In this week’s episode of the My Sleeping Baby podcast, I sit down with my friend Nikki Bergen of the Belle Method to talk about everything you need to know about your pelvic floor and pelvic floor therapy after having a baby.  We had a great time 🙂  Have a listen!

Want to get your little one consistently sleeping 11-12 hours at night so you can be a functioning human?  Join my FREE training HERE: https://mysleepingbaby.ac-page.com/registration-page-v-2   

Eva: (00:04)
Hey there, you’re listening to the My Sleeping Baby podcast, which is all about baby and child sleep. I’m so excited to teach you how you can get your little ones sleeping so that you can sleep too and enjoy parenthood to its fullest. I’m Eva Klein, your resident’s sleep expert, mom of three, founder of the Sleep Bible online coaching program, and lover of all things sleep and motherhood. If you’re looking for tangible solutions for your little one sleep woes or you simply want to learn more, this podcast is for you. For more information, check out mysleepingbaby.com and you can follow me on Instagram and Facebook @mysleepingbaby.

Eva: (00:44)
All right. Okay, Nicki, thank you so much for being here today. I’m so happy to have you on the, my sleeping baby podcast.

Nikki : (00:52)
This is gonna be a good chat.

Eva: (00:53)
Yeah. Thanks so much for being here. So we met, do you remember where we met? We met in a parking garage.

Nikki : (01:00)
I actually do absolutely remember that we were, we were both like running late for one of the mom’s to events. Yes

Eva: (01:06)
yes, yes, yes. I remember I was, yeah, we were both speaking at a mom’s to event. I was 10 days postpartum with my third. So I had this like little teeny baby with me, you know, in the bucket seat and finding this parking garage that was near the event. And then finding a parking spot was like a really big accomplishment for me, you know, at that point. And I remember you were driving and you were like, is there parking? I forget what you were saying. You ruled down your window and you were like, is there is this, is this near the mom’s co event? Is this where we’re supposed to park? And I was like, I don’t know. so we, I think so, but like you tell me and then, and then we just sort of, and then I think we walked, you know, into the, I waited around for you and, you know, hoping I figured, like, I think her brain’s working probably a little bit better than mine is right now. So I waited around for you and then, and then we walked in together and you know, and we’ve been, and we’ve been buddies ever since

Nikki : (02:03)
It’s true. It’s true. I remember thinking like, I’m like, she’s going to the mom’s event. Like there’s a mom right there holding like a tiny little infant car seat.

Eva: (02:11)
Yes, yes. That was, that was 100% me so why don’t you tell everyone, you know, a little bit about yourself and, uh, and what you do.

Nikki : (02:20)
Totally. So I am a Pilates instructor. I’m the creator of the bell method, which is essentially like a fitness program for women, for pregnancy postpartum and well beyond. So you don’t just have to have recently had a baby or be pregnant to actually do it. And it’s really about combining Pilates and pelvic health. So it’s not a traditional Pilates class. It’s it’s we take, you know, we’re inspired through Pilates, but we’re also infusing a lot of pelvic floor therapy within the workouts. I’m a former dancer too. So I promise you it’s not boring. Mm-hmm like, it’s fun. We play good music. Like it’s, it’s not just like do rehab on your back for th you know, 30 minutes. Um, so try to make it exciting and accessible for people as well. So, yeah, and I mean, I can continue to go on, but I’m sure it’ll probably come up throughout the conversation of some of the stuff and the work that, that me and my team do.

Eva: (03:11)
Yes. And I can definitely, I remember when we were walking to that event together, I, I noticed, I knew, you know, how I knew that you were a previous dancer is because you walk, you were walking with your feet, turned out really, and a little bit, a little bit. I noticed it. And I was just because you mentioned dancing. And I was like, oh, is that why your walking turned out?

Nikki : (03:32)
So funny.

Eva: (03:33)
It’s funny. I mean, I used to do that when I was in high school, one of my high school teachers also used to be a dancer and she noticed me walking with my feet, turned out and she was like, you’re a dancer, aren’t you? And I was like, how’d, you know, that she was like, was the way that you’re walking . And so since then I can spot dancers from mile away, um, with their slightly turned out feet. So, um, yes. And I can also attest the fact that your classes are a lot of fun. Um, I have done other, you know, pelvic floor classes, exercises and whatnot, and while they might be effective, um, they’re not as fun as yours,

Nikki : (04:11)
So, oh, thank you. We do play like lots of random nineties hip hop, so, you know

Eva: (04:16)
Yeah. Which is totally my jam. your little army. That’s my language. Yes. You lovely. So, so tell let’s let’s let’s first kind of take a step back here. So, um, before I’ll tell you, before I had my third kid, the term pelvic floor meant next to nothing to me, I didn’t know a thing about it. And the only reason why I knew what it was was simply because I work in the mom space, but for most people, um, it might be this very vague term. That doesn’t mean much. So why don’t you sort of explain like what it is and why it is relevant to understand pelvic floor health and pelvic floor therapy, um, if you’ve had a baby or if you’re pregnant for that matter.

