Licensee of the Month Prepares for Labor

I would like to introduce our Licensee of the month of February. Her name is Grainne Donnelly. She is located in Ireland.   Besides being an amazing physiotherapist, she is a new mom. She talks about her experience of using the Tupler Technique® in labor.

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Being a Pelvic, Obstetric and Gynecological Physiotherapist I regularly help my patients to prepare for and recover from the ‘marathon of labor’. As us women well know, pregnancy is not always smooth sailing….there are any number of aches, pains and ailments that we can be predisposed to such as pelvic girdle pain, back pain, rib pain, calf cramps, carpel tunnel syndrome, constipation, urinary incontinence, urinary urgency and Diastasis Recti to name but a few. Many women out there reading this may well have suffered from most of those listed!

In my quest to help my patients prepare for labor, I utilize my knowledge and skills to educate and direct them through strategies to increase their core stability, strengthen their pelvic floor, learn how to RELAX their pelvic floor, prevent and/or limit separation of the Rectus Abdominis muscle, utilize optimal movement patterns during day to day activities and transfers, direct them through optimal positions for labor, teach breathing/relaxation techniques and prepare for ‘pushing’. 

After training with Julie Tupler, RN and licensing in the Tupler Technique® I was able to build upon my knowledge and skills by adding further strings to my bow. The
Tupler Technique® aims to conservatively rehabilitate Diastasis Recti with a 4 step approach: Splinting, Exercises, Getting up and Down correctly and learning to use the transverse muscle during day to day activities. It also educates about the importance of learning to strengthen AND relax your pelvic floor. It teaches people to practice and prepare for the huge task of pushing in labor every time that they open their bowels. This is achieved by practicing conscious relaxation of the pelvic floor muscles along with controlled abdominal bracing, with added manual support of the diastasis if applicable. This coupled with visualizations, such as squeezing a tube of toothpaste or a flower opening, help to focus the mind on the task at hand.

 How often do we go to the toilet without even giving it a thought? How often do we not give ourselves proper and adequate time due to our hectic work and social lives? This process of taking the time to consciously think about what we are doing with our pelvic floor and abdominal muscles provides priceless preparation for labor. This became all too apparent when I myself was faced with the mammoth task of labor a few months ago.

I had always considered myself to have good body awareness and took pride that I had a good understanding of pregnancy and labor given my background as a women’s health physiotherapist. However, I soon realized how impossible a task it would be to start trying to get myself to ‘push’ in a safe and efficient way during the pain, chaos, fear and somewhat lack of control that you can feel during labor. I was so thankful for the time and practice I had taken regarding improving my core and practicing optimal pushing. When I eventually gave into the FEAR and UNKNOWN of pushing (believe me I did my best with delay tactics) my improved core gave me the strength to push in an efficient and controlled manner and I was able to focus on how to co-ordinate my abdominal and pelvic floor muscles safely without too much thought. In the heat of the labor room, when tensions may be high, pain levels are certainly high, and it is time to push, it can be all too easy to fall into a panic and take the ‘lets just get this baby out as quickly as possible’ approach by entering into uncontrolled bearing down along with pelvic floor resistance. This in my opinion will contribute to a tougher labor and the increased likelihood of perineal tearing and trauma….not to mention what it will do to a diastasis.

My personal experience of labor has given me a whole new understanding of my role as a physiotherapist within this specialty. I understand the process in a more holistic and empathetic way. It truly is a marathon!!!!! And as Julie Tupler says….you would not take on the task of running a marathon without training and preparation, therefore you should not take on labor without preparation.  

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