Niki's Story - Episode Transcript

Helen

Hi, I'm Helen, and this is Why Mums Don’t Jump; busting taboos about leaks and lumps after childbirth. All the stuff that happens to your pelvic floor that no one ever talks about. Incontinence, prolapse, pelvic pain… problems that affect millions of women, one in three.

I'm one of them. I have a prolapse. My pelvic organs fell out of place after the birth of my second child. And if you had told me back then that I would be speaking about this stuff out loud, I would have told you to give your head a wobble.

Helen

Hi, welcome back. So much interest in the pessary episode last week. If you missed it, I had a pessary fitting for a cube, which was actually quite exciting. I haven't had the chance to try it as much as I'd like because I came on my period almost immediately and then also kind of living on a building site right now, which is why I'm recording this in the back garden. Anyway, so I am wearing the pessary. I don't think I've quite got to grips with it yet. Taking it in and out, getting it in the right place. Tracy Matthews, the physio who fitted it, found me out for being a bit complacent with my pelvic floor exercises. So I'm now following the programme she gave me. So I would say it's all a work in progress, at the moment… we’re about, I mean it's just been a few days really, so I'm still really optimistic about it all and I'll keep you posted. If you missed it, do check out the pessary Q and A that Tracy did on my Instagram stories. Loads of good stuff there. Today's episode, then, is something a bit different again. We’re going to hear Niki's story. Now this is Niki Odogwu. She's a mum of two daughters, they’re ten and seven. She lives in London and since childbirth, she's had problems not just with her pelvic floor, but also diastasis recti or recti, I'm never sure which. If you haven't heard of it, and I hadn't until a few years ago, it’s where the muscles that run down the middle of your stomach can separate during pregnancy. So often they'll go back to normal in the first few weeks after your baby is born, but for some people they don't. And that can impact your core and lead to back problems, even to a hernia, which is as you'll hear, what happened to Niki. So I was trying to work out the relationship between diastasis recti and pelvic floor dysfunction, and it seems like it's really unclear. But the POGP, which is a specialist network of physios, says that incontinence and prolapse are also among the symptoms of diastasis recti. So it's definitely worth reading up on and I'll put some more information in the show notes. And, as ever, none of this is medical advice. So that's enough of me. Let's hear from Niki, whose problems began after the birth of her eldest daughter:

Niki

My pregnancy was fine. Obviously the birth was traumatic, but you know I think it is every, you know most first births. But in terms of, you know, nothing, there was no interventions or anything, so everything was fine. It's only when I was discharged and the consultants do a little check of you before they discharge you and the baby. And then I remember them feeling my tummy and just explaining to me and it was all very casual and sort of so you just think, oh, okay, no one mentioned this happens, but I'm not really surprised with all that's going on.

Helen

I mean, that's the thing. So what we're talking about here is the diastasis recti, which is the separation of the abdominal muscles…

Niki

Exactly!

Helen

… which apparently happens, is quite common in pregnancy.

Niki

It is - I know that now.

Helen

Which I didn’t, I had never heard of it before.

Niki

I'd never heard of it before. Even in all, you know what it’s like, first pregnancy, you read everything, like pregnancy books, every stage of the pregnancy, delivery, birth, going to all the antenatal classes, there's not one single mention, it's not about the aftercare afterwards, like what to expect once the baby is delivered.

Helen

And so you're in hospital, you've been checked, you've been told you've got this separation. And how was that? Did that affect you? I mean, were you feeling symptomatic from that or I mean, you're just in such a haze…

Niki

I felt like I've been run over anyway after having the baby. You know, that feeling like I'm not even actually in my own body. Whose body is this? I was completely battered from the birth. Everything was just sore anyway. So I was on paracetamol for about a week or so. I was on regular paracetamol and you're just out of it anyway, to be honest. And then it was more like, I don't think I didn't even have symptoms straight away. I just remember them saying to me, when you first go to the toilet, it's going to feel like you haven't got a pelvic floor. It's just going to feel really strange, like you're going to the toilet for the first time. I kind of expected that because I thought, well you know, so much is going on, so I sort of expected that, and okay, in time. You just know that it's going to be like, well your whole body is just having to recover. And I still didn't quite understand, so when I was going to the physio, they put the fingers in the gap, and they tell you - I can't remember how many - I think it was quite wide. I think it was at least three fingers. At the time.

