Disclaimer: If you are a man, stop reading this article immediately. If you are related to me, stop reading this article immediately. If I even know you, I’m going to ask you to stop reading this article immediately - I know you probably won’t but at least now we have a lie that enables us to look each other in the eye again.
OK. Now it’s just us girls... we need to talk about my vagina. And indeed your vagina.
You see, our pelvic floors in general have been through a lot lately, which is to say that a lot has been through them. Babies’ heads, obstetricians’ hands… let’s not think too much about it but obviously after a pregnancy and birth there are going to be some changes Down There.
Even if you had a Caesarean, things will have shifted around a little. Maybe your bladder doesn’t work quite the way it used to (“Aaaaaaaaachoo - oh no”). Maybe you're constipated ("Hnnnnnnnnn"). Maybe it hurts to have sex (“Is it in y- ow!”). Maybe it doesn’t hurt, but you spend the whole time you’re doing it worrying that your partner feels like he’s throwing a toothpick into the Grand Canyon (“Yes!” CLENCH “Yes!” CLENCH “Yes! Be honest though, how different does it feel for you?”).
Some people fight all this with a positive mental attitude. “I feel it is just as beautiful… a vagina that has birthed a baby is lovely, like a mature flower blooming,” one mother posted on a message board I saw. I’m glad for her, but personally I’ve only dared to look at mine once; it wasn’t long after the birth and suffice to say, it was not a beautiful flower type of situation.
Lately though I’ve discovered that there are things you can do to fix up the downstairs, as it were. No amount of exercise will remove disfigurements like the “fanjo tonsil” I saw one woman describe on Mumsnet, but there are a few simple things you can do to get your pelvic floor back in working order, according to Mummy’s Physio , a London-based company who specialise in pelvic floor re-education.
"We see so many ladies, even women in their early 20s, who have stress incontinence and they think that it’s just the way it is,” says Sabine of Mummy’s Physio. “Women call us talking about a loss of sexual sensation and they think it’s normal because their mothers had it too. It’s not. There is a solution, you don’t have to have a lesser quality of life.”
In France, every mother is given ten sessions of “la rééducation périnéale” after she has a baby. I’ve read a few accounts of this treatment by American and British women living in France, and they typically describe a terrifying French dominatrix who orders them to strip and then ticks them off for their “très faible” pelvic floor. So I spent a lot of time preparing for my first session with Elodie, my Mummy’s Physio therapist: waxing, washing, extracting a reasonably new pair of knickers from the carnage that is my underwear drawer. But she was much younger than I expected, and very gentle-mannered, putting me at ease - not easy in a situation where someone is about to grade your lady bits.
Yes, grade: Mummy’s Physio rank pelvic floors from 1 to 5, with 1 being the weakest - a woman who cannot move her pelvic floor muscles at all, and 5 the strongest - a woman who could crack nuts down there. Mine gets a 2, and apparently it needs to be at least a 4 if I want to go running. (I’ve foolishly mentioned the time I went out with the ELLE Running Club and got caught short.)
For my entrance exam, pun intended, I lie on my bed with a towel underneath me while Elodie assesses my abdominal muscles - pretty good - my transverse muscles - pretty bad - and my stomach, which she says has a lot of hair in it. Pardon? I say, thinking gosh, I suppose I have been shedding a lot lately... “You have a lot of water and hair in there. You need to be more careful when you eat.” Ahhhhhh, you mean air. “Yes, hair.”
Elodie is very French, but that makes her very matter-of-fact about this treatment, which is good because it’s not the most dignified moment of my life when she puts her latex glove on and inserts a finger into my hoo-ha, searching for my lost muscle tone. First, she asks me to clench my muscles as if I was trying to hold urine. Next, as if I was trying to hold gas. Then the left side - “I can’t do that,” I tell her, but I try and she seems happy enough with the results - and the right, and then the whole area, drawing it upwards.
It’s not allowed to clench your leg muscles, or your stomach muscles, and bearing down rather than drawing up is counterproductive. This is the reason it’s helpful to have someone’s hand up your jacksy while you’re doing it: if they weren’t there, you would probably get it wrong. Or laugh. Or not bother. Because although we’re all told that pelvic floor exercises are important, I’m pretty sure I’m not alone in doing them once a week, half-heartedly, at a bus stop. At this point in my life, knowing an activity is important doesn’t make me do it; it just makes me feel guilty about it. Knowing Elodie is coming back in a week, however, makes me do my exercises every day because I know that she’ll know if I haven’t, and French people scare me witless.
I only average one a day - it takes 15 minutes to go through the lot and it’s amazing how rarely you can find that sort of time in a day when you’re a working mother and don’t want to have to explain to anyone that you’re giving your undercarriage a workout. But this is apparently fine: “I said two to get you to do one,” she says (she really seems to have gotten to know me since rummaging around in my box) and I’m better at holding the contractions for longer.
After two sessions, my pelvic floor isn’t about to go on to postgraduate studies but it does feel a bit easier to do the daily “wee workout” and I feel more than equal to sneezing, coughing, maybe even running without fear. Mummy’s Physio recommend five re-education sessions, and so would I - but they are £75 per hour and only available within London. You can also tell a GP or community midwife if you're having problems and ask for a referral to a physiotherapist with an interest in pelvic floor rehabilitation, but Sabine and Elodie both believe that the treatment should be standard rather than on request. Many women don't know that help is available, or they're too embarrassed to ask.
Alright, nobody ever died of an underperforming pelvic floor (unless maybe their uterus prolapsed... which is a real thing! My friend's mum had it!). But if there were millions of men wandering around peeing themselves, don’t you think someone would have done something about it by now? To borrow an idea from Eve Ensler, if my vagina could speak it would say that we need to bloody well sort it out.
Reach Mummy's Physio on 020 7125 0262 or via mummysphysio.com - they are happy to talk through any problems you're having even if you don't live within the area for a home visit