• How do I know what exercise is safe to do during pregnancy?
  
  
• What are the benefits of exercising during pregnancy? There are many benefits to exercising in pregnancy, both for you and your baby. To find out about these, click HERE.
  
  
• Are there exercises that I should avoid during my pregnancy? Yes, there are certain activities that are not recommended during pregnancy, or at particular stages of your pregnancy. To find out about these, click HERE.
  
  
• How does returning to sport or exercise too soon after the birth affect my pelvic floors muscles?
  
  
• What about my back - can exercising too soon after the birth cause back pain?
  
  
• When is the right time to start exercise and sport again after the birth of my baby?
  
  
• Calf cramps in pregnancy. I have been experiencing calf cramps now that I am pregnant. What can I do to help this?
  
  
• What effect does wearing shoes with high heels have during pregnancy?
  
  
• What can I do if I have a backache?
  
  
• When I get up from lying down, I notice a bulge in the middle of my abdomen. What is this?
  
  
• What is safe to do after a Caesarian Section? My baby is 7 weeks old and I had a Caesarian Section. I was told not to do too much when I left hospital, but what can I do now?
  
  
• I have heard about friends getting wrist pain after they have had their baby - why does this happen?
  
  
• What do I do if I have wrist pain after I have had my baby?
  
  
• When I get out of the swimming pool, I feel like I am leaking. I can feel something running down between my legs. This never used to happen. What can I do about it?
  
  
• What is mastitis?
  
  
• What can help with mastitis?
  
  
• How can I prevent mastitis?
  
  
• Should I feel like I need to go to the toilet all the time while I am exercising?
  
  
• What are good bladder habits?
  
  
• How do I know if I am really doing my pelvic floor exercise correctly? If you read How NOT to do your pelvic floor exercises, this will give you a good idea on whether you are doing your exercises correctly or not.
  
  
• How common are problems like poor bladder control or incontinence in pregnancy and after? Click HERE to find out.
  
  
• What is a prolapse?
  
  
• Why can a prolapse happen?
  
  
• I thought prolapses only happened to women when they got older, but I heard that younger women can get them too. Is this true?
  
  
• What can I do if I have a prolapse?
  
  
• How quickly can I expect to improve if I do have a prolapse?
  
  
• Do pelvic floor exercises really help?
  
  
• Is it normal to not feel your pelvic floor muscles after the birth?
  
  
• Should my stitches feel uncomfortable after the birth or during intercourse?
  
  
• What are hemorrhoids?
  
  
• What can be done to help hemorrhoids?

"How do I know what exercise is safe to do during pregnancy?

There are many factors to consider when exercising during pregnancy. These include:

• Your pre pregnancy fitness.
• Previous exercise activities.
• Your current health.
• How far along you are in your pregnancy.
• The climate where you are exercising and your choice of exercise program.

We have developed some guidelines called "Considerations for Pregnancy and Post Natal Exercise" which outlines the most important factors to consider. It includes suggestions for suitable exercise during pregnancy and some precautions to consider. This pamphlet is included in Your Powerful Pregnancy Program together with the booklet As Your Shape Changes which also includes information about exercising during pregnancy.

Click on the "Exercise" button to find out more detailed information on exercise guidelines during pregnancy.

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Calf cramps in pregnancy

I have been experiencing calf cramps now that I am pregnant. What can I do to help this?

During pregnancy many women notice that they experience calf cramps, especially at night time when sleeping (or trying to sleep). There are varied causes of calf cramps during pregnancy, but no noted single cure for them.

One of the reasons your calf muscles may cramp is because you have an extra 40-50% of blood volume in your system which needs to be pumped around your body. When you are walking and moving during the day, your calf muscles act like a pump and help the blood to flow against gravity, back up towards your heart. When you are lying down at night, it is not as easy for your heart to do all the work, pumping the extra blood down to your feet and then back up again. Fluid can 'pool', that is the circulation slows down, and swelling can occur in the veins in the legs. This fluid retention can contribute to cramps occurring and also leg aches.

The other reason that leg swelling or slowing of the circulation can occur while sitting or lying is your growing uterus as your baby grows. This makes it harder for your blood to move through the veins back towards the heart. Simply being aware of this can help you to understand why leg swelling or calf cramps can occur.

After sport or exercise, calf stretches would often be considered important, amongst other stretches. During a busy day of being on your feet, the calf muscles are working, but stretching after 'a days work' is not often thought of. Your calf muscles are working harder during pregnancy with the weight of your growing baby to move you around. Why not try and stretch them at the end of the day or before you go to bed?

