Melissa Bowley

Times are challenging. Between figuring out school days for kids, worrying about how your birth plan has changed, and managing a drastically different work environment, our ability to adjust is being tested. Now it is more important than ever to restore and replenish our bodies to allow the best chance at surviving with grace. 

Our bodies have specific physiological reactions to stress to help us cope with the next twist of fate. One of the first places to react are our pelvic floors. Similar to your abdominals, the pelvic floor muscles are an important part of your core that is always working to support your sphincters and keep you from leaking. They also lift your pelvic organs, help keep you upright, and assist with sexual pleasure. 

Additionally, the pelvic floor is connected to our sympathetic nervous system, which lets us flight-freeze when we experience danger or stress. Sound like every day this week? The pelvic floor is integral in our response to stressful situations. To illustrate this response, researchers observed women’s pelvic floor muscles while exposed to a threatening stimulus: watching scary films. In response to a scary stressor, pelvic floors increase in activity and tighten up. 

COVID-19 is one long scary stimulus. Your pelvic floor may be holding too tight because of the emotional difficulty of the current situation. Tight or “overactive” pelvic floor muscles can cause pain with sex, abdominal discomfort, trouble fully urinating or defecating, increased urinary urgency, and digestive system slowdowns. I propose we save this survival mechanism for the split second we need it, and let go of what we can’t control. To return your body, brain, and pelvic floor to a relaxed state, here are a few options: 

1. Deep breathing: Inhale through your nose and focus on letting your ribs expand outward as your belly fills up. Then let the air woosh out of your mouth. Try five breaths in a row. If you can’t feel your ribs move outward, put your hands on your ribs and let your breath press your ribs outward into your hands as you inhale. 

2. Pelvic floor relaxation: Focus on the muscles at the bottom of your pelvis. Imagine the bottom of your pelvis is a hammock. As you take a breath in through your nose imagine a little girl is gently sitting on the hammock and the fibers are slowly stretching open. Let your muscles drop down with an inhale and come back up to their normal state as you exhale. Practice again, imagining those muscles moving down and opening gently. 

3. Mini pelvic floor squeeze and full release: Many ladies I see have trouble simply “letting go” of their pelvic floor muscles. We don’t have great awareness of our pelvic floor. So instead of trying to relax, try a mini-squeeze and release. Start by sitting down. Take a breath in. As you exhale, gently squeeze your pelvic floor muscles like you are “holding back gas.” Ideally, try to engage in the tiniest, almost imperceptible squeeze. Then, let your pelvic floor muscles relax into the chair you are sitting on. Imagine that movement releasing down and away. 

4. Let your belly go: As women, we often hold our abdominal muscles tightly. Our abdominal muscles need to be able to react to movement, so they should be released most of the time. Throughout your day, check in with your abdominal muscles and let them release. There is no need to hold them tight all of the time. 

One last thing: as a pelvic floor physical therapist, the first thing most women ask me is, “Shouldn’t I be focusing on doing 1000 kegels to fix x, y or z?” Especially right now, the answer is “No. Please don’t overdo it.” It’s great that there’s growing awareness of kegels — they’re important — but that’s the focus of this post, as excessive kegels are often exactly the opposite of what our pelvic floors need. 

The current situation is hard on everyone. If you need help with relaxing your pelvic floor muscles, have back or pelvic pain, or are experiencing incontinence, constipation, scar pain, pain with sex, pelvic organ prolapse, or want to prepare your body for birth, many pelvic floor physical therapists are offering virtual visits. 

In my career as a postpartum doula, I find that I’m often educating people about what I do. I like to say that I offer practical, educational, and emotional support to the parents of newborns to build calm, confidence, and connection in their early parenting experience. Sometimes, I go with a quick answer, something like “I help new parents at home after they have a baby.” Like so many of us, the events of recent weeks has forced me to consider how I can do my job while doing my part to limit the spread of this new virus, and a big part of the answer has involved a switch to working online. Many of my clients initially seek help keeping up with the practical needs of the postpartum time- learning how to care for a newborn, getting rest, grocery shopping and cooking, laundry and tidying up, for example. These can often seem like the most pressing needs to an expectant family, and do indeed play an important role in recovery, bonding, and mental health. But the truth is, looking back on the other side of those first intense weeks and months, it is common to hear families say that the most important part of doula support was actually the emotional piece. Feeling heard, the ability to share the full range of emotions and experiences without being judged, help to discover their own way without pressure to follow another’s advice, someone to talk to who isn’t emotionally invested in your choices, and a path to community support through meeting other new parents and professionals, are all benefits that can have a long-lasting effect on a new mother’s (or father’s) sense of identity and well-being long after the extra help is no longer needed. And the good news is, this level of support does not require us to be in the same room. Here are some of the ways video call support from a postpartum doula can transform your experience of a difficult time:

• Reducing isolation and stress- In the best of times, new parents can feel cut off from the world and unsure of the future and their abilities to cope with the day-to-day. Now, these feelings seem to be magnified for everyone. Human beings are hardwired to seek social connection as a way to survive stressful situations, but we often don’t know where to turn to find the support we need. I am here for that.