Helen

Yes. They sort of press firmly down the line of your abdomen to see exactly how big a gap. And I think I read that a small gap is kind of fine within the realms of normal, but a larger gap, where sometimes you can get kind of a finger.

Niki

You can get a few fingers - mine was in that stage.

Helen

And then, that means you've got no core support, really. And this is the problem, isn't it?

Niki

This is what it is, yeah. And I didn't understand the connection with that and my core strength, like how it all ties in, in the pelvic floor of the core. And at the time, you're just literally just going by whatever they tell you, and you just think, okay, I'll just do these exercises and everything will go back to normal. And then I'll be trying to feel where my gap is. And I was doing it as best as I could, but sometimes I would do the exercises and then I might forget, like am I doing it right? I wasn't quite sure if I was doing it right when I was at home. So I was trying to do it regularly. I think I had about three or four sessions, and then after that, you're sort of left to your own.. and you're supposed to obviously keep it up, but then you don't really know how long you're supposed to do it for. Maybe after a year or so, you're just like.. I felt like I didn't see any improvement. It had closed a little bit, but I didn't feel like… well I thought I'd just go back to normal to be honest. I didn't realise it was just going to actually be a thing that was going to be there.

Helen

No! I think for a lot of women it does just go back to normal so I think, you would think that.

Niki

Yes it does. And in my case it didn't, because what started to happen, I started to develop back problems. So that was actually my initial symptom. First, obviously, the gap was there and everything, but it was more the fact that my back just always felt like it was on the verge of… like I was going to just pull my muscle in my lower back. I’d get a lower back ache.. and you're constantly lifting the baby, and I wasn't aware of my movement. They didn't tell you about things like that either; like the way you're moving, the way you're carrying the baby. It all affects, you need core strength to do things like that! So you're constantly lifting.

And my back was just getting worse and worse and that's what actually made me, well it was the back problems that made me seek out, like going online just to find out what's going on.

And I just put in details: after pregnancy/back pain/lower back pain after pregnancy. And obviously I started to piece together what was happening..

Helen

Doctor Google!

Niki

Yes. And that's when I found out what the term was, that it was diastasis recti. It gives you the description.

Helen

Oh right!

Niki

So that’s what it was that I had!! Because they didn't actually say that. So, you know, when they normally tell you that this is what you have, then you go home and you research it.

Helen

Yes!

Niki

This was more just like; you got a gap. They explained it, obviously, in the layman's terms, but they didn't put a condition to it. The way they said was like, oh, this is just what happens. They don't give you instances, this is really common. It's just like, oh, this is just what's happening. And you just accept, you're just like, okay, yeah, I'll do these exercises like they said, and hopefully that'll be fine. And then I just started taking notice and reading everything. But then again, you know, when you've got a young baby as well, you're sort of half in it, you're not quite fully, it's just a lot to get your head around. I didn't really focus on it, but I was aware of it. And then, obviously, things like when you're on the trampoline and your core is so weak - and like, I find myself wetting myself. By doing things like jumping or if I'm coughing, anything that's causing any pressure there, I could basically wet myself and it was so embarrassing.

Helen

So, obviously, this is at the same time as you had the diastasis recti, when did you realise that the incontinence was an issue as well?

Niki

Well, I think it was more or less all around that first year of having the baby, and you're just thinking that, oh, your pelvic floor is weak. And I wasn't to be honest doing my exercises... when I remembered, maybe I'm in the shower, oh, let me just do it, I’d do a few little squeezes. It was all very half hearted.

Helen

Yeah, can relate to that!

Niki

Yeah!! I wasn't really focused on it.

Helen

And were you having to wear pads and things as well?

Niki

Yeah, I started to. Not every day. Sometimes, it's weird because sometimes it's like if I go to the trampoline, which I didn't do for a while, but when I went on the trampoline, that's when I first noticed how bad it was. It literally felt like there was just no pelvic floor muscles there at all while I'm jumping. And then it was more like if I'm coughing. And I kind of started to accept it. I know it sounds really strange, but I would  sometimes just go and change my underwear or something. Then I started wearing the dailies and then I just accepted it. ‘When it gets better, as it gets stronger, then it will stop’ kind of thing. But I obviously wasn't doing enough to make it stop. I wasn't focusing on the exercises and stuff, and then I was just too distracted, just getting on with everything.

