WEBVTT
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Hello, Today I have with me Wendy Powell.
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Wendy is the founder and CEO of Mutu System, the digital health platform clinically recommended globally for perinatal pelvic health.
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A recognized leader in women's pelvic health, Wendy's work is endorsed by doctors, midwives, specialist women's health PTs and surgeons worldwide.
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She serves on the Women's Development Board of the charity Microloan and as a consultant to health and hygiene companies and health insurers on women's incontinence and postpartum issues.
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Wendy, welcome and thank you so much for joining me.
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Thank you so much for having me.
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I just think that all the work you do is so exciting, like the Microloan and the women's hygiene companies and health insurers.
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Is that just in the UK or is that worldwide?
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No, that's worldwide.
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Changes that need to happen, that's worldwide.
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Yeah, as to how much influence I can have with regards to the US health insurers, obviously we temper our expectations there.
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But, yes, I am asked for input on some elements there around really understanding the effects of pelvic health on the rest of our health, because I think that we tend to think of some of these issues whether it be incontinence or diastasis recti or prolapse or, for example, they're not just physical issues, are they?
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They're issues that literally impact our, our intimate lives, our self-confidence, our self-esteem, everything.
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So there's so much of a knock-on effect in terms of, if we take it from a payer point of view, if you like, from an interview or a health system point of view because I work with the NHS in the UK as well there is a knock-on effect in terms of the costs, both personal and literally financial, of those issues.
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Yeah, that's the sort of context of the health system consultation and I work with a big European health and hygiene company.
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Essentially, they are involved.
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They're in the incontinence business, so making management products for incontinence, but whilst also trying to make sure that they bring in expertise around.
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Not just managing incontinence, but whilst also trying to make sure that they bring in expertise around not just managing incontinence but actually doing something about it.
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So context for those.
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That's so amazing because I feel like we're just now starting in the US to even recognize it.
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I know I've interviewed a lot of pelvic floor physical therapists who were physical therapists before.
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Then they had their kids and then they.
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Why didn't they say anything about this?
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And it was just maybe a paragraph in a textbook in school, which I mean to one degree makes sense because you have to generalize everything.
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But I just feel like in the US our health system is just so specialized that we don't even think about the person as a whole, and it's specialized in the consideration of a 160-pound male and there's not enough.
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There aren't studies on women we're starting to.
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There aren't studies on people who are pregnant, because it's considered unethical.
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We just don't have the information, and that is hindering the health of women, especially as we medicalize birth.
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The more you medicalize birth, the less natural the effects are on the body and then we have more pelvic floor health issues.
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So I'm sure you know all this, but I'm reiterating for our listeners because this is just so important and I probably, like you and I also had no real thoughts about this until it affected me.
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It's the way that these issues relate to other issues.
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I think when I first started doing this, which is 15 plus years ago, and I think when I first went into it, I went into it as a new mom and also as a certified pre and postnatal trainer, personal trainer at the time, and I think in those early months and years, there was this perception that, oh, we're making an exercise program to help with these particular symptoms and issues because currently solutions don't exist.
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But as it went forward, it became more and more evident from the feedback we were getting from members and users, which was, oh my gosh, I thought I was just buying an exercise program.
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This has changed my sex life, this has changed my self-esteem, this has changed how I show up at work in my community.
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So it's understanding how these issues around pelvic health, sexual health, how we feel about our bodies, how well our core and our lower back functions literally this affects everything.
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It affects how productive we can be at work, how present we can be with everybody in our lives.
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It really does affect everything.
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When women are worried that they're going to wet themselves or that they feel in pain, they're not going to drink enough, they're not going to exercise class.
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They're going to say no to social events at work.
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There's so many knock-on effects.
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I remember being at an event years back and everybody was dancing.
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It was an evening, it was an after-party thing and everyone's them.
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I could see this woman sitting in the chair and she was dancing in a chair and I said how are you going to come and dance?
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And she went I can't.
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And I had to.
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I cajoled her a couple of times and she went I can't because I'll wet myself.
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And it was just that realization that this is affecting women in enjoyment of life quite literally.
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This woman wanted to get up and dance and she couldn't.
