Podcast Episode #366: Elective C-Sections, Women’s Core & Pelvic Floor Health, and Pregnancy & Birth Recovery with Jessie Mundell

Topics

1. Disclaimer before the interview [2:01]
2. Introducing our guest, Jessie Mundell [4:21]
3. Body image in postpartum [9:52]
4. Difference in postpartum from baby one to baby two [12:07]
5. Elective cesarean section [19:57]
6. Meeting yourself where you are [25:27]
7. Core and pelvic floor [29:19]
8. Hypertonicity in the pelvic floor [32:41]
9. Kegels [35:08]
10. Modern living and birth experience [39:10]
11. Reconnecting to your abs after c-section [42:27]
12. Final words from Jessie [47:16]

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You’re listening to the Balanced Bites podcast episode 366.

Liz Wolfe: Welcome to the Balanced Bites podcast. I’m Liz; a nutritional therapy practitioner, and author of the Wall Street Journal bestseller Eat the Yolks; The Purely Primal Skincare Guide; and the online program Baby Making and Beyond. I live on a lake in the mystical land of the Midwest, outside of Kansas City.

I’m the co-creator of the Balanced Bites Master Class, with my podcast partner in crime, Diane. And we’ve been bringing you this award-winning podcast for 7 years. We’re here to share our take on modern healthy living, answer your questions, and chat with leading health and wellness experts. Enjoy this week’s episode, and submit your questions at http://blog.balancedbites.com or watch the Balanced Bites podcast Instagram account or Facebook group for our weekly calls for questions. You can ask us anything in the comments.

Remember our disclaimer: The materials and content within this podcast are intended as general information only, and are not to be considered a substitute for professional medical advice, diagnosis, or treatment. Before we get started, let’s hear from one of our sponsors.

Liz Wolfe: The Balanced Bites podcast is sponsored in part by the Nutritional Therapy Association. The NTA trains and certifies nutritional therapy practitioners and consultants (including me; I’m an NTP), emphasizing bio-individuality and the range of dietary strategies that support wellness. The NTA emphasizes local, whole, properly prepared nutrient dense foods as the key to restoring balance and enhancing the body’s ability to heal.

The NTA’s nutritional therapy practitioner program and fully online nutritional therapy consultant program empower graduates with the education and skills needed to launch a successful, fulfilling career in holistic nutrition. If you're interested in learning about holistic nutrition but don’t necessarily want to become a practitioner, check out their new Foundational Wellness course. To learn more about the NTA’s nutritional therapy programs, resources, and to enroll in their free course, Nutritional Therapy 101, visit http://www.NutritionalTherapy.com.

1. Disclaimer before the interview [2:01]

Liz Wolfe: I’d like to give a quick prelude to the interview I’ll be doing today with an amazing woman who works with pregnant and postpartum moms. We are going to talk about some really emotionally charged stuff, including birth and elective cesarean section, in particular. Alongside some fantastic discussion about core and pelvic floor health.

And we might talk about some of this in ways that not everyone is comfortable with. And in ways not everyone views as “right.” I want folks to know that I believe these discussions are vitally important. And if what we talk about doesn’t apply to you, or doesn’t resonate; that’s ok. We aren’t suggesting your way is wrong, or your beliefs are flawed. We may be introducing new concepts that aren’t often talked about in this community. But I personally think it’s really important.

I know not everyone will feel the same way about this; even those who have walked in my exact shoes with pregnancy and birth. We’ll have different thoughts and feelings about it, and different ways of processing. And that’s perfect. We’re so different. In having these talks, we’re not being prescriptive. We’re not trying to put every woman into one box. We’re not trying to tell you how you should or shouldn’t feel. We’re simply speaking to our own experiences and attempting to speak to those who feel their experiences; their thoughts, their feelings are not represented in the community to which we belong. Which was certainly the way I felt after I had my daughter.

We’ll be discussing some strong feelings that we as individuals have or have had around our pregnancy and birth experiences. And there may be people who had nearly identical experiences who process them entirely differently, or didn’t feel an emotional need to process them at all. And that’s great. We’re all so different, and yet none of us is wrong.

All of us want what’s best for our families. And both Jessie, my guest, and I want to support women where they are. So bring an open mind to this interview. And also, be ready for some awesome wisdom on pelvic floor and core health, postpartum exercise, postpartum bodies and recovery and more. It’s going to be awesome.

2. Introducing our guest, Jessie Mundell [4:21]

Liz Wolfe: My guest today is Jessie Mundell. She is the mama-in-chief at JessieMundell.com. And she’s an expert in all things poopy diapers, sleepless nights, and sneezing so hard you pee yourself! {laughs} TMI is not in her vocabulary, as she says. And by the way, she can help you stop peeing yourself.

She holds a bachelor’s degree in health and physical education, and a master’s in kinesiology. She focuses not on helping moms fix their bodies postpartum, as too many practitioners do today, I think. But on empowering them in their perfect post pregnancy bodies.

