Mum's The Word! The Parenting Podcast - Dr Zoe Williams

Episode Date: September 26, 2021

Zoe gives us some wisdom that Ashley wishes that she had heard during her pregnancy in this episode, they chat finding the birthing plan that is right for you, the importance of pelvic floor and how she found stepping into the mummy club herself!If you have a question you want Ashley to answer, go to [e-mail]--- A Create Podcast Hosted on Acast. See acast.com/privacy for more information.

so rather unexpectedly in the last couple of weeks i've managed to get into a bikini who knew that september would give us a little bit of good weather and it kind of got me thinking about the postnatal body because it's weird because i'm nearly nine months postpartum which means that I've basically had Alf out of me for as long as I had him in me but I still really feel like I've got postpartum body like I still feel like I'm recovering I still don't quite recognize myself when I look in the mirror and that's not to say it's because it's a worse body necessarily. It's just a different body. So I thought it would be quite a good episode to talk about birth prep, the perineum, the pelvic floor and the postnatal body in general. Because to be honest, I really had an expectation that you recover from childbirth in six weeks.

expectation that you recover from childbirth in six weeks. And I don't know if that's because that's the time that you have in your head that you get signed off by the doctor, because it's usually six to eight weeks, isn't it, that you go see the doctor, and I thought they would kind of check you over, and then you'd go back to kind of doing exercise or not doing exercise, whatever you want. But as somebody who, you know, I love running, I've run a lot of marathons, I love boxing, I fully expected that I would just get to go back to all of that. And almost nine months down the line, I'm still not doing any of it. And it's so interesting, isn't it? Because I feel like you only ever hear about the postnatal body in the context of weight. Like, have they lost their, have they lost weight? Have they gained weight?

Have they let themselves go? Have they lost the baby weight? And I feel like that saying is, well, like the baby weight, it's such a like vulgar way to talk about a female body, isn't it? Or like a person who's given birth to body because let's be honest, our body has just done something pretty amazing. Like not only grown an entire human over the period of nine, 10 months,

but it's done childbirth. However you choose to do childbirth, whether it's a C-section or vaginal birth, like it's a pretty-section or vaginal birth like it's a pretty miraculous eventful huge thing to have achieved and your body is recovering and to talk about it as baby weight I feel like it's such a like why is it amazing and glowing and miraculous when the baby's in and then as soon as the baby's out it's like something that you should shift or not shift I just find it bizarre and you know what I was actually looking

forward to childbirth because I felt I felt like finally I was being given the key to uncover this mystery box around what happens to someone who gives birth to body, because I really felt like people are pretty open around pregnancy. You know, you hear stories of piles and not being able to walk and swollen ankles and, you know, whatever people might be experiencing. And then there'd almost be a blackout where you don't hear from someone for a couple of weeks. And in your head, you're like, oh, they must be giving birth now. It must be happening. I wonder if they're giving birth but you know you don't want to keep asking have you given birth yet because it must be annoying and now that I've been in that position with a 10 day old baby 10 day late baby rather I am I just don't ask now but you wait and you wait and you wait for

the news and then and then you hear mother and baby doing well you know parent doing well and I would always be like what is well how can How can you be well? Like, what happened? Do you have stitches? Do you have tears? Like, what's happening down there? And I hate the expression down there, by the way, because I strongly believe that we are not basements. Our genitals are not basements. And I wish that we could just use the word vagina. But that's a little bit of a side note, isn't it? We are not basements, Ashley James. So yeah, I was kind of looking forward to knowing what would happen. And I think that's one of the reasons that I wanted to be really open about my own journey.

You know, I've spoken probably too openly about the fact that I've have had I was going to say had but still have piles had a rectocile which is essentially a rectum prolapse which is just beautiful isn't it I had stitches and I think my reason for wanting to be so open about it is because I was like why do we feel ashamed to talk about our body recovering like and and it also it kind of made me angry you know because i was like we are made to feel embarrassed of our bodies or taboo around our bodies even with incontinence and all of these things and it's like but if someone has a leg operation let's say they're not gonna be embarrassed about the fact that they might have stitches or that they might not be able to walk for or they might be on crutches that there's no shame in it

because it's part of the recovery right and so I was like why are we being made like why why is it to be and why should we be we be embarrassed because actually like we're warriors and we've just done this amazing thing and our bodies need time to heal. And I think people need to understand that we are healing because there is this like weird pressure and fascination around weight. And a few people I know actually did, as much as I hate this expression, but for purpose of explaining it, like lose their baby weight. it like lose their baby weight and they almost felt embarrassed of it because they were still going through you know mastitis leaky boobs stitches all of these things that you can go through but yet people were almost like celebrating them and or criticizing them because you know it was irresponsible and it was it was they're setting a bad example So I feel like I just wanted to open the conversation around the postnatal body, which doesn't go away after six weeks. And, and also kind of talk about the birth prep, because I very much feel, I mean, the first, I still vividly remember the first day

I heard the word perineum. And I think I must have been about two months pregnant and I decided to go to a pregnancy yoga class and I was very intimidated to go to this class because you know at the time I was like I don't want to be like the mums I'm not I don't want to be a mum and I'm not like the other mums so um it took guts and I remember being really cringed out because I kept hearing the word perineum and I was like oh my god what is this world that I've entered I don't want to touch my perineum and also funnily enough that I think this says a lot about education doesn't it that the only time I'd heard that area the perineum ever described was at school and it was called a notcha you can tell I went to a largely boy

school but it was called a notcha because it was not your bum hole not your balls and that's that was as far as my education around that part of the anatomy had gone and so when people would say I'll make sure you do your pelvic floors make sure you do your perineum massages I was a bit like yeah like I'll get around to it like maybe I will maybe I won't but I had this kind of I suppose probably like are we going to say delusional or just like maybe just like I had confidence in my body because I've run a couple of marathons I didn't really train for them and I was like do you know what it's a mental battle more than a physical one like it's all in the mind and we've been giving birth for ages for like hundreds and hundreds of years since the time that I was going to say God came along and made Adam and Eve but um since the big bang let's say and um sorry there's so many jokes we had over saying the big bang in