• Calf muscle stretches ~ There are two different calf muscles to stretch:
  
  
  • Gastrocnemius ~ which is a muscle that goes from behind your knee down to the Achilles tendon behind your ankle. To stretch this muscle you should place one foot in front of the other at a comfortable distance apart. Keep the heel of your back leg on the floor and your knee straight, (front leg, knee bent), while you lunge forwards until you feel a gentle stretch at the back of your calf.
    
    
  • Soleus ~ this muscle goes from just below the back of your knee down to the Achilles tendon behind your ankle. To stretch this muscle, stay in the position described above, and keeping the heel of the back leg on the floor, bend the back knee until you feel a gentle stretch at the back of your calf. You may feel this stretch lower down in your calf muscle. This stretch can also be done with both legs at the same time. Stand in front of a wall, place your hands on it for support with your feet level but comfortable apart. Bend both knees until you feel a gentle stretch in your calf muscle.
  
  Hold each stretch between 10 - 30 seconds, and repeat on the other side. You may want to do this more than once on each side. When you are pregnant you should not overstretch due to the relaxin hormone in your body which softens ligaments. You should feel the stretch comfortably with no pain, but do not push into a strong stretch.
  
  
• Ankle circles and calf pump exercises ~ Pooling of the blood in your calf muscles can also occur if you have been sitting for long periods during the day or in the evening. Again your circulation slows, so to help the muscles pump the blood back you can do ankle circles or simply move your feet up and down while you are sitting (calf pumps). This can also occur if you are standing for any length of time. Again calf pumps may assist to reduce leg aches in this situation or cramps from occurring.
  
  
• Cool down slowly and stretch after exercise ~ If you exercise during the day it is important to do a longer cool down while you are pregnant. Your heart has been pumping the blood around faster so if you stop suddenly it can cause pooling of blood in the veins in your legs. Slow down for the last 5 - 7 minutes of your exercise program, and then finish with some calf stretches, especially if you have experienced leg cramps.
  
  
• Use a towel to help you stretch if you get cramps at night ~ If you do wake up with leg cramps, you can try to relieve it by gently pulling your toes up towards you. This will stretch the back of your leg, and the muscles should relax. If you are unable to do this, sometimes using a towel under your foot and pulling gently can help you to do the stretch more easily. It also stops you from needing to wake up your partner to help you get rid of the cramp.
  
  
• Try not to cross your legs and have your legs supported properly ~ Crossing your legs for long periods of time is not recommended as this also slows down your circulation. If you are resting during the day or evening try to have your legs elevated, but do not place your feet on a chair or stool and leave the backs of your knees unsupported. Lying on a lounge with your legs up is a better option.
  
  
• Overheating at night ~ Being too hot during the night may also lead to leg cramps. The extra heat can cause the veins to open up slightly, and this in turn can cause pooling of the blood in your calf muscles. Wearing too many clothes to bed including socks, and the use of doonas have been associated with becoming overheated during the night.
  
  
• Seek further advice ~ There are other suggested reasons for calf cramps occurring. These include calcium deficiency or lack of potassium in the diet. If the above suggestions do not reduce your cramps, please seek further advice from your Midwife, or Medical Practitioner.

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What effect does wearing shoes with high heels have during pregnancy?

When you wear shoes with high heels regularly during pregnancy, your calf muscles are constantly being placed in a shortened position. This can lead to tightening of your calf muscles over time, and the development of calf cramps. If you do wear heels and you notice that you are getting cramps or tightness in your calf muscles, you may need to reconsider the type of shoes that you wear.

Try alternating flatter shoes with those with heels and see if this helps, i.e. don't wear your shoes with heels every day. Doing calf stretches more often can also help, so that you do not let your calf muscles tighten and shorten over time. Use the stretches described in calf cramps in pregnancy, regarding how to effectively stretch your calf muscles. There are also other tips included which can help calf cramps if you are experiencing them.

The other effect that wearing heels may have is that of altering your posture. High heels can tip your pelvis forwards, which increases the curve in your lower back. When you are pregnant the weight of your growing baby will already be pulling you forwards, so this can become even more exaggerated if you are not careful with the shoes you choose to wear. If you notice a backache, consider changing shoes to see if this helps. Also be aware of your posture, standing tall and pulling your tummy in gently during the day.

Just being aware that the type of shoes you wear may have an effect on your body while you are pregnant, may help you if you do experience any of the discomforts mentioned above. It is only one factor to consider, but not one always thought of. I hope this extra tip helps you to enjoy your pregnancy, without lots of discomforts.