Nikki : (04:58)
Okay. So first of all, everybody, even if you’ve never been pregnant or had a baby should be, you know, learning about their pelvic health. So there are people who have pelvic floor dysfunction and need pelvic floor therapy, who’ve never even been pregnant. So mm-hmm, , I wanna make sure that everyone listening to this, I mean, I’m guessing the majority of people are gonna already have had a baby or maybe be pregnant. Yeah. But you never know. I just want everyone to know that. And secondly, even if you had your baby a long time ago, it’s never too late to actually improve your pelvic health or your core. So I wanna make sure that that’s also clear because it’s a question that I get in my DMS almost every day, people are concerned. They’re like, I missed the window. I’m like, no, no, yeah. It’s not too late. So, you know, if you’re dealing with dysfunction, we’ll talk about that.

Nikki : (05:41)
Like leaking like feelings of heaviness, um, like, you know, something’s falling out of your vagina, that’s a sign potentially of pelvic organ prolapse. Yes. 50% of us in our lifetime will develop pelvic organ prolapse. It’s a very common thing. You know, if you’re dealing with, um, even abdominal wall laxity, diastasis, recta, feeling like your abs have separated. All of these things are very common issues, but we are not really given enough guidance on both either how to prevent them and also how to deal with them once we’re dealing with them postpartum. So, right. That’s kind of what we talk about all the time, every day.

Eva: (06:16)
Right. Right. And I think that also it doesn’t help when you see commercials for pads that you can wear if you’re leaking. Right. Yeah. Nor does it help, you know, when probably many people think like, oh yeah. You know, when my mom, when my mom was, you know, or is dealing with, you know, one of those issues, like, yeah, she has these pads that, you know, she wears and, and that’s just what you do. And that’s just what happens when you get older, after you had a baby and it’s just, you know, part of the circle of life. And you’re saying not circle of what

Nikki : (06:49)
Okay. Old disclosure. Like I would be probably fairly wealthy if I could accepted all the advertising offers for, you know, different poise and depends and tea, whatever I am, I’m pitched all the time. And I, it’s funny, I say to them, I’m like, okay, okay. I’ll do, I’ll, I’ll work with you under the condition that you’ll update the information on your website and actually direct women to pelvic floor physiotherapy and make sure that they understand that your products are, you know, part of the journey, but not the solution. And then I never hear back.

Eva: (07:22)
And then you never hear back because they’re like, but then if a woman goes for pelvic floor therapy, it means they’ll resolve the problem. And then we lose money.

Nikki : (07:31)
Right. You mean in a nutshell. Yeah. Yeah. And so, but

Eva: (07:34)
Why would we want people to go for pelvic floor therapy? Why would we want people to strengthen their cord? Then it means they’ll stop peeing their pants and then they won’t need our product.

Nikki : (07:43)
Well, you, you, I think you kind of nailed it. So, I mean, again, it’s, it’s not to say that there, there isn’t a use, especially like on your journey to recovery. Right, right. Like, you know, fine. And there are pessaries, you can use, there are different devices that you can insert into the vagina that can actually help support your, your organs mm-hmm . And, and that can also be more of a longer term thing, especially if you’re dealing with prolapse, but we can get into that. Mm-hmm um, and they have pass raise for incontinence as well. But I guess really the message is, is that, you know, it’s not too late. I mentioned that already, but also that we shouldn’t be afraid to talk about it. There is no shame or there should be no shame. And I think that we are trying to do that, like on TikTok, for example, I see lots of trending videos where it’s like, you know, you did this to me and the mom crosses her legs and sneezes, and it gets lots of likes and lots of comments and yeah. Engagement, which people are after. And I think it’s important to add a caveat to that, to say, okay, we’re, we’re normalizing that this happens, but we have to also normalize that there’s help for it and not let women think like, oh yeah. It’s just, as you mentioned, part and parcel of motherhood.

Eva: (08:51)
Yeah. Yeah, no, listen, I, I totally agree. So, and you know, what’s something else that I learned that I didn’t know was a reflection of pelvic floor dysfunction is lower back pain and that pelvic floor therapy can help. And, and I realized that, you know, when I was, when my son was maybe two months old, so how, how much did he weigh at that point? I don’t know, 10 pounds, 11 pounds, you know, something like that. Not, not much in the grand scheme of things, but I started noticing after holding him for maybe three or four minutes that I started getting lower back pain. And that was when I thought to myself, is this my pelvic floor? And it turns out it is . And if I didn’t know that, and I went to a pelvic floor, you know, physiotherapist and got some exercises and was really able to, you know, work on that. But if I didn’t know that I probably would’ve been suffering and then just gone for massages to help, you know, ease the pain. Um, but not deal with the underlying root of the problem.