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And so I think whether it's this lady wasn't a new mom, her children were much older and, of course, these aren't postpartum issues, these are women's issues, these go right to our lifetime and they're affecting everything about the way that we show up in our lives.
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So it's that knock on effect that we really need to appreciate more and understand better.
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Yeah, so it sounds like you weren't always doing this.
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What brought this about?
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So I was.
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I'm 53 now my kids are 19 and 17.
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So my babies are all grown up.
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I made MUTU pretty much around when my daughter was born, so 18, 19 years ago.
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Prior to that, I was a personal trainer and I had been for some time specializing in pre and postnatal work, and that had come about simply as an interest.
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I'd started working with some moms and I thought, oh, I like this, but I don't know enough about it.
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So I started to specialize in that area of certification and study, and prior to all of that I was in advertising and had a different job in publishing in London.
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So this is my second life.
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So you started Mutu because you had noticed the effects of motherhood on the female body in order to mitigate those effects.
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But you also do a lot of work with a concept that was new to me, but I started Googling because I feel like it conceptualizes a lot of experiences that mothers have in the birth space.
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So I talk a lot about birth trauma and not everything is a trauma.
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So I just, on a whim, googled birth shame to try to put some words to what I notice women are feeling and you and all of your work came up.
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So I'd love to hear, first of all, let's talk about what is birth shame and then how all of this evolved for you, like your birth story and how you became an advocate for women's physical health and the concept of birth shame and helping women through this process where they feel like maybe they did something quote unquote wrong in their birth feel like maybe they did something quote unquote wrong in their birth.
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Yeah, so I think birth shame is something that, as you say, as a term, I may not have been aware of until more recently, but it summed up where I think I was after my birth some time back, and I know the way a lot of others feel.
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So what we mean by it is feeling, as you just said, like you maybe did something wrong, like your body didn't perform, behave, function quite as it's supposed to.
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We're fed two narratives, aren't we?
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On the one hand, birth is this, which obviously it is an entirely natural procedure and an entirely natural process, and we're fed this belief in a way that it's supposed to feel very instinctive, very intuitive.
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It's supposed to happen very naturally, but, on the other hand, that's not actually most of our experience and, depending on where we live, it may be absolutely the opposite of our experience.
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And so I think, when things don't work out or turn out the way maybe you thought they would, then one many women feel like they somehow failed at that, like they didn't do a good enough job, and also feeling like they should have done something differently, and also feeling like this isn't as instinctive or intuitive, as I thought it was going to be, and then, as we become new moms again, we're supposed to know what our baby wants, we're supposed to know what our body's doing, whereas actually everything, including our new baby, often feels entirely alien.
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We haven't got any idea what we're supposed to be feeling or doing.
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So I think that feeling of just feeling totally discombobulated, confused, overwhelmed, and feeling like everybody else has got it nailed and everybody else knows what they're doing and everybody else is just like flowing with it and of course that's not really the case there's also that element of feeling, I think, physically almost broken and I've heard that term a lot from women, especially if they did have a physically traumatic birth in the sense of tears, interventions, other interventions that have meant that their power was taken away from them.
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Now, when birth is very medicalized and for example mine I had vaginal births with huge amounts of intervention, massive hemorrhage after both of them, so something that sort of started as natural birth then required a lot of intervention.
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Now if I hadn't have had that intervention, I wouldn't have survived the first one, second because of massive hemorrhage.
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So obviously I'm not for a second saying that shouldn't occur.
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We're incredibly privileged that we have that kind of intervention at our disposal, it literally saves our lives.
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But what it means is that feeling of this is out of my control.
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I need other people to take over this for me.
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I don't really understand what to do.
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My body doesn't really understand what to do.
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That continues on post-birth.
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So it's not as if, once we're sewn up and healed in an acute sense post-birth, we don't suddenly snap into intuitive more.
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So it's this whole process of it's often not the natural or instinctive thing that we think it's supposed to be, and when we don't feel that, we feel like we screwed it up and that we didn't do as good a job as we should have done.
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So I think that's where it comes from.
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And for me personally, what happened with me?
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As I said, I had massive hemorrhages after both of mine and required a lot of care afterwards, and at that time I was a personal trainer qualified in pre and postnatal work.
