Revolutionizing Postpartum Care: Insights from Prenatal Osteopath Leslie Abraham

What if the postpartum period wasn't just six weeks but extended into years? Join me as I sit down with Leslie Abraham, a prenatal osteopath who has journeyed from France and Canada to the US, to uncover the significant gaps in postpartum care in America. We delve into the multifaceted challenges women face after childbirth, from physical changes and nutritional deficiencies to mental health issues and identity loss. Leslie shares her insights on why comprehensive postpartum care is crucial and how the effects of childbirth can linger for years, impacting women throughout their lives.

CONNECT WITH LESLIE: https://bonjourbaby.net/ 

CONNECT WITH NIKA: https://mtr.bio/nika-lawrie

SUBMIT A QUESTION OR REQUEST A TOPIC:
I would love to hear from you! Please record your question or topic request to be featured in a future episode: https://www.speakpipe.com/NikaLawrie

DISCLAIMER:
*This podcast and its contents are for informational purposes only and are not intended to replace professional medical advice, diagnosis, or treatment. Always consult your physician or a qualified health provider for any questions concerning a medical condition or health objectives. Additionally, the advice and strategies contained herein may not be suitable for every individual and are not guaranteed for business, personal, or wellness success. Use discretion and seek professional counsel when necessary.

AFFILIATE DISCLAIMER:
*Some of the resources and advertisements shared throughout the podcast episodes may contain affiliate links. If you use these links to buy something, I may earn a commission.

Transcript

Nika Lawrie: 0:06

Welcome to the Inspired with Nika Laurie podcast. Leslie, welcome to the show. I'm so excited to have you here today.

Leslie Abraham: 0:19

Thank you so much for having me today here with you, Nika. I really appreciate it.

Nika Lawrie: 0:24

Yeah. So we're going to kind of deep dive into kind of the postpartum conversation. I think there's a lot we can talk about in that area. But before we get started, can you tell me a little bit about yourself and maybe what sparked your interest in health and wellness in general?

Leslie Abraham: 0:41

Yeah, absolutely so. My name is Leslie Abraham. I'm a prenatal osteopath and so, yeah, I've been working with moms who are pregnant, who are postpartum and women that are not moms as well, for as long as I can remember. So I started my career as an nostril path back in France and in Canada, came to the US in 2016, became a health coach and an exercise specialist, and I really dived into pregnancy and postpartum recovery, and today my focus is really on postpartum recovery, for the most part, just because I saw a need at one point when I came here but I believe we're going to talk about that but there are so many things that are lacking in how we treat postpartum that I was just blown away from my own experience in other countries and I just wanted to provide women with more information and more resources and more tools to care and heal their bodies after birth.

Nika Lawrie: 1:50

Well, I love that you're doing that and I totally agree. You know, I was having a conversation the other day with a couple. My daughter has kind of a group of little girlfriends and all the parents get along, we all have a great time together. We were all talking the other day at a birthday party about how it's crazy that, you know, we had these kids and the hospitals just handed them to us and sent us on our way, expecting us to know what to do with children, let alone taking care of our own bodies, and so I think there is that huge gap there of like we just send parents out there and expect them to know what to do and how to care for themselves, and expect them to, uh, you know, their hormones to be all worked out and stuff, like they're saying again, and it's crazy to me so.

Nika Lawrie: 2:32

So with that, I wanted to kind of break this interview up into kind of two different parts. The first part, uh, one I just want to kind of talk about what postpartum is, so that people know. So we'll get to that in just a second, but I wanted to ask you about your perception on the difference of care in the US versus Europe. And then the second part of the interview. I wanted to talk about what we can do for postpartum care, for ourselves, especially as women, but also for the men listening who are partners to the women who've had children too. So sound, good Sounds perfect.

Nika Lawrie: 3:07

Perfect. So let's, before we get started, can you kind of define what postpartum is? Give kind of I know it's kind of a general term, but kind of give that overview a little bit.