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When I get up from lying down, I notice a bulge in the middle of my abdomen. What is this?

During pregnancy the abdominal muscle wall can separate in the middle. The fibrous band between the abdominal muscles softens, so that your abdominal muscles and this band can stretch to make more room for the growing baby. Sometimes the muscles will separate enough that you notice a bulge when you lift your head and shoulders as you go to get up off the floor or out of bed. You may also notice this when getting out of the bath, or out of a chair.

Your should try to reduce the strain on your abdominal muscles as much as possible during pregnancy and soon after you have had your baby, until this gap goes away. You should not "jack-knife" when you move from lying to sitting. This means that instead of sitting straight up, you should roll over onto your side and use your hands to push up into a sitting position. When getting up from a low chair, you should wiggle forward in the chair and then get up without putting strain on your abdominal muscles.

You should also avoid exercises which place strain on the lengthened abdominal muscles, including sit ups, abdominal curls and crunches during pregnancy (remembering that after 19 weeks you should not exercise lying on your back anyway). Even modified abdominal curls or crunches, for example while lying on your side, may still place strain on the abdominal muscle wall and increase the chance of developing an abdominal muscle separation.

You should continue to follow this advice after your baby has been born, until the separation closes again.

To check whether you have a separation, or how large it is, refer to As Your Shape Changes, and use the charts in the booklet to record your measurements. You can then monitor that it goes away again after your baby has been born.

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What is safe to do after a Caesarian Section?

My baby is 7 weeks old and I had a Caesarian Section. I was told not to do too much when I left hospital, but what can I do now?

By now the scar from the Caesarian Section (also known as C-section) should be healed well, although the tissues on the inside are still strengthening up. So you can do things like walking, low impact aerobics, swimming or bike riding for exercise.

Normal day to day lifting is OK, but take care to tighten your tummy and look after your back, keeping it straight when lifting. Holding your breath is a good gauge. If you need to hold your breath, it is too much for you to lift (lifting furniture is not recommended!!!). Household activities like vacuuming, mopping, sweeping and hanging out the washing are fine.

An important thing to guide you at any stage after a caesarian is that if you feel any real pulling or stretching or pain at the scar site from your caesarian, you should not continue to push through that.

You should also take care when doing abdominal exercises. Abdominal bracing is recommended once you are comfortable to do this (usually five to seven days after the birth) and should be continued for at least the first few months after the birth. You should take care when doing other abdominal exercises such as sit ups, abdominal curls or crunches, as these can place strain on the caesarian scar. If you experience any discomfort after doing any exercise, it is too soon for you to do these. Stop for one or two weeks and try again later, meanwhile continuing with the abdominal bracing exercise (pregnancy and post natal bracing exercises are described in the booklet As Your Shape Changes).

Your body is still recovering from the birth like anyone else, so you can still have the effects of the relaxin hormone in your body, so you should take care not to overstress your pelvic floor and also your back. You should not commence any high impact exercise until at least three to four months after the birth. Use the guidelines in Considerations for Pregnancy and Post Natal Exercise, which you receive with your copy of As Your Shape Changes, for further information on exercising after your baby is born. You should also use the post natal tests in As Your Shape Changes, to ensure your body is back to normal 'on the inside', to be strong for you and your baby.

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I have heard about friends getting wrist pain after they have had their baby ~ why does this happen?

Most new Mums don't think about how they pick up their baby, but starting to do this over and over again can cause soreness of the tendons around the wrist. Often we pick up babies with our thumbs pointing upwards which places most of the strain on the tendons of the thumb and the side of the wrist. Try to vary this, placing your palm upwards. This technique will use the forearm muscles more and protect the other tendons. Varying the way you pick up your baby can take strain off your wrists and reduce the development of pain.

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What do I do if I have wrist pain after I have had my baby?

• Sometimes wrist splints can help.
  Seek professional advice on what is the best for you.
  
  Use ice on the affected area.
  First cover your skin with some oil or a flannel, then place an ice pack over the sore area. This can be left on for 10 to 15 minutes and can be repeated every 3 to 4 hours. Do not place ice directly on your skin as this can cause an ice burn.
  
  
• Seek professional advice from your doctor or physiotherapist.
  If the above tips do not help, seek advice as soon as possible. If you notice your pain becoming more frequent or getting worse, seek advice first, rather than trying any of the above tips. Other treatment is available and a health professional can assess your problem and provide you with the best advice and treatment.