the context of childbirth isn't there I just didn't really bother I'm not gonna lie like I was told I I did take my pelvic girdle pain serious because that stopped me from being able to walk but I didn't take it that seriously um around all the pelvic floor training and I didn't take it that seriously around all the pelvic floor training and I didn't realize how important the pelvic floor is and also how much of a part in your recovery and basically like would I have had a rectum prolapse if I'd have done my pelvic floors maybe I would maybe I wouldn't who knows but I'll never know now anyway, I thought today's guest is just the most perfect person to have on because she is an NHS general practitioner in London. She's currently on maternity leave. And she is this morning's doctor, our favorite doctor, Dr. Zoe Williams. She is also

a new mum to Lisbon Lion. What a brilliant name, by the way. And I thought it'd be so great to chat to her because she's been so open about her postnatal journey as well. And funnily enough, we've both seen the same pelvic health physiotherapist, Marta Kinsella. So I know that there's lots to chat about, but I would just love to know how her experience is as a doctor and also a mum and also if these things cross over. So I'm really excited to get to chat to her. So I'm so excited to have today's guest. She is a friend of mine who actually we chatted a lot throughout our pregnancy. And now that we're in this crazy baby bubble we've not spoken so I am so excited to welcome Zoe, Dr Zoe Williams. She

is this morning's resident GP. She's an NHS general practitioner although I believe you're currently on maternity leave. Is that correct? Yeah, I do my GP job, yes. She works with Public Health England as a clinical champion for physical activity and is the founder of Fit for Life, which is an organisation that delivers workshops to children to inspire, educate and motivate them to lead healthier lives. Zoe, I am so excited to have you on. It's just so nice to hear your voice, Ashley, and to be finally chatting with you and catching up. I should probably have mentioned in the intro that your most important role is from new mum to Lisbon Lion, who was born on the 31st of May.

Yeah, the little boy. 12 weeks old. Oh, it's been amazing. I guess parenthood is just whatever you expect it to be. Somebody was saying, is it what you expected? I'm like, I really can't remember what I expected, but whatever I expected was very, very small, probably could have been summed up on a few pages.

And what it is in real life is a whole library's worth of stuff. So it's a lot more than I expected. Do you feel like it's a lot more in the good and the bad? Yeah, absolutely. And in between and also the, you know, the mediocre, the middle stuff. There's just now I'm in this club, the motherhood club. It's like, oh, I get it now. I know now it's I don't know. You can't really explain it, can you? It's an incredible roller coaster. It's amazing. It's terrifying. It's sad. It's happy. It's every emotion you've ever had, but times 100 all

rolled into one. I don't know how you feel, but when I was pregnant or even before my pregnancy, I kind of felt like this motherhood club was this sort of really negative and cliquey and almost like do I want to say like anti-feminist or like I don't know it was just like I had such different connotations of it and now I'm in it I've never felt such support and so included in something and it's so nice like throughout the highs and the lows like I feel like people just get it I don't know I guess I came at it from a different position as you I guess I felt like I almost had a honorary membership because of my work as a GP and because of you know I see and I hear and I've been on that journey to some extent with so many women and especially you know even in my private life

friends will confide in me. I'm always at the end of the phone when my close friends have got an issue to talk it through. They trust me. They know they can speak to me in confidence. So I've always felt like I've had one foot in the mummy club, but it's only now I realise I absolutely did not at all. I was just seeing like the outer bubble of the mummy club.

Now I'm fully in it it's uh yeah it's a whole new world I tell you what I've got a new sense of admiration and a new level of respect for every single not even just mum's parents every single parent out there because it's uh yeah nobody's prepared for this are they? It's mad, isn't it? And I even said to my mum, like, I'm so sorry I sometimes forgot Mother's Day. I feel like now I will never forget Mother's Day. And I'm so thankful for everything that you did. Yeah, I know sort of a lot of my friends and a couple of family members, actually, who haven't necessarily had the best relationships with their parents or you know they've sort of been the troubled teenager and being a bit naughty and then they've become parents themselves and

heavily perhaps heavily relied on their mums to help them but also just realised that oh my gosh you know this is what you are to me or this is what I am to you and all those times that I put you through hell I'm so sorry yeah it's interesting isn't it and also I feel like you have a newfound respect for parents but also you kind of see it a bit more of like oh my god we have no idea what we were doing and they didn't either and they did their best even if their best wasn't necessarily in hindsight the best thing yeah yeah they didn't have the internet they didn't have google um i've been chatting to um stewart's mum that's my partner's mum and uh you know she told me some of the things that she told me this story about one time they were rushing to get to a wedding

it was actually their the sisters her husband's sister's wedding and they had the mother of the bride's dress in their car and they were running late so the only way she could feed the baby was before children had seat belts they didn't have car seats so she had the baby on her knee breastfeeding not driving in the passenger seat but whilst going you know probably a little bit above 70 miles an hour on the motorway and it's just like god you just wouldn't do that now would you but i remember my mum doing her makeup in the rear view mirror yeah whilst driving driving i remember like when we'd be doing the school run and she'd be doing a lipstick in the traffic lights like now i just feel like you would never do that i remember my my mum told me she remembered when the no drinking and driving rule came in it's

before we were born um and she thought that meant that you couldn't drink alcohol at the same time as driving you had to like finish your alcoholic beverage before you got in the car like what no wine at the wheel i feel like this is a chit chat and I haven't even touched on what I want to talk to you about so um Zoe obviously you are a GP and um you mentioned that you kind of felt semi in the mum club because obviously you've been on the peripherals of it but do you feel like your role as a GP and your knowledge as a doctor, helped you in pregnancy? Or did you find you almost feeling like contradictory between your maternal instinct and your doctor knowledge? Exactly that, what you said, Ashley, at the end. I think in some ways, you know,