She reaches moms through her podcast, To Birth and Beyond, and her programs; To Pregnancy and Beyond, and Core and Floor Restore. Her Instagram is the place to see the real-real of postpartum healing and recovery. And it’s where I discovered her work, talking about her elective cesarean section, which was incredibly refreshing and real and open and honest and something that I really, really needed to hear discussed openly and without shame. So I’m just really, really thrilled to welcome you here, Jessie. Thank you so much for talking to me today.

Jessie Mundell: Oh, thanks so much for having me, Liz. I’m excited to chat with you.

Liz Wolfe: This will be wonderful. And I’ve got to give credit to Steph Greunke, my friend Steph. Who is absolutely amazing, and introduced me to your podcast. And the first podcast I listened to of yours was when you were talking about your elective C-section. And we’re going to talk about that a little bit.

But, what you tackle in your professional work, and in your personal life is just so very much needed. Particularly, I think, in a community that many of us kind of live in. This wellness community. Where we’re so preoccupied with the outcome, and doing things “right”. And I think a lot of us feel a lot of shame about not doing things perfectly, holistically. I don’t know what the word would be. And really having an open conversation between those of us who maybe have made different choices for various reasons, I think is really, really important. And that’s definitely something that I want to foster here on the Balanced Bites podcast.

But I also want to talk about some of the really important work you do around movement and exercise that is maybe a little bit; not outside the mainstream, but it’s not necessarily what you hear from most practitioners who are helping women with postpartum recover. So, can you give me a little bit of a bird’s eye view of what you do and what you're passionate about?

Jessie Mundell: Mm-hmm. So I focus in prenatal, postnatal exercise. The focus really is in strength training programming, and then we take a strong focus in that on the core and pelvic floor. And not necessarily making sure it’s safe. I think that word can trip us up, too. But just making sure what we are doing movement wise is appropriate for our body, and using strategies in our movement, our exercise, our physical activity, to ensure that our body can handle the loads, and the pressures, and the stresses really effectively. And that’s so key during pregnancy and postpartum, for moms of any stage and phase.

So, I work with pregnant people, postpartum people; and again, that includes moms who are in any stage of that postpartum journey. And we do strength training exercise programing. That’s usually why people come into our online program. So everyone that I work with and coach is online, distance based. People from all around the world.

So I started out personal training one-on-one, in semi-private and small groups in person for 10 years. And then I started to move more towards an online focus when I wanted to get pregnant, and we were trying to conceive with our first daughter, who is now 3. And by the time she was born, I had fully moved into online distance coaching. Because I wanted the opportunity to be able to stay home with her as much as I wanted to. And to still be able to coach my clients, these women and people who are coming to me. Because it is something that I’m so passionate about. And it’s a huge part of me and my life.

So that is what I do now. I fully work online and exercise. But really what I was about to say is that people come to me for the exercise, but then the conversations and the coaching that we have is about so many other things. We really don’t talk about exercise all that much. They have their programs that they follow for four weeks at a time, then they progress to the next phase. But most of the conversations that we’re having is about what’s going on inside their bodies. Core and pelvic floor discomfort. Pain. Tons of body image work that we do. Lots of mindset. Lots of just trying to get people to feel ok in their bodies and in their lives.

And what I really want to do is help support people through these major transitions of pregnancy, postpartum, into motherhood. Whether its for the first time, second time, third time with more babies. It just is so major and does mostly, in most cases, rock people’s worlds in such huge ways that I just want to be an anchor for them in any way that I possibly can.

3. Body image in postpartum [9:52]

Liz Wolfe: Oh my gosh. There’s so much there, and I’m trying to take notes as you speak because there are so many things that I want to talk about. A recent post that you put on Instagram kind of talks a little bit about body image. And how you’ve been posting photos of your body without really acknowledging; this is a photo of my body! I have this opinion about it, or this feeling about it! Just being. Which I thought was really, really cool. And it’s something I’ve been thinking about a lot. Rather than posting something and saying; these are my thighs. And I love them despite this. Or, this is my body. And it’s squishy but this. It’s very interesting to me just the way that you’ve approached it.

Can you talk about that a little bit? You talked about body image and mindset and all of those things, and how they work into the work that you do. Can you kind of loop in that Instagram post, and that mindset that you were talking about in there? Just expand on that for me a little bit.

Jessie Mundell: Yes. So I was saying in that Instagram post that I think these conversations about postpartum, body image, are so important. And it does make up a big bulk of the work in the coaching that I do. But in the same vein, I also think it’s important to not talk about. So allow me, allow us. I want to see photos of other postpartum bodies without addressing that it’s a postpartum body. Because as I scroll through my feed, I’m seeing all these beautiful, positive, reflections on postpartum bodies and how we love them, and appreciate them, and despite these squishy…

Liz Wolfe: Despite.