Nikki : (09:47)
Yeah. It’s true. A lot of women are, are suffering in silence because they don’t recognize the connection. I’ll give you the example of pain with sex, which is a hugely common issue. It’s called DYS Peria. And a lot of women are told even by their medical care providers, oh, just use more loop, PVA, glass of wine, you gotta relax, blah, blah, blah. Yeah. And, and then that sort of feeds into this, oh, I’m frigid or it’s my fault. Or I just need to relax when actually you’ve got like massive amounts of tension in your pelvic floor, maybe you’re dealing with C-section scar tissue adhesions, and that’s causing your uterus to not glide out of the way, like it’s supposed to during penetrative intercourse. And so, you know, these women are like, I’ll just use Merlo, it’s not getting better. And that, and then they can actually start like this feedback cycle of anticipating pain with sex. And then the problem becomes this biofeedback loop and it gets worse and it gets worse and they don’t talk to anybody about it cuz they’re like, oh, there’s something wrong with me. Meanwhile, mm-hmm, , there’s so much we can do.

Eva: (10:45)
Yeah. Yeah. And I think that, you know, this is, I mean, and this is probably, uh, this is for sure. I can tell you like a bigger problem, you know, with the overall medical system and you know, by no means, am I knocking medical doctors here, folks, like that’s, that’s not, you know, the purpose of, of what I’m about to say, but you know, generally speaking, the medical world is very focused on treating things that are clinical and making sure that you stay alive. Right. um, and we need those. We need people to keep us alive when we get sick with something. But a lot of what we’re talking about here is not necessarily something clinical that’s going to affect our lifespan, but it affects quality of life. Right? Totally. So it’s a matter of, you know, surviving versus thriving. Can you survive, you know, leaking and dealing with painful sex and lower back pain?

Eva: (11:38)
Yeah. A hundred percent. It might not affect your lifespan in the slightest, but when it comes to thriving and being able to enjoy life to its fullest, that’s where, you know, I think the medical that’s, that’s just not the specialty of our Western medical world. And that’s where we need people like you to say, okay, here’s the good news. The good news is that you’re not dying. Okay. So we don’t need a medical doctor necessarily for this. Um, you know, and, and the also piece of good news is that we can, we can improve this so that you don’t have to deal with this anymore. Mm-hmm you get what I mean?

Nikki : (12:14)
I know, I love it. You say it. So articulative, I love it. Like it’s not surviving versus thriving. It’s true. Yeah. It’s very true. And, and people ask me all the time, like, well, what, what should I get surgery, for example, for prolapse mm-hmm and I’ve interviewed, you know, a friend of mine that you were gynecologist, she’s a surgeon, she’s the one who does the bladder lifts. And, and she’s very candid. And she’s like, listen, like you’re not gonna die from prolapse. How much is it impacting the quality of your life? Mm-hmm what other things have you tried? Have you tried pelvic floor physio cuz surgeries don’t necessarily have a huge high success rate, especially this kind of a surgery, like the, the bladder lift surgery or the prolapse surgery and you, and there can be lots of complications. So, you know, and some people are like, oh, I’m just gonna get surgery. It’s like, that’s not, that should be the last sort of

Eva: (12:58)
Line of yes, you’re going under the knife. Like it’s not a, it’s not a, a little minute thing

Nikki : (13:04)
And it doesn’t have a huge success rate either. Like there’s a lot of, I guess what I’m saying is there’s a, a, you know, it’s common for you to go through that surgery and then, you know, less than 10 years later, you’re dealing with the problem again kind of thing.

Eva: (13:16)
Yeah. So yeah, a hundred percent. I mean, just on a, on a quick side note, I mean, I see this as no different than, you know, when the moms that I’m working with are chronically sleep deprived because their babies are not sleeping. You know, it’s so easy for someone to say like, yeah, this is just normal. This is just like normal part of being a mom. Like babies are just not meant to sleep and you’re gonna be chronically sleep deprived. And that’s all there is to it. And you’re not gonna die from sleep deprivation and you’ll survive and you know, you’ll sleep eventually, you know, when they’re 18 and suck it up. Right. And enjoy motherhood, cuz it’s so beautiful. Right. Not to, not to, you know, put a little bit of guilt in there. But um, when the reality is that okay, fine. Yes. You’re not gonna die, but on the other hand you also don’t have to live like this if you don’t want to. So, you know, it’s, it’s, it’s the exact same thing. It’s, you know, the surviving versus thriving thing. Like I wanna thrive. I want to be able to live my life to its fullest. And if there is something that, you know, I can do that we can do to help people live a better quality of life, like why the hell not? Right. Yeah.