having medical knowledge and embarking on this motherhood adventure, it can be a help in some ways, but it can be a hindrance. And I found very much throughout my pregnancy, the doctor Zoe in me, her voice was getting quieter and quieter and the maternal Zoe was getting louder and louder. And that particularly came into play around my birth preferences and what I wanted because I always thought that I would want to have an elective cesarean and that's partly due to my experiences of working as a GP but also as a junior doctor I did six months working in Obzengaini working at a busy London hospital that had a labour ward where sometimes women from other hospitals would be referred there if they were very high risk. So it was quite a high risk labour ward. And my medical

brain told me the only way to have any guarantees, have any assurances, know what the outcome is going to be, know what's going to happen, is to go down the route of having an elective cesarean section. And I think because of some of the birthss that I've witnessed I kind of knew what I didn't want um so I came into pregnancy thinking that was probably what was likely to be my my decision and probably by about six seven months I'd started thinking just thinking I maybe want to have a home birth which is the absolute opposite and I was going to say that it's probably even more the opposite of like having a natural birth in a hospital you were like I'm just going to cut the hospital out altogether yeah because my maternal brain was sort of starting to say look you need to you need to not medicalize this and you know

this is it I have to you know say this is in the context of my own situation, which my pregnancy was very low risk. I didn't have any risk factors. And I know that I'm also privileged in that I know I can read the data and understand the data, and that can really help me make that decision. So I really needed to look into, is home birth safe for somebody like me? And I found unequivocally that yeah actually it is the evidence the data would support that it is and i had a doula who was amazing um and helped me look into without you know in any way trying to sway my decision um my doula how could i sit

and have a conversation with her about the data, about the research, about the different options? And then I did hypnobirthing as well, which helped me even further. We chatted about this, didn't we? Because that was when we kind of started chatting because you were like, there's so many options. What should I do? Because I think we did the same hypnobirthing course, didn't we, with Emiliana at the Mindful Birth Group? think we did the same hypnobirthing course didn't we with Emiliana at the mindful birth group that's right that's right so yes so I was considering doing that course and I saw that you I knew that you'd done it so I um I reached out to you and asked you how it was I remember you're like Emiliana was amazing um and although you didn't you know you said you you kind of didn't necessarily use all the hypnobirthing techniques.

It really, really helped you having done that. It was amazing. And it helped Tommy as well. I think, you know, to prepare him for what to expect and how to manage me and how to manage people in that environment, you know, like basic things like if you come in, can you introduce yourself or can you tell us who you are and I think you know without that which sounds really obvious when you when you say it but obviously when you're sat there with your legs open and you're in loads of pain and somebody comes in and it's a stranger like it is it is a very like intimidating thing so and also Emiliana is just amazing. Oh, she's so lovely. Her friend was unable to have a baby and Emiliana actually was a surrogate for her best friend,

which I just think is the most rockstar thing that you could possibly do for someone. And especially because, I mean, the story goes further than that, doesn't it? Because she, Emiliana, with her own children, she had vaginal births, but then she had a cesarean or an abdominal birth, as she prefers to call it, when she was a surrogate for her friend. Because they discussed it and agreed that they felt that was the more appropriate birth choice for that scenario.

But what a woman! I know, it's just amazing. But anyway, we digress. So your maternal instinct, you think, started to kick in around six to seven months. And in terms of preparing for the birth, I know, obviously, we did hypnobirthing, but more the physical side of it. Did you feel really prepared with pelvic floor and core work? Or what was your approach to it? And how was your postnatal recovery as a result? to it and how was your postnatal recovery as a result yeah so I did I did put some work in beforehand and you know there's there's so much stuff that I did not know as a doctor that I learned during pregnancy largely from these people amazing people that were around me so Madhula and Emiliana and also Marta the pelvic health physio who with with who we love we love her um and you know she gave me some tips and tricks of things that i could do beforehand

because i was planning on having a vaginal birth to to prepare myself for that i'd already heard about perineal massage she also told me about the epino which a friend of mine my friend holly had also mentioned to me an epino which is a device it's a balloon device that you insert into your vagina and you blow it up you blow it up to where it feels just about slightly uncomfortable and then you leave it in there for 10 minutes and read a book cross your legs and then you essentially you birth it and you can practice your hypnobirthing breathing whilst you birth this little balloon and then you're aiming to sort of blow it up a little bit more each time so so I'd got the balloon up to eight centimeters um a few days before I gave birth which I think really helped when I get even even though that

stretching probably helped physically it also really helped me mentally because I wasn't fearful of a baby's head which is only a few centimeters bigger than that then even though it's completely different I wasn't fearful of it yeah you knew you could do it see I got the epinoe and it's so funny because I had never heard of a perineum but my god have I heard a lot about it since getting pregnant I I remember I went to um a pregnancy yoga session and I found it quite intimidating because they kept saying and press your perineum and I was like what on earth is a perineum like I never heard this and also I kind of knew a bit about pelvic floor because I'd had reoccurring um kidney problems and um like bladder

issues as a result so I actually had an LV trainer but I'll be honest I have a very lazy I don't know if the word is lazy, but I have a very laid back approach to things around my body. So for example, when I ran a couple of London marathons, I didn't train and I did it. And for me, it was more of a mental battle than a physical battle. I'm basically just very stubborn. So I was like, I will keep running until I get to the finish line. And I did okay. But I mean, the recovery was a lot longer, but I was like, I'll keep running until I get to the finish line. And I did okay. But I mean, the recovery was a lot longer, but I was like, I'll be fine. So when Marta recommended getting the Epino to me, I got it, but I think I used it twice. And I was like, I'll be fine. What's the worst that can happen? And I wish I knew now what I know.

And I would encourage anyone to just take the pelvic floor seriously. But also, I'm so confused as to why we're not taught about pelvic floors. Yeah, no, I absolutely agree. And it was something Stuart kept saying when we did the, I don't know how you did your hypnobirthing course with Emiliana, but with us, it was a time in the pandemic. She was just around, just about allowed to come to our house. so she came on a Sunday and just did it all in one go and she basically spent the full day with us and Stuart kept saying over and over again it's like why are they not teaching this in schools like this stuff is not only fascinating and amazing it's really important um but yeah you'revic floor, fertility, it should be taught.