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So if anybody was supposed to know how to prepare their body and get through this and snap back and all those wonderful terms straight afterwards, I had, in theory, those tools and that knowledge and that education at my disposal.
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But I didn't feel any of those things.
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Not only did I feel those emotions I just described of feeling like I hadn't done a very good job at this, like I'd failed at it, but on top of that kind of feeling quite bitter almost that it was like hang on, I did everything right, like I did all the exercises, and so this whole feeling of what the heck just happened to me, what the heck with this body?
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I don't recognize, it, doesn't feel like it used to, it doesn't respond like it used to, and I know that that's common to most of us post-birth.
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So I think that the shame term that you started that question with, I think it feeds into all of those things your body doesn't respond to.
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For example, the exercise, the workout that you used to do, it doesn't do the same thing, it doesn't feel the same or look the same with intimacy, with lifting things.
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So, whether it's like whoa, I just wet myself or wow, that hurt, or that didn't feel like it was supposed to, all of these things just contribute to this process of feeling, I think, very out of control, very disempowered.
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So I think it all feeds into all of that stuff.
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Well, in addition, I feel like you're talking about what's happening to me and this should be natural.
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I feel like the medical community has this narrative where it's see, I told you, See, I knew you wouldn't be able to do it without us, and that's just so gross.
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And it's also the afterwards, the gaslighting, where it's oh, that's normal, Welcome to motherhood.
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Yes, and it needs to be addressed.
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It can be normalized so that you don't feel alone, but dismissing it leads to shame and doesn't lead to going through the steps that need to happen to fix the process.
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And I've heard I'm not there in other countries that's part of the process of giving birth, namely France, from what I've been told, they require pelvic floor interventions and I know Denmark requires mental health follow-ups just from the mothers that I've talked to that are from there.
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So there's just so much that we're lacking and, as a result, I guess we don't have the processes in place to be able to help moms the way that we need to, or the processes aren't in place because we dismiss them.
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I'm not sure it's like a chicken or the egg situation.
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It's an entire culture.
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It's like the patriarchy.
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The medical patriarchy doesn't address these issues.
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I'll respond with regards to you said about normalizing and how.
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I think that the conversation around a lot of these issues, especially incontinence for example, bladder leaks there is this narrative that it's normal.
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There is this narrative that this is what happens when you've had a baby.
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Like you said, welcome to motherhood.
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Doctors will say this to moms, let alone friends, moms, sisters, etc.
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So, on the one hand, we're not prepared, and so probably the phrase we hear the most often at Mutu is why did nobody tell me?
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Why did nobody tell me it was going to feel like this?
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You have all this preparation in one sense, but none at all in another In terms of how our postpartum body will feel and function.
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We are utterly unprepared, and so that feeling of why did nobody tell me?
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I didn't know this was going to happen, then, coupled with it's normal, that's what happens to moms.
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Welcome to motherhood, that's the deal.
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And I think that in recent years there has been an increase in conversation around peeing, when you sneeze or laugh, that kind of thing, that sort of stress, incontinence.
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There's a bit more narrative about it and that has positives in the sense of validating women's experiences, making them know that they're not alone, making them know that it's okay and that it's very common, but there's a difference between common and normal, and there's a difference between what's common and what we should therefore just put up with.
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So for me, the conversation stops way too early.
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It's great that there is more conversation about these issues for moms, but what is very much missing in many of these conversations is and there is something you can do about it.
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So we often talk about postpartum bladder leaks, and when I say postpartum, I don't mean first year after baby loss.
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Your kids can be teenagers, you can be a grandma because these issues don't go away if we don't do something about them.
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And, of course, as we go into perimenopause and beyond, they can get worse too.
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So this is for women at all stages of their lives, of motherhood, of their journey.
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But there is something that can be done about it.
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And that feeling that it's normal, everybody's got it.
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We really need to take that a step further and say yes, and there's something that we can do.
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Something that we hear at Mutu very often is I'm too late.
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I'm too late to do anything about it.
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My kids aren't babies anymore.
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We hear that a lot.
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So, first of all, to reassure, it is never too late, you can always do something about it, and so it's understanding, really, that these issues can be dealt with, that that the lot of motherhood is not to feel crappy about your body.
