Prolapse in Parenthood, Clare Bourne

Prolapse in Parenthood, Clare Bourne

Pelvic Organ Prolapse is a diagnosis often accompanied by fear! Clare is changing this by normalising the narrative and sharing valuable information enriched by personal and clinical experience. 

If you are a parent (or not, as this is NOT a diagnosis limited to postpartum)  and the topic of prolapse impacts your daily life, be it; talk of a pregnancy, exercise, heavy lifting, intimacy …We discuss it all! 

 Todays Guest:

Clare Bourne is a pelvic health physiotherapist with a passion to support women and men throughout their lives. She believes in talking openly about taboo topics and ensuring everyone feels comfortable to get support even for problems that may feel embarrassing to talk about. She worked extensively in the NHS before starting up her own private practice. She is a Mum of 2 and has learnt first hand the importance of care and support during the perinatal period. Clare is the founder of All About Mum which provides postnatal education cards, webinars and ebooks to support women with all the information they deserve. 

Links:

www.clare-bourne.com

IG: @clarebournephysio

To recommend interviewee guests and suggest topics, please leave a review for the show along with your suggested topics.

More from Candice 

IG: @nurtureyourvagina 

NurturePelvicHealth.com 

Use the code NURTUREPOD for a 20% discount on any courses.

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If you want to learn tips and tricks to manage symptoms from home, you can sign up for the “Bladder Bootcamp”

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Disclaimer: Material and content discussed on the Nurture Pod are intended for general information only and should not be substituted for medical advice 

Thank you and as always, stay curious!