Leslie Abraham: 3:18

Yeah, absolutely so. Postpartum, as you may know, is the time in the life of a woman just after she gave birth. So usually we define it by the six weeks after giving birth. I don't necessarily agree with that in the sense that I see so many, I would say, side effects. Side effects, it's really a general term, but, um, that we still carry, you know, some things happening and changes and adaptation from pregnancy and giving birth.

Leslie Abraham: 3:51

In more than six weeks after and I see that up to two, sometimes three years after giving birth, and it's on so many level. It's physical, it's, um, nutritionally, uh, you know that better than me. But we see deficiencies, you know giving birth to deficiencies that were happening during pregnancy, even if we take prenatal. So, and that's something that has, that plays a huge role on our physical recovery but also on our mental health. We also have that dimension and all the moms know that and you know that that when we become a mom, there is this kind of loss of identity who am I now that I'm transitioning to motherhood? And this can last, you know, several months and sometimes several years. Even though we don't maybe label that as postpartum anxiety or postpartum depression, there is this questioning of who we are as a woman and you know it can vary. Maybe for some months you will be perfectly happy with that, and maybe one year after you want to go back to something that was your life before, and so this has a toll on how you perceive yourself, on how you, the love that you put on your body as well, because it has to go with that. So to me, it's really those, you know, years just after giving birth where we see all those changes, all these adaptations. As I said, we're talking physical, so abdominal changes, posterior changes, pelvic floor changes.

Leslie Abraham: 5:28

As an osteopath in my practice in France and in Canada, I was working so hands-on on women it's just like hand manipulations that we're doing and so you were able to feel some changes that were linked to pregnancy, really years after on the organs and how the body is reacting as well. Especially if you had a C-section, you will have changes that will stay forever with you and anyway, we say once postpartum, always postpartum, because your body is different, the size of your uterus is different, your pelvic floor is different. So many things are kind of sticking with you that we can't ignore that, and it's it's. It's very important to take things in order and be able to address them.

Leslie Abraham: 6:16

Um, you know, down the road in the years that, um, in the years after giving birth, and it can go all the way to your 50s or whatever I know my mom and my grandmothers. They are still today feeling the effect of giving birth, meaning it's coming back to them. They might have a bit of urinary leaks, that kind of thing. That, of course, is linked to aging, because we have the tissues that are very different, but they also gave birth and so we can also link that to this. And I know my grandmothers. She didn't have access to pelvic floor therapy at the time. That wasn't a thing my mom she did. But so it is very different and that's why it is so important to act as much as we can and as fast as we can after giving birth to protect a woman's future.

Nika Lawrie: 7:10

So it was kind of a long answer, but I hope it answers your question postpartum and I will say you know, I'm seven years out and I still feel different. You know I don't. You will never feel the same after you've had a child. Like you just are different. Your body's different. Your hormones are different.

Nika Lawrie: 7:35

Your, your thought patterns are different, your everyday activities are different, right, but I can tell you, you know, it was probably two years after my daughter was born where my body started to feel like it was just getting back to normal, you know and normal is a relative term because it never went back to where I was pre-child, right but it started to feel like I was at least in my own body again.

Leslie Abraham: 7:59

Right.

Nika Lawrie: 7:59

Yeah, and then and then on top of that and I work in health and wellness industry I know how to take care of myself and how to heal my body and do all the things. I still didn't feel normal or in my own body, comfortable in my own body and now I would say kind of figuring out my identity and my role and feeling comfortable again. That was probably a six-year process and it's just been the last year, maybe 18 months, that I've started to feel six year process.

