In perspective: Vive la France!

Last month I began re-educating my pelvic floor. Unlike some women I was aware that I had one and had located it once or twice in the past when doing Pilates.  

The birth of my eldest daughter four years ago made me think about it again. Back then when I left the London NHS hospital where I had given birth I was given a leaflet explaining the various exercises I should do in a bid to get the somewhat elusive and definitely under-exercised muscle back into shape.

Yet, back home sleep deprivation, sore nipples and a crying baby meant that my pelvic floor was largely forgotten. Four years on, however, and having followed my partner across the channel to live in France our youngest daughter was born in June. I found out that as part of my postpartum treatment I would be prescribed 10 sessions of la rééducation périnéale with a physiotherapist.

This is designed to retrain the muscles of the pelvic floor, and is one of the cornerstones of French postnatal care. It has been paid for by French social security since 1985.

The idea is that by doing so women will be able to have children again more quickly and will avoid the problems related to serious incontinence when they are older.

So I start the sessions while on maternity leave, and with baby in tow the physiotherapist explores the state of my pelvic floor.

I am pleased when she decides that it is moyen or average. And that’s when the hard work starts. There are two methods for the re-education itself, manual and biofeedback and most physios use a combination of the two.

Mine largely uses the latter which means using an electronic pelvic floor re-educator hooked up to a machine that records the force of my internal contractions.

I have to follow a series of on-screen exercises contracting and relaxing my pelvic floor as well as instructions from my physio. By the end of the course she says my pelvic floor is much stronger but that I should remember to continue to do the exercises manually every day (for the rest of my life!) and suggests doing so when brushing my teeth, watching television or sitting in the car at traffic lights.

In the UK incontinence figures are startling: one woman in three leaks.  Yet evidence shows that conservative management and good postnatal management is the most effective way to deal with pelvic floor issues (Cochrane review).

The French know this and it’s time women in the UK had these specialist sessions on the NHS.

I did not have to pay a penny for my pelvic floor physio sessions and just when I thought I was through my doctor gave me a prescription for 10 more, this time for my abdominal muscles. With any luck I’ll be wearing a bikini on the beach next summer.Well, we’ll see. Vive la France!

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