All of it should be taught in schools because all of it depends on what you do and how you live your life, starting from when you're a teenager. And I feel like pelvic floor is so important, even if you're not considering childbirth. Pelvic floor is so important, even if you're not considering childbirth. I didn't realize that you can get prolapses when you're older just from not doing pelvic floor. Absolutely. It's mind blowing. And also, I don't know how you feel, but I was like, I feel like people would respect mothers so much more if they kind of knew what the body did yeah I feel a bit like because obviously women have been giving birth to babies since the start of human life I think in the past perhaps the reason none of this stuff was talked about and acknowledged is because there was nothing we could do about it we didn't have the

knowledge we didn't have the science we didn't have the gadgets and the devices so therefore it was almost if you gave birth vaginally and had a baby and there wasn't probably wasn't any other way of doing it then it was almost inevitable that you would then later in life have some urinary leakage or you know even worse you may have faecal incontinence or whatever but there was nothing could be done about it it was just like isn't it you're like oh after you've had baby like oh I laugh and I laugh and wee comes out and it was almost like a joke like that's just what happened exactly and in our parents generation that is they will say that oh just laughed in a bit of wee came out and laugh it off which is fine but it's almost viewed as normal and

it's not normal and it is preventable and certainly nowadays we shouldn't be normalizing this stuff we should be talking about it we should be educating girls in school which is when it all starts you know looking after your pelvic floor looking after your fertility starts then because we do now have the knowledge we do not now know how to prevent it how to look after it how to treat it if it occurs so there's just it doesn't make sense I think as well I thought I found very much that you know people are always very open about um you know documenting the pregnancy and then I would always feel like as an outsider and I don't know anyone that had ever had kids really um I do now but I didn't at the time that I felt like

there'd always be like a bit of a social media blackout and then about two weeks later it would be like either either the the the mom or the partner would be like announcing the birth of da da da da mom and baby both doing fine and I would always be like but what happened how like and how can it be fine like what what is fine like have you got stitches like what what is fine like And I was always like, I want to know the mystery. So I almost went through pregnancy. And even when I went into labor of now I'm going to know what happens. And I think because it is such a taboo to, you know, nobody wants to talk about or admit bladder issues or prolapses and piles and all of those things that it almost allows the system to get away with being a bit substandard or letting women down because nobody is brave enough to

talk about it enough. I agree. And because nobody talks about it, then as individuals, women feel like they're the only ones and that they shouldn't talk about it because nobody else does. So it's a bit of a vicious cycle like that, isn't it? That somehow that cycle needs to be broken. And I know you and I are going to, on this chat today, we're both going to be really open and talk about our own experiences. But I bet everybody listening to this, whether they have been through pregnancy and childbirth or not will know somebody who said afterwards oh my god why did nobody tell me about this stuff I remember when my best friend Mimi had her first baby and um we both played rugby together at university and there's still a large

group of us um the team smash we call ourselves um who we all played rugby together at uni we're still in a whatsapp group we still get together once a year when we can and she said right i'm going to write a manual just for you girls because you all need to know that this stuff is going to happen to you physically psychologically emotionally to your relationship because you just need to know because having just having a heads up you might not be able to do anything about it but just having a heads up makes a big difference so let's talk about um your i guess like the the birth and the postnatal recovery for you like what did you experience and what are your are you about 12 13 weeks now yeah 12 weeks just over 12 weeks um so yeah i mean i

guess i have to say first and foremost that i know i am really really i'm one of the lucky ones um because i did get i did get my home birth um it wasn't quite as planned because i'd planned to have a midwife present there wasn't. There wasn't a midwife present. The midwife was late, came 25 minutes after he was born. Yeah, yeah. Luckily, we had Letty, the doula here, who obviously is not medically trained, didn't lay a finger on me, but was just there to give us the reassurance.

So I just remember looking her in the eye. It must have been a hundred times. But wait, what do you mean that she was late? As in she was like, oh, sorry, I'm stuck in traffic or what, or like the baby came in unexpected or what? There was a little bit of a comedy of errors, to be honest, because although I wanted a home birth, I was never, I never put the pressure on myself

to say I'm having a home birth. I didn't want to feel that I failed if I didn't. So I was always open to going to hospital, but we'd spoken with the local home birth team. They knew about us, the midwives had come and they'd met me and, um, and it was all meant to be going ahead and we've got the pool and all of that. Um, so I started with contractions. I mean, in hindsight, I was probably having contractions all day, but was in in denial but they became undeniable at about midnight on the Sunday night um I still really didn't want to admit I was in labour so kind of was getting on with it myself for the first couple of hours then I woke Stuart up and by three o'clock you know I was in established labour so we tried to call the

midwives on the numbers that we had and nobody was answering so we contacted the hospital um the 24-hour line and they got in touch with the midwives for us and I know Stuart I mean I was in labour I wasn't involved in this but I know Stuart and the doula they spoke to the midwives on three occasions and at one point they said right we'll be there in within the hour because it sounds like I mean I was about to give birth um and they came an hour and a half later how did you feel about that obviously thank god everything worked out and Lisbon's here and healthy and you managed to do it but how do you feel about it the only time I felt fearful um throughout my old childbirth experience was when I knew he was imminently about to, in fact, when I felt his head. So I would add some misdemeanors with the pool as well. But anyone who wants to use a birth pool, make sure you do do a practice run and do it in good time.

We were planning on doing a practice run, but Lisbon came, it was only 10 days early, but we hadn't got around to it. And the tap adapters didn't fit any of our taps so we couldn't fill the pool with we found a way around it well Stuart found a way around it um he actually managed to you also get a drain pipe a draining pipe so after you finish with the pool you can drain the water straight into the drain so in the end he reverse engineered that and drained I was in the bath so they drained the hot water from the bath downstairs into the pool oh what a genius I feel like that would be the point where Tom would have been like I give up um so so I so it was quite late by the time I got into the pool I only had three contractions in the pool and then he was born but the first I got into the pool, I only had three contractions in the pool and then he was born. But the first, I got into the pool, got into a good position on my knees facing outwards.

