24 Nov Post-delivery Recovery and Fibre: Why is it so important?
Just after giving birth, you will go through a recovery and healing period. No matter how your delivery went, your body was under a lot of stress. Now comes the time to face the transitional period from pregnancy to postpartum, which brings a variety of new symptoms.
Usually, it takes at least 6 weeks for the mother’s body to return to the pre-pregnant physiological state. This does not necessarily refer to a return to a pre-pregnant weight though – give yourself time with this! However, how quickly you recover after delivery will depend on many things, for example, how you gave birth: if it was a C-section or vaginal birth.
Just like me, Taryn Watson, a Women’s Health Physiotherapist and owner of FitRight Physio , is passionate about making a positive impact on a woman’s experience in the childbearing years. She states that, “many complications can occur during this new transition period, and if not recognised and treated promptly, it can result in a lot of stress and discomfort for the new mum. Some of these complications include, pelvic floor muscle injury, caesarean scar infection, or abdominal muscle separation, and all can be worsened by regularly straining on the toilet to empty your bowel.”
As in pregnancy, the postpartum period is often associated with many gastro-intestinal disorders, including nausea, vomiting, and heartburn as your hormones and body organs readjust, however, the most troublesome complaint in some women is constipation.
WHY ARE YOU CONSTIPATED?
It’s fairly common to have constipation for the first days and weeks after childbirth, and there are several things that could cause this. For example, it is thought to be caused by the high progesterone levels during pregnancy, being more bed bound while breastfeeding, and the altered eating habits as you adjust to your new routine also affect bowel movements as well. (1) (2)
Likewise, you might feel slightly afraid of damaging the stitches or that a bowel movement will aggravate the pain in that area.
If you have a hard time going to the toilet, it may be because of a variety of different symptoms, and recognising the cause behind them and how to manage it promptly can ensure that it doesn’t negatively affect your recovery.
For example, Taryn Watson mentions that pain in the anal area can be due to haemorrhoids or an anal fissure, both of which should be diagnosed and managed promptly by your GP and pharmacist.
“Pain can also be due to healing stitches from a tear or episiotomy. It is very normal to feel afraid of damaging the stitches or that a bowel movement will aggravate the pain in that area. Managing the pain with manual support to the area in front of the anus, for example with your hand wrapped in toilet paper, keeping the stools a relatively soft consistency, and making sure that you wait until you feel a definite urge to go to the toilet, can all help to ensure that you empty more easily and with less pressure on the healing area.”
“Feeling the need to excessively strain to empty your bowels can be from hard stools, but it can also be from overactive muscles in that area that are tensing to try to protect from pain, rather than relaxing as they should to defecate.”
If this is the case, a Women’s Health Physiotherapist, such as Taryn, can teach you relaxation strategies and exercises for the pelvic floor muscles to help you to relax the muscles when you need to. Check out FitRight’s postnatal pilates and hydrotherapy classes that can help you learn these techniques while protecting and strengthening your pelvic floor.
It’s important to pay attention to these symptoms and to do something about it because they will end up putting a lot of stress on the new mum and may even affect your long term recovery.
FIBRE, WHY IS IT THE KEY?
Although there’s no universally accepted definition for what dietary fibre is, we usually refer to it as a wide and diverse group of carbohydrates that can’t be broken down and absorbed by our digestive system. You can find fibre in all plant foods, including fruits, vegetables, grains, nuts, seeds, and legumes. (3)
Fibre has long been used for the treatment of various medical conditions, including gastro-intestinal disorders such as constipation, therefore, it’s recommended that adults eat about 20 – 35 g of dietary fibre per day (Check out my blog on food labels, to work out how to read nutritional food labels).
You should also know that not all dietary fibres are made the same. There’s a huge variety of different fibres, and each one has its own effect on the human body.
For example, when we want to improve our bowel movements and ease constipation, we need to focus on the solubility of fibre or its ability to dissolve in water, for example, there’re some fibres that are soluble in water and others which are insoluble.