Nikki : (14:20)
It’s true. And there’s so much, there’s so much there. There’s so many layers there and I’m sure it is the same with the people that you work with. And it’s, it is the same with the people that I work with. It’s also sometimes a belief that like it’s gonna work. So for example, a lot of the exercises we do at the beginning of a rehab in our say our level one postnatal class mm-hmm are very subtle, kind of deep core connection exercises. And someone will be like, well, this doesn’t burn. Like I’m used to in spin class. Or when I do my insanity workout and may question it’s efficacy. They may, well, what’s really happening here. And I always try to encourage people. It’s like, I recognize that this is different in the way that you’re working out. You’ve never done this before, but promise, I promise you it’s gonna get easier and it’s gonna, it’s gonna get harder.

Nikki : (15:06)
It’s not gonna be so boring. Mm-hmm um, but, but you can’t really skip that stuff. And so I think acknowledging that it’s boring, it’s not sexy, but you’re not gonna be here forever. Like even just like four weeks of it can, can make a lasting impact and build your brain muscle connection. It’s the neuro connection to really get you better results. So you’re not like doing your insanity workout, leaking, not getting results. And you know, and there’s also a scenario where you’re just chronically energy deficient mm-hmm and then you’re trying to like punish your body into submission, to like, you know, whatever it may be, lose the baby weight, improve your core. And you know, you keep throwing more energy at it. Energy. You don’t probably have as a, as a mom. Yeah. And it’s not working and you get frustrated and your issues might be getting worse. You might be leaking more, you know, mm-hmm and so there’s so it’s like this. And so that’s why I really wanna encourage people to say, you know what? I know you wanna like, go run. I want you, you wanna go and do your CrossFit or whatever it may be. And you can give back to that, but you first have to really take the time yes. To learn how to connect to these muscles.

Eva: (16:12)
Yes. So what are the first steps? So someone they’ve had a baby and you know, they’re dealing with some of those issues, maybe, even just one of them. Um, they do wanna eventually get back to their CrossFit. Their OB told them at the six week checkup, , you’re good to go, like go and exercise. Um, so what, what should one’s first step be? I mean, I, and you know, specifically when it comes to, you know, someone like you that has this specialty, as well as an actual pelvic floor physiotherapist, like what kind of journey do you recommend that people go on or what’s that next step

Nikki : (16:46)
Breathing, breathing and sounds again, people are like, really? I’m like, come on, gimme something juicier than that. No, it’s, it’s learning how to breathe using your diaphragm so that your pelvic floor is moving correctly. Mm-hmm and I actually just hosted a, a big free workshop on this yesterday. But essentially when you inhale your diaphragm and your pelvic floor are meant to both drop down and expand, think of jellyfish, swimming down and opening its tentacles. That’s kind of what happens when you inhale your diaphragm is like a toilet plunge your plunging down on your pelvic floor. So when you’re inhaling, everything is dropping and opening. However, a lot of us are breathing. Like we’re constantly stressed out. And how do you do it right now? Like how do you breathe when you’re stressed out your shoulders rise? Don’t you?

Eva: (17:32)
Yeah. Oh yeah. I just noticed that.

Nikki : (17:34)
Yeah. You’re just, I just watched you and the camera here. Right? So you’re inhaling and your shoulders go up to your ears. Well, when you breathe like that, it will turn your pelvic floor off. Essentially your pelvic floor goes on a little vacation. Yeah. And it’s not functioning and you’re dealing with more pressure in your core. And in side note, that breathing pattern is actually very common to develop in pregnancy. Mm-hmm because of the pressure. Right? I don’t know if you had this, but like you get rib pain. You feel like you can take the proper breath in cuz the baby’s taking up so much space putting the pressure everywhere. So you can often develop this upward shoulder breathing tendency in pregnancy. Yeah. The problem that is that you have your baby and your brain thinks that the baby’s still there. So you’re still stuck in that breathing pattern. Yeah. And until you deal with correcting that breathing pattern, you’re not gonna improve your pelvic floor.

Eva: (18:24)
Mm-hmm right. And is this something that specifically app pelvic floor physio can help with or is that, is that always a necessary step for people to, to take

Nikki : (18:35)
It’s always a necessary step and a pelvic floor. Physio will teach you on that. However, they’re doing so many things that their assessment. So really you need to see a fitness person like myself who can actually teach you how to integrate that into your daily movement. How do you breathe during a workout such that you can retain pressure? You can create that tension in your pelvic floor. You’re not gonna pee your pants when you do jumping jacks, all that kind of stuff. So yeah, both, both a fitness professional who’s really understands pre and postpartum. Um, and also a pelvic floor physio. Yeah. But they’re gonna give you an internal vaginal exam, which of course is something that I’m not gonna be giving you. Yeah.