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What is mastitis?

Mastitis is when there is redness, tenderness, lumpiness or firmness, pain and/or swelling in the breast, in women who are breast feeding. Women can have one or more of these symptoms, and often it is noticed to be more in one section of the breast. Some women will also feel flu like symptoms, chills, nausea, and a fever, which can sometimes occur overnight or very suddenly with little or no warning.

The development of mastitis may make breast feeding painful and may lead to some mothers stopping breast feeding.

15% of Australian women between 5 and 12 weeks after the birth of their baby experience mastitis, although mastitis can occur at any stage of breast feeding.

Mastitis can occur due to a blockage in the milk ducts, which if not cleared, can then become inflamed (redness and tenderness), which can cause more of a blockage. Sometimes an infection can occur via a cracked nipple, also causing mastitis.

It is important that if you suspect mastitis, and feel any of the above symptoms that you do see your doctor for an appointment. Getting treatment early can help prevent the problem from continuing. You should see your doctor as soon as possible, preferably that day, rather than waiting to see if it will go away. This is particularly important if you have any flu like symptoms. Medications can help to relieve the symptoms.

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What can help with mastitis?

• Ultrasound Treatment.
  Doctors sometimes refer women for ultrasound treatment by a Physiotherapist, which can help to unblock the milk ducts when applied over the affected area. If you are unsure whether this may help in your situation, check with your doctor.
  
  
• Massage.
  Gentle massage during a feed may help, but make sure that you do not press too hard or this can cause more tenderness and inflammation. 3 different massage suggestions are:
  - Massage using your fingers, sweeping gently from under your armpit down towards the nipple.
  - Massage lumps gently towards the nipple during and after a feed.
  - Massage in a circular motion starting from the nipple to try and clear areas from close to the nipple, then moving out slightly, and continue until you reach underneath your armpit. Gentle massage under a warm shower can also be helpful.
• Cold/Heat.
  Applying warmth to the affected area before a feed can help let down. Using a warm face cloth may help, or a warm heat pack as long it is not too hot or heavy on the breast, otherwise this may add to the discomfort. The use of a cold compress or ice after a feed can also be useful to help relieve discomfort.
  
  
• Cabbage leaves.
  Many women have found that placing cool cabbage leaves over their breast helps to relieve pain and discomfort. It is not known exactly why this helps, but it can be relieving.
  
  
• Rest.
  Rest as much as possible until the mastitis is over. This will help your body to recover more easily.
  
  
• Keep your breast empty.
  Keep the affected breast as empty as possible, to keep the milk moving through the breast.
  
  
• Feed from the affected breast first.
  Feed from the affected breast first, when baby's sucking is most vigorous.
  
  
• Have good attachment of your baby onto the breast.
  If you are unsure regarding your attachment, or are experiencing pain while feeding, not just due to the mastitis, please seek further advice. Your Midwife, Child Health Nurse, Nursing Mothers Councillor, Lactation Consultant or Doctor should be able to give you advice. It depends on the services available in your area as to who is the best person to contact for help regarding attachment and positioning of your baby during feeding.
  
  
• Do not wean at this time.
  This is not normally a good time to wean your baby. Seek advice if you are considering this.

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How can I prevent mastitis?

Good milk flow may prevent mastitis. For good flow, consider the following points:

• Good attachment is important.
  Learning about breast feeding during pregnancy can help prepare you, and make you aware of the key factors for good attachment. Asking for and using the assistance of the midwives while you are in hospital can help you to get established with breast feeding your baby. If you are experiencing any pain during feeding (and you do not have mastitis), your attachment may not be good. Seek advice from the health care provider in your area. Your Midwife, Child Health Nurse, Nursing Mothers Councillor, Lactation Consultant or Doctor should be able to give you advice. It depends on the services available in your area as to who is the best person to contact for help regarding attachment and positioning of your baby during feeding.
  
  
• There should be no restriction against the breast.
  
  • Sleep without a bra.
    If you leak then place a towel under you or wear a crop top to bed.
  • Sleeping on your stomach can restrict milk flow.
    A lot of women look forward to sleeping on their tummy again after the birth, but it can place pressure on the breast which could lead to blockages.
  • Avoid pressure on the breast while feeding.
    This includes, for example, pressing your fingers against the breast to hold it in position.
  
  
  
• Avoid hurried or interrupted feeds.
• Keep your breasts from getting over full.

Remember there are many trained breast feeding councillors and health professionals who can help you if you need it. Find out who is available in your area and seek advice when you need it.