And the next contraction, his head came right down and I could feel his head. So I said two things. I said, oh my God, he's got so much hair because I could feel the hair on his head. And the second thing was, shit, the midwives aren't here. I was like, that's all right, not to worry. I'll clench my bum cheeks, put my hand over his head and I'll hold him in. And that was when I just got a wave of fear because I thought, well, hang on a minute. If he's born and needs attention, needs oxygen or something like that, or if I have a really bad tear and I'm bleeding badly, there's nobody here to look after us. So that was when I guess it was a transition stage as well.

I had this like wave of fear and decided I was going to hold the baby in. And Letty kind of looked at me and went, you know what's about to happen. So just, you know, basically go with the flow and don't fight it. And then, you know, five minutes later, he was here and luckily he was fine. So I didn't feel resentment you know in hindsight for us it was quite nice that the midwives weren't there we had this incredible like intimate yeah amazing yeah but you know if that happens 10 times in a row there's going to be somebody's going to get hurt um if the midwives don't go. So anyway, it's kind of something that I've decided to just put behind me because we got our perfect, really.

You know, it turned out well for us. But I have been assured by the midwife team that it is being looked into. So in the NHS, we do something called a datex, which is a report whenever there's been a near miss or if there has been a poor outcome so that it's looked into so it can be avoided in future. And I know that whenever there's a BBA born before arrival, they do one of those and it is being looked into so that, you know, they'll make sure it doesn't happen again. and it is being looked into so that, you know, they'll make sure it doesn't happen again. And how were you after birth? Because I'm thinking, my midwives were really my rocks and Alf's heart rate dropped at birth and I also needed a lot of stitches. So I'm like, oh my goodness, like what did you do without the midwives and how were you after? And did you need stitches?

Yeah, I did need stitches. so afterwards I mean I was in the pool obviously with the baby on me and Stuart was outside the pool with his arms around us and we had this lovely moment where Letty like went and made herself a cup of tea and just left us to it um so so I just stayed in the pool and everything was fine Letty was sort of looking keeping an eye on how much blood was in the water and she was happy with that so she said we'll just wait for the midwives to come. And I hadn't given birth to the placenta at this point. So they arrived 25 minutes later and it was just very calm.

Everyone was just like, yeah, you know, sorry we weren't here. I'm like, it's fine. Look, we've got a baby. And they said, you know, are you planning for a physiological third stage? So that's when you wait for the placenta to come of its own accord rather than having an injection that helps your womb contract to get rid of the placenta. So I'm like, yeah, let's just leave everything to go naturally.

So they left me in the pool for a bit, but then they were a bit concerned about the amount of blood. So I got out of the pool onto the sofa, which we'd covered everything in like plastic sheets and towels. And it took a while and that was that wasn't very pleasant that's another thing I'm so glad you said that because when I gave birth everyone was like honestly you don't even feel the placenta like you're so in love with your baby that you won't feel the placenta when I I waited for my placenta to come and I was like what is going on

I this is not comfortable and maybe I'm just not in love enough because I feel this yeah yeah no unfortunately you give birth to the baby you've still got quite a bit to go through haven't you because you yeah you've got to give birth to the placenta and then you if you need any form of repair down below that's got to be done um and some people continue to have contractions so after pains um and they can be some people will say that their after pains are as severe as their contractions in labor so so it's not all over so yeah so it took about almost an hour before the placenta came and it finally did and so then she was able to like assess me for damage. And I was very

lucky in that I didn't have any significant tears of the perineum, which is that tissue that's between the vagina and the anus that was intact. I just had lots of grazes that were bleeding. So she gave me stitches to start. I think I had about eight stitches to stop the bleeding. And at this stage, they were like, well, you know, you've gone through this whole birth without any pain relief at all do you want gas and air or is it a bit of a shame to have something now I'm like give me the gas and air are you kidding I need gas and air she's like well we normally recommend that you take six puffs first I'm like do you know what I'm just gonna take 20 puffs and then we'll start so I am yeah I just went crazy with the gas and air and had quite a quite a nice time actually that's just pretty good I was off apparently I was offering everybody tequila we didn't have

any tequila in the house but I was like saying Stuart get some shots of tequila and then yes I had my stitches which took it took quite a while it took about two hours for them to yeah which was quite Stuart had Lisbon they had bonding time skin to skin yeah and then I remember having a shower and then it's all a bit of a blur after that I remember eating pizza but I know I was I was super super lucky um but yeah but but 12 weeks on you know I think I kind of thought because I'm pretty fit and i've always been an athlete my whole life um i think i thought that i would and i had no plans i put no pressure on myself for the first six weeks i had no interest in doing any form of exercise as such except for ideally doing

a walk every day um but then i kind of felt that i'd get my strength and my form back pretty quickly um but yeah I've still got my glutes like my bum is like jelly I've never had a jelly bum I've always had a really ever since I was a little girl I've always had quite a muscular strong firm because a lot of my I've always been a power athlete and a lot of my powers always come from my bum and um and yeah it's like it's kind of like through pregnancy because your body's such a different shape and you're carrying your weight differently I've recruited different muscles so I don't use my glutes anymore my butt it's actually starting to get there now obviously I'm seven months long but my bum was never as flat as it

was after birth it's so weird isn't it's just a different shape. It's really bizarre. And with that comes, for me, with that comes knee pain. It comes back pain. Yeah, my body feels more, should I say, vulnerable now than it did when I was eight months pregnant. Hiya, we're here to tell you about the Loose Lips podcast. We, being me, Georgie Porter. And me, Sharon Carpenter. We're all about honesty and not holding back,

especially when it comes to what's in the news. Plus, we answer your questions and we give you advice whenever it's asked for. Even when it's not asked for. We're all about what you're really thinking and what you really want to know you can expect to hear some of this i have to say come on people we're getting a little too sensitive here and also some of this she is plugging her entire career in that one moment that's the loose lips podcast out every tuesday and not forgetting extra lippy on Fridays. Find it wherever you found this podcast. We'll see you there.