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That's not it, that's not what we have to just accept, put up with and move forward with, and that there are strategies and techniques that we can use.
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And it does, of course, start with that conversation and with that education, because if we're not talking about it, then we're not even asking the question.
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One of the things I know from a lot of the work we do with doctors, with clinicians One of the things I know from a lot of the work we do with doctors, with clinicians, with medical assistants is the shocking, really, or appalling, length of time it takes before most women will present to a medical professional with a problem such as this, and many never do.
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The average is seven years.
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Our data tells us that women will deal with prolapse symptoms, with incontinence symptoms, with all sorts of other pelvic health issues, for on average seven years before they'll even see a doctor, and very often there is still that belief.
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I've left it too late anyway, I'm too old.
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So, yeah, there's a lot of work to be done at every stage of that conversation, but it definitely needs to go beyond just validating our feelings and letting us know we're not alone and moving into actual solutions.
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Yeah, I agree.
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And then the solutions if we are given.
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The solutions I feel are not necessarily the conventional solutions that we're given are not necessarily helpful.
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I was told there's the Kegels, which Kegels by themselves aren't necessarily the solution.
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I was also told there was this biofeedback that was happening, or also just laser, and that's not addressing the entire problem, because the problem is not just one isolated area, it's the entire system as a whole that is now weakened and stretched and bones are moved around.
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So having to get everything back together, ideally non-surgically I don't know that.
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A lot of medical providers have that information.
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They're given what they're presented, which I think people come in from companies that have a device and they sell them the device and it seems like a solution and a quick fix, but it's not addressing the entire problem.
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Yep, that's so true.
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So what we look at is to come to the key goal point first, which is most people's understanding of what pelvic floor exercises are, what they mean.
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If you ask most women about pelvic floor exercises, they may use the word Kegels.
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They know they're supposed to do them.
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Whether or not they know how to do them or what it feels like when they get them right or what it feels like when they get them wrong, that's the crux of it, isn't it?
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So what we do at Mooji System is very much start with this foundation of breathing techniques and strategies to actually understand what is this supposed to feel like.
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We hear terms like do your Kegels or engage your core utterly meaningless to most people.
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What the heck is that?
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What does that feel like when I do it?
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I think you know.
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I know that there are millions of women spending their time, money and resources lying on a mat in Pilates clothes thinking that you know, am I doing it?
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I don't know.
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Is she doing it?
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I don't know it's, unless we cue breath by breath to really understand what that's supposed to feel, and not just in an instructional way, but in a.
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This is what it will feel like when you get it right.
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If you're feeling it here, okay, stop regather, do it again.
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So, for example, you'll know this, of course, but for example, a lot of women are squeezing the big muscles of their glutes, of their backside, they're squeezing their inner thighs, they're holding their breath, they're sucking in hard, they're doing all of these different things that we think is engaging our core or doing our Kegels.
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So we very much start with that foundation of what does it feel like to first of all just reconnect with those bits of our body.
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Because, coming back to the birth process, whether that was recent or much longer in the past, there is this disconnection I think is absolutely key, certainly key in what we do that it is very hard to connect, to let alone engage or strengthen a muscle or group of muscles that you quite literally stop talking to.
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If you come out of the birth process, as I say and this could have been a long time ago but if you're left with a feeling where you don't like your body very much, you don't like the way it looks, you don't like the way it feels.
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Maybe you don't look at yourself naked, maybe you don't touch your body, maybe you don't like to look at your body.
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Maybe you don't eat in a way that nurtures your body, maybe you eat in a way that punishes in some way.
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All of these factors feed into a disconnection where our body's, from tummy down, this does not look like it used to, it doesn't feel or behave or respond the way it used to.
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I don't know it, I don't know what to do with it, and so there's this cutoff, there's this disconnect, which I think is I compare it to say we're going for a pelvic examination, a pap smear, for example, and for those few moments we go to our happy place, right, this isn't much fun.
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I, those few moments we go to our happy place, right, this isn't much fun.
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I don't particularly want to be here.
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It's got to be done.
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So we check out, but the problem is when that checkout is going on for weeks and months and years, and so what we start with is that reconnection, to simply sit and go through these breathing exercises that we kind of cue, literally breath by breath, to tune in to.