Candice

Transcript

pelvic organ prolapse if you are familiar with this term or if you are living with pelvic organ prolapse I'm pretty sure that you are aware of the accommodating fear and anxiety and worry and shame that comes alongside a diagnosis such as prolapse today we are speaking to Claiborne a pelvic Health physiotherapist a mum a businesswoman as well as an individual with prolapse she is giving us an unfiltered and informative interview that is just so full of relatable information we're talking about the symptoms you might be experiencing about future pregnancies delivery cesarean versus vaginal deliveries and whatever it might look like in between as well as exercise she is giving us her lived experience as well as the clinical experience in and around prolapse Claiborne is a pelvic Health physiotherapist with a passion to support women and men throughout their lives she believes in talking openly about taboo topics and ensuring everyone feels comfortable to get support even for problems that may feel embarrassing to talk about she worked extensively in the NHS before starting up her own private practice she's a mum of two and has learned firsthand the importance of care and support during the perinatal period Claire is the founder of all about mum which provides postnatal education cards webinars and ebooks to support women with all the information they deserve prepare to leave today's interview feeling validated and feeling as though you can advocate for your Comprehensive Health and well-being in its relation to prolapse enjoy welcome to today's episode of the nurture part where we will delve into curious questions in pelvic health I am Candace Langford a pelvic Health physiotherapist eager to explore the minds skills and expertise of public health professionals and of course share those conversations and learnings with you but first let's talk about bladder leaks are you using the correct pads or panty liners because periods are not the same as P I'm excited to share that lilits have a new range of dry lock pads and panty liners specifically designed for incontinence with three times more absorption pads and panty liners are not a Band-Aid solution to leaks as a pelvic Health physio I believe that the correct products play an important role in giving you the control and the confidence to move through your day whilst working with professionals to improve your symptoms all right hello Claire and thank you so much for being here today um I as I've mentioned and wanting to ask you a really important question because I feel as though you've got some incredible insights to share with everyone that is listening and that question is going to be in and around um prolapse so I would love to know your personal insight as an individual that has spoken up about having prolapse but also someone that is a mom as well as a pelvic Health physio that is really well respected within the industry so if you could ever so kindly just share with us um you know just your perspective your Insight your knowledge that we can all take home and learn and gain from oh yeah well thank you for having me I just love these conversations and I think they're so important um to keep having because I still think prolapse as a topic is still not spoken about very much um and I think our narrative around it is hugely changing I guess from even when I trained and was first working in pelvic Health just over 10 years ago to where we are at now is a very different conversation so it's really exciting and um you know I think hope and promise for women is growing um and I think but I think there's still much more for us to do around spreading that word so um yeah so I guess you know I had so much knowledge about prolapse you know like I was working in pelvic Health before I felt pregnant before I had my kids and and I guess just a bit of background about what prolapse is in case anyone's listening it doesn't but I mean we're talking about pelvic organ products obviously we can talk about other prolapses that occur in the body like disc prolapse I guess is another one that we hear but from a pelvic floor pelvic organ point of view and again this is like a fascinating Topic at the minute because what we've always said it's like where a pelvic organ drops or falls down and falls down into the vagina Canal now there's these theories coming out about is it you know more like about tension and that they're being pulled um and there's great physio in the UK called Anna crowl who's doing some fascinating work and kind of research in that area um and so I think you know the workaround classification is also being really challenged at the minute you know we used to be like it's one two three four now we're starting to have the discussion of is grade one actually within the Realms of what we should be encouraging as normal postpartum um just within the Realms of normal of life that there are going to be changes like we all know we have skin changes like our face skin changes the age or body skin changes we change and so therefore our vaginal skin will change and tissues will change so you know it's it's one of these things where I think we're constantly this evolving conversation which I think makes it really hard because you then you don't really know where the goal posts are but I think for me and all of it the most important thing regardless of the theory but regardless of the classification is the woman in front of us and that we're working with and what she is feeling what her symptoms are and what we can do with the pelvic floor with the pelvic organs with emotionally her goals her lifestyle what we can do to help her because really aside of all the like you know the I guess the grading all the structural stuff you know really is the life in front of us that matters the most so you know I often say to women like try and not think too much about the grade and the like all of those bits and pieces because actually isn't that's not going to change how you feel as a person and your life itself is helpful and it can shape certain decisions that we do make but let's try and think about practically how we make your life as easy as possible and I think I knew all this but when I like lived it it was just like trans just transformed I guess my perspective and my experience really you know I was 28. so I was you know young and um you know those words you know you've got a prolapse oh I think the things that really as women we kind of fear the most yeah it's funny isn't it because I feel like incontinence is become a much more accepted part of life motherhood laugh off a bit more and I think it's a funny thing because I think incontinence though like it's not something I've experienced so I don't feel like I can fully give an opinion on it in that sense but I think the way women are like always like I can avoid it I just don't go on the trampoline or I just don't go for a run