Nika Lawrie: 8:23

And it's just been the last year, maybe 18 months, that I've started to feel comfortable with that, and so I love that you're saying. I mean, when people say six weeks, I'm just like my mind is blown. I'm like, have you had children? Because nothing happens in six weeks, you know. And then, like you mentioned, I had to have an emergency C-section and my abdomen is completely different. You know it's never going to be the same. I'm pretty sure they put my bladder in slightly different than where it was right, cause I can feel changes, and so you know it's. It really is this huge change to the body, and I think we need to have more conversations about this, because women are so quickly expected to just turn around and be, you know, these perfect beings that we were, you know, leading up to childbirth in our twenties or early thirties, and it's, it's really not a fair thing for us to have those expectations put on us Absolutely, and it creates even more stress.

Leslie Abraham: 9:22

And so we we know that stress down regulates everything and up regulates sometimes. But, yeah, these expectations are way too high, but that's something that's a common theme that you can see in every Western civilization anyways. It doesn't have to do necessarily with just the us. Uh, I think it's just like society today when you look at social media or you look at your favorite magazine and you saw, you know, celebrities that snap back. Yeah, and I don't like using that word, but that's what we see.

Leslie Abraham: 10:00

When they gave birth, you know, a couple of weeks ago, and right after, they're like nothing happened to them, and it can happen. I'm not saying you know that it's not normal. This is their normal, but they have so much help and it is different for them. And so, as for us, normal women would say, who don't have access to all that help and and, and we have days that are looking very different as well we don't have to expect to snap back, because that's not realistic and I don't feel it's something very healthy neither, unless this is your physiology and indeed, in a few weeks, you feel like you were feeling before. Maybe you know that's the case and that's your physiology and if that, if it's that, I mean kudos to you, because that's amazing.

Nika Lawrie: 10:52

Yeah, absolutely. So. Talk to me a little bit about, you know, the care for the postpartum care that you've experienced in Europe versus what you've seen in the U? S. I mean, are there differences? What are those differences? Are there goods and bads on either side? If you can kind of elaborate into that, yeah, absolutely.

Leslie Abraham: 11:13

That's exactly the reason why I created my company Bonjour Baby in the first place when I came to the US. There are a lot of differences. First off, maternity leave is a real thing over there.

Nika Lawrie: 11:26

Yeah, we're still working on that here.

Leslie Abraham: 11:29

Absolutely. Unfortunately, in some states it's not even a thing. Here it blows my mind every time. In Canada it's even better. They have a full year.

Leslie Abraham: 11:39

So I'm going to talk for France, for Europe, because I don't know for all the other countries, but for us we have a minimum of I don't remember how many months, but it's like five or six months, I think, and depending on your employer, you have more months. That is added to your maternity leave. So that's number one. So it really helps to bond with baby, to kind of go through all the recovery appointment that you have as well and just to take care of yourself in the end and just, like you know, step into that new chapter of your life. And when you have to go back to work, if you want to, you feel more ready than when you have just a few weeks, like here in California, in the States or in other States in the US. So that's the first difference and it makes a huge difference in the post or in other states in the US. So that's the first difference and it makes a huge difference. In the postpartum care Then we have when we talk about the care by itself. So our healthcare system is very different from here. So most of our appointments, if not all, are covered by our healthcare system, meaning you don't have to pay for it. The government is uh, which is amazing in a way, because you have access to basically everything, right when, when you see your ob-gyn and usually you see that like four or six weeks, it's kind of here in the us, um but that you can have like a midwife coming to your home and they can help with you know, baby care and checking on your pelvic floor and, you know, like helping you to kind of settle in. It's not a doula, it's very different, it's really a midwife. So they stay like not so long at home but they ask you questions and if you feel like you're feeling anxiety or depression, you can always, you know, ask them too, which is convenient because they're coming to your home for the most part. So that's really nice. And then usually they prescribe you pelvic floor therapy session and that's something that I was seeing like each and every time in my practice on my clients. They were going through that and that's something that you can do with your PT or with your midwife. So most moms in France are going through that because this is prescribed to them and it's at no cost for them, which is amazing.