00:22:26.214 --> 00:22:35.449
Okay, what even is my core, what around your abdominal muscles, your deep abdominal muscles, your pelvic floor muscles, what even is that pelvic floor thing?
00:22:35.449 --> 00:22:36.332
What does it feel like?
00:22:36.332 --> 00:22:50.578
So we start there on the basis that I strongly believe in sort of 15 plus year, 20 plus in personal training, that we can engage our core and plank and crunch till the end of the day.
00:22:50.578 --> 00:22:54.728
If we're not connected to those muscles it's just not happening.
00:22:54.728 --> 00:22:56.050
So we start there.
00:22:56.872 --> 00:23:20.011
Yeah, I agree for moms and future moms, because as a nurse I learned about those muscles and I danced my whole life and I did yoga and I did Pilates while I was pregnant all of those things and they tried to teach me what those muscles were and how to engage them, especially during pregnancy.
00:23:20.011 --> 00:23:35.680
And I felt such a disconnect from the time that I started pushing to, I believe, when I finally I started pelvic floor physical therapy again when my son was four, because I did it when he was born and that just wasn't the right time.
00:23:35.680 --> 00:23:37.358
So I want to validate that too.
00:23:37.358 --> 00:23:39.002
If you can't do it right after birth, yeah.
00:23:39.002 --> 00:23:42.880
Just don't Absolutely Start slow if you need to.
00:23:43.454 --> 00:23:49.226
But I just remember, like being at work and where I'm a nurse so where you hold your pee a long time, yes.
00:23:49.226 --> 00:23:52.063
So where you hold your pee a long time, yes.
00:23:52.063 --> 00:23:59.971
And just being like God I just sneezed or I just laughed or I just moved to bed and I leaked a little.
00:23:59.971 --> 00:24:01.011
That's so annoying.
00:24:01.011 --> 00:24:03.503
Like where are those muscles, trying to connect with them?
00:24:03.503 --> 00:24:05.502
And every once in a while, like I would get it.
00:24:06.635 --> 00:24:34.150
But even if you know when you're getting it, you don't know if you're getting it completely right or you can't sustain it, and so it just it really does take time to get to know your body again, and I think that is a huge part of why we A we don't know that we have to do this and, b when we start we feel like such a failure, because it's this is so hard and I'm just doing this one small movement with a breath and I still don't know if I'm doing it right.
00:24:34.796 --> 00:24:56.958
And it can be long and tedious to try to reconnect with that part of your body to the extent that you feel like it's impossible, yes, and so you really need guidance and we need it to be accessible Because, to be perfectly honest, pelvic floor physical therapy, at least in the States, is very expensive If your insurance doesn't pay for it.
00:24:56.958 --> 00:25:05.951
And even if your insurance pays for it, they may not pay for a specific person that has time, that has appointments and that has been doing it for a long time.
00:25:05.951 --> 00:25:20.905
And then the people that you do connect with, that have been doing it for a long time, that are very skilled, have gotten sick of the insurance system here and are doing it outside of the insurance, and then it just turns into this whole process where it's just inaccessible.
00:25:21.194 --> 00:25:24.040
The system here in the UK might be different.
00:25:24.040 --> 00:25:27.347
The difficulty and lack of resource is the same.
00:25:27.347 --> 00:25:45.843
So in the sense that I do a lot of work with GPs, with general practitioners, and they are so happy when they find out about something like Mood2, like a digital solution, like she can follow these exercises at home, kind of thing I've heard so often from doctors oh my goodness, that's great, we just send them for surgery.
00:25:45.843 --> 00:25:46.989
I didn't know where else to send them.
00:25:46.989 --> 00:25:52.564
They don't even know that pelvic floor physiotherapy, physical therapy, even exists.
00:25:52.564 --> 00:25:56.160
And that's not all, but it is definitely a proportion.
00:25:56.160 --> 00:26:04.082
And then when you do have those that know of it, again long waiting lists or expensive to go to do it privately, whatever.
00:26:04.082 --> 00:26:08.557
So it's there, just isn't the resource to do that.
