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The Important Pre-Pregnancy Conversation No One Is Having

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Photographed by Ben Ritter.
Six days after giving birth, I emailed my Pilates instructor: “Let me know when I can come back and see you!” She told me to wait five weeks.
Looking back, I realise how completely unrealistic that expectation was — it was too early for me to be opening this conversation, as my body was still healing from labour and delivery. But staring down at my post-pregnancy belly, in shock over how stretched and open my skin and muscles looked, I knew something wasn’t right. I understood why it was too early to start exercising, but I was also left with the feeling that it was too late. Why, I asked myself, hadn’t I better prepared my body before I got pregnant?
A 2015 study from the University of Michigan compared giving birth to running a Marathon in the way that it taxes the body for hours upon hours at a time. The difference? We train for marathons. Should we be training for childbirth?
I thought I had prepared. I applied oils and creams to stave off stretch marks, and I did some prenatal yoga and Pilates. But the conversations and thought processes surrounding these practices all had to do with looks: bouncing back, losing weight. And anyway, I was prepared to own my post-baby body — with a new baby, surely I'd have much more urgent priorities than a weight change.
By 36 weeks pregnant, I wasn't feeling so strong. Walking had become difficult. I had slipped on some late-November ice and was in excruciating pain. Every step felt like being stabbed in the vagina with a sharp knife. An ultrasound confirmed my baby was fine, which of course I was grateful and relieved about. But...what about me? "It's almost over," was my Ob's only response.
At the suggestion of my doula, I went to a physical therapist and was told I had pubic symphysis dysfunction, or pelvic girdle pain. It's been nearly three years since that appointment and I'm still dealing with pain relating to my pelvic floor. My experience isn't that unique. A 2015 study of more than 1,200 women in the British Journal of Obstetrics and Gynaecology reported that 24% of women were still experiencing pain during sex a year and half after having a baby.
“We always tell clients who are thinking about getting pregnant, the more they prep beforehand, the better transition they are going to have,” says Natalia Hailes, DONA certified doula and cofounder of Brilliant Bodies. “It's almost too late to start thinking about it once you're in it. And the truth is, we see a big difference in outcomes for childbirth and the postpartum recovery when people have taken the time to prep.”
Many experts who focus on the pelvic floor and the musculoskeletal system believe injuries like mine are preventable, if only we prepare our bodies more — and earlier — for pregnancy and delivery. Ahead, let's dive into what that can look like.
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