Leslie Abraham: 13:56

There is a certain number of sessions, and I know right now the midwives. They are trying to bring up the number of sessions because they feel like it's not. It's not enough. It's already a good number. I don't remember exactly how many, I think it's 12, but it might be. Yeah, it might be a bit less, but it's between like eight and 12 sessions, which is already good, but they would like to to to have more, which makes sense as well, but they would like to have more, which makes sense as well. So you have that. So that's kind of the automatic care that you get, if I can say so. So if we look from that point of view, and then you do like I did, so you come to the US and you start working with postpartum moms and you're asking questions around that.

Leslie Abraham: 14:41

This is where I was extremely surprised to hear that most of my clients never heard about pelvic floor physical therapy. And same thing for my clients who had a C-section. They didn't know that they should do some self-massage to their C-section scar or that they can see someone that help with that a PT, a fascia therapist we have a lot of professions here that are specialized into that as well, but they just don't know about it. So when I was seeing that, this is exactly when I was like, oh okay, there is an opportunity here, so maybe I can bring the type of care that I know here to the US, and that's exactly what I did. So those are really the most striking differences, I would say. And after that it's just like access to care. That is very easy in France because, again, of our healthcare system. We have to recognize that and then from there, those are really the main differences that I can think of right now, but those are major differences when you think about it.

Nika Lawrie: 15:50

I mean it's basically care and support versus nothing, Absolutely. That's the reality.

Leslie Abraham: 15:57

I didn't want to say like that, we can just say that yeah.

Nika Lawrie: 16:01

I mean it is truly heartbreaking and you know, I just keep thinking about my experience as you're talking and I mean it was so difficult and so detrimental and you know I had to have this emergency C-section. I was literally you know I had to work the day after I delivered like we had a large event for my company that I was working for at the time. So they were calling and texting me while I'm sitting in the recovery room.

Nika Lawrie: 16:27

You know my abdomen is cut open, I have a brand new, you know, our old child, and they're calling and texting me, asking me questions. So that was it. And then I had four weeks of quote unquote, uh, you know, uh downtime, still getting calls, still getting questions, you know. And then I had to go straight back to work because, financially, I had, I had to pay bills, I had to, and you know, that was a big driving force for me to leave the industry and start my own business. Um, simply because I felt like the time bonding with my child, the time I needed to be able to breastfeed, you know, I didn't have anywhere to pump or support my child in that sense, you know, and I, I, I will say I even had a great boss at that time, but I just didn't have that support. You know, and I say this knowing that, even though I got that four weeks off, I am privileged for having four weeks off.

Nika Lawrie: 17:23

here there are so many women that go back to work within three or four days of having a child I mean it is. I mean that is criminal in my opinion, that that is in this country. It is Over and over to so many women. It's just devastating.

Leslie Abraham: 17:41

No, it's unbelievable, you know, just like hearing you saying that you're receiving calls and texts the day of. I mean, in France, you can't do that. Yeah, that's not something legal, you can't ask. You know, I mean, the moment you go to your maternity leave, there is someone replacing you at work and so that's it, you know. I mean, of course you can do the exceptional call, but you're not like texting and calling non-stop, right? I mean, I don't think it's even legal. You know, I'm, yeah, I'm pretty sure if you do that, they can sue you. I mean, we have a pretty strong social system. It's, it's what it is. You have good and bad, but for that it's protecting, you know, women and that sacred time with, I mean, of bonding, which is leave me alone.

Nika Lawrie: 18:28

I don't even know. Yeah, the other thing to understand is not just you know the needs for the women, but the needs for the children. Like babies need that time to bond with their bait, their mothers. They need that attention. You know, in order to create a happy, healthy child, you need to give that, that affection and that had created that bond, and I think there's.

Nika Lawrie: 18:51

you know, I'm not sure how you study it, but I think there's a big open research project to look at. You know, the lack of time away from work for mothers and how society is affected by that in the long term, how that affects, you know, aggression in children or a lack of connection with parents with children. You know, I don't know we could go on a soapbox on that, but I think there's a big area of research there as well.