So it was happening, but I wasn't thinking it was a problem. I think on its own, I was just like, oh, it might probably resolve itself, but it was more the back that was actually my main problem. So I think that overrode my feelings of the incontinence.

Helen

So at what point with your back did you realise that the diastasis recti was going to be a big problem for you? Is this after your second daughter's or where are we at now?

Niki

Yes. So basically now I've had on and off back problems up until after I gave birth to my second daughter. And that's when it all just… everything basically got worse. I got a hernia actually, I got a pregnancy hernia after my second pregnancy.

Helen

I think I read because I knew that you'd said that you had an umbilical hernia.

Niki

Yes, I did.

Helen

Those things can be linked, right? We haven't got the muscles there to support.

Niki

Exactly. Your insides are sticking out! Your intestine is just coming out of the gap because the gap is there. Then my intestines are literally poking out around my belly button.

Helen

So you could see a different shape….?

Niki

…above my belly button - yeah, I've still got it!

It's one of those things, I know I can have it removed or rectified or pushed back with surgery and stuff, but haven't really. They said that you have to make sure you've had all your children before you do that. It's a good idea because obviously you might just defeat the whole purpose if you have another pregnancy.

Helen

What were your back problems like? What was day to day life like?

Niki

So what will happen is that it'll be fine for a period and then maybe if I'm overdoing it, maybe I've just carried some heavy shopping or I've just moved too quickly…. I think it's just that consistent, constantly carrying maybe the baby and then doing other things, that you're moving awkwardly. What would happen is that one day suddenly my back would, I’d bend down and my back would just go… I’d literally just get a shooting pain right on my back and then that would be it for about a week or so.

When you're walking, you're just feeling rigid and you can't bend. I wouldn't be able to put my, like my socks on and things like that.

Helen

How did that affect you mentally? Like, I mean, I imagine that's very, very draining.

Niki

Yeah, I felt like, you know, like my body was just falling apart. I was like, you're only in your early thirties and you always think I'm going to be one of those people that has back problems for life. And I just thought, oh gosh, I just resigned myself. You’ve got back problems. I just resigned myself. That's it. You're always going to have these kind of problems on and off. But at the same time what was really worrying for me was the fact that I couldn't look after the girls.

Helen

Of course!!

Niki

There were times I'd be changing nappies, I'd have to be crawling around on the floor. Normally I might be on the sofa, I'd have to do everything on the floor and it would just be so painful and uncomfortable and I'll be just taking painkillers.

Helen

Was there kind of a low point for you or a point at which you were just like, this is too much?

Niki

Oh, yeah. It was when my second daughter was 18 months, she was about 18 months old. My back had been going, it had been really bad that particular week and I was at work. I'd been prescribed quite strong painkillers, co-codamol, it’s codein and paracetamol, and those knocked me out anyway, it makes me feel really nauseous. I took them and that was a big mistake, because that particular day, I remember for a whole hour, I couldn't work. I was in the staff room, literally laying down on the floor because of the side effects of the co-codamol. And then you were in pain as well, so it was just such... it was really bad. And I remember getting home that particular night and lying down and then the next morning, I couldn't get out of the bed.

Helen

That must have been terrifying!

Niki

It was agony. This was like the worst I'd ever experienced it. I even called the ambulance because I was like, I actually can't move. And that's how it was for the whole day. I couldn't go to the toilet. I was like that until I got some anti inflammatories. I couldn't even go to the GP, they had to send it, and then my mum had to come and stay with me for a week. That was me for a week. In a way, it was quite good because I got to sleep, like I couldn’t do anything…

Helen

Ooooh, that’s such a mum response! ‘’That was quite good that I was in agonising pain because I got to lie down and have a rest!!’’

Niki

Like, once pain was controlled..! It was obviously really bad because I was looking at the reality of it, I was like Niki look at this: a whole week. You can't look after your children, you can't work. And that's when I just knew that this is like, I need to do something. And that's what prompted me to really as I know, Niki, this is it was really scary. And then that's when I really went to look for the osteopath and get treatment. And during that process of having my treatments, that's when I was really looking into diastasis recti. I was like, I'm going to fix it, I can't go on like this. I thought, me just leaving it, thinking it was all going to heal on its own is not going to happen. So, yeah, that was a turning point that time.