Jessie Mundell: More cellulite, more stretch marks. And I think that is a beautiful lens to take on postpartum bodies to; I think that’s important conversation for us to start with and begin with. But now I want to move into the next phase of this conversation, where we don’t need to address it. We see a postpartum body, and we don’t need to talk about how it’s a postpartum body. We don’t need to talk about how it’s a postpartum stomach. I don’t need to say anything about how my stomach is bigger, and it’s squishier, and it’s fatter. It can just be. And I can just exist. And I can just show up. We don’t have to talk about how my body is postpartum in nature. It can just be.

4. Difference in postpartum from baby one to baby two [12:07]

Liz Wolfe: And you're very recently postpartum. By the way; I want to tell folks that Jessie is joining me; even though she just had her second baby. And we appreciate that so much. How has your postpartum differed this second time around?

Jessie Mundell: In every way imaginable. Yeah. So 7 weeks postpartum today. This baby was born by elective cesarean. And I was terrified in this pregnancy. We got pregnant unexpectedly. And this has been hard to talk about, but I’ve been very honest talking about it. It was devastating. I was so sad, and mad, and angry, and scared, and confused. I had a lot of processing to do after first baby was born, who is 3 now. A lot of birth trauma that resulted from that experience; PTSD symptoms. And I thought that I had processed it quite well, and I was feeling quite good about it.

But whenever I thought about the possibility of us having a second baby, it was like I could not even go there. In no way could I have said; I want to have a second baby. But I also couldn’t say; no, I don’t want to have any more babies. It was just this big block that was holding me back from wanting or imagining myself going through that whole process again.

Pregnancy number one; difficult in general for me. Very sick the entire pregnancy. Birth was really tough. We were planning a home birth with midwives; I’m in Canada, by the way. And then had a long labor, ended up transferring to hospital, ending up in emergency C-section. And the mental and emotional recovery of that birth was far more difficult than the physical C-section recovery.

And then postpartum in general is just a very difficult time. It can be a very difficult time. The relentlessness of that experience. Being needed 24/7; it’s just hard. I felt a lot of resentment from that time period. And I felt like I was just coming out of that as our daughter was just over 2 at that time. We had just weaned from breastfeeding. So I was finally feeling like I had a sliver of myself back.

So when I got pregnant, it was just; it felt like this huge blow. And it was very uncomfortable. We actually weren’t sure if we were going to keep the pregnancy; if we were going to continue on with it. I was just really distraught over it.

So, tough things to feel. Tough things to talk about, absolutely. But as you were asking how this postpartum time period has been. It’s been ok. And I did not think that postpartum could be ok at all, absolutely, whatsoever. I was imagining it to be exactly how it was the first time. Which was not a good experience.

So this time, it has been good. And the birth has really factored into that so, so much. I went into the mindset of this second birth; this elective cesarean, not thinking that I needed it to be healing. I felt quite healed. I felt ok and at peace with how that first birth went. It taught me so many things, and I know that I needed it to go exactly how it went. Even though in the beginning I didn’t want that birth at all. Not even a little bit. I wanted everything opposite from how that birth went.

But as I worked through this, and through therapy and counseling, and lots of personal reflection on it, it was exactly how I needed that birth to go. So going into the second birth, I decided on an elective cesarean pretty much at the last minute. Maybe 37, 38 weeks we got that birth scheduled. And it just felt so right. And I felt so whole during and afterwards. And the physical recovery was so, so much better too, coming out of that birth. So I think that had a huge piece to play in it. But I also think that physical recovery played into how much better my mental and emotional recover was, as well.

But yeah, this is basically what I’ve been telling people. Postpartum, this time around, has been ok. And I just didn’t even fathom that that could be something that I would feel, or that I could feel.

Liz Wolfe: Oh my gosh. There’s so much there. And I can’t; I don’t want to try and echo anything that you’ve said. Because everything that you’ve said was just so eloquently put. But I just want to say; me too. I really just want to say all of that; me too. And it’s taken me three years to even be able to talk about it. How my first birth went, and how everything that I wanted.

And what I wanted from my first birth was based on what I felt was my really solid knowledge of how birth “should” be. How it should go. How practitioners in this holistic; holistic is such a tough word sometimes. But this realm where we look at the whole person. And the whole experience. And we kind of reject any kind of one-dimensional model of how bodies operate. We consider the mom and baby dad, and all of this beautiful hormonal cascade, and we, as leaders, are supposed to be able to harness that and represent it. And that’s where my head was.

When everything went completely the opposite direction, it was, as you said, almost harder mentally and emotionally and psychologically than it was physically. And it took several years for me to get to a point where I could even talk about it. And I also still have that block of; while I feel like I’m doing pretty well. I’ve recovered a lot emotionally. Going to therapy. Really doing a ton of work, even in the periphery. Not even specifically about birth. But personality. And why these things were so important to me. And letting go. And all of that.