Eva: (19:10)
yeah, of course, of course. So it’s not just a matter of doing keels is what you’re saying.

Nikki : (19:17)
Keels are, are given keels are very misunderstood. So essentially KES are the name for the lifting of your pelvic floor. It’s the colloquial term for lifting your pelvic floor. And they’re named Dr. Arnold Keal discovered them in 1940 during a gynecological exam and naturally named them after himself. Oh yes.

Eva: (19:39)
Ly

Nikki : (19:40)
Obviously, but the keel is just the lifting of your pelvic floor. So you may hear people tell you, oh, just go do your keels. But then you also might people, might people say like, don’t do them at all. So essentially you have to figure out what’s the state of your pelvic floor. So if you’re dealing with existing tension in your pelvic floor, then it’s important for you to learn how to lengthen the muscle before up training before Keeling. So you would wanna first focus on like reverse keels or pelvic floor drops or blossom breaths. There’s so many things we call them. It all means the same thing. It’s the sensation of get your diaphragm moving. So that, that toilet plunger visual, that jellyfish can drop down and expand your pelvic floor can expand before it can lift. So not everybody, but a lot of people need to first focus on that before they’re gonna benefit from keels per se. It’s kinda like if you go, you know, and I, you’ve probably heard this analogy before, but a bicep curl, what? Imagine your arm was kind of permanently bent and now you’re like, I wanna strengthen my bicep. So then you just do tiny little mini bicep curls. It’s not gonna give you results first. You need to learn to fully straighten your elbow before contracting it back. So that’s

Eva: (20:53)
The equivalent of like having a tight pelvic floor,

Nikki : (20:55)
Correct?

Eva: (20:56)
Yep. And so if you’re doing KES with a tight pelvic floor, presumably that’s just gonna make matters worse,

Nikki : (21:01)
Correct?

Eva: (21:02)
Yeah. Which is why, I guess going to a pelvic floor physio to be told your pelvic floor, you know, to get that diagnosis, your pelvic floor is tight. Your pelvic floor is loose. Therefore you should be doing this. Not that is gonna be essential

Nikki : (21:15)
And it is essential. But I also wanna say, it’s not so black and white, so you can have a combination of hyper and hypo tonicity. So just like you might have knots on one side of your shoulder, you can have knots on one side of your pelvic floor. Right. So you can have tension on one side and laxity on the other side. So wow. You know, you might be needing to do a combination of different things, right? Uhhuh . So you know, some, and I think this might be helpful for your listeners, but some signs that you might have tension in your pelvic floor and I’m just gonna list a few of them. Yeah. So the number one would be like pain with sex, which we spoke about. Yeah. Um, unexplained, low back pain. Pelvic pain. Yeah. Mm-hmm urinary hesitancy. So you’re sitting on the toilet and like nothing’s coming out, but you

Eva: (21:57)
Feel like you need to go pee.

Nikki : (21:59)
Yeah. But like it’s not coming you, uh, constipation. Um, those are some pain like vulva pain, just pain in that whole area. Tailbone pain mm-hmm can be associated. I’m not saying it’s causal, but it’s certainly correlated with tension. Yeah. In the pelvic floor and then hypo or laxity, hypo, toity or laxity is more associated with like the feelings of heaviness, something bulging down, coming out, um, a tampon falling out mm-hmm so more prolapse type symptoms. Um, and by the way, this is kind of mind blowing for a lot of people. You can have leaking in continents with both hyper and hypo, so you can actually be leaking. Cause you’re too tight. And people are like,

Eva: (22:42)
Cause

Nikki : (22:43)
Normally how does that work? Well, you go for a run and you leak and you assume you need to go do keels, right? Yeah. When, and you might need to, but you know, you might also be someone who’s already too tight and you’re leaking because you’re too tight. So it lo it works like this. So I’m going to, and I know people listening, aren’t gonna be able to just necessarily see my hand here, but I will describe what I’m doing with my hand. so essentially, um, I want you to picture the, um, you know, when you go to like a bowling alley and they’ve got that arm, that claw that comes out to go and like, you can put your coins in and then you’re trying to catch like a stuffed animal with it. Or like, you know what I mean? Like, or you have like the fair of the CME or whatever. Yeah. You put the coins in and it’s like, okay, now it’s, you know, you pretty much never walk away with stuffed animal, but you try, right. The kid wants to try. So the claw comes out. It’s like this robotic arm that goes down, the claw is open. Then the claw tries to like close to pick up the stuffed animal and then lift it up. You’re with me here. Yeah. Okay. Not too obscure of an analogy.

Eva: (23:42)
Not at all. We’ve all been to, we’ve all been to Chuck cheese, cheese ones and our lives.