• Protection for your physical health- With the current concerns about exposure to the new virus, people are trying to separate themselves from the outside world as much as possible. Video calls allow us to build and maintain a sense of connection without risking exposure to illness.

• Increased flexibility- When I visit a client in their home, I charge for a minimum of four hours per visit. With video calls I am able to offer a package of as little as one hour a week, plus text support every day. This may allow some families to experience the benefits of a postpartum doula who might find it difficult to commit to a greater number of hours. It also removes the restriction of location, allowing me to support you no matter where you live. I am excited for this increased opportunity to work with many more families, whether weekly or in a one-time session to address specific issues and concerns.

• Visual education- Educational support is another aspect of my work that is available through video calls. I can use my collection of newborn parenting education materials to demonstrate anything from soothing and burping techniques, to latching and paced bottle feeding, to different styles of baby carriers. You can also allow me to see what you are doing and offer in-the-moment suggestions of things that have worked for other parents with similar issues.

• Resources and referrals- As a doula, I consider myself a sort of living library or search engine for newborn parenting information and expertise. I do not push parents towards making any particular set of lifestyle decisions, because I believe that they are the experts on their own family’s needs, and different situations regarding caregiving, sleep, feeding, etc. are going to work best for each individual situation. At the same time, I realize that the sheer amount of information and advice available at our fingertips can be overwhelming and often serve to increase the universal feelings of parental self-doubt. It is my goal to balance these two factors by listening carefully as you describe your experiences, thoughts, feelings, and circumstances, and offering suggestions for you to consider that I believe have the best chances of being helpful to you. I am always seeking to expand my knowledge of books, videos, techniques, research, groups, and experts that I can connect with families that might find value in what they have to offer.

No matter where you decide to seek support and self-care, remember that every time you make a commitment to show up for yourself and get your needs met on a regular basis, you are making it easier to be the person (and the parent) that you want to be. It’s cliché, but true- you can’t pour from an empty cup, you can’t give what you don’t have. It’s so easy to feel overwhelmed by the pressing needs all around you, but if you don’t take care of your health, including your mental health, you will eventually lose the ability to be helpful to anyone. Like meeting a friend for a workout or signing up for a yoga class, many people find that making an appointment or financial commitment helps to ensure that life doesn’t get in the way of their best intentions. The effort is worth it. 

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Here we are in the middle of Coronageddon, you, your spouse and children are home and life as we knew it all but came to a grinding halt. My own three youngest children are at home doing their homeschool thing, the transition to distance learning has actually been pretty smooth. I guess I’m lucky in that respect, my childrens’ school really rose to this unforeseen challenge.

From the empty toilet paper shelves to the seemingly always open nail salons being deserted, things are definitely different. I don’t know about you but I can do without almost everything non-essential being shut down but I may have shed a tear when I realized that included movie theatres. That one hurt.

The one thing that has remained constant is my phone ringing non-stop and my emails being bombarded with frantic moms. Aaaaaaaaah…the constants in life. It’s very common for new moms or even experienced moms to have lots of questions about their little ones. Coronavirus has not interrupted that. If anything, there are even more questions. I would have never thought that possible. Covid-19 has pushed my lactation consultant business (and my ability to stand my ear pods for extended periods) to the limit.

Outside of practicing safe social distancing and employing good hygiene practices (which we should have been doing all along) there isn’t much we have to do differently. Rest assured moms, you can continue to confidently breastfeed your babies. Dads, it’s ok for you to keep going skin to skin, just make sure you’re washing your hands and taking precautions if you are exhibiting signs of the virus or have been around someone who contracted it.

This is certain to go down in history but it can’t last forever. Well…it can in the books but with smart and proactive measures, we can and will return back to normalcy. Until then, I’ll continue to Zoom, GoToMeeting, Join.me, Roundee, Adobe Connect and Microsoft Teams myself into oblivion and you continue to enjoy this probably much needed time off with yourself, your family, your pregnancy, breastfeeding and/or going skin to skin with your sweet little baby.

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