At the same time; I still have that block about having another child where I’m like; gosh. I want to want to have another one. But I don’t. And people don’t seem to understand that. It’s like; oh, well it’s fine. You don’t have to have more than one. You can be fine with one. I’m like; no! I want to want to have another one! I don’t, but I want to want to.

And there’s that blank spot, where I just can’t see beyond that. And I thought to myself; the only way this is going to happen is if it happens by accident. {laughs} And then you just get pushed over the precipice.

So everything you said; I’m just like, I get it! I totally understand what you're saying. And I can’t thank you enough for so openly sharing about it. It’s just so many of us have felt this way. And just have had nobody to look to who is openly sharing about these things and this community. And I cannot say enough how much I appreciate it.

Jessie Mundell: Thank you. Everything you're saying, I’m just nodding along.

Liz Wolfe: Yes.

Jessie Mundell: Because I’ve said that so many times. The only way we’re going to have another baby is if we get pregnant and it was not planned. And that’s exactly what happened. And the universe is always listening to the things I’m saying.

But yeah. And so much of your story I resonate with you, too. This idea of how birth should be. This is best for mom. This is best for baby. And in these very specific, boxed in ways is how I went into that first birth. And I vividly remember, after my oldest was born, being in the recovery room post C-section and thinking; what is my community going to think? How will they trust me to coach them in pregnancy, and in postpartum? I didn’t experience a vaginal birth. Obviously, I didn’t do the “right” things to prepare for this birth, or it wouldn’t have ended up this way. It was just so much to unpack.

5. Elective cesarean section [19:57]

Liz Wolfe: Yes. So, so much. Would you be willing to share a little bit more about the reason you decided to go with an elective cesarean? I want everyone to know that this is actually something that I’ve given a ton of thought to, if we were to have another. Just going ahead and doing the elective cesarean. Brianna Battles is another woman that I follow online who also had an elective cesarean for her second.

And I really just want to say; because I know how I would have been before my first. If I had heard two women on a health podcast talking about this. I would have probably had some judgment in my mind. I would have been actively rejecting the conversation. I would have felt it’s probably even irresponsible. Anyone who may have a little bit of that inkling in their minds; I just ask you to just drop that for a moment, and just listen to what we’re saying, and see if you can sit with it for a moment. Just so we can have this conversation. This might not be 100% directed at you, but there are women who need to hear this. So I really want to bring it out and talk about it.

So, we talk a little bit about that choice, and what led you there.

Jessie Mundell: Mm-hmm. It was a long process. Interestingly, I remember at 9 days postpartum with my first, my husband and I talking about if we would have a second baby in the future sometime. And me saying that absolutely, I would try for a VBAC. A Vaginal birth after cesarean.

Liz Wolfe: We’re told that that could be healing, right? This is something people were telling me within two weeks. “Oh, you’ll have another one, and it will be a vaginal, and it will be so healing.” And I would kind of think; well, I don’t need to fix my daughter’s birth by having another. And it’s ok if it feels healing. Because I do hear from women who are like; my second was a VBAC and it was healing. But not everybody looks at it that way.

Jessie Mundell: Yes. Yes. Absolutely. One of my clients actually just had her second baby by VBAC over the weekend. And it was so beautiful and perfect and healing for her. And that makes me so happy. And it gave me goosebumps and I was crying reading about it. And that just wasn’t what I wanted. It wasn’t what I wanted. And that’s what it really boiled down to. As I weighed all my options, and went through all these choices, and considered what postpartum would look and feel like after the second baby was born. I mentally and emotionally was not in it to have a trial of labor. That’s what it boiled down to.

And I had a good laboring experience the first time around. And obviously I think labor is such an incredible; it was just an incredible experience. I didn’t want to experience it again. That’s really what it came down to. I didn’t know if mentally and emotionally I was in it to stay focused in it to really do some things that I thought would be necessary for me to prepare for that. And really I’m talking about pelvic floor health in general. I’m a big-time tension holder in my pelvic floor, so there were definitely some things I needed to do in order to best prepare for a VBAC for my body, I thought. And just really some other things that were surrounding that pregnancy in terms of anxieties that I felt. My mental and emotional health.

I didn’t know if I could put more energy towards thinking about a VBAC. I wanted things to feel simpler, and I wanted things to feel easy this time. Last time, I wanted to do everything that I could in order to prepare for that vaginal birth. And this time, I just wanted to take a route that felt simpler.

And I had a lot of shame and guilt that was coming up about that, too. Like, what if I do have the cesarean and it did feel easy; would that be ok? Would I feel like that was ok, because I’m the type of person, and this goes decades back, that I think there’s so much value and worth in doing hard things. This is kind of the mindset that I take with me in most things. And it can be very detrimental for me. So thinking that the hardest way possible, I will find worth and value in that after.

