Postnatal Pelvic Health Check

Becoming a mother is a transformative experience, and while the focus is often on the new arrival, it's crucial not to overlook your own post-birth recovery. Many women assume that certain discomforts or physical changes are simply a normal part of motherhood. However, this is not always the case. A significant number of women experience ongoing issues related to their abdominal and pelvic floor muscles after pregnancy and childbirth, which can lead to pain, instability, and functional difficulties. This is where the concept of a 'Mummy MOT' comes in – a comprehensive postnatal check designed to assess and address these common concerns.

What is a Mummy MOT?

The term 'Mummy MOT' is a colloquial term for a specialised postnatal physiotherapy assessment. It's essentially a thorough evaluation of your body's recovery following pregnancy and childbirth, with a particular focus on the abdominal muscles and pelvic floor. This assessment is typically carried out by a physiotherapist who specialises in women's health and is designed to identify any issues that may have arisen during pregnancy or birth, such as:

• Diastasis Recti (Tummy Gap): This is the separation of the abdominal muscles, which can occur due to the stretching of the connective tissue as the uterus expands during pregnancy. Up to half of all women experience weakness in their abdominal muscles, and up to a third still have a noticeable tummy gap at eight weeks postpartum.
• Pelvic Floor Dysfunction: The pelvic floor muscles support the uterus, bladder, and bowel. Pregnancy and childbirth can weaken or damage these muscles, leading to issues like stress incontinence (leakage of urine when coughing, sneezing, or exercising), urgency, or even prolapse.
• Back and Pelvic Pain: Instability from weakened core muscles, changes in posture, and the hormonal effects of pregnancy can contribute to persistent back and pelvic pain.
• Core Weakness: Beyond just the abdominal muscles, the entire core (including back muscles and diaphragm) needs to be assessed for proper function and strength.

When Should You Get a Mummy MOT?

The ideal time for an initial postnatal assessment is between 6 to 8 weeks after giving birth. This period allows your body some initial healing time. However, it's important to understand that you are not limited to this timeframe. Many women seek a Mummy MOT much later, even years after giving birth, if they are still experiencing symptoms. If you gave birth years ago and are still dealing with a tummy gap, back pain, or pelvic floor issues, it is absolutely not too late to seek help and make significant improvements.

Common Symptoms to Look Out For:

Don't dismiss these common postnatal complaints. They could be signs that a Mummy MOT is beneficial:

• Leakage of urine when you cough, sneeze, jump, or run.
• A bulge or heaviness in the vaginal area.
• Difficulty emptying your bladder or bowel.
• Pain during sex.
• Persistent back pain, hip pain, or pelvic girdle pain.
• A visible 'doming' or 'coning' of your abdomen when you sit up or strain.
• A feeling of weakness or instability in your core.

What Does a Mummy MOT Involve?

A comprehensive Mummy MOT typically includes the following:

1. Subjective Assessment:

This is a detailed discussion about your pregnancy and birth history. The physiotherapist will ask about:

• Your symptoms and how they affect your daily life.
• Your birth experience (type of delivery, any interventions like forceps or vacuum, tearing, or episiotomy).
• Your current activity levels and exercise routine.
• Your general health and any pre-existing conditions.

2. Physical Assessment:

This is a hands-on evaluation, which may include:

• Abdominal Muscle Assessment: The physiotherapist will assess the width and depth of any separation in your abdominal muscles (diastasis recti) and check the quality of the muscle tissue. They will often use their fingers to measure the gap or, in some cases, ultrasound imaging.
• Pelvic Floor Muscle Assessment: This is a crucial part of the assessment. It usually involves an internal vaginal examination to assess the strength, endurance, coordination, and resting tone of your pelvic floor muscles. This is essential for understanding how well these muscles are functioning.
• Posture and Movement Analysis: Your posture, how you move, and any compensatory patterns will be observed.
• Scar Tissue Assessment: If you have had a C-section or an episiotomy/tear, the physiotherapist will assess the scar tissue for mobility and any potential impact on surrounding muscles and nerves.

Benefits of a Mummy MOT

Addressing postnatal issues early can prevent them from becoming chronic problems. The benefits are far-reaching:

• Improved Core Strength: A strong core is vital for overall stability, posture, and reducing the risk of injury.
• Reduced Pain: Targeted exercises can alleviate back, hip, and pelvic pain.
• Continence Improvement: Pelvic floor exercises can significantly reduce or eliminate stress incontinence and urgency.
• Enhanced Body Confidence: Regaining strength and function can boost your confidence and allow you to return to activities you enjoy.
• Prevention of Further Issues: Early intervention can prevent conditions like pelvic organ prolapse from worsening.
• Safe Return to Exercise: A Mummy MOT provides guidance on how to safely return to exercise and sport without exacerbating existing issues.

Frequently Asked Questions (FAQs)

Q1: I'm only 4 weeks postpartum. Is it too early for a Mummy MOT?

While the recommendation is 6-8 weeks, some practitioners may offer a very gentle initial assessment earlier. However, for a comprehensive assessment, waiting until 6-8 weeks is generally advised to allow for initial healing. Always consult with your chosen physiotherapist.

Q2: I had my baby over a year ago. Is it too late to get help?

Absolutely not! As mentioned, many women benefit from this assessment years after childbirth. Your body can continue to heal and improve with the right guidance and exercises.

Q3: Is the internal examination uncomfortable?

A qualified women's health physiotherapist is trained to perform these assessments sensitively and professionally. You will be fully informed about what to expect, and you can usually communicate any discomfort. Many women find it reassuring to have their pelvic floor properly assessed.

Q4: What if I had a C-section?

A Mummy MOT is highly beneficial for women who have had a C-section. It will assess your scar tissue, abdominal muscle function, and pelvic floor, as scar healing and the impact of surgery can affect these areas.

Q5: Can I do this on the NHS?

While some NHS trusts may offer postnatal physiotherapy, specialised assessments like the 'Mummy MOT' with a focus on detailed abdominal and pelvic floor assessment are more commonly found within the private sector.

Conclusion

Your body has undergone an incredible journey. The 'Mummy MOT' is not about returning to your pre-pregnancy body overnight, but about ensuring your body is functioning optimally and safely as you navigate the demands of motherhood. If you are experiencing any of the symptoms mentioned, or simply want peace of mind about your recovery, booking a postnatal physiotherapy assessment is a proactive and empowering step towards long-term health and well-being. Remember, these issues are common, but they don't have to be accepted as permanent. Seeking professional assessment can make a significant difference.