there's ways of avoiding I guess that symptom when it's very very structural change like prolapse which gives a very ongoing symptom all the time it is very hard to get away from it and unless you pretty much do nothing and lie down all day the chances are you can't really Escape your symptoms so they are very different and I think how is something to deal with them is very different neither should be accepted as normal or you know you're just something you've got to put up with but I think they are very different experiences and I think yeah I had never really realized how much I would feel like I had aged just through those simple words and I think that really expressed to me how much we've got to do around The Narrative of prolapse and younger women that it isn't just something that you're going to have when you're 60 or 70. it's something that you could be navigating for more of your life then you're not navigating um equally we can't be saying to 28 year olds well you can't exercise anymore don't lift anything it's like what actually is that I've got one child I want to have another one you know I I really enjoy exercise like I can't do nothing for my bone health at 28 you know and I'm gonna hit menopause and what I'm not going to do anything for like 60 years of my life like it's just unrealistic and unsustainable and completely unhealthy and so I think it's really driven this passion in me to be like let's really understand why like why do we have these narratives and more importantly like how can we make this approachable and applicable to women so they can live their life because you know I would literally fear picking up my child like that was a real fear and like now I don't but having that feeling where you feel like you're almost choosing do I do with the child should I lift the child can I not lift the child like as a mother that is so conflicting against all of your natural desires to look after your child but obviously you're uncomfortable and you care about yourself and it's exhausting that's all I can describe it as is this constant like tug against yourself and these like voices in your head that are like if you do that it's gonna make it worse if you do that it's going to make it worse you know and it's finished yeah yeah so much fear and it's funny isn't it because I think when I question that fear I think that fear very much came from my training of what I had been told to tell women it wasn't actually true for my situation but you know and I remember speaking to quite an experienced physio who was like you know just keep your pelvic floor strong and keep your weight down and I was like that's really fascinating and look I get the whole conversation around weight but equally what we do to women is we're like don't exercise don't lift anything don't lift anything heavy and don't put on weight yeah sorry um how exactly and I'm probably pretty low about myself and you're telling me not to it just is like what and when you break it down like some of the stuff that is said to women is utterly crazy and you know yeah in one breath we're saying lose weight and then the other breath we're like but don't exercise and it's like you know and these women are like fearful to walk down the street you know so you know I think there is just so much still to be done around this conversation to empower women and I think just help them to understand just like what's really going on I say to him and I find it really fascinating that like changing breast tissue and breaststroke you know this breast skin you know droopy boobs completely acceptable droopy tummy completely acceptable concept of vaginal changes what yeah no way but I'm like really like it's just another part of change that we do have to come to accept the the symptoms yes we want to deal with the symptoms but the fact that there are structural changes are we really surprised there's a lot of structural changes that happen in our body and actually when I started to piece that together for myself I know there was clear differences but actually when I started to be like my body has been through a lot it has grown and stretched two times there are going to be some changes now what I do with those changes is what matters but actually expecting the fact that there has been change was a huge step for me in the right direction that actually I wasn't constantly pushing back to a time that I was never going to get back to like I was never going to pay 25 again you know that was not going to happen so either could accept where I'm at and try and move forwards or I don't and I stay where I am looking back and it yeah yeah I love what you have just said now you've I mean I'm I'm just thinking I'm so I'm so grateful that you are sharing this very personal story um because you've just added I mean even to me completely changed my perspective and I think it really can only come from someone that's lived it and wow okay so the things that are really standing out to me is that you know we we our our skin changes our boobs changes you know and we're okay with that and it's just it's flabbergasting I can't think of another word to to think how crazy we've felt it is in order for there to be vaginal change changes or public organ changes um and I think that weighs into the whole bounce back mentality that a lot of us have been exposed to um we we see other changes in our skin for example but no we must use these creams in order to reverse those changes and you've had a baby but oh never mind that we need to make sure that everything looks as though you haven't um and definitely something that we need to move from but I really like this relation that you've made between a skin and our other tissues and everything else that we we have in our bodies and to our public flows too and and then the way that you've spoken about how um we've been told or we've made to feel and even in our training and I can agree on that how um we've been told how little one must do um and that these these words and words matter right we speak about a prolapse disc and that is just surrounded by so much fear and anxiety of movements and now we've used that same word for the pelvic floor and then we use descriptors of pelvic organs dropping into the vaginals now you know this really scary thing and I mean where they're dropping to are they going to drop out are they going to fall out and that just exacerbates this the sense of fear and us um and further causes us to like you say be fearful of picking up your own child um and then questioning your your future like you said I want to have another child like but I'm scared of picking up this child and as a physio you were able to almost adjust that perspective and and slowly see okay I've been told this but this in my lived and personal experience that doesn't actually make so much sense I can't just sit and do nothing and lose weight and not pick up my child um but the average