Nikki : (23:48)
Okay. So that’s an analogy for what your public floor is doing. So pretend like your public floor is this, this robotic claw trying to pick up like a stuffed giraffe. Mm-hmm so basically if your claw is kind of already half closed, do you think you’re gonna have good luck picking up the giraffe?

Eva: (24:05)
No, no,

Nikki : (24:06)
No. So tension is equated to weakness in this case, because mm-hmm, imagine your clock can only open a little bit and only close a little bit. Oh. So then you that, right? Like you aren’t gonna be able to maintain continents. Yeah. Because it’s not closing all the way and it’s also not opening all the way. You have a reduced range of motion. So tension can lead to that leaking because you can’t fully contract as much as you can’t fully release mm-hmm so that I hope explains why, you know, again, you want, it’s like the Goldilocks thing. You want a perfectly pliable, flexible, strong, functional pelvic floor. Not one that’s too tight and not one that’s too weak or

Eva: (24:49)
Relaxed. Yes. Yes. Because if the claw is just, doesn’t actually close, then you can’t grab the little stuff giraffe either.

Nikki : (24:55)
Exactly. Yeah,

Eva: (24:57)
Yeah, yeah. Yeah. So when, when you have, you know, clients, people that you work with that say, but my OB said at my six week appointment, that I’m totally free to start resuming everything. Um, I mean, how do you feel? I mean, it’s, it’s very common messaging that, you know, people here at that six week appointment. So what, what’s your thoughts on, I guess how this system is set up right now?

Nikki : (25:23)
Yeah. I mean, doctors are doing their best, you know, they’re not, they’re not fitness experts. They’re not physiotherapists. They don’t have the training on the pelvic floor. Right. Um, they just don’t. I mean, I hope that that changes cuz it would make so much sense for them to have some training, to give you a quick assessment of, you know, prolapse or diastasis or whatever, ask the right questions. But they’re also like not incentive to do so they need to get a certain, especially in Canada and they need a certain volume and number of patients through their door, they don’t have a time to sit down for an hour with everybody to go over all these things. Yeah. So, you know, and, and as it relates to the six week postpartum checkup, I have friends, I’m friends with lots of OBS and I’ve asked them this question, like what’s up with the six weeks and they’re like, Nikki that’s cause it takes six weeks for stitches to dissolve.

Nikki : (26:07)
That’s it? That’s it. The only reason it’s the six week thing. It’s like, well, if you had stitches, they should be dissolved by six weeks so we can check them in. That’s the only, there’s nothing magical that happens at six weeks postpartum. And people seem to think that that it’s this magical like benchmark. It’s not, it’s not. So we actually recommend you start, if you are listening to this and you’re very early postpartum or pregnant start like pretty quickly after birth, you can start your core breathing literally the same week you deliver regardless of its vaginal or cesarean birth.

Eva: (26:39)
Yeah. No, I remember you posting about that on Instagram. Like after you had your son, you were showing everybody like your breathing that you were doing maybe seven days postpartum.

Nikki : (26:47)
Yeah. Yep, yep. Right. No. And it’s, you know, and it’s not to say, and this is so funny, like let’s go back to when we first met and you were in the parking garage. Yeah. Yeah.

Eva: (26:57)
How

Nikki : (26:57)
Heavy was that freaking infant car seat and you were 10 days postpartum and yet you’re told not to work out and you’re lugging like probably at least a it’s a massive ketlebell that you’re literally doing like a unilateral core exercise where you’re holding all this weight on one of your hips and arms and walking like pretty far.

Eva: (27:16)
Right? Yeah. Like,

Nikki : (27:17)
And yet would tell women not to work out, gimme a break, come

Eva: (27:20)
On. Yeah. Yeah. I mean, we have this thing called life. Um, maybe in an ideal, in an ideal world, you know, I wouldn’t be lifting a thing for six weeks and I’d have my various, you know, servants. bringing me, my staff, you know, bringing me the baby whenever I need. But you know, for those of you who don’t have a staff, um, in your house, um, you know, that that’s just not realistic and um, and we somehow make it work. Right?

Nikki : (27:45)
Yeah, we do. And it’s so this is where it’s like using the techniques that you can learn in pregnancy. We can also learn, you know, postpartum, it’s like protecting your core so that you’re not, you know, exacerbating issues. You’re in a very vulnerable state in those early. Yeah. You know, I’d say three months postpartum and there’s so much we can do to protect our core. Um, and pelvic Florida improve our own body’s healing. Yeah. Um, and, and it comes with gentle movement and this is much easier. Like the pressure load of picking a baby out of a bassinet is much higher than doing the exercises that we would recommend you do. I’m

Eva: (28:20)
I’m sure. I’m sure. And it’s, and it’s kind of crazy cuz when you think about any other injury or that someone might, you know, that someone might experience, um, first of all, there aren’t number one. There’s no arbitrary times when you know, oh, it’s been a month. All right. Time to get your cast off no matter what. Um, nor, and, and, and as well, most depending on the type of injury that we’re talking about, most people need some type of rehab, you know, they end up going to a physio as part of their recovery process. But for some strange reason, neither of those factors have been addressed when it comes to birth. We don’t see childbirth, whether it’s vaginal or C-section as an injury that requires rehabilitation.