Leslie Abraham: 19:18

Definitely, definitely. We know that they need our undivided attention. We know that, especially in the first days and first weeks so having a mom, that is already, you know, stressed out from what happened just giving birth, because we have so much inflammation in our body that it does something to us anyway you have the anxiety of not being quite sure of what to do because, especially if it's your first um, and then you add, you know work that is kind of, you know, uh, kind of just taking a part of your brain as well, it's too much. You know you don't have all the energy that you need and all the attention that you need for your little one. It's too much. You don't have all the energy that you need and all the attention that you need for your little one, that's for sure.

Nika Lawrie: 20:00

Absolutely so. Since so much of postpartum care is placed on the moms, I want to talk about kind of the second half of this interview is what can we start to do to recover in postpartum? I know there's a couple of areas I wanted to touch on specifically, but do you have a couple of general things that you could give off the top here?

Leslie Abraham: 20:22

Yeah, absolutely. So you know the two. Non-negotiable is and I always tell that to all of my clients you need kind of a roadmap, so that's something that you want to establish. It's better if you can establish that before giving birth. Having an idea of you know who you need to go to, uh, who you need to ask help to, that's very important to have kind of your um, uh, your um, your team kind of set up around you so you know who to go to. So usually, um, I say my clients, you you have to go to. So usually I say my clients you have to have in your direct entourage, like sorry, a physical therapist I was thinking at the same time.

Leslie Abraham: 21:05

So physical therapist, but who is specialized in pelvic floor therapy super important. You need to have a postpartum therapist. If you're struggling with anxiety or depression, you don't need to wait, you have to ask for help right away and you need someone who is specialized in postpartum as well. You need to have a kind of program like mine that will take you through recovery exercises for abdominal recovery and pelvic floor protection. So that's like an added layer to what you do with your PT, but it helps you to be consistent with your exercises and you will have more results, and that's really like a starting point as well, so you need that. I also recommend that you have your choice a chiro, a craniosacral therapist, or an osteo who is doing a really hand manipulation to get adjusted as soon as you can after giving birth. That's a thing that I really recommend not to wait too long, and usually you know what I was doing with my clients. They were coming with their little one, with their baby in the crib, so that's something that we can do. You know, don't be shy with that. You can perfectly do that. Usually, especially in the first week, they sleep anyway. So if we have an idea of you know the schedule when they will want to nurse or to be fed, you can maybe, you know, plan around that for it to be more convenient. So you have that. If you had the C-section, I would like you to see a fascia therapist as well to work on your scar. You know, eight weeks after the surgery, of course, and so that's about it. When you have that, you already have a pretty good team to help you out and, of course, if you can afford it, a postpartum doula to help you at home is always a good thing, and a meal service delivery. That's always something that I advise if you weren't able to set up a meal train or to have people around you making you delicious home-cooked food.

Leslie Abraham: 23:07

We're not talking about pre-packaged food here, but like really nourishing food and not salads only. There are some companies that are made really especially for postpartum now that does exist that are really lovely and providing you with some meals that you can add in your day, and I feel it's a great help too, because you know that better than me. But nourishment and nutrition is so important in that time and that that is such a missing piece. That's. That's really something that we don't talk enough about. Um, we think calories when you think postpartum because you want to think weight loss, but if we are using the right type of food that are nourishing, warm enough fat, that's something that we really want to put out there. It's no time to restrict calories. It's no time to cut on a food group at all. It's really time about nourishing and providing all those nutrients that you will need for quite some months and some years after giving birth. So that's very important to not imagine that you will thrive on just salads and lettuce, because that is not sustainable and that won't support your physical recovery and that won't support mental health as well.

Leslie Abraham: 24:25

So, yeah, that's the starting point knowing where you go. Establish that, and I always tell my clients. If you can schedule your appointments ahead of time, when you know basically when you're going to deliver maybe you know three, four weeks after you begin to have your appointments set up it's better, because at least it's already organized and you can see how you can organize yourself. Maybe your partner is watching your little one while you go to these appointments, or maybe you go all together and he or she is watching your little one while you go to these appointments, or maybe you go all together and he or she he's watching your little one during the session. So there are always ways you can do that and you don't have to have like 1000 appointments in a week. It can be just one, you know. So yeah, so that's my number one recommendation. Like, just thinking about it, that's the first thing that you want to do.