00:26:08.557 --> 00:26:26.159
And I think and we do a lot of work with pelvic health, physical therapists all around the world and it's that perfect sort of compliment in the sense that if you are seeing a physio which is great and if you are seeing a physio that specializes in pelvic health again, even that varies.
00:26:26.159 --> 00:26:30.508
They call them women's health, physical therapists or pelvic health.
00:26:30.508 --> 00:26:32.681
Some do internal work, some don't.
00:26:32.681 --> 00:26:35.157
Biofeedback some will do that, some won't.
00:26:35.157 --> 00:26:41.445
So you're not really even guaranteed that you're going to be getting the same sort of diagnoses or tests either.
00:26:41.445 --> 00:26:50.320
And when you do like you say, it's hard to get that appointment, it can be expensive to get that consultation and when you do, it's one session or a handful of sessions.
00:26:50.821 --> 00:26:52.306
These are techniques for life.
00:26:52.306 --> 00:26:57.963
These are techniques for we are lifting our kids and doing life every day.
00:26:57.963 --> 00:27:05.184
We need our floor, we need our pelvic floor and an instruction we were given in clinic once or twice.
00:27:05.184 --> 00:27:06.567
It's often just not adequate.
00:27:06.567 --> 00:27:16.777
We really need that ongoing nudge, that ongoing reminder, that ongoing sort of cue and somewhere to revisit, to like how do I do this again?
00:27:16.777 --> 00:27:18.039
What's it supposed to feel like?
00:27:18.039 --> 00:27:19.544
Because it become unnatural.
00:27:19.585 --> 00:27:41.119
I think a lot of people start with something like our program and they're like heck, apparently I can't even breathe sort of just understanding because then, if you've got a background in yoga or in dance, like you said, or whatever your background, there may be postural habits, for example, somebody that's done ballet training or military training.
00:27:41.119 --> 00:27:49.286
There's so many different things that affect our postural alignment and all of these things that affect the way that our core and pelvic floor works.
00:27:49.286 --> 00:27:50.856
All of these things are as you said.
00:27:50.856 --> 00:27:53.361
They are all related, they all work together.
00:27:53.361 --> 00:28:05.779
So we really need that check-in and that understanding of how our whole body works, and there are, so a solution that one might buy privately, such as a device, obviously have their place.
00:28:05.900 --> 00:28:20.208
Far be it from me to criticize anybody or anything that is genuinely helping women with these situations, but what we come across too is that, for example, an internal device is simply not appropriate or desired by many people.
00:28:20.208 --> 00:28:24.734
There are multiple reasons sexual trauma, religious reasons, cultural reasons and sheer expense.
00:28:24.734 --> 00:28:35.397
There are many reasons why an app-based internal device is not going to cut it, so based internal devices is not going to cut it.
00:28:35.397 --> 00:28:36.259
So yeah that we we need the conversation.
00:28:36.259 --> 00:28:46.647
We need it to be a fully rounded one, so that it's not just about an isolated muscle or set of muscles and that it's about literally the way we live and lift and work and walk every day.
00:28:48.335 --> 00:28:51.617
Yeah, I I really love that, as a personal trainer, you're addressing this.
00:28:51.617 --> 00:28:53.719
Yeah, I really love that, as a personal trainer, you're addressing this, what we normally.
00:28:53.719 --> 00:29:00.904
I don't know that even it was ever given to me as an option to have a personal trainer help me with this.
00:29:00.904 --> 00:29:05.288
I have since hired personal trainers who have helped me with this.
00:29:05.288 --> 00:29:07.469
It's like that wasn't the point.
00:29:07.469 --> 00:29:08.891
But they're like oh, you have this issue.
00:29:08.891 --> 00:29:10.412
Oh, look at your posture.
00:29:10.412 --> 00:29:11.752
Oh, look at all these things.
00:29:11.752 --> 00:29:18.777
Oh, you're having pain here.
00:29:18.797 --> 00:29:20.102
We need to work on your pelvic health.
00:29:20.102 --> 00:29:34.605
So just getting the knowledge out there, first of all, that an exercise therapist that has this knowledge could help you with this is first, and the consideration that maybe that might be the first place to start, and then, if that's not helping, you might need more interventions.
00:29:34.605 --> 00:29:36.582
It's like where are we attacking the problem from?