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Should I feel like I need to go to the toilet all the time while I am exercising?

To answer this question, an example from someone who actually came in for help with this exact problem will be used. Caris (not her real name) has given permission for her story to be used).

Caris started aerobics again when her baby was four months old. She felt that she needed to go to the toilet the whole time that she was in the class. This happened even when she went to the toilet just before the class. She did not experience any leakage of urine, although many women do, but needed to go to the toilet again after the class had finished. Caris also noticed that she was going to the toilet much more often after having her baby, even up to eleven or twelve times. She also went two or three times during the night. Once her baby slept through, she found that she didn't!

Caris spoke to her friends about this problem, but they all thought that it was normal after having a baby. As her Physiotherapist explained to her, it is not normal, but it is common. The same is to be said for leakage of urine during exercise. These are problems that can be helped.

After making a physiotherapy appointment, Caris learned that she had 'trained her bladder to go too often'. This can happen when you go to the toilet often, 'just in case' you need to go, like before going out, although you may already have been recently. When you wake up to feed your baby, if you go to the toilet when you don't need to, you are training your bladder to go more often than it needs to. You may then find that like Caris, your baby may sleep through and you won't. This is also mentioned in As Your Shape Changes, so take another look at the section on "Your bladder and your baby".

Caris did a bladder chart, where she measured the amount of urine that she passed when she went to the toilet. She often passed 175 - 200 mls of urine or less. (This does involve weening into an old measuring container, but it can be an interesting exercise).

Once she became aware of good bladder habits (see What are good bladder habits), after a few weeks she was passing 300 - 400 mls of urine, and was now only going to the toilet about seven times a day, and only one time at night. She had even had a few nights of not waking up at all to go to the toilet!

By being aware that these habits weren't normal, and finding out that it was OK to hold on a bit longer, Caris was able to get her bladder habits back to normal fairly easily. If she had continued with her old habits though, when she had another baby the problem could have become much worse. This problem can also become worse as women get older, so sorting it out as soon as possible after the birth is important.

The other thing Caris needed to do was to continue to work on her pelvic floor muscle exercises. Her baby was four months old already, but her muscles were still getting stronger and were not yet back to normal. This also contributed to the feeling of needing to go during exercise. Caris decided to continue with working diligently on her pelvic floor muscle exercises and continue with lower impact exercise like walking on the treadmill and bike riding until her pelvic floor muscles really felt strong. Then she would go back to aerobics classes.

If you experience a problem with visiting the toilet often or leakage of urine after the birth of your baby, try the following tips. If they do not work within four to six weeks, seek further advice.

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What are good bladder habits?

Do you know how much your bladder holds?

Normally our bladder holds 300-500 mls of urine before we need to go to the toilet. This means that we should go to the toilet every three to four hours during the day, and no more than once per night.

Now when you are pregnant it is a different matter. Hormonal changes together with your baby pressing on your bladder (as your baby grows, there is less room for your bladder) means that you usually go to the toilet more frequently. This is common during pregnancy but should not continue long term after the birth.

If your bladder capacity is reduced AFTER having your baby, or you find yourself going to the toilet more often than you used to, then you can try to retrain your bladder.

• Write down each time you go to the toilet.
  Having it in writing can help you to really see how often you do go.
• Measure the amount of urine you pass over two or three days, including at night.
• Re-train your bladder habits.
  If you capacity is less than 300 to 400 mls regularly, or you are going much more often than three to four hourly, then you may need to re-train your bladder habits.
• Hold on when you can.
  Try to hold on a little longer when you are able to, before you go to the toilet.
• Seek further advice.
  If you find it very hard to hold on, or find that you leak on the way to the toilet, you need more individual advice. Make an appointment with a Physiotherapist working in the area of Women's Health or speak to your doctor to find out about health professionals near you who can help.

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Should my stitches feel uncomfortable after the birth or during intercourse?

If you have stitches after the birth of your baby, it is not unusual for them to feel uncomfortable initially, but this pain or discomfort should not continue long term.

Initially stitches may mean that your perineum area may also be swollen or bruised. Using ice pads or packs in the first 24 to 48 hours and sometimes longer can help to reduce the swelling and can make you feel more comfortable. As charming as it sounds putting ice over your perineum area, it really does make a difference to how you feel. Ice pads or packs can be used regularly while in hospital in those initial few days. They can be easily made at home if you do continue to need them. Simply dampen a sanitary pad with a little bit of water, and place it in the freezer until you need it. These can only be used once, for hygiene reasons, as you are usually still bleeding at this stage.