I think it's really interesting what you said as well, that you kind of just presumed you'd get back to it because I had this kind of belief that I'm fit, I'm healthy. I've always, you know, I've run marathons. I was like, in six weeks time, I'll be back doing everything that I'm fit, I'm healthy. I've always, you know, I've run marathons. I was like, in six weeks time, I'll be back doing everything that I need to. And what I find mad is I was signed off by the midwife after two weeks. And I had really bad tears. And I did tear my perineum, which is probably testament to the epineur that if you're listening to this and you're pregnant, get epinoe use it um but I I had really bad tearing but I thought I was on the road to recovery I didn't really feel much pain after like a few weeks um and then it's only when I went to go see Marta so she um was at the

mummy MOT which I always say to everyone if you can go and get a postnatal physio go see a postnatal physio or if you're not able to demand a physical check from your GP because I thought I was absolutely fine and on the road to recovery and I'm pretty sure I was even talking about running again which to me is wild because I've done one run in the last couple of weeks and I was like you know what I'm not quite there yet but it was only when I went to go see Marta that she was like, yeah, you've got quite bad rectocele, I think is it called, which is basically rectum prolapse. And obviously the tummy gap. I don't know what the, you'll know more than me about the proper term for that, diastasis recti. Diastasisastasis recti yeah so that's when you've got a the abdominal muscles

at the front the abs the what the ones that form the six-pack where you can see that the line that separates the right from the left as as got a is separated is not knitted together yeah and I um basically I was in no physical pain but I was suffering from fetal incontinence but I just kind of thought well that'll be some that that's just something that must happen and no one talks about um but obviously it was like horrific for my confidence because I was like I don't know if I go out if I'll shit myself or not and that is a position that nobody has to put themselves in and I was almost expecting to like pee myself and my my bladder was absolutely fine but obviously it was diagnosed and um you know thank god that I've I've only recently by the way recovered but it just took so much longer than I than I expected and um I I

actually found myself feeling quite angry that this is something that as women we need to to do privately because in France it's they automatically get 10 physio sessions with a women's health physio after giving birth and yeah I'd love to know kind of a your journey but also how you feel about this as a um as a as a GP I mean I feel like the support that's available on the NHS um for maternity care is just insufficient in so many ways in fact we we know that even outside of maternity care in the perinatal period, we know that women's health issues have long been underfunded, under-resourced. And there was a, earlier this year, there's been a big campaign. I'm sure you've heard about it. So

anybody could go onto this government website that they set up and talk about their experiences of women's health and give suggestions of how it should be improved. Because I think it's finally being recognised that we live in a man's world and the NHS was set up by men, for men. And women's issues have never been given

as many resources as they should be. And hopefully, we're on the cusp of some change, but it won't be enough. But yeah, I mean, let's just compare, if we make a direct comparison between something like having a cesarean section or an abdominal birth, that's major abdominal surgery, where they cut through your abdominal muscles, they cut through into your womb to take the baby out. It's major abdominal surgery where they cut through your abdominal muscles, they cut through into your womb to take the baby out. It's major abdominal surgery. Now, if you were having that level of abdominal surgery for something else, then you'd be expected to have a period of rest. You'd be

expected to, you know, put your feet up and not do any heavy lifting at all you'd be expected to take time off work you'd be expected to potentially depending on what you'd have done maybe even have some physiotherapy sessions but when women have that type of surgery for the purposes of birthing a baby you you have to heavily if you have to lift your baby at least if you have toddlers of course your advice not to but in reality how do you get around it um you don't go back to work work but all of a sudden you become a mother and you are working at a rate of knots like you've never worked before you're sleep deprived sleep is really incredibly important for healing you're not eating as highly a nutritious diet as you should be at that time you should be eating you know a high protein high calorie diet um so all of a sudden you've had major abdominal surgery and

there's no support to help you recover actually the most shocking is my friends who've had c-sections they didn't even get their stitches checked at the six week check. And it's like, how can you go through something like that and not even get your stitches checked? Yeah, I mean, the six week checks, the six weeks, for people who might not know, between six and eight weeks, your GP will get you in to check the baby and to check the mum. And it's always a topic that I, it's talked about a lot on Instagram, how that is insufficient. And it's obviously as a GP, it's a topic that I come at it from two different angles. I think the overwhelming answer is that the six week check is not sufficient and it's not enough. And that's not your GP.

You know, the GP gets 10 minutes to 20 minutes for the baby and 10 minutes for the mum and that's what is allocated and that is atrocious because you've just been through the biggest physical and emotional for many women for the majority of women who give birth who have their first baby they've been through the biggest physical and emotional trauma of their life. And they get a 10 minute appointment. So I hear people on Instagram who are quite angry because it's like, well, all my GP did was ask about my mental health and ask about contraception. And I'm like, yeah, that's not good enough.

But then on the other side, there's this 30 minute appointment. And generally, you know, the baby gets most of the attention and things like diastasis, recti. It's something that I've heard talked about a lot in recent years. But when I trained to be a GP, it wasn't something we were even taught about. It's not it's not you know, we have a list of things that we're meant to do on a six week check. You know, we have a list of things that we're meant to do on a six week check. And it's only really very recently that that's something that GPs are potentially checking for. And older GPs probably realistically still aren't because it's not on the list of things to do.

So it's insufficient. It's not enough, but it's not necessarily the GP's only got 10 minutes. It's bigger than that. The NHS needs to be providing provision of services for women from the day they become pregnant to whenever, if ever, they make their full recovery. But especially around that maternal period and especially in the postpartum period it shouldn't be a 10-minute GP appointment it should be access to physiotherapy it should be access to psychological support it should be access to further midwifery support there should be more health visitor sessions they need that for what we call a multidisciplinary team support and the GP can be at the centre of that but a GP doing a 10-minute check it's just it's not it's not enough and I feel like I've probably been one of those people really vocal on um social media like feeling angry and you know what it was it was actually like a really like confusing time because obviously especially in

a pandemic like we love the NHS they are putting like everything on the line for us I've always loved the NHS so to kind of go through this where you the support for the NHS has never been greater and rightly so but then also to feel so angry and so let down and and I think you know even the contraception question I felt a little bit jarring because I felt like it was almost like you said earlier like a man's world it felt like it was double checking that I knew that if I were to have sex again I I don't know I felt like it was like more for Tommy's sake than for mine because I was like do I know about contraception I've got I've got a prolapse like I don't need contraception. My contraception is the fact that I am afraid of my body and that I don't know if I'll ever go back to normal.

