what 4th degree tearing was. I had no idea what kind of trauma I sustained. How was I supposed to look after this newborn child while unsure if I could walk, go to the bathroom, or look after myself?

What I learned is, many women who have a vaginal birth will have a superficial tear that heal relatively quickly and do not require stiches. A small percentage of women who deliver vaginally end up with a more serious tear in their perineum that extends to or through the rectum. A third-degree laceration is a tear in the vaginal tissue, perineal skin, and perineal muscles that extends into the anal sphincter (the muscle that surrounds your anus). A fourth-degree tear goes through the anal sphincter and the tissue underneath it.

I’m here to tell you that you can and will return to exercise after whether you have a “traumatic” birth or a birth with no complications. You will be able to return to exercise after a cesarean section. It may not look the same, you might need more time to recover, but you will get back to it. I’m going to share with you my five tips for an effective recovery to ensure you return to exercise the right way.

1. Take your time and rest.
I took almost eight weeks off of any exercise other than walking. For the first three weeks I had to sit on an invalid ring (the official name for a donut – not nice!). There felt like a large led weight in my pelvic floor if I walked for any duration. I truly believe that taking the time I needed to truly heal the trauma part, was crucial. Yes – I almost went stir crazy in the house and the hormones didn’t help, but had I not taken the time I needed, I might never have healed.
2. Take the medication you need.
I was prescribed some pretty heavy duty pain killers that I needed to take every three hours. At one point over the Christmas holidays, I figured I could tough it off and get off the pain killers. I realized very quickly, I didn’t need to be a hero (and wasn’t very good at it). Check with your doctor and pharmacist that the pain killers are safe, but take what you need to heal. While you need to look after this newborn baby, you need to look after yourself. And if you are in pain, that’s very difficult to do.
3. Go see a pelvic floor Physiotherapist.
This is probably the best advice I could have received and could give to you. Even if you didn’t receive 4th degree tears and even if you delivered via scheduled cesarean section - GO SEE A PHYSIOTHERAPIST. I had the opportunity to attend the Royal Alexandra Hospital’s pelvic floor physiotherapy clinic because I had such severe tearing. I also sought out a private physiotherapist who specialized in pelvic floor therapy. The internal exam was scary but so was my first bowel movement with 4th degree tears (was it going to open my stiches?). All three physiotherapists that I saw provided me with techniques for safe bowel movements, exercises to repair and strengthen my pelvic floor and make me feel like I was normal again. I am happy to report that I have not struggled with bladder incontinence but still struggle to hold gas from time to time.  I still complete my exercises (including relaxation exercises) and feel stronger than ever.
4. Ask for help.
I spent a lot of my first two months with Arlo healing and learning about myself and my new family. I am fortunate to have amazing family and friends nearby who were more than willing to help when I needed it. People were more than willing to provide food, advice, gifts and a listening ear when I needed it. I couldn’t have done it without them.
5. When exercising again – seek a post-partum exercise specialist and do the modifications.
I am an extremely competitive person. I have always been an athlete and a competitive athlete. Not exercising intensely for eight weeks in the cold of winter nearly drove me crazy. At one point two weeks post-partum I cried to my husband saying “I used to be a productive member of society and now I sit and breastfeed for five hours a day!”. Having a baby is a big change and so when I was cleared for exercise, I wanted to jump right back into where I left off pre-pregnancy. Just because you are cleared for exercise by your doctor doesn’t mean you can go all out. Just because you had a cesarean section and are cleared for exercise, doesn’t mean you can take the highest intensity route. Your body changes after pregnancy and needs time to heal (more than eight weeks). The only reason I can run, jump and exercise at this intensity now is that I attended Fit Your Life classes (with Jamie and Kellie) and chose the low intensity exercises for another 3-4 months post-partum. I needed to re-learn how to control my pelvic floor and exercise with breath and purpose. Don’t rush back too fast. I know it seems slow but you can and will get back to full exercise, in due time.

I’m sure there are many other tips out there. What did you do to return to exercise? Did it take a long time? This list is not exhaustive. Everyone will have their own unique journey back to exercise, just as each pregnancy, labour and delivery, and baby are unique. One thing that I learned for sure is that women are superheroes. I am amazed by the body’s ability to grow a beautiful human being, sustain such trauma, and heal again. Remember – you are amazing!


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