So what if the cesarean is actually easier? Not that any birth is easy. What if it is simpler? What if it feels like a big exhale, and a big sigh? What if it feels ok? What if I get to that phase afterwards and I feel like I didn’t do enough? So I did a ton of work about and around that mindset on what would be enough for me. What amount of effort or work would be enough. And again, it just boiled down to wanting some ease. Not caring to have this vaginal birth. And that was so strange, because this was what I wanted so desperately for so many years. To experience this vaginal birth. And I really just got to a place where I felt ok with not having that. It’s even weird to talk about, still. Because I never would have said this a few years ago.

Liz Wolfe: Right.

Jessie Mundell: It’s just really; my experiences shaped this moving forward.

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6. Meeting yourself where you are [25:27]

Liz Wolfe: It’s just so refreshing. It’s just so amazingly refreshing to hear someone speak about this. And I hesitate to use the word ideal, because that feels a little bit loaded. But I do want to acknowledge that maybe there is an ideal. Maybe that ideal is birth as represented by natural laboring, vaginal birth, at home or whatever that is. Maybe that is the ideal, and maybe I can acknowledge that. But there’s an ideal, and then there’s reality. And I think there is so much beauty and so much long-term; it’s a long-term approach to deal with reality rather than the ideal.

Because when you're willing to deal with reality, and meeting yourself where you are. And I’m talking to myself right now. Meeting yourself where you are, when you get pregnant. Because I could do psychological therapy work for the next 20 years and maybe get to the point where I want to make a different choice. But this is where I am now, and meeting myself in that place. That’s the sustainable approach. That’s where I’m able to live the healthiest life humanly possible, rather than relentlessly striving for some ideal that is going to cause more pain and limit me in more ways in the short term. Does that make sense?

Jessie Mundell: Mm-hm. Yeah, it really does. And on that note; even if we just bring this back to pelvic floor and core health. Because this did factor in for me, too. People in my family carry babies very long. At least 42 weeks. I had a castor oil induction at 42 weeks with my first. I had a strong feeling that I would probably carry this baby to 42 weeks. And just thinking about; again, long labors tend to run in my family as well. I did not want to experience this full, post-date pregnancy if that’s what I want to categorize it, to 42 weeks. And last time, I wanted to let the pregnancy go as long as it needed to go. I was over it. I was over it most of the pregnancy, really. I just had uncomfortable this time around. So I was ready to not be pregnancy anymore.

I was having a lot of belly button pain. I wasn’t going to do what was needed at all costs to birth this baby vaginally. And what I mean by that is; I wasn’t going to push for, say, more than an hour to get this baby out vaginally. And that can be a short time; but again, this is in consultation with my pelvic floor physio, and knowing what was best for my body. So I didn’t want to go long pregnancy. I didn’t want to risk an induction. Again; just my personal wants and needs at that time. I didn’t want to labor. I didn’t want to get to pushing, and then go to cesarean. Just considering the trauma that that might put on my body; especially a body that had already been through one major surgery before. There are just all these things that line up to go into our personal decisions about this experience.

7. Core and pelvic floor [29:19]

Liz Wolfe: Hmm-mm. Ok, let’s talk about core and pelvic floor. One of the things that really piqued my interested when I was first exploring your work was something that you had said about how you hold a lot of tension; I think you said actually in your abs at that point, but also in your pelvic floor. Can you tell me what that means? And also maybe what that might look like, if somebody is not entirely sure that that’s them. But they’re like; yeah, that feels like something maybe I’m dealing with.

Jessie Mundell: Mm-hmm. Yes, I’ve been a big-time tension holder in my whole abdominal wall, pelvic floor for, again, years and years and years. This really, I think, relates back to so many things. We’ll start with competitive gymnastics. I was a gymnast for many years. And really, there’s so much tension holding in the pelvic floor and the abdominal wall in that sport in general. But further from that, for me, it was just thinking that my belly was too big, too fat, from the time; vividly remember this, as well, 8 years old, onwards for a good 15 years on from that point. So wanting my belly to always appear smaller, or not as round. So lots of tension being held inwards by the abdominal muscles. And that in itself can make us hold tension in the pelvic floor. These muscles are so connected. So if we’re holding abdominal tension, we’re holding tension in the pelvic floor, too.

So, for me, I need to constantly remind myself. And I’m doing it right now. To let my belly go. And I think of this as letting that tension go in the musculature, in the abdominals. Especially from underneath the belly button. Just seeing if I can let my belly hang. If I can let my belly be soft.

And if we take this back to that idea of body image; this is really getting comfortable with allowing my belly to be round, and appear bigger. And it does not have to be flat. So letting it go. Taking some good breaths into my abdominal wall. And you’ll probably know that you're doing this if you're sitting here, if you're walking, if you're standing, listening to this right now. If you can just try to let that belly button relax. Try to let the area all the way from your belly button to your pubic bone; your pelvis, relax. And you feel this kind of drop. You feel this hang sensation. And it can feel so strange at first, and also really relieving.