person doesn't have that perspective they don't have the background and the training and the kind of critical thinking and the problem solving that we've been trained to develop um so thank you for sharing that and um I really hope that that just mindshift said it settles in with so many people so that they can realize hey yes if I Google it might say don't do this whole long list of 10 things but I am a unique individual every single prolapse symptom and experience is different and there's so much that can be done I'm going to stop talking and I'll um I'm clearly getting very excited about this very biosecosocial approach that you're taking um um yeah so I'm going to ask you to just carry on on um the kind of trajectory that you were on and if you can maybe just share with us some of those symptoms that people might be experiencing because there's lots of different terms and around um prolapse and although this sounds like it is changing with the colleague that you mentioned um but if you can share maybe some of the symptoms and then how that really comes into our life you know what we can do about it how does it impact exercise um work future pregnancies Etc and yeah of course so I think you know like main symptoms that women report are this like heaviness this dragging and it's funny because again I'd heard that description and I was like I have no concept of what that feels like and then I felt it and I was like oh that's what they mean and it is it's quite an intense like heavy draggy feeling and so but equally some women don't and this is what's really interesting you know some women will just be bladder and bowel symptoms like not being able to empty fully um of their bladder and bowel some it will be it you know um discomfort with intercourse but to reassure a lot of women and there was so much fear I know but in you know you feel like my vagina is different I therefore feel different I don't feel as sexy because I know my body has changed but I say the majority of women that I have worked with going back to sex they have been absolutely fine it hasn't been painful their partner doesn't know you know no one's there thinking like oh gosh she's like broken for life you know no one's actually thinking that so just to reassure it on if they listen that you know that is something that's a very real fear and there's nothing for me it's like I feel the feelings that's totally valid you know like I'm like we need to talk that out don't just think oh that's a silly feeling it's a valid feeling feel it and then we need to talk about it and then try and think about how we move on from there because I think sometimes it's just like we just say to people oh no don't be silly that'll be fine it's like it's not silly it's a very valid and a real emotion that we feel and ignoring that is not going to get us anywhere you know you need to engage with that fear um but yeah so I think sometimes sex is an issue Sometimes women describe this and someone's saying to me just in clinic yesterday this like I feel like a bubble in my vagina like this is like a bubble that you can't pop and I just like want to like wiggle to try and see if I can move it so that's not people don't often talk about that one but I've heard a number of women say that to me I mean you never see that on like any well for us in the UK like NHS NHS symptoms bubble feeling um but loads of women do report that um The Sensation that my vagina is just not quite right that there's something there like just so many different things that women describe it as and but I think a really important thing that you were saying there around fear and this is where the whole relationship with the poet floor and prolapse I think is so key is that again like all the focus has been on strengthen the pelvic floor get the pelvic floor as strong as possible and then it's going to do all the support and then hey Presto you're going to be as you know fine as possible whereas actually again that just leaves no space for the other end of the spectrum as we know as physios or tension and actually I think I'm seeing more and more and this is not research based this is very anecdotal but also speaking to a number of physios you know I think actually when you're when you're fearful as you say that everyone's told you everything's falling out of you what do you do you hold on to hold everything up because you were like I'm not letting go because that means everything's falling out of me so that leads to more pelvic floor tension or maybe not even tension but just a pelvic floor that's not moving through range it's a limited pelvic floor that pelvic floor can't then respond to the lift of the heavy toddler to the cough to the run to the sneeze and I think through that we're then actually totally disempowering women because they're so busy holding that they can't do the thing that they need to do to help their symptoms so I think what I always say to women is like and I say this is a majority of them we just need to let go and we need to feel safe that letting go of our pelvic floor is not going to equal worsening of a prolapse or everything falling out of you and interesting I said my own personal stories actually I am only symptomatic now when I get pelvic floor tension so often it's it's almost like once a year now there's something stressful happens or life gets a bit Bonkers and then I'm like I'm really symptomatic again and I'm like what's going on I can feel my old scar tissue I go and see my physio friend she's like your pelvic floor's got really tight again you know and probably because I'm then symptomatic I'm then like oh let's do all the squeezes let's hold you know ah and then not fully Letting Go not breathing well we realize you know we resort that sort the pelvic floor a little bit do my breathing again my symptoms go away amazing yeah amazing but this is the other crazy thing is that we think symptoms are worse prolapse has progressed and yet often there's been no further progression of the actual structure of the prolapse it's actually just the structures around it that have had problems and again but again we're just I don't think we do this well enough with women we're too busy just like do your key goals we won't give you much advice but just go squeeze they don't know how to do it correctly probably working in detention and then we're like oh well it doesn't work for you the other thing that blows my mind is that we're like you've got to prolapse okay maybe you do want to run and then women are like you've told me I can't do anything we'll screw you I'm just going to do it anyway we then don't do the functional rehab so we go from like do a few kegels and sitting okay fine didn't what we'll just run anyway I'm like what are the injury in the planet do we say do a couple of exercises lying down cool run 10K what no I know I know and yeah unfathomable it's not normal you're just literally like