Eva: (29:12)
Because I guess it’s also this beautiful thing. I mean, you do have you don’t I understand on the one hand, I mean, I don’t wanna think about my births as an injury per se. You know, the term is not, it’s such not such a nice way to describe the fact that, you know, you just birthed a life into this world. It’s a wonderful, amazing thing, but you’re zinc thing, but your, your body does go through it is the equivalent of an injury that your body had to go through in order to bring this child into the world. Right?

Nikki : (29:40)
Yep. A hundred percent. And, and it, I mean, I I’ve spoken about this before, so I had heart surgery at four months postpartum. Yes. It was like a catheter ablation. So it wasn’t like open heart surgery, but you know, it’s still like, and it’s a relatively, like pretty, literally it’s a day surgery. So I went in and they go and they put the catheter in your femoral vein to go up and put a wire in your heart. And I had to have an ablation for an arrhythmia that I’ve had since I was a teenager. And honestly the amount of street cred I got for this day procedure and it’s a surgery and you’re in like, you know, but still like I could have milked that, let me tell you, oh gosh. And yet everyone was like, oh my God, heart Sergia how are you? Take some time off.

Nikki : (30:22)
I’m like, do you realize this was literally zero on a scale of zero to 10 when childbirth was a 10 and I didn’t get that kind of street cred no. After, you know, or like that’s support or that like outpouring of like, wow. You know, but like that’s the way our culture sees birth. Birth is like, man, meanwhile, anything to do with your heart. It’s like, oh my God, your heart. Right. When literally I went home the same night, I felt like I could have gone out the night after. Right. It was fine. Right. You

Eva: (30:50)
Felt a lot, a lot better after your heart surgery than you did both of your births.

Nikki : (30:55)
Oh, it was like, yeah, literally it was, it was a non-event and yet, you know, and so this, I shared this to illustrate this sort of double standard. Right. Mm-hmm like with what it is that women go through and having been through other medical things. Yeah.

Eva: (31:11)
Childbirth

Nikki : (31:11)
Is still by far the largest recovery.

Eva: (31:14)
Yeah. Yeah. So, you know, let’s, let’s take that six week milestone as, um, with a grain salt, you know? So it, your OB says that, you know, you’re healing well, okay. That’s great. You know, that’s not something to knock, let’s celebrate that. But, um, you did also birth a child six weeks ago in some way. And uh, and it’s just like, think of it as any other procedure that you went through. There’s no, you know, magical cutoff point where life just completely goes back to normal.

Nikki : (31:48)
And we tend to tell, I tell the students start your rehab early, but gently. Yeah. So one of the worst things you can do is do nothing for six weeks, wait for your clearance. And I’m using air quotes here. Yeah. And then go for a run cuz you’re cleared and go to, you know, your favorite CrossFit class again. Or you’re gonna go for a run around the block or whatever it may be because, and then this is such a common scenario. You don’t get any guidance, you don’t do anything cuz you’re waiting for that clearance. Mm-hmm you get the clearance, you go for a run, you pee your pants and then you go, well I guess it’s part of motherhood.

Eva: (32:24)
Yeah. Yeah. When really there is what that you can do during that six week period. You don’t just have to sit, you know, sit down and wait. Um, and then by the time you reach that six week mark, it doesn’t mean that your body is magically back to the way it was before you got pregnant.

Nikki : (32:42)
No, not even.

Eva: (32:43)
That’s just not how physiology works.

Nikki : (32:45)
No. And, and there’s even research like guidelines outta the UK regarding like when is it safe or recommended? I should say to go back to high impact exercise like running and they, they actually recommend waiting. No like really don’t do it even any earlier than three months postpartum. And I ideally better to wait until six months postpartum.

