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Women’s Health After Motherhood (WHAM)

By the MAMMI team

Free online educational resource on women’s physical and mental health after motherhood

A new free online educational resource on postnatal health was launched on 21st October 2019. This 4-week course, structured in one hour modules, has been developed by the Maternal health And Maternal Morbidity in Ireland (MAMMI) team in Trinity College Dublin, women's health physiotherapists Cinny Cusack and Niamh Kenny from the Rotunda Hospital, Dublin, Ireland and experts in perinatal psychiatry, patient advocacy, mental health and sexual health. The course content was based on what women told us ‘they wished they had known’ about their health after motherhood, and emerged from the Irish longitudinal study looking at the health and health issues experienced by over 3,000 first-time mothers. One of the most important features of the Women’s Health After Motherhood course is that it was designed FOR and WITH women, (participants of the MAMMI study) and aims to address the knowledge gaps that surround women’s postnatal health, and improve women's health by providing them, partners and healthcare professionals with easy-to-access, free, evidence-based educational content.

This course shares advice and strategies to enable women to look after their bodies and minds during the postpartum period. So they can 'thrive' and not just 'survive'. It builds a forum, a community of learners, for women to offer support to one another and learn how to address common physical and mental health challenges after birth.

Findings emerging from the MAMMI study show that, following birth, women struggle to access reliable, evidence-based information about their postpartum health. In Ireland, there are no national data on women’s postpartum health, and this means that there is a national silence around postpartum health issues, such as urinary incontinence, or pain during sex, which often leads women to believe that these issues are simply a consequence of pregnancy and birth. Many women do not know that these problems, while common, are not normal and can be prevented and treated. This silence also leaves women feeling that they are the only ones affected, so they suffer alone and do not seek help.

As women's health physiotherapists, we are often the profession that has the most opportunity to listen to women share their stories and tell us about their fears and concerns. It is important that we give women the time to speak all about their birth experiences and postpartum journey, and really listen to how they are and understand what they need. Often the topics we discuss are embarrassing, sensitive and still taboo. Women find it difficult to describe their symptoms, or how it has changed their relationships with their partners. However, we are also uniquely placed to empower women to engage in their postpartum rehabilitation by taking a holistic approach to their recovery and which will enable them to enjoy this challenging but exciting phase in their lives.

As a mother looking back on my early days of motherhood now my children are all young adults, someone said to me "the days seem very long but the years are very short". Now I realise how true those words were and if women have the help and support they need at a time when they most need it, then maybe the days won't seem quite as long.

This free online resource was developed not only as a point of reference for new mothers to become better informed about their own health and wellbeing, it was designed to complement the practice of healthcare professionals, such as women’s health physiotherapists, with resources that can be downloaded and printed off for use with postpartum women.

Week 1: Maternal health: Presents myths and misconceptions on maternal health globally. Learners will understand what is common versus what is normal, and how to prioritise your health postpartum. This week also looks at postnatal recovery and returning to normal activities and exercise. It highlights the importance of considering the health and recovery of the pelvic floor when returning to exercises and promotes the use of the returning to running guidelines, which were published in 2019.

Week 2: Staying continent: This week places a strong focus on maintaining pelvic health. Women’s Health physiotherapists, Cinny and Niamh, discuss the science behind urinary incontinence, what causes it, how the bladder works and the impact that urinary incontinence has on women's quality of life. There is a coached pelvic floor exercise task, which has both visual and auditory feedback to facilitate a woman doing her fast and slow pelvic floor exercises, and complete a full PFME routine correctly. There is downloadable and printable PFME tracker tailored to the women’s ability, and a useful habit building infographic to encourage women to view pelvic exercises as integral to their overall health maintenance. These will help women record their progress and add as a motivator to progress from a beginner to advanced level.

Week 3: Mental health: Week three encourages women to speak up for themselves and their health, with a strong focus on encouraging women to break the stigma and silence around mental health or other sensitive issues. The content addresses postpartum anxiety and depression with psychiatrist Dr John Sheehan and mental health expert Prof Agnes Higgins, and enables leaners to identify life strategies and techniques that help them achieve mental wellness and build a social support network.

Week 4: Sexual health and relationships: Returning to sexual intimacy, identifying sexual health problems, recognising intimate partner violence and building social support networks are the topics examined in our final week together. The role that physiotherapy can play in the physical recovery of postpartum sexual dysfunction is addressed. It is vital that women know that holistic treatment is available and that the physiotherapy approach to sexual health looks at the all the aspects of the women's recovery. This week aims to help and empower women to recognise when and how to seek the appropriate treatment.

Our hope and wish for women as mothers is that they use these resources and this course to become informed, and help themselves maintain, or take back, control of their health and wellbeing. We hope that by working together as genuine partners, women and maternity care professionals begin to break the silence on health problems that are common but not normal during motherhood. Our ultimate goal is that these trustworthy resources help women thrive, and not just survive.

Cinny Cusack, Women’s health physiotherapist, on behalf of Niamh Kenny, Susan Hannon and Deirdre Daly.

Women’s Health After Motherhood Online Course:

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