Helen

And so tell me what happened from there then, had you been seeing somebody regularly about the diastasis recti?

Niki

No, up until that point, I hadn't. Even after my second birth, I had physio again. Obviously I told them my experience of the diastasis recti from my first pregnancy, and obviously it's just widened more now with the second pregnancy. And now I've got the hernia on top of that. So I did the standard physio sessions that they give you in the NHS and was doing the exercises again. It was just sort of like a repeat of before; pelvic floor. And then my back problems were getting worse and worse when I found the MUTU website, that was one of the first ones that described the diastasis recti and about the core strength. And in my mind, I think, oh, that makes sense. Like, you know, my core obviously, because of the gap, my core strength is weak and then it's causing me back problems..

Helen

So this is the MUTU website. This a fitness programme for the core and the pelvic floor, isn't it?

Niki

Yes, exactly. Specifically for mums that have given birth. Exactly. And you can actually use it throughout pregnancy.

Helen

You came across the website and you were like, that's me, I'm ready, I'm ready to do something about it. And that's what you found.

Niki

Yes!

Helen

And how did it go?

Niki

It was great. So basically, I was seeing the ostheopath, and that was good, because the osteopathy was more like treatment I was getting. I think I had three different sessions just to align my back again. They did manipulation, just so I'm not walking around like lopsided and it really helps, those ostheopath sessions. But in my mind, I needed to correct the problem, not just have the treatment when it's occurring. And then I went back to the…. obviously a year previously was when I first looked on the website. I went back this time, signed up - it was like four months. And then I read all the dietary stuff as well, I thought it won’t hurt, because what was happening as well was that people were thinking that I was pregnant! My daughter was two, and I got it a couple of times and people asked me or congratulated me on my pregnancy. Because I'm a pharmacist, I'll get patients..  because I had that classic mummy tummy where you're slim everywhere else. And then you’ve got that… it was like the bulge. And it was because of the diastasis recti, it gives you that bulge as well. And it was quite obvious that some people thought I was pregnant. It happened on two separate occasions, so that was another incentive.

Helen

No one likes to be told they're pregnant when they're not.

Niki

Oh, no. I was like, Niki, you can't go through this. People are asking if you're pregnant. It was so embarrassing. So that, on top of the incontinence, the back problems, I was like the classic case. I was like the case study for MUTU!

Yeah, so I just did it. I'm going to do this thing properly, I'm going to follow everything. I'm not going to miss a single day, because you have to do it every day for four months, and then after that it's like maintenance.

Helen

And if you were to describe the sorts of exercises that they are, what sort of things does it look like?

Niki

There's lots of stretches, lots of squats. And then the actual focus on the pelvic floor and the core together, because they work together, so the core and the pelvic floor, you do those exercises and they're helping both. I did the whole programme, the intensive, the core, everything. And then after that, I was so amazed at the difference. I felt like I'd gone back to how I was. You know, I didn't have that mummy tummy anymore. And most importantly, my back. My back had in that four month period, I didn't have any problems with my back. And then after that I've just continued doing the core exercises as maintenance. Just try and do it in the mornings. It was a bit hard in the beginning, but what I noticed was that when I didn't do it I’d start to feel a little backache and things. Oh Niki, you haven't been doing your core! I just knew what it was and I realised that with the MUTU, it's not something you just do for four months and it's better. It's just something I know, and I have accepted that I have to do it for life really.

Helen

Yeah. Because, I mean, if you think about it, it's ten years now, nearly ten years?

Niki

Yes ten years. I'm 40 now, so I had my first daughter when I was 30.

Helen

That's a long time to have been going through all of this. I mean, where do you feel like you're at with it all now? How are you?

Niki

So now I feel completely in control, I know exactly what my body is doing. I'm not perfect. I aim to do my MUTU exercises every morning, but I don't always manage it, but I try and do at least a few. And then I've become more - in terms of health and fitness I'm definitely much more progressive than I was back then. Obviously the children are older now, so you have that bit more time. I try and do running, but definitely the core is just so important for me because now my back is great. I'm not going to say I never have that problem, because when I do feel twinges, I know when I've been overdoing it, I might feel the slight twinge and then maybe you haven't really been really on your core exercises for the past couple of weeks. Then I just start it up again intensively, and it never gets to that point of where before I would just pull my back muscle and be out of it. It's so controlled now and everything's really firm, like my pelvic floor, it's so improved. I don't get…you know when I'm coughing or jump…. actually jumping on the trampoline I do find that I’m still… well not as bad as before…..

