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Published July 19, 2021

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THANK-YOU @femalefirstphysio for this awesome insi

THANK-YOU @femalefirstphysio for this awesome insight. And it’s so so true! Shea posted this and I love it!!!

As a WH Physio, I want to be the stepping stone to get you back to the function, hobbies, sport or lifestyle you love and enjoy.

As lovely and great as my patients are, I want you to be able to GRADUATE FROM PHYSIO, and not need me.

Yes, I’m here for you when the wheels fall off, or new symptoms arise, or a check in here or there, but all in all, my goal is to help you achieve YOUR goals by giving you the knowledge and skills so you don’t need me.

I have such incredible women as patients, I both love and hate telling them they don’t need to come back. But, as @femalefirstphysio puts it, nothing makes us happier than bidding farewell to a patient (as it means you’re better!)

HONORED! Honored to be apart of an incredible nig

HONORED!

Honored to be apart of an incredible night!

Honored to live in The Mackay and Whitsundays region with all the amazing women around.

Honored to witness and encourage women supporting women!

Honored to hear all the amazing stories of incredible women who just go about their regular lives being superwomen!

Honored to be nominated for HEALTH AND WELLBEING WARRIOR. And to be apart of such a long list of truly life changing women in that category

And overwhelmed and HONORED to be A FINALIST for that category.

With all the amazing stories of local ladies last night, to be among them, sit with them, chat with them was such a special experience.

And I loved the take home message… to be PERFECTLY IMPERFECT!

Thanks Fallon @thejustsayingproject for putting on such a brilliant night to celebrate the hundreds of nominations for the incredible women around our region, and showcase some super special ones!

Still on cloud nine, and so grateful to be able to share a magical night xxx

How can we predict prolapse worsening?? gh + pb m

How can we predict prolapse worsening??

gh + pb might be our answer!

[ Genital hiatus + perineal body length ]

gh has a strong association with prolapse and has been shown that women who have a symptomatic prolapse have a greater gh at rest and on valsalva than those you are asymptomatic, regardless of their prolapse stage.

So why measure this distance?
Because it’s our strongest indicator for symptomatic prolapse and provides a strong prediction of pessary failure, risk of surgical failure, and the development of an asymptomatic prolapse becoming symptomatic.

Make sure you ask your WH physio if they measured your gh + pb and thus likely risk of a prolapse or prolapse worsening.

(Muniz et al, 2021 & Handa et al, 2019)

An OASI is an “Obstetric Anal Sphincter Injury”, also known as a 3rd or 4th degree tear. If you’ve had an OASI often you want to know, what should my next delivery be? Vaginal or C-section?

Well here is a deep dive into what the research says…

A large study (1.7 million women!) found that women vaginal birthing after an OASI had a reoccurrence rate of 7.2%. Women who hadn’t had an OASI for their first birth were 1.3% likely to have an OASI with their second delivery. In summary, there is a FIVE TIMES higher risk of having another OASI after having had one.
BUT, 93% of mumma’s who had an OASI, do NOT have a reoccurrence of an OASI!!! (Edozien et al. 2014)

Another study by Fynes et al (1999) suggested women that have had an OASI and
…if CONTINENT after 1st delivery: 90% remain continent after 2nd delivery
…if TRANSIENT incontinence: 40% chance of being incontinent
…if PERSISTENT incontinence: 87.5% WORSE incontinence.

We also know that if you’ve has an OASI, and following rehab there is NORMAL structure (anal ultrasound), and NORMAL function (manometry testing), it is reasonable to assume NO SIGNIFICANT WORSENING of anorectal symptoms with future vaginal delivery (Jolly et al, 2018). This means that after an OASI, you should have anal ultrasound and anal manometry testing to allow individual recommendation for subsequent deliveries.

So if you’ve had an OASI, what should your next delivery be? Marc Gladman, from The Bowel Clinic summaries this beautifully;
- Current anal symptoms: 87.5% chance of worsening symptoms with 2nd vaginal delivery, therefore recommend c-section.
- Had symptoms which have now gone: 40% become incontinence after 2nd delivery, therefore maybe recommend c-section.
- No symptoms: GREAT, but don’t guess everything is ok… Have anal ultrasound and manometry testing to see if structure and function are ok. If abnormal anal ultrasound (muscle defect seen) or anal squeeze pressure below 20mmHg on manometry testing, recommend a c-section. But if these tests are NORMAL could consider another vaginal delivery.

So ask the question, ask your health care provider, and follow up with a good BUTT DOCTOR to help answer the question for YOU!

You can’t learn how to engage your pelvic floor

You can’t learn how to engage your pelvic floor properly from a pamphlet!

And yet, this is exactly what women are given after birth in many hospitals.

We deserve BETTER!

We know that 50% of women don’t do their pelvic floor exercises correctly. This has the potential to lead to conditions such as prolapse or pain with sex.

The best way to learn to engage your pelvic floor is with a Women’s Health Physio as part of a complete pelvic health assessment. This might include a vaginal examination and/or real time ultrasound of your pelvic floor muscles so you can see your own muscles engaging.

WE ARE EDUCATED ON HOW TO CARE FOR OUR BABIES… B

WE ARE EDUCATED ON HOW TO CARE FOR OUR BABIES… BUT NOT EDUCATED ON HOW TO CARE FOR OUR BODIES

Is our health care system adequately supporting women and mothers?

Did you get seen by a Women’s Health Physio after the delivery of your baby?

Did you know “this could happen” as part of delivery?

Did you know what exercises to do to help heal post delivery?

How did you know your body was ready to run, jump, have sex?

Are we not educating mums because we don’t want to “scare” them?

You know what is SCARY - feeling uniformed, lost, confused, dismissed and not knowing where to get help. That’s scary!

Our bodies, babies, relationships, careers and quality of life are suffering due to poor education on what to expect following delivery and what mumma’s need to do help their postnatal healing.

Often times after giving birth we don’t know where to start. It could be days, weeks, month or years postpartum, and we are trying to find a way to be ourselves. To heal ourselves. To feel like our pre-baby selves. And it is hard!

Pelvic Floor Physio’s are working hard to spread the message and change this! We are seeing mumma’s preconception, early pregnancy, preparing for childbirth, early postpartum and even years down the line.

What was your experience? Could something have been done better?

Big love mummas xx

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Ritu Rana Medical

Stanley House
5 Discovery Lane,
Mount Pleasant

NG Gyne

Suite 28,
Mater Hospital Suites,
76 Willetts Road,
Mackay

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