I had the pleasure to interview Célia Hughes who is originally from France. She lives in Tokyo since 2011 and is a certified midwife. She is also the co-founder of the French network group IPPO IPPO for parents or parents-to-be. In today’s interview she gave us important insights about the recovery of the pelvic floor and why it is so important.
Célia, you are one of the few contacts I found who actually help women in Tokyo to recover their Pelvic floor after birth. Why do you think there are not many therapists in Tokyo who can help moms to recover?
I think, in many countries, those concerns are only a women problem and it doesn’t matter because usually women accept their fate without thinking it can be different….also it’s a really intimate issue so maybe a bit of taboo to talk about it…
What is actually the pelvic floor, how is it used during childbirth?
The pelvic floor is basically what is holding all you abdominal organs up, it’s all the muscles working together to fight the gravity and not letting everything going down through the pelvis. It’s also all the sphincters like anus, and urethral sphincter which help you being continent.
During childbirth baby is going through the pelvic floor so the muscles has to relax and stretch to let the baby going down through the vagina.
Why is it so important to heal your pelvic floor after childbirth?
Because of all the work and stretch and weight the pelvic floor muscles endured during pregnancy and birth, like every muscle they need a bit of work out to get strong again.
The consequences of weak pelvic floor muscles can be :
Lack of sexual sensations
Why do you think it’s not a big think in Japan? I know in I Germany there is a postpartum free class that every woman who gave birth is advised to take. How is it in France?
In Japan, women do have some advices from midwifes but not classes or personal evaluation. In France the social security system cover 100%, 10 sessions with a physio or a midwife and during those session there is a personal evaluation of the pelvic floor and then exercises.
It’s quite intimate because the midwife is evaluating the exercises by placing her fingers inside the vagina to control the efficiency of the exercises but it’s a better way to evaluate and explaining the exercises.
Are there exercises you can do at home to start with the recovery of the pelvic floor?
Just after birth you can start some exercises but what is more important is to avoid doing harm on a weak pelvic floor so basically the first two weeks you should lie down a maximum and doing no chores at home and resting a maximum. After the first two weeks you can slowly going for walks but it’s better if you have a pelvic belt in the beginning.
How long after childbirth should you wait until you start with the pelvic floor exercises?
You should wait until you are not in pain if you have stitches. Anyway we have to wait at least one month for exercises and gently starting sports.
I heard that you can actually start the exercises when you still pregnant. What’s your experience?
We should actually start exercise our pelvic floor event before pregnancy so we know how to use it, we know where is it and it helps during pregnancy to prevent urine leaks. Also working our pelvic floor during pregnancy help for the birth itself, because then you know better how and where to relax during labour to facilitate the descent of the baby.
Is there one simple exercise you can explain now?
Fondation breathing In a sitting position
You inhale deeply from the top of the belly to the pelvic floor you can feel your perineum going a little down. - You exhale from the pelvic floor to the top of your belly, you feel that your perineum is pulling up a bit and you continue by contracting the lowest muscles of the anal and vaginal tracts as tightly as you can. Keep tightening the vaginal muscles until you feel the contracted muscles all the way up into the top of the vagina. Then hold few second and release slowly. Frequent practice is all to your benefit.
I love Dr De Gasquet, who is a French gynecologist explaining a lot about pelvic floor and breathing exercises (see link on the end of this article).
How can a woman identify when she definitely should visit a therapist?
If a women during pregnancy and/or postpartum experience urine leaking, feeling pressure on the pelvic floor, having hemorrhoids, for sure she needs to see a specialists. Also before starting back strong workout or running, it’s a good idea to check with a specialist.
I encourage women to get in touch with you after childbirth for the pelvic floor recovery. What is the best way to get in touch with you and how much are the sessions?
Email is the best option and for the session’s price it’s 5000JPY for the first one and 4000 for the followings. I usually recommend at least three sessions but sometimes we need more depending of the progress. It’s one session per week.
The private insurance will refund part or all the cost. And if you are under Japanese health insurance you can also turn in the bill to the tax office. Everything more than 100.000 yen expenses a year will be taken into account - Since only a childbirth will be already over this amount, you can easily turn in the bill.
Célia, you are a certified midwife. And you also offer a lot of great other services. Can you tell us a little bit about it?
Yes I am a French certified midwife but I am also a lactation consultant and I have a baby massage training and an Ayurvedic massage training so I offer classes during pregnancy and after :
Baby massage classes
I can also offer home visits for breastfeeding advice, postpartum visit
I do Ayurvedic massage in postpartum at my place.
I work with other French professionals also for Ippo Ippo a French association for French speaking parents of young kids and parents to be.
All Célia's services are available in English and French
Learn more about Célia and also the French Ippo Ippo group in Tokyo:
Experts mentioned during the interview:
Suto-healing Center http://www.shc.gr.jp/eng/
Dr De Gasquet, who is a French gynecologist explaining a lot about pelvic floor and breathing exercise:
Dr De Gasquet Institut in Japan: https://www.gasquet-japon.com/
If you prefer pelvic floor recovery with instruments:
Mari Gish http://www.tokyophysicaltherapy.com/
Postpartum Pelvic belt: LINK