Are you interested in your pelvic health? You should be. 1 in 3 Irish women suffer from pelvic floor dysfunction and 40% of those women will experience some degree of incontinence in their lifetime. Pelvic floor dysfunction is the term for symptoms such as pelvic pain, pressure, pain during sex, incontinence, incomplete emptying and prolapse. Almost 50% of women will experience some degree of urinary incontinence in their lifetime. While it’s most commonly caused by pregnancy and childbirth, being overweight, age and menopause can also be the cause.

Pelvic floor dysfunction can significantly impact your quality of life both physically and mentally. While many EU countries include free women’s health physiotherapy sessions after childbirth (in France they get 10 free), there’s nothing similar here in Ireland. Unfortunately, most people are too embarrassed to talk about it and instead accept it as a part of life after having children. It’s common, but it’s not normal – there are many things you can do to improve your pelvic health, you don’t have to live with it. Even if you don’t have any symptoms of pelvic floor dysfunction now, please keep reading, as there may be actions you can take now to prevent it as you get older.

I don’t want to make anyone fearful – I just want to encourage you to be assertive when it comes to your pelvic health. As a fitness professional working with pre and post-natal women, I feel responsible for raising awareness and getting people talking about pelvic floor dysfunction, so I went along to meet Jo Chapple at Pilates Physiotherapy Cork, to learn more about the “Mummy NCT (MOT)”, and what’s actually involved in a post-natal or pelvic health check-up.

What is a mummy NCT?
A mummy NCT is for women who want the full post-natal physiotherapy package. The Physiotherapist will check:

• Your functional ability – this includes your posture, strength, balance and breathing
• Lifestyle / Medical history
• Your tummy (checking for any abdominal separation)
• Your pelvic health – the strength and function of your pelvis and pelvic floor

Once the checks are completed, you’ll be presented with a full report and a plan to correct anything they may be concerned about. The plan will be specific to you – based on your lifestyle, they’ll make it tailored, realistic and achievable – you can be sure that they’re not going to give you an hour of exercises per day if you’re too busy to complete them (we don’t need any extra mummy guilt, thanks).

What happens during the pelvic health examination?
Firstly, absolutely nothing is done without your consent. So even if you book a mummy NCT, don’t feel like your signing up to it. The physiotherapist will discuss the process with you in detail, and ask you for your consent before they begin any examination.

If you agree to the examination, the physio will take measurements of the genital hiatus (urethra to the hymen) and the perennial body. This measurement will help them determine how likely you are to experience pelvic organ prolapse in the future. Pelvic organ prolapse is when the muscles and tissues supporting the pelvic organs – the uterus, bladder or rectum – become weak or loose which allows one or more of the pelvic organs to drop or press into or out of the vagina.

They’ll then do a full internal pelvic examination, through the vagina or in some cases, the anus, to check check your pelvic floor function. You may be asked to do some functional movement at the same time, so the physio is able to determine the behaviour of the pelvic floor when bearing down or lifting. They may do some internal physiotherapy at this time. The internal examination will take between 5 and 15 minutes.

If you’re not comfortable with the examination, the physio will assess the risk of pelvic floor issues over your underwear or over a pair of leggings.

So, that doesn’t seem so bad does it? No more than 15 minutes of your time, albeit a little uncomfortable? When you think about how fundamental pelvic health is to your quality of life – urinary incontinence, faecal incontinence, pain during sex, pelvic organ prolapse, can we put our pride aside for 5 – 15 minutes?

What if I don’t have any symptoms of pelvic floor dysfunction?
The clever thing about a pelvic health check-up is that they’re actually able to determine if your at a higher risk of developing these issues later in life. As we age and go through menopause (a whole host of new hormones), pelvic floor dysfunction can develop. Imagine if you could have a little more insight, and take steps now to help prevent that happening? Personally, I think it’s money well spent.

When should I have the check-up?
In the first few months after you give birth, your post-natal body is still recovering, so for the most accurate results, wait 3 or 4 months or at least until at least after your 6 week check-up.

In saying that, it’s never too late! Whether your suffering from symptoms or not, you can have a check-up by a woman’s health physio at any stage. You may not want the full Mummy NCT, but you can just book in for the pelvic health check-up. I’ll be booking in for mine, will you?