Starting your pelvic floor muscle exercises will actually help your stitches to heal. Make sure that you are doing your exercises properly. Refer to 'How NOT to do your pelvic floor exercises!' or get your Midwife or Physiotherapist to check for you if you are unsure. The exercises will help to improve the circulation in the perineal area, which can help to reduce the swelling. Providing you are doing your exercises correctly, they will not place any strain on your stitches, as doing your exercises lifts your perineum upwards. Often women think that it will hurt to do the exercises, but it actually helps and usually feels quite comfortable to do. Just start gently and it will also help your pelvic floor muscles to recover more quickly after the birth. Doing your exercises 'little and often' at this stage can be more helpful than doing a lot in one session.

While in hospital or in those early weeks at home, ultrasound treatment by a Physiotherapist can help to reduce the swelling and tenderness around the stitches. This usually makes a difference to how you feel quite quickly, so if you do have ultrasound available, make the most of the opportunity to have this done. It does not hurt during the treatment either, and is actually quite soothing because of the cold gel that is used.

Everyone heals and scars differently. As you can imagine having a scar at your vaginal opening means it is in quite a sensitive area. Normally your vaginal opening is quite supple and stretches easily. Sometimes a scar can mean that it doesn't stretch so easily, so when you start to try and make love again, it can be sensitive and sometimes uncomfortable. Some couples are unable to actually start intercourse because of the discomfort from the scar site, whereas others may be able to continue, but it is not comfortable for the woman during intercourse. Sometimes discomfort can be felt over the scar tissue from the stitches after intercourse. If any of this happens, it is NOT normal, although it is common, and you should not continue to put up with the pain.

Sometimes there is a little bit of discomfort initially and then it gets less with each time you try making love. If this occurs, it is likely that it will get better by itself. But if the pain continues, or intercourse is 'no go' because of the pain, you should seek further advice and treatment.

Something you can try yourself at home is perineal massage, which you may have heard about in Antenatal Classes or read about in pregnancy books. You can try massaging over the scar, starting gently and pressing as hard as you can tolerate, using some sort of lubrication gel or natural oil to massage with. If you cannot tolerate the massage, or it does not get better after a few weeks, you should seek advice from a Physiotherapist working in the area of Women's Health.

A Physiotherapist can use ultrasound which can be applied directly over the scar at the opening of the vagina, and over any tender area of the scar. Again, it sounds charming and also embarrassing thinking about this, but it is a treatment that works really well. The ultrasound softens and breaks down the scar tissue, and over a course of treatments, the scar tissue becomes less painful and stretches more easily. Perineal massage is sometimes easier to do after the ultrasound, so that you can do this at home between treatments to help speed the recovery process along. It is better to have treatment which will sort out the problem, rather than to be put off intercourse because you know it is going to hurt. There are enough other factors like having a new baby in the house, and being more tired, that make intercourse a challenge for new parents.

Sometimes the scar tissue from stitches can hurt with just sitting down, or with going to the toilet, particularly to use your bowels. The scar rubbing against your underwear may also be uncomfortable at times. If this occurs, ultrasound in those first few weeks or months can help to reduce the sensitivity and discomfort.

If you think that your scar might hurt when you try intercourse, you can have some ultrasound treatment before you even try. Then you will know that you are going to be comfortable, and there is more chance of relaxing when you do try.

Don't continue to put up with this problem long term. It is not good for you or your relationship. Cary (not her real name/story used with permission) started trying intercourse when her baby was a few months old, but was unable to due to the pain at the vaginal opening and just inside, which she thought was from her stitches. She left it 6 months before seeking advice and treatment from a Physiotherapist. Within a few weeks of treatment, the problem had resolved and they were able to successfully make love with no pain.

Continuing with your pelvic floor exercises at this stage is still important. They will help to improve the circulation in the area, and will also help to keep on strengthening your muscles after the birth.

Physiotherapist Note:

I have seen women put up with pain for longer, even up to a year or more, because:

• They didn't know that intercourse shouldn't be painful after having a baby.
• They didn't realize that it wasn't normal or were told that the pain would go away.
• They were too embarrassed to come in for treatment and just hoped that the problem would go away by itself.
• They just didn't know that treatment was available.

It is hoped that this article will encourage you to seek help early if you need it, rather than continue to put up with pain and discomfort, like women have in the past. Also, please advise any friends who have had a baby and mention that treatment is available, as they may not know that they can do something about this problem.