Some people just feel like they can’t make it happen. I think that there are strategies we can use, but even just one is lying on your side, somewhere comfortable on the floor where your body feels supported, and letting your belly just hang towards the floor. Letting the floor really support your whole body weight. And then taking some breaths into the belly.

So this is a big one for my clients. I know that we hear so much about the pelvic floor being weak, and to do our Kegels. And this why you're leaking, because your pelvic floor isn’t strong enough. Honestly; most of the time, for postpartum people. A lot of the times for postpartum people. We have this hypertonicity. Too much tension being held in the abdominal and pelvic floor. And that can lead to weakness, but first step is really just learning how to let that tension go before we even get to Kegels. Because Kegels are strengthening. They’re tension building. And we don’t even need to go there if we’re already holding too much tension to begin with.

8. Hypertonicity in the pelvic floor [32:41]

Liz Wolfe: That makes so much sense. So, how might that type of; holding tension. What did you call it? Hypertonicity. How might that affect a pregnancy or a birth.

Jessie Mundell: Mm-hmm. In pregnancy, it really can lead to some discomfort and pain. Again, if we are gripping these muscles super tight, sometimes it can ramp up some discomfort in the pelvis. Whether that’s the front of the pelvis, the pubic symphysis, the back of the pelvis, the SI joints, sacroiliac joints on the back of your pelvis. Lower back pain. These tend to be the areas where it can pop up. And just really holding tension in that abdominal wall.

In the pelvis, we can rely on some other areas of the body to kind of take over, and do a bit more work for us. Say in the inner thighs, the groin, the adductors, the spinal muscles of the back, as well. And we can just create this whole body where we’re feeling very tense, and we can’t let go. And again, these discomforts might pop up, resulting from that.

For birth, so incredibly important if we are hoping for, preparing for a vaginal birth. Even if we’re preparing for a cesarean. Especially if we want baby to come out of the vagina, we need to understand, practice, and learn how to relax those pelvic floor muscles. So my clients really are not practicing Kegels during pregnancy. They’re practicing this letting go sensation of the pelvic floor in order to allow the baby to come out that way.

This, I think, affected me in my first laboring experience, too. I was just holding too much tension. Even though, at that time, I was practicing letting go. Working with a pelvic floor physio. I was still just holding a lot of tension in the pelvic floor. So if we want baby to come out of the vagina, we need to learn. We need to be effective at letting the tension of those muscles go and yield under that pressure.

9. Kegels [35:08]

Liz Wolfe: That’s just so fascinating. None of this was not even on my radar when I was pregnant, which is really interesting. We talk about spinning babies. There are a couple of other methods that we talk about. But one of the things that was kind of shoved in my face postpartum was Kegels. And you mention Kegels as well. Can you kind of give a run down on your feelings about that?

Jessie Mundell: Yeah. So Kegels can absolutely have their place. And really, what a Kegel is a pelvic floor contraction. A pelvic floor lift. The thing that we kind of get tripped up on is the pelvic floor needs to be able to lift strongly, hold strength, and then let go and come down. So if we even think about this doing, say, a biceps curl. We curl the weight fully up, we let the weight come fully down. We want the muscles to go through their full range of motion. We need to practice this with the pelvic floor, too.

So again, often when we’re told to do Kegels; do a hundred Kegels a day. Do 50 Kegels every time you're at a stop light. Often what this just looks like is a lot of tension being built up, up, up. Squeezing, lifting. And it’s never coming down. So we need to practice this. Fully lift up, or even 25, 30% of a lift of the pelvic floor. And then allow it to come down. So we can think about this even as elevator floors. Lift the pelvic floor one, two floors. Allow the pelvic floor to come all the way back down to the basement, and then start again.

So, for most people, this can be an affective training tool. For most people doing hundreds of Kegels per day in that traditional sense, of this building tension, carrying it high. That’s really not going to be helpful. And again, this is even if you’ve been told you have a weak pelvic floor. If you experience incontinence or leaking of urine or feces. If you have pelvic organ prolapse. This is typically not the route to go.

And disclaimer; always see your pelvic floor physical therapist. We love them so much. They can do an internal assessment if you are comfortable with that. And they can really be the ones to determine what is going on inside the pelvic floor, and how those muscles are functioning.

Liz Wolfe: So, postpartum, I went to a pelvic floor physiotherapist. I was told I didn’t need to, because I had a C-section. But I still just kind of felt like I wanted to get all the professionals involved. This is how I operate. I want to get everybody’s opinion. And yes; they will do an internal exam. Come prepared. Because I did not know I would be taking my pants off that day. {laughs}

But yes, Foundational Concepts in Kansas City, by the way. Anybody in Kansas City, I went to Foundational Concepts. And they were lovely. I felt they did a really good job. Were very respectful, and talked me through everything that was going on. So that was definitely a good stop to make.

Would you recommend that; is there any kind of checklist that women should kind of ask themselves when they decide whether they need to go to a pelvic floor physiotherapist. Either pre- or postpartum.

