As you contemplate the journey towards a second or subsequent pregnancy, it's natural to have questions about the best approach for your body and your family. Kelly, a renowned physiotherapist, shares her expertise to guide you through this important phase. Kelly is women's and pelvic health physiotherapist based in Melbourne, Australia. She is passionate about educating and empowering women to move well, feel strong and confident in their own body, and do the things that they love, operating out of Melbourne Pregnancy and Pelvic Physio.
Timing your next pregnancy
When considering the ideal gap between pregnancies, remember that the decision is deeply personal and varies based on numerous factors unique to you and your family. Kelly recommends discussing this with your medical team, including your OB or GP, to determine the most suitable time for you.
Supporting your body and pelvic floor
Before embarking on another pregnancy, it's important to establish a routine of regular exercise and movement. Kelly emphasises that this is beneficial not only for your general health but also for your pelvic floor. This routine can help manage weight, reduce complications, and ensure both your and your baby's well-being during pregnancy. Developing a habit of regular exercise before pregnancy can make it easier to maintain this routine during pregnancy, as long as it's uncomplicated.
For those planning a second or subsequent pregnancy, Kelly shares “If you're already managing the weight of a heavy toddler, your body needs to have a higher level of general fitness, strength and endurance.” Kelly's biggest message to all mums considering (or may be already expecting) another child is to work on overall fitness and strength. Ensuring that you are strong enough to be able to keep up with the extra load of carrying around a toddler (and all the extra STUFF that goes along with that!!) is such an important part of being a toddler parent. It’s also important to work on carrying different loads on each side and in different ways - after all, you might find yourself carrying a toddler on one side, while carrying a capsule, pushing a pram, and/or carrying multiple bags in your hands or on your shoulders. Think of the possibilities!
Additionally, it is "highly recommended to check in with a pelvic health physiotherapist to assess your pelvic floor function and address any pelvic health conditions prior to pregnancy. Even if you aren’t experiencing pelvic conditions, assessing your pelvic floor function can be really helpful to prepare your body and pelvic floor for pregnancy and birth, and recovery postpartum." explains Kelly.
Exercise considerations
When it comes to exercise, the key is finding activities that fit into your life and that you enjoy. When pregnant, or planning a pregnancy, the goal is to maintain a level of exercise rather than trying new, intense activities or striving for personal bests. Most exercise can be modified or be substituted for something similar that is suitable for you and your needs and is dependent on your activity levels and fitness. If you are unsure of what might be best suited to you, seeing a pelvic health physio or other relevant profession is definitely recommended to help guide you through the options.
Pelvic floor exercises should be tailored to your specific needs. “Generally speaking, your pelvic floor does need to be able to contract, as well as relax and lengthen (especially for labour and birth!!), and therefore never assume that “kegals” are the best thing for you to do. Some women need specific exercises to help strengthen or for endurance, some need exercises to work on coordination or speed, some need to work on downregulation and relaxation. It’s always best to have an individualised assessment and guidance around what sort of pelvic floor exercises are appropriate for you” Kelly explains.
Is it likely that my pelvic floor will feel more of the impact this time?
Each pregnancy and birth experience is unique, and various factors influence how your pelvic floor responds. These include your birth history, any existing pelvic health concerns, and individual factors like age and body type. Educating yourself about labour, interventions, and delivery modes, and discussing your specific risks with your medical team, can help you make informed decisions for your upcoming birth.
Kellys top tips for preparing for another pregnancy
- Educate yourself: Understand the risks, pros, and cons of labour, interventions, and delivery modes. This knowledge will help you make informed decisions about your upcoming labour and birth.
- Discuss personal risks: Talk to your medical team about potential risks specific to your body type, pelvic floor, ethnicity, etc., to tailor your birth plan accordingly.
- Organise a birth debrief: Review your previous births to understand how they progressed, the decisions made, and the outcomes. This can inform your approach to your next labour and birth.
- Consult a pelvic health physiotherapist: Even if you've seen one before, a pelvic health physiotherapist can help prepare your pelvic floor for birth, focusing on the ability to contract, relax, and push effectively.
- Address current pelvic health conditions: Existing conditions like incontinence or a tight pelvic floor, can impact your postpartum recovery.
- Be kind to yourself: Recognize that each pregnancy and birth experience is unique. Prioritize your health and well-being.
- Prioritize self-care: Make time for your health, ensuring you are strong and prepared for birth. This includes managing any current injuries or conditions.
- Establish a support network: Build a “village” of support, including family, friends, and professionals like your GP, obstetrician, midwife, lactation consultant, doula, and pelvic health physio. This network can provide invaluable support throughout your pregnancy and postpartum journey.
- Prepare for different experiences: Understand that your next birth experience may differ from previous ones. Having a birth preference list and being aware of your options and risks is crucial.
- Seek professional guidance for exercise: Consult with healthcare professionals to determine the best exercise regimen during pregnancy, tailored to your needs and health status.
“While incontinence, constipation, prolapse, painful sex, pelvic pain and other pelvic conditions are common, these conditions/symptoms shouldn’t be swept under the rug or considered normal - regardless of whether it’s a longstanding condition prior to having children or appeared after your previous/first birth. There are so many things that can be done to help, so if you can, it’s highly recommended to check in with a pelvic health physiotherapist to assess your pelvic floor function and address any pelvic health conditions prior to pregnancy. Even if you aren’t experiencing pelvic conditions, assessing your pelvic floor function can be really helpful to prepare your body and pelvic floor for pregnancy and birth, and recovery postpartum.“ Kelly
Where can I find support and help with breastfeeding?
Lactation Consultants of Australia and New Zealand can help you find a lactation consultant near you.
Ask your GP, midwife, obstetrician, or healthcare provider to connect you with a lactation consultant locally.
The Australian Breastfeeding Association have many resources available including a 24-hour helpline for new mamas, face-to-face workshops, and online classes.
Click the links below to read more on the topics:
How Lactamo can help with breastfeeding