Like that is the contraception I'm at right now. Like what would help me start to think about contraception is a physical check and a road to recovery. recovery yeah yeah exactly and i think i like what you said earlier about telling women to to demand that physical check from the gp because i've just looked it up actually i've just looked up what is the nice guidance around a maternal check and what should it focus on and it really is largely dependent on the woman um voicing what her concerns might be i'll read it out to you so there are four bullet points um it says a review of the mother's mental health and general well-being using open questioning um the return to physical health following childbirth and early identification of pelvic pelvic health issues so that's where the gp is going to say, do you have any concerns about your pelvic

health down below? What's going on? And it's down to the mother then to raise those concerns. The third one is family planning and contraceptive options. And the fourth one is any conditions that existed before or arise during pregnancy that require ongoing management, such as gestational diabetes. So you can kind of see for that for every woman that walks through the door it's it's really different women's concerns might be different you've got the whole of their mental health and well-being the whole of their physical health after having a baby including identifying pelvic health issues family planning and contraception and any conditions any health conditions that that woman had or that arose

during pregnancy like hypertension and you got 10 minutes so it's it's an impossible task to do well by the way just for context when we talk about Marta she's a a pelvic health physiotherapist she works at a place called um bh woman in fulham and um her full name's martin seller and for anyone in the london area like she i cannot recommend going to see her enough like even if you only go see her once to get the diagnosis and she she honestly i don't know how i would have got through my recovery without her yeah same i mean i if you can it's worth seeing that seeing her beforehand as well for an antenatal because then they she'll know what your what your baseline is she's actually just she's just changed i was with her yesterday so she it was beyond woman they've just rebranded as Leto woman, L-E-T-O. I believe Leto is a Greek god, I think, or some mythical person who represents

motherhood. So Leto woman, and she is really good. If it hadn't been for me going to visit her, then I'm pretty sure that I would be back running, lifting weights, doing all the things that I would usually do. but because she's been assessing me she's keeping me on quite a short leash because she knows what I'm like and she had me in the gym at the end of last week and she gave me so she she actually allowed me to lift some weights which I was very excited about and do some jumping um but like I say I'm one of the lucky ones I didn't have any major injuries. I didn't have forceps or frontis. Everything went pretty much as well as it can go. And I'm coming from a place

of being an athlete, always having been fit. I know genetically as well, I've got quite good muscle tone and collagen, all those things come into it. So genetically, I'm very lucky in every way and it's 12 weeks and I'm not ready to run or lift weights and I'm ready to do some gentle exercises and she said even if you do a slight jog just for a short distance I'm probably okay but I'd stand up to do a half marathon in October and she's like no you won't be ready I'm'm like, wow, I'm amazed. I'm a GP. And I did not know this, that it takes that long before you can safely do these things. And of course I could go and run a half marathon. I could run a half marathon today and I'd be fine. I'd be okay. I wouldn't fall to pieces. I wouldn't collapse. But all those tissues inside, not just

the pelvic floor, which is the sling that holds up the bladder and the womb and the rectum, but all the other tissues inside, all the connective tissues inside that have been stretched for nine months, it takes time for them to heal and they're still healing. And if I was to go and start running, doing long distance running or going back to CrossFit lifting heavyweights right now, it would affect how they heal. They'd still heal, but they wouldn't perhaps heal as well. They wouldn't heal as tight. They wouldn't heal in the right position. And that means as I get older, I'm more likely to have issues later in life.

I mean, I'm learning this and we don't know this. If I don't know, presumably most people don't know how important it is to give your body time to rest and recover in the right way I think that's what's so crazy to me that it takes well nine technically 10 months to grow a baby but yet the expectation is we just go back to normal after six weeks and of course like now you know it's obvious of course we don't like my my hips are still moving like I feel like I'm still very much recovering seven months later but seven months postnatal like I was pregnant for longer than that and childbirth obviously the most like like mind-blowing thing that you could put your body through and like yeah I just I found it crazy that

we're not actually taught about this and so while I've got you as well what would be your advice to parents who are listening that maybe didn't know about the like the mummy MOT or the pelvic checks and or maybe one year two years three years even 10 years down the line who are suffering with um like bladder or um prolapses or whatever it might be or things just don't feel right my biggest bit of advice is don't feel like you have to accept that it's not normal and it almost always can be fixed or at least improved. So the way to go about that, I guess if we think, what can you do self-help, what can you do for yourself?

Pelvic floor exercises. So look up some resources. If you use the NHS resource, there are loads of guides out there for how to go about doing pelvic floor exercises. And there are various different devices you can buy now as well that assist you. one example is the lv and that's i've gone straight to that's it's quite expensive um and and i'm not i'm not i don't work with them or anything so but i i do have what i was gifted one a few years back and and i used it just for just to see what it was all about. And it's almost like gaming. So you put this little device inside your vagina so that it feels when you can track your pelvic

floor muscles and it sort of trains you to do it in the right way. And it's like a little game. So it gets you to clench to a bit like playing Space Raiders. Space Raiders, vagina. That's the extreme end, but there are lots of various different things. So if you want to have a go at doing something yourself, all about focusing on pelvic floor, and actually you need to be quite regimented. You need to do it three times a day consistently for a couple of months before you notice any significant change. But it shouldn't stop there. It shouldn't be just down to you. You know, in an ideal world, if you've got the funds, seeing somebody like Marta,

