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Home » What Your Momma Never Told You About Childbirth: Marianne Ryan (Transcript)

What Your Momma Never Told You About Childbirth: Marianne Ryan (Transcript)

Here is the full transcript of physical therapist Marianne Ryan’s talk titled “What Your Momma Never Told You About Childbirth” at TEDxWilmingtonSalon conference.

Listen to the audio version here:


Pregnancy and Childbirth: The Journey Begins

Pregnancy and childbirth can be an amazing experience. I remember how excited I was when I first found out I was pregnant. And I couldn’t wait for the day I was going to hold my child in my arms. But along with the excitement can come some physical problems that can become permanent, like back pain, pelvic pain, a leaky bladder, and a flabby tummy.

From the moment we become pregnant, a special bond forms between a mother and a daughter. I remember all the great advice my mom gave me, and I still hear her New York accent. One day, when I was complaining about morning sickness, she said, “Don’t worry, Marianne, I know how to handle it. Just put a plate of saltines on your night side table, and every time you get out of bed, eat it.”

Okay, it didn’t work, but okay. She also suggested I use supportive shoes, and then she bought me a pregnancy girdle, and this thing was huge and made out of rubber, and it was supposed to stop back pain or prevent it, and I never used it. But she did give me lots of good advice, because she wanted to make sure I had a healthy pregnancy.

Preparing for Parenthood

And she wanted to also make sure I was fully prepared to take care of her grandchild. So that’s why she shared so much information about what it was like to be pregnant herself, and gave me great tips on how to prevent, or how to take care of, my newborn baby. But what I wonder, with all of the tips and advice my mother gave me about pregnancy, why didn’t she warn me about what might happen after I deliver? I mean, she had plenty of opportunities.

Why didn’t she tell me during one of her millions of trips while we went shopping for nursery furniture and the baby’s clothing? Or one of the many times we sat in a restaurant, and instead she would reminisce about her pregnancies and what it was like to carry me and tell me the same story for the hundredth time. I wonder, did my mom ever think about the physical punch my body would take after childbirth? I know she meant well.

Postpartum Reality

Maybe she just thought I was one of the lucky ones who wouldn’t experience a problem. Or maybe she thought there isn’t anything she can do about it now, so why worry her? Thanks, Ma. As a woman’s health physical therapist, what I’ve noticed and discovered is that women assume that their bodies are just going to magically snap back together right after childbirth.

If you’ve been through childbirth, you know this isn’t true or realistic. And what you might not understand is that after childbirth, your body is less efficient and the muscles are weaker. The muscles that used to support your pelvis and belly are now all stretched out and a lot weaker than they were before you were pregnant. And this can leave your body and make it more unstable and can lead to developing injuries.

The Misconception of Recovery

And it takes time, a lot more time than you think, to regain the strength of these muscles. So women, beware. When you go for your six-week postpartum checkup to your doctor or healthcare provider and they say, “everything looks normal, you can go back to all your normal activities,” it doesn’t mean your body fully recovered.

The danger is, moms usually tend to focus on taking care of their babies and ignore their own personal needs. They go back to business as usual, they start doing their pre-pregnancy activities and with the added responsibility of taking care of a newborn baby. And this is just too much, too soon. By doing so, women are at risk of injuring themselves.

Seeking Help

Now, the best way to prevent injury is by going to a physical therapist for a thorough evaluation when you’re six weeks postpartum, that’s six weeks after giving birth. That way, you can find out where your body is and how to gradually and safely add activities to your schedule until you get to your normal activities.

But here’s the thing that really drives physical therapists crazy. New mothers often think, and are often told, “It’s normal to have back pain, it’s normal to have pelvic pain, and so what if you leak a little urine? It’s normal after childbirth.” It might be common, but it’s not normal. And it’s not normal to live with these problems. Gals, you got to listen to me.

The Importance of Addressing Postpartum Issues

If you leak urine, it means the support system that’s holding up your bladder has a fault in it and you need to seek help and go get it fixed. And if you have pain, guess what? It means something’s wrong. Please try to take the time out to figure out what’s causing it and get some help to get rid of it. If your body’s screaming at you, please don’t ignore it.