how does this become any way accepted practice and when I say it's women I'm like if you had a knee up or you had tore your quad would you literally do a couple of bridges on the floor and then run 10K and they're like well no obviously I wouldn't and I'm like exactly so why when we tear our pelvic floor through childbirth we don't rehabilitate it in standing we don't load it graded we don't introduce impact gradually you know after ACL replacement okay fine slightly different but you know there's all these protocols I remember as a physio it was like you need to do this you need to do this you need to get them standing you need to do multi-directional hopping and you need and then you might do a graded run perfect floor yeah crack on bonku it's just so mad so I love this word Bonkers pretty very British hey Bonkers um yeah I just it really blows my mind but I think the more we get that message out there that there is so so much from doing some key goals to running or jumping or lifting you know I'm five years and five and a half years postpartum after my first when I was diagnosed I have now got into lifting weights amazing yes amazing yes yes and I'm loving it now there's many reasons I didn't get back to it sooner structurally I probably could have done however I didn't because I was tired I had a toddler I was busy I hadn't done the rehab I felt like I needed to I just wanted to do another pregnancy and just you know get through all of that and now I'm ready like now I'm ready and that's great and I think the main message to women is it just because you haven't done it six months postpartum just because you haven't done it a year postpartum doesn't mean it can't or it won't happen it's just give yourself time you're just you're never you're never too late to give it a go you know and I want to get back to running and like there's been just constant things as to why I haven't I know I know physically I could but again this is the thing as a mother there are so many factors there were so many factors that contribute into your life it's not just about okay I'm physically ready oh good let's go there's tiredness there is ill children there is constant having to learn how to parent in a new phase of life like oh I've now got to learn how to parent parent two children oh now I need to do it at a pandemic oh now I've got to do the school run okay now I need two one in Nursery here and one in school there okay now I've gone back to work now I've got to do work and this one there's always something you know and it's just giving yourself Grace I guess to have yeah time to do it so I've probably just gone on loads of tangents there but I I think you've done an amazing job of of depicting that we are real people and we have got knives and we are not robots and we you know we we need a personalized approach and if anything everything that you've said right now has just highlighted the importance of anyone with prolapse or thinking that they might have prolapse or having funny symptoms such as bubbles in your vagina you know go and seek help because there isn't just this kind of Stark standard go and do x amount of kegels a day that's going to help you it's what are your personalized goals where are you right now are you planning on trying to conceive do we need to work towards you feeling comfortable and confident with that first as opposed to just being like okay well I want to feel like I'm 25 again I would like to run a marathon and I also would like to have a baby next year and I also think I've got two grade two prolabs and someone said this hot this horrendous word of things dropping out of you know and we are multifactorial and what you've just said is just highlighted that there's so many little things that weigh into your experience and your comprehensive rehabilitation that we can and that we need to bring in so I don't I don't feel like that that was a tangent at all I feel like that's a really real life story that a lot of people are going to be living and listening to and thinking oh my word I feel so validated oh my gosh I'm not broken I'm a word I was also scared of lifting up my child but whoa Claire said she's she's not really right now to run but she can run and her body's capable of it and she's had prolapse and then another pregnancy and then another delivery you know um whether it's CU um cesarean or vaginal doesn't doesn't matter we can do both um but yes yeah I think a lot of people are feeling very supported right now by um your your shared experience um I would like to know from you Claire um the the things that tend to pump up a little bit and you're welcome to just kind of go as brief as you want on these um is like I've said pregnancy and delivery can you just share you know because I know a lot of people might be feeling like oh okay I cannot have another baby or I'm so scared of a vaginal delivery um I know that it's possible so can you can you share what and what this experience might be and and yeah so I always say to people it's like listen if you don't want to have more children that's cool but please don't let this Define because we should be able to support you enough to make this a possibility if you want to in an Ideal World explore ex you know expanding your family and I think the main things I would say is there is not a foreground conclusion that pregnancy is gonna make your prolapse worse a and that you are going to feel worth b sometimes women feel better because you get all this amazing estrogen again you get all this amazing plumpiness in the vagina and actually you feel better and I was shocked I was like I was always waiting for that day when I felt worse and it just never came I just felt good so I was like oh okay and look I did the work I did the rehab I kept going with my poet Floyd kept active so you know but I was really surprised and then I think the other big fear I mean in some ways what I say to women is sometimes you've just got to get pregnant and then deal with everything afterwards like I knew I wanted more children I remember saying to my husband I've just got to not think about it let's just get pregnant and then I'll just have to see how my body responds and we'll make decisions about birth when that comes because I'm someone who would love to plan it all and know every single step but I couldn't because I just didn't know how I was going to feel and obviously I was open I was like if I feel terribly worse I'm open to the Cesarean but if I don't then I'm open to um you know a vagina delivery as well so I've had a vagina very first time and you know in an Ideal World I didn't want to have surgery I I didn't yeah for me the idea of an epidural freaks me out the idea of surgery kind of freaks me out which it's weird because like I'm so medical and I love medicine and I think it's magical but like it's just for me personally I'm just not great with that so I was like you know I've done