In November of 2018 and January 2019, I had the great pleasure of being a preceptor to two 3rd year midwifery students from Laurentian University. (Ive had another student previously, and all three were warm, caring and insightful women!) As part of their placements, they have the choice of certain electives, in areas that can be related to the care they provide to their clients. I was honored to have them chose to enhance their learning and provide me with the opportunity to show how they can expand their practice and have the knowledge of other options they can offer their mommas and mommas to be. I asked if they would write a blog on their perspective. This is their collaborative work and I’m very happy to add this to my blog!
As a midwifery student, a large part of our learning and education involves reproductive physiology and anatomy. Midwives learn more specifically of the function of the pelvic floor throughout pregnancy and postpartum, however we do not have a lot of training on alleviating pain and discomfort that people can experience in their pelvic floor during pregnancy and postpartum.
The body goes through immense changes during pregnancy. Preparing the pelvic floor for childbirth through physiotherapy may reduce the risks of perineal or vulvar laceration, as well as correcting any pelvic dysfunction before birth and postpartum.
Nevertheless, injuries to the pelvic floor are unfortunately inevitable. Midwives therefore have the knowledge and skill to repair parts of the pelvic floor by suturing perineal and vulvar lacerations, or in rarer cases, episiotomies. However, just like any other muscle or tissue injury (like a strain or muscle injury elsewhere in the body), the pelvic floor often needs healing and recovery. Physiotherapy can help with recovery of issues such as perineal scar discomfort, urinary incontinence, pain during intercourse, and muscle and core strength, to name but a few.
I also learned that the pelvic floor can be affected at all ages (childhood through older adulthood). After spending a month in the clinic, I realized that in the case that there is pelvic floor dysfunction, if it does not get resolved, it often worsens. The beauty of pelvic floor physio is that it can correct problems that have existed for long periods of time, so it’s never too late to treat!
Another aspect which drew me to pelvic floor physiotherapy is the minimal intervention required to resolve and heal many issues relating to the pelvic floor. This non-invasive technique is consistent through midwifery as well. Unnecessary interventions during childbirth have been shown to lead to negative outcomes. Similarly, resorting to invasive techniques to fix issues with the pelvic floor, before considering a non-invasive technique, seems unsafe and unnecessary. In a short time, pelvic floor dysfunction can dramatically improve, sometimes within 2-3 sessions.
Becoming pregnant is a life and body transforming event. And in every single case, whether a person gives birth vaginally or through caesarian section, the pelvic floor is affected and may undergo changes. Sometimes recovery goes well. However, often, women suffer from uncomfortable and uncontrollable changes that can only be healed with a recovery program or physiotherapy. Having spent a month with Celeste made me realize how few people know that it is possible to heal the pelvic floor from within.
Elizabeth LeBlanc & Kara Vandersluis
Student Midwives at Laurentian University