So that’s not the whole story. Research has shown that these problems can linger. One year after childbirth, 77% of women reported having back pain. 49% of women reported having incontinence. So, that means one year after childbirth, three-quarters of the women said that they had back pain, and half of them had incontinence. Eighteen months after childbirth, 24% of women complained of having painful sex. Now, do you think a guy would put up with that?

A third of the women also complained of flabby tummies. Now, the medical term for that is called diastasis recti, and that’s where the six-pack abdominal muscles spread, and this can make a woman look pregnant when she’s not. But that’s not the problem. The problem is that that condition can also lead to chronic pain and incontinence.

And believe it or not, these problems, these conditions, can show up as problems years later. So even if you’ve made it through childbirth without any problems, it doesn’t mean you’re in the all-clear. That’s why I tell women, once postpartum, you’re always postpartum. Moms are often shocked when I explain to them that the incontinence or the pain that they’re experiencing today could be directly related to their childbirthing experience that they had 10, 15, 20 years ago.

A Personal Journey to Healing

My best advice to new moms is don’t do too much too soon. I’d like to tell you a story about a patient of mine, and we’re going to call her Megan. She had a great pregnancy without any complications and a terrific delivery experience. By the time she was going for her six-week postpartum checkup, she felt good. She was told everything looked good, you can go back to your normal activities, you have the green light.

So Megan — being Megan, she was very excited. She went back to the gym and resumed her gym program and then also all of her other household tasks. And everything was going well until suddenly, without warning, she felt something really strange. She said, “I suddenly wet my pants, and I felt as if I had a golf ball in my underwear.” She looked in the mirror and was absolutely horrified. She saw something poking out of her vagina.

She called her doctor, made an immediate appointment because she knew something was terribly wrong, and was diagnosed with pelvic organ prolapse. And that’s a condition where the pelvic organs like the bladder and the rectum can move downwards. And this can become a serious problem and lead to incontinence, chronic pain, and a lot of times surgeries. So even though Megan had no problems right after childbirth, she developed them because she put too much strain on her body by doing too much too soon. So anyway, so after three months of physical therapy, she had a great recovery.

The Importance of Awareness and Action

And this was lucky for Megan, and it was good that she did this because she was wise and sought out physical therapy treatment. But this isn’t the norm. Do you know that most new moms don’t consider going for physical therapy treatment if they’re in pain or even if they have to live with the embarrassment of incontinence? And you might be saying to yourself, why, why aren’t they going?

And the answer is really simple. They don’t know it’s an option. And I know, I’ve been there. I am going to share something that’s a little personal. After my first pregnancy, I suffered with chronic back pain and a leaky bladder for over two decades. And I didn’t know there was anything that I could do about it. Until about ten years ago, I read an article about how French women all go for physical therapy treatment after each baby for two to three months to rebuild the strength in their pelvic floor and abdominals. And the French had been doing this for decades.

I didn’t know that there was treatment for this. So I became determined to fix my problem. For a couple of years, I tried several different programs, including physical therapy, biofeedback, acupuncture, meditation, various exercise programs. I did Kegel exercises until I was purple in the face. And nothing helped. So I decided I had to find a solution. And I did tons of research and countless clinical trials. And as a result of what I learned, I created an exercise program that works. And that was it.

I solved my problem, I am fully healed, and now I can offer to help others do the same. My program comes in the form of a book and can be used in conjunction with physical therapy or a woman can do it on her own. It’s unfortunate, but in the United States, most mothers go home or are sent home without proper information and support about postpartum rehab or rehabilitation. The focus in medical care goes from the mother to the baby.

And I remember when I was leaving the hospital, my doctor gave me a pat on the back for a job well done and a piece of paper with Kegel exercises on it. That was it. And this is really sad because studies now show that these problems are preventable, they can be reversed or at least made better by the proper medical care by a women’s health physical therapist.

Towards a Healthier Future for New Moms

It’s essential that we focus on the physical health of new moms to prevent future chronic problems. That’s why I believe in providing women with the right information and options so that they can make the decision to control their own health and life. Physical therapy is not common or is uncommon for after childbirth, but I’d like to make it the new norm. And we can make it the new norm if you help spread this message with your sisters, friends, and colleagues.

You might want to give them three pieces of advice. New moms, please don’t do too much too soon. It might be common to have physical problems after childbirth, but it’s not normal to live with them. And physical therapy can help a woman fully recover from childbirth, and you deserve it.

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