the vagina birth I'd quite like to do that so I think the hardest decision and the most important thing when you're trying to decide and I truly don't think it's black and white and I truly don't think you should in any way feel pushed into one decision of the other I don't honestly feel that there is an absolute right and an absolute wrong decision in it as well I think you could probably I always say you can argue both and you could probably do both and also be happy I think the most important thing is that women feel heard they feel known um and they feel again validated in what they're feeling at that time so for me my decision was okay I'm feeling pretty good ideal scenario I would like a vagina delivery I did think about my other delivery and how I felt certain things would potentially contributed to my experience I had a longer second stage and all the things I and I got my Hospital notes and I went through it because I wanted to understand I was like I want to understand what went on so I can then make decisions about this delivery and long story short I went decided I'd like to go for a home birth because I actually I had a relatively quick label and I found the transition into Hospital quite impacted how my labor progressed so in the end I was like and it was actually my husband who is medical as well who I thought was Bonkers when he suggested a home birth because I was like you're a doctor you shouldn't be saying let's have a baby at home get all the help but he's like no he's like I saw your labor we were great here everything was going to plan he's like I think you would have had the baby here if we hadn't tried to transition in so we got the right support we've got midwives here and actually I had a very very uncompetent super quick for John delivery in our kitchen um in a pool and it was amazing and it was the most intense hour of my life but you know he arrived and nothing progressed and you know it was I felt a bit more symptomatic for a bit yes and I was anticipating that you know my parent floor still had a big stretch I still had a slight scar that and wounder had to deal with and so that's always going to impact things but again I was so much more empowered I had the live knowledge that even if I feel worse now I can get better and that experience is so different once you've lived it first time so but what I say to him is remember there was there's so many options for birth you know we break it down to like vaginal delivery or cesarean but the spectrum of that is huge and I know around the world obviously things work differently but you know within the UK I'm like there are ways of having these conversations of like you know last time I was induced these things progressed I don't want to do that again okay so may we make the conversation of like if I get to 41 42 weeks and we're discussing induction I don't want to do that I'd rather go for cesarean great let's support you in that decision okay the labor starts naturally everything's going well okay Labor's stalling let's make the earlier call to have cesarean rather than waiting waiting waiting waiting waiting like we did last time which may have also for various reasons contributed to why you had the experience you had or you just say you know mentally I'm can't cope the anxiety the fear you know having a prolapse and those symptoms really impacted my mental health and how I bonded with my baby for me I can't take that risk again I would rather have a control old safe cesarean environment great you know the decision behind it is so multifactorial it is just like prolapse better or prolapse not better you know I say to women yeah look we can discuss grades will it get a bit worse would it not but again we're just looking at the vagina we're not looking at the woman there are so many factors and actually I I felt for me having done delivery being at home was the best thing meant I felt like I didn't have a longer recovery but don't get me wrong like I went over to like 41 weeks and I cried my eyes out and every day being like am I making the right decision you know and I remember my midwives coming it was around Christmas time as well I remember my husband I was like crying and crying my husband was going out with my daughter and the Midwife rocked up my husband was like yeah good luck and she just opened the door and I just cried and cried for like half an hour or something but you know all those emotions need to come out and the fears are valid and you know I questioned the question was I making the right decision and sometimes you know what you just don't know but the most important thing I say to women is it needs to be your decision because ultimately afterwards if things do get a bit worse you need to know that you made the right decision for you with all the information you had that no one forced you into this decision because you know you could you're probably not going to regret your decision if you truly felt it was you that made it and it was right for you and your baby and your family at that time so that's the most important thing I think in all of it making those decisions they're hard and we need to have lots of conversation I do a lot of online consults with women about this just kind of like going through and I had a lovely story yesterday from a lady who's not in the UK actually and she sent me a picture of her baby being like you know thank you for supporting me in the end I managed to get my cesarean it was an absolutely right decision and I'm starting this postnatal period feeling amazing the birth was so positive I'm feeling generally really good and I was like amazing amazing you know that's that's what it's all about and yeah she might have had a vagina Livery and been fine but that was not right for her decision in that time that's what we've got to do hear the woman yeah I love that um um yeah I'm just going to kind of summarize summarize what you've said so far you know you can have prolapse and you can exercise you can have prolabs and you can have sex you can have her labs and you can go through another pregnancy you can choose to either have cesarean you can have a very happy and comfortable and in your home vaginal delivery you know and going against how we started this this episode where we highlighted all of the things that we're made to feel that we cannot do you've just gone with a very lived experience absolute I call BS right and thankfully research is changing and it's supporting this and we are we're looking more biopsychosocial we're looking at the whole person um and it's really I was smiling ear to ear when I just heard you speaking about how you um you've delivered vaginally in your kitchen husbands are in the medical field as well and he's like you can do it um we just need that support and we need to feel as are we making those decisions based on as much information as we can possibly get um and I think that brings me