Thursday, August 9, 2012

Pelvic Floor Rehabilitation, French-Style

We may not all have access to an electrical probe (!) but mums around the world can learn a lot from the emphasis and care placed on the pelvic floor by the French post-childbirth. 

One of our France-based members Lucy Herman-Taylor has generously agreed to share her intimate experience of their proper, medically assisted pelvic-floor rehabilitation. Totally normal, prescribed and paid for by the state. Why not in the UK? Surely prevention is the way to go NHS? Saving ££s in the future from treating incontinence, prolapse, etc.?

Anyway, here is what Lucy says:

Bonjour fellow active Mummys! 

I am a UK expat living in France, near Versailles and I had my first baby, a little girl named Olivia in October 2011. Katy has asked me to share with you my experience in France of pelvic floor rehabilitation following birth.

Every woman who gives birth in France leaves hospital with what seems like a zillion standard prescriptions for herself and her new born baby. For the new mummy, the most important of these prescriptions is for the course of 10 pelvic floor rehabilitation sessions every woman is entitled to on the national health system (Sécurité Sociale). You are duly told throughout the duration of your pregnancy by your gynecologist, midwife and any other medical specialist you might see (it can be many in France) that under no circumstances are you to undertake any exercise until you have completed your course – gentle walking is allowed thank goodness, otherwise I would have gone insane!

My Ready Steady Mums personal trainer constantly stresses the importance of pelvic floor exercises, and so I knew to appreciate this extra attention compared with UK based mums. And I embraced the system -

Generally, after a normal birth in France you leave hospital after 5 days with strict instructions to make an appointment with your gynecologist in 6 weeks’ time (no sooner, no later!) If your gynecologist is satisfied that you’ve fully healed he/she will give you the go ahead to make your first appointment for your course of pelvic floor rehabilitation. This is usually around 10 weeks after giving birth. Both specialised midwives and physiotherapists can offer pelvic floor rehabilitation and it’s down to you to find your specialist.

The pelvic floor rehabilitation itself is a very intimate process so it’s important you feel comfortable with the person who will provide the 10 sessions. I honestly had no idea what was involved and had just imagined it would be lying on the floor and doing lots of squeezing. This is obviously part of the process, but when my physio said I had to purchase a “probe” from the chemists, also curtsey of the Sécurité Sociale, I started to have my concerns. What am I in for now? I was thinking. I didn’t feel any more comfortable when during the first session; my physio casually explained that she would pass an electric current through the probe to “stimulate” my pelvic floor muscles. I really didn’t like the sound of this and was beginning to think that the French were completely crackers to put themselves through such torture! Although I felt like running away, I stayed and was glad I did as it is a lot less painful that what it sounds and I quickly had my pelvic floor muscles back into shape (they weren’t great following birth.)

Basically, the sessions all followed a similar format starting with some basic squeezes, which are also to be repeated at home as often as you can: 10 rapid, 10 holding for 3 seconds, 5 holding for 5 seconds and then 2 for 8 seconds. Using the “probe” the Physio measures the strength of your pelvic floor muscles during these initial exercises. Then it’s time for the dreaded electro stimulation part where the physio sends an electric current through the probe to stimulate the muscles. In later sessions when you are strong enough, you are asked to accompany the current with a different set of squeezes.  I was told I was allowed to shout stop at any time it became uncomfortable and the strength of the current would be reduced (phew!) After this, the initial exercises are repeated and the physio basically compares your “performance” pre and post electro stimulation. Over the 10 sessions your progress is charted and I found it really motivating and reassuring to see that I was making progress and that my pelvic floor muscles were strengthening. I also started to notice a big difference in everyday life very quickly.


I am pleased to say that I have now completed my 10 sessions and been given the go ahead to start physical activity again, so I’m making my way through my Ready Steady Mums sessions and enjoying some swimming!

2 comments:

  1. Wow, I cannot believe this! The UK have to catch up! At the same time though, it can all be a bit invasive, I presume women can opt out?! But, to have the option of treatment is amazing, and to not have to walk about "whispering" about prolapse etc must be so liberating. Nobody warned me at all, I had to find out the hard way, and get treated at my own expense. I also think we need more education about the body in schools, but I shall put my soapbox away for now :-)

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  2. The UK is not the only country that needs to catch up... All countries with women having children (think thats about all of them!!??!!) should be recommending this excellent course of action!

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