Eva: (33:06)
Your always seems to be a little bit further ahead. they seem to be a little bit more, um, yeah. Forward thinking. And then, and then Canada and the us sort of catch up, we lag behind them and we catch up, you know, a

Nikki : (33:21)
Few years in some ways,

Eva: (33:22)
In some ways when it comes to these sorts of things, I

Nikki : (33:24)
Think it depends on the country, I would say. Um, cause it really depends, but yeah, there’s some really great physiotherapists in the UK and they put together this guideline and, and it’s something we, we talk about a lot in, in our classes, but essentially yeah, making sure that you’ve got enough strength and function, unilateral, glute strength, like there’s a whole bunch of, of sort of benchmarks and tests that you can do on your own to determine is your body ready to go for a run? Right. That’s

Eva: (33:50)
So smart. Yeah. We need that. And it’s we do. It’s also straightforward. You know, it’s not complicated, but I feel like we, we need that. We need something more than just that six week benchmark. Um, to be able to tell us what we’re, what we’re safe to do, cuz I’m sure there are people that at the six week mark, they might be ready to go for a run it’s possible. No, no they’re not. No. Okay. Not

Nikki : (34:15)
Possible. They, they may feel they are, they may go for a run. They may not have leaking, but their body, they’re not doing their body any favors because okay. One of the things people don’t realize is like, when you have a vaginal birth, the axons of the nerves are actually stretched to a point of damage. Mm. So that’s partly why, when you’re, when you are doing quote unquote keels postpartum, it might feel like I lost my connection. I can’t feel my keel. Yeah. Cause your nerves were damaged. They will come back. Yeah. That neuromuscular connection will come back. But like it certainly hasn’t completely come back at six weeks postpartum and then you’re gonna go and do a very high impact exercise. Yeah. Adding more downward pressure and strain on nerves and muscles and fascia and connective tissue. That’s not fully rehabbed. So there are people who actually develop prolapse postpartum because they do things too soon. And this isn’t meant to be disempowering. This is just me. This is in on the contrary. It’s meant for me to say, you know what, like give yourself a bit more grace. Six extra weeks of your life is a blip on the radar, but it can make a lasting impact on your pelvic floor.

Eva: (35:20)
Yeah. Okay. Well I stand corrected but nonetheless, nonetheless, that tool, some, a tool like that sounds really remarkable. So do you have a link to that? Like can I put that in the show note? Do you have, is there something I, I, I definitely wanna put that in the show notes because, um, that sounds like a really fantastic, um, tool for postpartum women to get. So, so right now, so how do you work with women right now? How do you support them? What’s what’s your, what does your business look like?

Nikki : (35:47)
So we offer live classes every two months. It’s an eight week session. So we have a level one postnatal class, a level two postnatal class. So level one can be started, you know, as early as I would say, three to four weeks after a vaginal uncomplicated delivery. Mm-hmm and closer to six to eight weeks after a Cesan or a more assisted vaginal delivery with epitomy forceps mm-hmm um, or third or fourth degree tearing. I mean, that’s a guideline, a very rough guideline, obviously it’s gonna defer for each individual. Yeah. Yeah. So that’s first level one. And then level two is sort of like, I, I created it cause I realized there was like this gap. We had this gap in, in what was being offered. So women doing early rehab, you know, like the toe taps and the leg slides. And then they’re like, okay, I guess I’m done my rehab.

Nikki : (36:36)
I’m gonna go back to my regular class. Mm-hmm and maybe they weren’t quite ready for it. Maybe they still were getting leaking doing the high impact movements. So level two’s really, it’s pretty hard. I’m not gonna lie, but it bridges just the gap between early rehab and like super high impact exercise. Right. So that’s the postnatal stuff that we offer. I also have, we offer classes that are specifically for pregnancy and push prep. Um, probably our most popular classes and they’re all online. You don’t need to join live. Um, if you can, if you want to. But yeah, there’s a whole member login. It’s been the journey. Like we used to teach. I always only teach in person in Toronto for the past, like 15 years.

Eva: (37:16)
Right. Wow.

Nikki : (37:18)
But then the pandemic came and I was 35 weeks pregnant and the world shut down and I was like, crap,

Eva: (37:25)
Oh,

Nikki : (37:25)
Out and like shut down all the locations and take all of our classes online. Yeah. And um, in a way it’s been a blessing because now we’re teaching women all around the world.

Eva: (37:36)
Yes, yes. You can serve so many more people, um, who need you so if people want more of you in their lives, where can they find you

Nikki : (37:46)
The bell method.com it’s bell, B E L L E method.com. Yes. Yeah.

Eva: (37:52)
And on Instagram as well.

Nikki : (37:54)
Yes. Same. It’s all the same handle. Yeah.

Eva: (37:56)
Yes. Okay. All right. So that will all be posted in the show notes. Nikki, thank you so much for coming on. This is, um, gold. This is gold stuff that, you know, every, that everyone needs to hear and digest and apply to their life, however, which they need it. So thank you. Thank you. Thank you. And thank you everyone for listening. All right. Have a good day, everyone.

Eva: (38:22)
Thank you so much for listening. If you enjoyed this episode, please subscribe, leave a review and share this episode with a friend who can benefit from it. I also love hearing from my listeners. So feel free to DM me on Instagram @mysleepingbaby, or send me an email at eva@mysleepingbaby.com until next time have a wonderful restful nights.

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