to my next point and asking you to just kind of um weigh in on the the physio side of things now so so kind of really um helping people to to realize you know okay I think I think this is me I think I'm experiencing these things or I was once told that I've got prolapse what what is the next what can people do will they need to work in person can they just go and buy a device um can they will they need to use um pessaries Etc or can they just do like whatever at home tell us tell us what it's what that's like and then we can close off for the day about the physio side of things yeah look ideal scenario would be sea of physio one-to-one care find out about your prolapse find about your pelvic floor look at your breathing look at your abdominal wall look at how you stand look at how you move like having examination whilst doing a deadlift with a kettlebell like that for me I was doing that this morning and it's just so empowering for women's I'm like your prolapse is not going anywhere your pelvic floor is doing the right thing and you are dead lifting 10 kg amazing let's start that that's an amazing thing that ultimately for me would be gold standard unfortunately across the world that is not always an option you know online consults I think can be incredibly powerful and I it's a whole new concept I think the pandemic forced us to do but I'm actually seeing amazing results by just working virtually with people and sometimes you know we make the call of like it would be really good to examine you now or have someone examine you who's more local but it is an option you know I think we can get an awful lot from amazing trainers as well who are doing a lot in the field like postnatal courses that are trying to challenge this narrative and again I think bridge the gap between Physiotherapy and other you know trainers you know maybe regular trainers like you know your average PT and you've got these trains that trying to bridge the gap that kind of take you from being postnatal doing a rehab getting you doing more before you're ready to go to your CrossFit class I think that's really happening I don't think you've got them in the UK but so in South Africa we've got biokineticists who really do an amazing job of bridging that Gap so they exercise scientists right so they've got that much more information and they they train to work with special interest groups or special need individuals whether that's pregnancy postpartum pro-surgical um kind of taking that rehab load off of the Physio and having more expertise on it and carrying through and then they can kind of refer out and be like okay go and join the gym now go and join that class you are prepared yeah so in in South Africa we got um biokinesis but now that I'm in the Cayman Islands and I've been working with more kind of us-based protocols I think you can say and they've got kinesiologists I think geologists yeah yeah yeah I know that is that kinesio therapy and these kinesiologists so I'm just I must make sure about that but they also pretty much it's it's exercise science um so so if you are listening from from anywhere else in the world and and you're looking for that person to help you to transition then um look for those those uh qualifications yeah that's amazing that's so good and I actually now you say that I have met a few people here but I think in the UK we're still so sucking stuck in our very like NHS you know it's very like and rightly so you know we've got nice guidelines we've got things and legislation and it's very important but I think sometimes then we do I guess neglect some of the other options that we don't always have research about everything that can help you know there's a whole conversation around hyperpressive which we don't have time to have today and I'm not an expert but I'm interested you know I'm like at the end of the day if there's an option that it could help a woman then we should be considering it whether whether it's I don't know exactly got gold standard research or not I think we just have to sometimes consider it again for the women in front of us from a pessary point of view and again I think pessories is such a fascinating thing I think they're becoming much more widespread understood that they're not just something that you have when you're 60 70 and that's it you know when there's no other option for you it's like how can we use a pestic to actually support your postnatal recovery how can we use it maybe in in the short term how could we use it to make it free so you can dance the night away at your mate's wedding and live your best life you know there are so many options for pessaries and I think again just having an open mind to that um right something like physiotherapy should be multifactorial and I would say to women that like I did some physio didn't help and I'm like did they get you off the bed did we do everything we should be doing because I'm like I'm more than happy to send you to a consultant for you to have that opinion if I truly believe we have done everything else first but if we haven't then I'm not happy to do that because we're missing part of the picture yeah yeah and I think that it is it that's a tough one right because um unfortunately not all pelvic physios have that same exposure experience guidance um and getting off of the bed and doing examinations and standing and squatting and with weights and being very patient oriented with regards to what are their personalized goals not not everyone is doing that and it makes it it is really hard but like we've said in the beginning we in this transition phase where the the diagnosis of prolapse isn't even very clear so how can we expect this perfect knowledge translation to professionals but more so even to to to patients so unfortunately um it's not not everyone is getting exams and standing um and I do believe that it will um that it will change um and exercises as well kind of exercise and also kind of defining exercise not as just on on on on but defining exercise as your range of motion your full relaxed that's part of exercise your stretch and Mobility that that um Letting Go side of things as part of exercise so it's if you haven't had that experience of testing on and off the table and in different positions etc etc and you're feeling as though you haven't made progress then Reach Out reach out to people like Claire have it online consult with the get that support just ask those questions and um you might find some clarity a virtual consult really in in pelvic curls are are so valuable and I think it highlights the importance of how much uh what we do is education based it kind of forces practitioner practitioners to lead lead with that education based and empowering the patient themselves to to make those changes because at the end of the day uh Hands-On stuff only does so much it's what that patient does in their day and they're 99.9 of the day when you're with