Jessie Mundell: So the checklist for me, for my clients, is have you been pregnant? Do you have a pelvic floor?

Liz Wolfe: {laughs}

Jessie Mundell: Really, that’s it.

Liz Wolfe: Do you have a brain? Then you need a therapist.

Jessie Mundell: Yes. Even if you have not been pregnant, if you will never be pregnant again; do you have a pelvic floor? You could benefit from pelvic floor physio. And I know this is something that we are so lucky to be able to access. Some people simply are not able to access this depending on if someone is available in their area. There is a cost barrier to it, absolutely. I definitely recognize that. But if you are able to swing it, it can be so helpful.

I just went from my first postpartum appointment at 5 weeks after C-section. We did an internal exam, like you were saying, Liz, about how you were told you didn’t need to see someone after a C-section. Absolutely; we still go after C-section, again, if we are able to. There is a lot of trauma that can happen to the pelvic floor. Simply from being pregnant. Carrying a baby. Then, when we layer on this major abdominal pelvic surgery on top of that, it can definitely affect how the pelvic floor is functioning, as well.

10. Modern living and the birth experience [39:10]

Liz Wolfe: Ok. So, I want to phrase this correctly. And I probably won’t, but let’s just go with it. One of the things that I’ve been pondering recently is this beautiful idea that our bodies are meant to birth. And I agree with that. But I’m also acutely aware of how we live in the modern world. We’re sitting constantly. We’re not walking like our ancestors did. We’re not standing. We’re wearing crazy footwear. Crazy tight clothes. All of these different variables that might, in some ways, just mean we need a little extra help. Or a little extra; bring a little bit of extra awareness to this very primal thing that birth is.

Would you; what are these things in modern life that we can bring awareness to, and hopefully shift? Whether it’s how we move, or how we sit, that might set the stage for more harmony during pregnancy and birth.

Jessie Mundell: I love that question. The biggest things we focus on with my clients; moving through lots of ranges of motion throughout the day, every day. So we don’t want to vilify any type or any way of movement. We talk a lot about alignment, and how there is some optimal or perfect alignment. And while that may be true for some bodies, that our pelvic floor, our abdominal wall, might more effectively work, say if we are in a stacked body position. With the rib cage over top of the pelvis. What I really want for my clients is to be able to be in that position, but then also move their bodies in lots of other positions, too.

So not spending most of our time sitting. Not spending most of our time standing. In one specific way, with our feet pointed straight ahead. No; I want them to move in many different ways. Rotate. Be down on the floor. Up off the floor. Kneeling on one knee. Kneeling on two knees. Squatting. Lunging. Hinging. Pushing. Pulling. Moving through as many ranges of motion as possible. That stimulus is good for the body. It’s good for the pelvic floor. For the pelvic floor to handle loads in different ranges. So that’s the biggie; move your body in lots of different ways.

And then the second one that we focus on big time is what we were talking about with the let down of the pelvic floor. Learning how to breathe into the abdominal wall, the whole trunk, the whole core, the whole pelvic floor. Learning how to let tension go, and learning how to build tension appropriately when we need it to the degree that we need it.

One of my favorite physical therapists, Anthony Lowe, always talks about matching the tension to the task. So we think about building as much tension in the pelvic floor and the core, say, if we were talking about doing physical tasks. If we’re talking about working out during pregnancy. We match the amount of tension we need in the pelvic floor and the core to how difficult the task is that we are doing. So learning how to build just a little bit of tension in the pelvic floor, and then let it down. Learning how to build lots of tension in the pelvic floor, say if we are carrying the groceries in, and the toddler in the other hand, while we’re pregnant. We’re going to need more tension there supporting the core and pelvic floor, versus if we’re just doing glute bridges in our exercise. We don’t need to build that much tension. Because the task isn’t that difficult.

So those are really the big thing. Move in lots of different ranges of motion. Understand how to build and release tension in the pelvic floor and the abdominal wall.

Liz Wolfe: And this can be a really cool process, I would imagine. Just bringing more awareness to the things you're doing in daily life. And in some ways, that’s almost kind of like meditation, right? Just being present and being aware. And I think it has benefits beyond just the physical.

Jessie Mundell: Absolutely. It completely does. Yeah. And if we can really get comfortable and tune into the sensations we’re feeling in our body, and just on a basic level understand where our pelvic floor is in our body, and how it functions, that will absolutely not just be important in labor and birth, but for the rest of our lives and in so many aspects of our daily lives.

11. Reconnecting to your abs after C-section [42:27]

Liz Wolfe: Amen. I have a question for the C-section moms. It feels a little bit difficult; really I just wanted to interview you so I could have a free consultation. Just kidding. So it can be a little bit difficult to find my lower abs, now that I’ve had this major surgery. Is there a way that you coach C-section moms differently from moms who have had a vaginal birth?