seeing a pelvic health physiotherapist is the best thing you can do. But otherwise, go to your GP. And I'm being aware of knowing the statistics around how many women are affected by things like prolapse or incontinence. And knowing how many patients I see with those issues, we know we're not seeing people. People are not coming to their GP and they should. So anybody who's experiencing, whether it's sexual dysfunction, incontinence, and yeah, that's just a little bit of wee when you laugh or that's not normal. So, you know, that should be addressed or whether it is incontinence, any of those issues, go and see your GP because there are so many different things that we can do to support you and we can refer to pelvic health physiotherapists it's a resource that we don't have access to for a lot of people but for the

more significant cases we can there are medicines we can give you there are exercises we can give you there are devices we can prescribe there are things like pessaries, ring pessaries. So that's a ring that's inserted into the vagina that helps give some lift and support to the womb. That's right for some women, it's not right for others. And all the way through to medication and surgery. So I think the biggest word of advice is don't accept it. It's not your fate. You don't have to put up with it. If you're in those first few months after having given birth, then often there is, like you've experienced, Ashley, you know, we need to talk about that. We need to support women, but a lot of things do improve just with time. But for women who are a year down the line, you know, that's, yeah, it needs to be addressed. It needs to be sorted. Please do go and see your GP and get the support that you're entitled to. I think that's such good advice. And also,

I always say to people, don't be embarrassed because in the same way that if you went to have an operation on your knee, you're not going to be embarrassed to walk around with crutches while you recover. And that for me is exactly the same with incontinence whether it's fetal incontinence or piles I've still got piles and I feel like because it's I hate using the term down below or downstairs because I'm like we're not we are not a bait like we're not a building do you know I mean it's what is the basement and I um but it's embarrassing because it is down there and um like I remember a friend saying to me when I said I had fetal incontinence they were like does Tommy not mind and I was like mind what that I gave birth to his healthy son he of course he doesn't mind and also if he did mind like I would leave him

like I'm recovering from childbirth of which I did. I did the work for him to have a son like he has no right to be. But it's interesting to me because that was a friend who I love to bits. And, you know, that there is that kind of like shame and taboo that I know a lot of people will feel. But please don't feel like it's something that you need to suffer with in silence, because actually there is no shame in giving birth through either c-section or vaginal like we are all rock stars for being able to do it and um i'm not ashamed at all and doctors say this all the time but i'm just going to reiterate it you

know if you do feel embarrassed about those things and you do feel uncomfortable please don't ever feel uncomfortable with your gp because to us you know sticking a finger in in a bum hole is no different you know it is different obviously but to us a bum hole an ear a mouth an eye a tummy is we don't care we've done it all a hundred times like we do never ever be feel embarrassed or ashamed to come to see your GP about a problem that's related to your anus or your vagina we we really genuinely do not give a shit I love that what a way to end Zoe I know I know that you've uh you're probably dying to get back to Lisbon and also you've probably got uh lots of work to do. So let's wrap it up. But every week I get questions through from lovely listeners.

And for anyone that does want to get involved and get in touch, even about things that we've talked about today, the email is askmumsthewordpod at gmail.com. But I thought while I've got you with me, you might be better equipped to answer this one. This is a question from Ellie. And she says,

my son's now two and he hates his vegetables. Do you have suggestions on how I can get him to eat more healthy food? Ooh, right. So first of all, disclaimer, I'm not an expert. I'm going to give you my answer, but I'm not an expert in nutrition. I'm not an expert in parenting. I always have to be upfront about that. But the reason I do have a bit of experience in this is I worked with an organisation called MEND for several years,

which works with children and families who are affected by obesity. And I worked with a child nutritionist and a child psychologist. worked with a child nutritionist and a child psychologist and when it comes I think something that's really important and really helpful for us is when we understand the reason why and when children are around the age of two and they become picky and fussy eaters if you think back to many many generations ago around the age that children become more able to be a little bit independent, they're walking quite well, and they can walk away from their parents, it's instinctive that they will become fearful of foods, even foods that they've liked previously. So a child who was eating everything all of a sudden becomes anxious around certain types of

food. That would have been protective because if a child walks away from you and comes across some poisonous berries or poisonous mushrooms, then them having anxiety and fear around certain foods would have been protective because it would have stopped them eating things that they came across. So I think having that understanding really helps as a parent think, oh, that's quite clever, really, that all of a sudden my child doesn't want to eat anything. but then the advice around helping them accept these foods is exposure and there's there's evidence to say that if a child is exposed to a particular food say that's broccoli for example 15 times then it becomes quite likely that they will get over that anxiety and be more likely to eat it. And exposure doesn't necessarily mean

them trying it. It means them seeing it, touching it, licking it, feeling it. So just having that food on the plate and asking them to, if they won't try it, just look at it, maybe smell it, interact with it, and not being stressed as the parent. And eventually, they're likely to come around to it the the little nugget of um of what is it what would i call it the little oh here's the baby brain baby brain kicking in the little phrase that i'll always remember is it's a parent's choice when food is offered and which foods are offered but it's a child's choice what they eat and how much they eat and a healthy child will never starve themselves um and so you know don't worry

about it don't stress about it just keep exposing oh i love especially because i was always made to sit at the table until i ate vegetables and that really put them and it can make it worse can't it because then you're anxious the child's anxious it can feed into it. So yeah. I'm also a very stubborn character and I remember spending entire afternoons at the table like, I will win this battle, I will not succeed. Me too. I remember I used to hide vegetables, I used to hide them in my pockets and then go and flush them down the toilet. is actually very genius like when you think about it um Dr Zoe Williams thank you so much I feel like this is going to be such a helpful podcast and if you did enjoy it make sure you rate us that always helps and hit the subscribe and follow button so you don't miss another episode

um if you're listening on apple podcasts leave. Obviously, a five-star rating is amazing as it helps other people to find it. And keep talking and spreading the news about the podcast to help us reach more people. But I'm so happy with this one. I feel like this is definitely an episode that I wish I'd listened to throughout my pregnancy. And Zoe, I'm just so grateful for your time. Now, get back to Lisbon.

Oh, thanks so much for having me. It was so lovely to catch up as well. And congrats on the podcast. I think it's amazing doing this podcast. It really will help lots of people. Thank you so much.