Don’t blame yourselves, American moms. French women are treated to post-natal care from therapists who not only specialize in rehabilitating the stomach muscles, but also the pelvic-floor muscles. From Bumpology.
We often envy the French: They generally have better food and are more chic. But there’s one area where we genuinely should feel green-eyed: postnatal care.
In many countries, women are discharged from the hospital and left largely to themselves. In France, women see a gynecologist within the first month of birth, when they’re able to discuss any pain or sexual problems they’re experiencing. They also routinely get twelve half-hour sessions with a postnatal physiotherapist who specializes in rehabilitating the pelvic-floor and abdominal muscles.
“We focus on bringing the perineum back to health and improving sexual sensation,” says James Turgis, a French physiotherapist who now runs a private physiotherapy clinic called Mummy’s Physio in London. The abdominal muscles will be checked for any damage or separation, and women are given exercises to tone them up. It’s no wonder French women are back in their pre-pregnancy jeans before they know it (mine are languishing sadly at the back of the wardrobe).
Although it’s normal for the skin of your belly to feel a bit saggy in the months after birth, some women develop “mommy tummy,” a horizontal roll of fat that hangs down in two horns if you bend over. This is a sign that the abdominal muscles have failed to close back together after pregnancy (the technical name is an abdominal diastasis). As the baby grows during pregnancy, the muscle that wraps around the front of the belly begins to pull apart. In a few countries, including France and Australia, the extent of the damage is checked before women leave the hospital, and they are given exercises to correct it. In other countries, this simple test is overlooked, and women go home oblivious.
Besides causing mommy tummy, an untreated diastasis can lead to lowerback pain and bladder incontinence, and if women start to exercise with a diastasis, it can cause further problems. “Unless the tummy muscles have closed back together, then the pelvic-floor muscles don’t have a good anchor,” says Maria Elliott, a physiotherapist who runs SimplyWomensHealth on London’s Harley Street. “Many women who were fit before birth consider their stomach muscles are really strong and mistakenly go out running or start exercising and develop problems like stress incontinence.” Doing sit-ups or abdominal crunches before the tummy gap has closed can cause the muscles to pull even farther apart. “In France, women are initially helped to strengthen pelvic-floor muscles and to close the tummy gap. Once this is achieved, they are able to start abdominal exercises,” says Elliott.
The good news is that you can check your abdominal muscles yourself. To do this, lie flat on your back with your knees bent, put your fingers into your belly button or just above it, and press down as you start to roll your head and shoulders up off the floor. You should feel the two sides of the muscle pressing together, and you should be able to get only the tip of one or two fingers into that gap. If the gap is much bigger, you should consult a doctor or physiotherapist. Problems are more common if you’ve had more than one baby or if your baby was particularly big. If you do discover a gap between your muscles, there are some simple exercises to help close it:
• Lie on your back with your knees bent, and using your hands or a scarf wrapped around your waist, push your abdominal muscles together. Now, keeping your shoulders pressed into the floor, lift your head, exhaling as you do so. Return your head to the floor. Do fifty reps twice a day.
• Still on your back, tilt your pelvis up toward your head and pull your abdominal muscles in while keeping your buttocks relaxed. Then roll your pelvis back down and relax. Repeat ten to fifteen times.
• In the same position, with your abdominals pulled in, add a load by sliding one heel down until your leg is flat on the floor, then slide it back up again. Now do the same on the other side. Repeat ten to fifteen times with each leg.
• Move onto your hands and knees and relax your stomach muscles. As you exhale, pull your belly button up into your body as tight as it can go, drawing your pelvic-floor muscles in at the same time. Hold for about ten seconds, breathing normally, then relax and repeat one more time.