Jessie Mundell: It is very similar. That being said, we do spend some time getting into that abdominal wall a little bit more with our hands, manually. And doing some work around the scar, and over the top of the scar and scar tissue. Getting things moving well again. And physical therapy can help you with that, for sure.

I think it’s also beneficial to start doing this on our own. Again, when or if you might feel comfortable doing that eventually. I know that can be a difficult thing for some people, to touch that scar.

Liz Wolfe: Yep. It took me two years, if anybody is interested. Yeah.

Jessie Mundell: Yes. Even if you can start doing some manual work, using your hands on your belly. And that’s really just looking like some gentle massage of your abdominal muscles. You can steer clear of that scar, absolutely. But one thing we can do quite simply, if we just lie supine. I find it much easier to do these basic connection activities when we want to just kind of find some muscle activity. If we are in positions that are super supported. That we do not feel like we have to hold our body up in any position.

So lying on the back, or lying on the side. And I would say people even find this easier to do lying on the side versus on their back. So if we are lying down, fingers inside the inside of the hip bones. We just take a nice big breath, really try to expand the air through the ribcage. So 360 degrees around the ribcage. Not pushing the belly up. Really send that breath into the ribcage, the belly will rise, of course. And then on the exhale breath, we’re going to do that gentle lift of the pelvic floor.

So this is really where it starts, when we’re trying to connect to the abdominal muscles. It actually more so starts from the pelvic floor. If we do this gentle lift from the pelvic floor, we will often feel this contraction or this contraction simultaneously of the abdominal muscles. And it is so gentle if you are feeling with the hands inside the hip bones. We don’t want to feel like the abdominal muscles are bulging our fingers out. It’s more like we feel this lateral slide from outside of the hipbones inside towards the midline of the belly. That’s what we will probably or want to be feeling with those deep, low abdominal muscles.

So again, not this bulging out. More so this sliding inwards. And it’s gentle. I think most of the time, we’re just trying too hard. That’s probably the number one cue I give my clients. Stop trying to so hard. Try less hard.

Liz Wolfe: OH, that’s so good.

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12. Final words from Jessie [47:16]

Liz Wolfe: You are a wealth of information, and I wish I could keep you on the podcast all day and make 10 episodes out of this. This has been so amazing. I guess the last question I would ask you is, what else do you want people to know? Is there anything. Like your number one favorite thing that you want all mamas to know?

Jessie Mundell: So we already talked about it, but number one, please go see a pelvic floor physio if you are able to. It will change your life. I think the biggest thing I want people to know is that you do not have to suffer in pain. You do not have to suffer with these symptoms of painful intercourse, or feeling like your tampon is falling out. Leaking during exercise or when you sneeze or laugh. These symptoms can be so easily, in many cases, resolved. And people just live with them forever. Because we don’t have time to address it. We don’t want to address it. Our doctor told us that it would go away on its own. Or it’s normal now that we’ve had babies.

These things are not normal functions of our body. I don’t want you to feel shame about it. It is such a common experience. Please know there is help available, and you do not have to suffer.

Liz Wolfe: And you have two, or three programs?

Jessie Mundell: I have three programs.

Liz Wolfe: Good lord, lady! When did you do all this? Wow!

Jessie Mundell: {laughs} Before this baby was born. {laughs}

Liz Wolfe: Amazing. Ok, well share a little bit about your programs and who they might be good for.

Jessie Mundell: Yeah. So Core plus Floor Restore is a do it yourself online based program. There is a version for vaginal birth, a version for cesarean birth. And this is really what I call the first line of defense postpartum. Getting our bodies back to feeling like they are strong, capable, and functioning really well at the pelvic floor. So it’s basic, simple exercises that we do 6-8 minutes a day for the first 8 weeks postpartum. It does not have to be every day. It certainly has not been every day for me this time around postpartum. But really just exercises that we can do to connect back to that breath. Back to this new version of our postpartum body. So again, two version of that. One for vaginal, one for cesarean.

Second program is called to Pregnancy and Beyond. And this is a monthly membership program. And this is where I actually coach my clients through their strength training and exercise programing. And we have lots of conversations in our closed Facebook group on all these other topics that we have been talking about today.

And then the third program is called the Postnatal Fitness Specialist Academy. And that is geared for health professionals and fitness professionals who want to coach postpartum moms, and teach them all the good things that they need to know about supporting these populations extremely well.

Liz Wolfe: Wonderful. And of course, folks, you can find Jessie at JessieMundell.com, and her podcast, To Birth and Beyond. I highly recommend it. Thank you so much for speaking with me today, Jessie.

Jessie Mundell: Thank you, Liz. I so appreciate it.

Liz Wolfe: That’s it for this week then. You can find me, Liz, at http://realfoodliz.com/ and you can find Jessie at JessieMundell.com. Join our email lists for free goodies and updates that you don’t find anywhere else on our website or on the podcast. While you’re on the internet, leave us an iTunes review. See you next week.