Helen

Do you jump on the trampoline a lot, Niki?! You have a lot of trampoline stories!

Niki

You know what it is? It's all these kids, these parties. And we've got a trampoline in the garden, which, when we first got it, I used to do a bit, but then not so much now, but the kids activities in the half term... Especially my older daughter, she loves it. Before, I used to kind of go in with them when they were much smaller, but now that they're big, they can just go in themselves. I'm just standing by the sideline. Not so much trampoline in life like before, when you actually had to do it with them.

Helen

But you were saying, basically so your pelvic floor has also obviously improved...

Niki

Oh, definitely, yeah. And you notice, obviously your sex life as well, because it's all important. In the beginning you feel like it's just like, oh, what's happened… the sensation is different. But then I noticed that when you do the pelvic floor regularly, you can actually go back to how you were before. And I didn't understand that then,, until I did the MUTU, and I noticed the complete difference sexually compared to before.

Helen

This is such a positive story. I'm so pleased for you.

Niki

Aaw thank you!

Helen

I mean, I know it's taken a long time and you've been through a lot, but it really seems like you've come out the other side.

Niki

Oh, definitely. And I wish I knew then what I know now. Because now, if I was to have another baby, I would straight away be doing those exercises throughout the pregnancy and I would do those exercises continuously because I know about it now. I know exactly how it helps. It's been such a learning curve, but I feel so confident now. I wouldn't worry. I remember being so anxious at the second pregnancy and thinking, oh, gosh, it's just going to get worse. And I didn't even expect to get the hernia and that was thrown in.. and you're like, oh, gosh, I didn't even know about that either. I didn't know about umbilical hernias until then.

Helen

Yeah, well, that's the difference. Knowledge is everything, isn't it?

Niki

Yeah, exactly. I talk to my friends about it and I just realised, you know what? We all say the same thing. It's like, oh, we just suffer in silence. We feel that when you have a baby, you feel like you can't complain. You got this baby and it's all about the baby. So we're just suffering, sleep deprived. It's always just about the baby. But we don't focus on ourselves and our own care, really. It's like we don't matter. And I think we need, as women, we need to get out of that mindset and just stop feeling like, by looking after ourselves, that we're being selfish mums… we should be putting everything into the children and this is the price you pay for having children kind of thing. It shouldn't be like that! Because you think about it. You start to feel really old before your time. When you're falling apart, you just feel like you're done as a woman. This is how I felt. I was in my early thirties then and I was like oh Niki, it's just downhill from now. You just become invisible. I mean, during that time, it's quite isolated anyway, when you first had a baby. But then you got all these other problems as well, and you're just like, literally suffering in silence and you're just thinking you're not even talking about it so you're not even sure, like, if anyone else is going through the same. Because we don't talk about our experiences after having babies. We all kind of thought, oh yeah, the birth was awful and stuff and then after that it's just sort of, we don't really talk about anything else that we all go through.

Helen

This is it. I love what you've just said. I couldn't have said it better myself. I agree completely and I just think the more conversations like this that we have, hopefully the more we can give people the knowledge and just make them feel less alone and know how to go and find new resources and help ease the confusion and all of those things.

Niki

Yeah, no, definitely. And I think also lots of things have been highlighted with maternity services and I just think something like this, women being informed about it beforehand, it would go such a long way because we get told about everything else. They tell you about, you know, they bang on about the breastfeeding and everything. I say why not about self care? But for the woman?

Helen

Yes!

Helen

Yes, yes and 100% yes. We can do so much better on postpartum care and if we as women have access to the right information and support, then we can do so much for ourselves. Niki is testament to that and she's obviously a huge advocate of MUTU, which I'll link in the show notes. For openness, this is not an ad. She's not paid by them and neither am I.

I'll be back next week. In the meantime, get involved! Tell me what you think. Spread the word, tell a friend or spam a WhatsApp group, put an advert on the side of a bus! You can support the podcast at buymeacoffee.com/whymumsdontjump. And it can be completely anonymous if you prefer. Thanks to everyone who’s done that. And you can find me on social @whymumsdontjump or online at whymumsdontjump.com. Bye for now!