me it's two percent 0.2 percent of the time right that was very bad maths but I acknowledge that um and not when um so yeah it's it's um it's enforcing that patient-centered and patient empowerment and patient education component of it um which which we absolutely do when we do virtual consults um so yeah thank you so much Claire I I feel as though there's going to be a lot of validation gain from this from this episode people really feeling as so they they feel comfortable in talking about their symptoms talking about their experiences advocating for themselves with regards to hey that wasn't done for me let me let me dig deeper let me try let me speak to X Y and Z and and see what we can do about getting to my personalized goals um I feel as though people are really going to feel that level of support um from from chatting to you today and listening to you speak about your your personal experience as well as your professional um Insight so thank you so much is it anything that you kind of want to highlight as like a take-home point for for people to to just remember or you know go telephone whatever it is that you want to just any parent that's living with prolapse um and navigating their day-to-day yeah I think you know do you trust your instincts on things like this because I get a number of when you come to me and they're like oh um I I really knew something wasn't right but someone just told me oh that's just normal or whatever you just have to live with that like don't accept that um know that you're stronger than you are I know your private floor is doing probably better than you give it credit you know and I always say to women look you're not literally walking around leaking all the time you're able to stand up you know your perfect floor is doing well you know yes okay can't quite do the higher level stuff that maybe we need it to right now but don't don't unrecognize what it's already doing like you know so I just recognize what your body's doing know that this is a lot to navigate whilst you're also changing as a human to learn how to be a mother to learn how to that change that perspective and it's a lot and finding it hard is also totally fine don't ignore the emotions like lit like sit with them engage with them and then we can move forward I honestly think unless we engage and sit with those emotions we just can't move forward physically mentally and emotionally and we've got to learn to support women to do that a bit more so we can then I think move that forwards it's beautiful beautiful thank you so much and I just want to throw in at the end there like um if if an individual does end up going for a surgical intervention um it's still incredibly valuable to work with someone um such as such as public health physiotherapist because like we've mentioned there are so many other factors that weigh into your experience the feeling support the education The Guidance with exercise so don't feel as though because in all this in all honesty with absolutely everything there is no one quick fix um and we have to put that work in we don't arrive at the front line of a marathon and just expect to run and win we put the work and we put the effort and we put the training and we put the nutrition everything in and um seek the guidance because there's no quick fixes and there's a lot that can be done on very many facets of our of our very complex and exciting and adventurous lives that we live um so yeah thank you so much Claire um all right so before I steal more of your incredibly valuable time and um still more more of your Pearls of Wisdom which I'm really really grateful for you sharing I would like you to tell us um a little bit about your all about mum so you you've got you're a really busy woman and you've also got other products that that can really help individuals um and tell us where we can find them what they are and we can just guide people to to that amazing yeah thank you so I started all about mum which is I mean it it's a variety of things but just as a brand I wanted it to be very much acknowledging that often women say oh it's all about my baby postpartum what about me and I'm like this is all about you so it's it's like at the minute it's a pregnancy webinar to help you understand your pelvic health and pregnancy and what you should be doing to help prepare and think about birth it's education cards postpartum um which basically take you from like the nitty-gritty of your first week your first poo to your recovery to exercise flash cards so you don't have to really an entire book you just literally pick it up you can put them in your hospital bag you're like in the moment you need it you're like breastfeeding okay cool that's what I've got to do I'm gonna do it and there's also the option of a post nasal ebook which has similar information but I just wanted to make it a bit more cheaper and accessible so it's slightly more concise I mean the pros developing a bit of a cesarean ebook so women who have lots more questions about cesarean and I will be developing other webinars as the year goes but yeah that's really what it's about it's just about a hub of education for women uh pretty much to do what we're saying to get the right information out in the time that they need it and not five years later when they're like why did no one tell me that five years ago yes yes so yeah amazing what a lovely gift to purchase for someone yes I want a baby flower gift for the month yes like you got enough presence picture you know on your cute baby growth here's something to save your mom's vagina yes amazing thank you so much Claire that sounds like an incredible resource and like you said it's at you you use the the phrase at the minute which I think is also very British I love it um so it sounds like it's something that's going to grow and expand um so that's really exciting I'm looking forward to that and I'm sure and that everyone that's um got to meet you today will also be looking forward to um learning from you further so thank you so much I'll be putting all of your links and everything in the bio I mean in the the the Page information uh so that they can be led for further to you to keep on learning so thank you so much thank you for having me it's been great to chat well nutripod listeners until next time please review And subscribe and as always stay curious as a special treat for listening to today's episode you can head over to the nurture public health.com website and use the code nurture pod for 20 discount on all pelvic and Sexual Health courses this episode is brought to you by the lit dry lock incontinence range of pads and panty liners specifically designed for bladder leaks because you deserve to maintain a healthy happy active lifestyle in the presence of leagues this is why when working with patients with incontinence I encourage them to use the correct type of pads as they work towards their treatment goals