Insoluble fibre, like the one from wheat bran, grains and skins of fruit and vegetables, do not blend with water and pass through the digestive system mostly intact. As a result, it helps to increase the faecal mass and the speed of the passage of food and waste through your gut, having a natural laxative effect. Soluble fibre on the other hand, allows more water to remain in your stool, making waste softer, larger, and thus, easier to pass through your intestines. Soluble fibre can be found in oats, barley, rice bran, psyllium, dried beans, and in a number of fruits and vegetables such as peas, potatoes, citrus fruits, strawberries etc. So, based on this, both types of fibre are necessary for keeping your bowels running smoothly.
HOW CAN YOU EASE CONSTIPATION AFTER GIVING BIRTH?
When you’re constipated, the first rule to improve the symptoms are to make lifestyle modifications. A lack of dietary fibre is always one of the main causes of constipation, so, try to eat fibre-rich foods.
In addition to a high fibre diet, an adequate fluid intake (ideally water or non-sugary drinks) and exercise are important to improve your bowel movements. According to some medical reviews, it’s all it takes to prevent and treat postpartum constipation. However, these can be more difficult to do in practice than you think – especially when you are breastfeeding and requiring a lot more fluids, are still in pain and don’t have much time to exercise.
High-fibre foods such as whole grains, fruits and vegetables can help to relieve symptoms and prevent constipation in the postpartum period.
WHAT ELSE CAN YOU DO?
Bowels love it when you are active, especially in the morning! If you feel up to it, even a short walk after breakfast can get the gut into action. (4)
For some people, abdominal massage can also help to get things moving. Taryn Watson, suggests, “that this massage should be a nice, firm stroke in a clockwise direction around your belly, starting from inside your right hip bone, going up towards your rib cage, across the area above your belly button, and back down towards the left hip bone. A minute or so of this in the morning, taking care not to work through any pain, can work nicely with the dietary and movement strategies already mentioned.”
If changes to your lifestyle and diet aren’t helping enough, you may want to talk to your doctor about taking a laxative or a stool softener. These are different things, but they are both used in cases of occasional constipation. Laxatives are products that help the body to have a bowel movement. In other words, they will make you do a poo, while the stool softener draws water into the stool, making it softer, more comfortable to pass and it is considered to be safe, even if you’re breastfeeding.
There are many types of laxatives, so it’s best to avoid buying laxatives over the counter. Ask your doctor which one is right for you to avoid undesirable side effects, such as dehydration, vitamin and mineral imbalances. In other words, if you use them longer than you need to, it may cause the body to become dependent on the laxative to have a bowel movement.
So, my final advice is to try to ease your constipation problems by changing some dietary and lifestyle habits before considering laxatives or other medication. Seek advice from an Accredited Practicing Dietitian about how you can improve your fibre consumption and also, consult your Doctor and Women’s Health Physiotherapist to know when you can start exercising after giving birth. In any case, if these do not bring relief, don’t practice self-medication, talk to your doctor instead.
I am so passionate about postpartum care to mothers. It is so easy in the first months post partum to forget about looking after yourself. Everyone, including yourself, often focus on the needs of the baby, and the mother is often overlooked. I want to leave you with some powerful words written by Annaleise Lawton and posted in scarymommy.com :
Our world forgets about mothers.
We slip through the cracks.
We become background noise.
And in that, we learn our role…our place in our family unit…to always come last.
Our babies need us…
To be healthy
To know that we are worthy.
To know that Motherhood, while natural, can sometimes feel like the least natural role in our life.
And that deserves attention.
Mothers deserve attention.
We need our world to fuss over us the way they fuss over ten fresh fingers and ten fresh toes.
We need to be seen.
We need to be heard.
We need someone to not only ask if we’re okay but to check time and time again, just to be sure.
We’re not just a uterus.
We’re not just a lifeline to a new and precious soul…
We are mothers.
And we need someone to make sure we are ok too.
So take time to seek professional advice on pelvic floor recovery, wound healing, establishing your breastfeeding supply, supplying the nutrients you need to provide to your baby through breastfeeding, and talking about your delivery and adjustment to motherhood to friends and professionals etc. All of these services, FitRight Physio and Growth Spectrum can assist you in, or refer you to experts in these areas, so please get in touch…and don’t put yourself last anymore!