We met Marimba Gold-Watts when we attended Momentum Fest, a pilates festival in the gorgeous setting of Denver, Colorado. We initially hit it off talking about her love of tie-dye - that nostalgia we often feel when looking at colours, patterns and textiles. Marimba opens up here about her pre-natal and post-partum exercises and challenges as well as pregnancy in the time of the Covid-19 pandemic. We love that she shared some incredible resources and hope these help you on your own journey of childbirth.
When I became pregnant I was determined to use all of my knowledge and resources to have the healthiest pregnancy and birth experience possible. As a pilates teacher and Craniosacral therapist, I have a unique roster of practitioners I refer to, resources, as well as experience working with women in all stages of prenatal and postpartum. My mother had 2 smooth home births with no complications. I devoured Spiritual Midwivery and other books on labor. I figured I would be armed with so much information, I would be prepared for anything.
After my morning sickness subsided and I could finally get out of the fetal position, I diligently did my prenatal workouts, strengthened and stretched my pelvic floor muscles, and did my best to prepare my pelvis for its most important job thus far. Unfortunately, about half way into my pregnancy I was diagnosed with placenta previa, in which the placenta covers the opening to the cervix. It can move on its own - mine resolved around 32 weeks with help from traditional Chinese medicine, however there is no Western medicine treatment for it. It also meant that I couldn’t take advantage of any prenatal pelvic floor therapy, and even squats past 90 degrees, lunges, and stretches that changed the shape of my pelvic inlet were contraindicated. My prenatal pilates training completely left that diagnosis out of its protocols, and my Doctor was vague, even though some version of low-lying placenta affects 1 in every 200 women and is more common in women over 35. If there are no undue complications like bleeding, most women with this condition give birth at 35-37 weeks by scheduled C-section. I asked my friend Brigitte Arle of Rooted Boston who specializes in prenatal pilates and yoga for clarification, and she and my pilates mentor Christine Wright (Toronto, Ontario) helped me devise a movement plan that would allow me to stay strong without causing any undue pressure of my placenta on my cervix.
"Women’s health practices will only change if we speak up and advocate for our own care, whether or not we’ve had easy pregnancies and labours".
Like many women who became first-time mothers in the last 7 months, Covid has made my entire birth experience and my post-partum recovery completely different than I ever imagined. I had an extremely traumatic labor wearing an N95 mask alone in a NYC hospital the week support people (e.g. my husband) were banned from maternity wards. I ended up with many complications, including an emergency C section and massive acute hemorrhaging that resulted in an emergency uterine artery embolization but luckily a wonderfully healthy baby boy.
Like most women, I’ve found that postpartum recovery often revolves around learning how to care for the baby and judgements about how quickly or slowly one loses the pregnancy weight. Even after my own near-death experience, I’ve been surprised that most people seemed more interested in the baby than concerned about my own recovery (and my ability to manage motherhood while dealing with major health issues). In my own practice, I’ve seen many women who have not addressed the changes left behind in their bodies from pregnancies even 20 or 30 years later, and yet they assume that their symptoms are normal. Brigitte Arle told me: “For some reason when it comes to after birth injuries, we don't look at them as injuries, we look at them as failures. But our perspective does change our outcome when it comes to healing injury.” Women’s health practices will only change if we speak up and advocate for our own care, whether or not we’ve had easy pregnancies and labours.
In order to recover and heal from the physical and psychological trauma, I’ve done as much as possible to take advantage of my resources- even if they are now virtual. I’ve had the good fortune to consult with my friend Brigitte Arle of Rooted Boston, who specializes in Pilates for prenatal and postpartum women and has helped me tremendously with my pelvic floor rehab as well as getting my pelvis back into shape. I’ve also been able to work with my two Craniosacral
teachers remotely (Marion Mazzocchi, RN, RCST in Nelson, British Columbia and Dr. Kate Klemer, DC, RCST in Massachusetts) on resolving much of the PTSD that came from having such an intense birth experience. My husband (a licensed acupuncturist and massage therapist) has been able to work on my scar tissue. Lastly, my mother (alias Nana) was with us for the first 4 months of recovery helping with both the baby and making sure I didn’t spiral into
Postpartum depression.
My weekly recovery routine has included the following:
- Movement Practice: diaphragmatic breathing, pelvic floor and abdominal work and gentle strengthening of my hips and legs. I pay special attention to releasing tight structures before trying to engage muscles, so that I can optimize good movement patterns. Daily walks with the baby. Now that I am getting stronger, this also includes more pilates and short dance sessions
with the baby.
- Biodynamic Craniosacral Therapy: weekly and/or twice a week Craniosacral sessions to address my birth trauma and PTSD as well as physical issues in recovering from birth.
- Bodywork: Manual scar mobilization multiple times a week. Acupuncture and/or cupping around my back, pelvis and scar.
- Nutritional Support with Dr. Kate Klemer to help with stress, restore my energy after the birth (and massive blood-loss) and to support my thyroid.
While recovery initially seemed daunting, I feel extremely grateful that I have been able to make huge strides in my healing process. While my Dr. has yet to lay eyes on me in person since I was discharged from the hospital (we’ve only done telehealth visits), I feel lucky that I have resources to take care of my own body. I know I have a challenging road ahead in my road back to health, but I urge anyone who has had post-partum challenges to speak up and seek out
resources to aid in their recovery. While I may not be as physically strong yet as I was before my pregnancy, I am infinitely stronger in my ability to deal with trauma, advocate for myself, and take control of my recovery process.
Here’s a brief lowdown on the anatomy of the pelvic floor:
The pelvic floor consists of a network of muscles ( iliococcygeus, pubococcygeus, levator ani) that run from the front of the pubic symphosis to the sitz bones and sacrum and encompass the vagina and the anus. The muscles themselves help regulate pressure in the abdomen by firing with the transversus abdominus and the small muscles called multifidi that support the spine, making them key for supporting the organs and regulating pressure in the torso. While we generally think of the muscles just at the base of the pelvis, their fibers can intermingle with the inner thighs (adductors), glutes, deep hip flexors and deep rotators, and can often be tied to hip pain and tightness in the hips and pelvis before and after birth. It is important that the muscles be both elastic and resilient; too tight pelvic floor muscles are often weak, and scar tissue from both vaginal deliveries and C sections can cause misfiring patterns that make it difficult for them to do their jobs. In Craniosacral Therapy, the pelvic floor is considered one of the many diaphragms of the body (the others are the plantar fascia, menisci in the knees, thoracic diaphragm, thoracic outlet, soft palate and falx). During and after labor, a combination of stretching/releasing and strengthening the muscles in and around the pelvis along with diaphragmatic breathing to restore a good muscle firing pattern are all key to rebuilding a healthy pelvis. When dealing with a specific issue, it is really important to consult a professional who can help you figure out the best course of treatment.
All photos by Vibecke Dahle https://www.
My Resources:
Brigitte Arle, Rooted Boston (prenatal and post-partum pilates and yoga)
Dr. Kate Klemer Divine Structure Cranio School ( Northampton, Massachusetts)
Marion Mazzocchi RN ( Nelson, British Columbia)
Steven Arboleda LAc, LMT (New York, NY)
Christine Wright, Pilates (Toronto, Ontario)
Jessica Valant PT, NCPT (Denver, Colorado)
Brooke Tyler LAc, NCPT (Asheville, North Carolina)
- Marimba Gold-Watts