Nika Lawrie: 25:20

Yeah, absolutely. You know we always talk about the plan for having your go bag ready, right, but nobody's talking about that plan after the baby comes home, and I think that is so key to recovery and stress reduction too, which is really, really important. I think you know. I wanted to bounce off of two things you said. You talked about nutrition, which obviously you know is a big thing for me, but I think that there's two key things to understand.

Nika Lawrie: 25:43

There is that a woman's body takes at least two years to recover from all the nutrients that are sucked out of it to give to the fetus, right, and so you know. That is why you know when you're in the hospital they'll tell you we don't want to see you back for at least two years before you have another one, because your body hasn't had that time to recover. So feeding yourself nourishing food in that time will help your body recover better and maybe quicker not necessarily, but but as it's recovering, if you're eating those nourishing foods, your body will naturally start to bounce back to where it was anyway. So you don't have to worry about the weight loss issue. It'll come naturally. The other thing I want to add is you mentioned the healthy fats. Is that we really need those healthy fats, those omega-3s for the baby and if we're not eating them then it's not going into their breast milk and then it's not going to the baby and that's such a key time for development for the baby.

Nika Lawrie: 26:41

So I love that you bring up those topics.

Leslie Abraham: 26:44

Yeah, and those, all those nutrients are really needed from a recovery standpoint as well. If we just look at, you know how the tissues are recovering and all the process that are happening. We need those nutrients. We we don't need, you know, like lettuce, that is just water in the end and a bit of fiber, which is great, but you need something else. It's, it's not just that, so so and it's something that's, um, not a lot of people know. I feel when you think healthy nutrition, you think salad. Let's be honest, that's the number one thing. When you go to the restaurant and you want to eat healthy, what do you take? A salad, right, and in that postpartum time, this is really not what you want to eat, that's for sure.

Nika Lawrie: 27:28

Yeah, you want kind of those healthy but hearty meals, right? I have lots of sometimes root vegetables are really great in that sense. Getting that really clean like grass-fed meat can be really good to help with the iron afterwards after delivery. So yeah, kind of that more hearty meal I think is really important yeah.

Leslie Abraham: 27:47

And that's what we see in traditional care as well, in Ayurveda, in Chinese medicine, and I mean we really have to watch what they are doing, because this all makes sense, so we can just like get inspired by that.

Nika Lawrie: 28:01

Right, and it's been around for 5,000 years.

Leslie Abraham: 28:04

I don't know why this isn't ingrained in us yet, but yeah, so much truth to it.

Nika Lawrie: 28:09

So you've mentioned the pelvic floor several times. Can you talk about why pelvic floor recovery is so important?

Leslie Abraham: 28:17

Yeah, and I just want to add to that that regardless of the type of birth that you had, pelvic floor recovery is mandatory to me, even if it was a planned C-section where you didn't have to go through labor. There are so many adaptations happening during their pregnancy at the pelvic floor level that we want also to be mindful with that and take it very seriously. So, just like you know, as a word of caution first, but yeah, so I mean just like thinking about when you know what's happening during birth. Of course there is a lot of stretching of the muscles, can be hard sometimes when you have a hypertonic pelvic floor, to kind of relax the pelvic floor. So that's why sometimes labor is slowed down or pushing is very hard, because we have a hard time really relaxing those muscles so they can be completely stretched out. So first, that's one thing that we want to be mindful of. Of course, maybe you had tearing or episiotomy and that's something that we can work on as well. And then usually after giving birth we have urinary leak. That is happening. So we need to take that into account. But again, it's not because you have that that you have like a weak pelvic floor. You can still have a hypertonic pelvic floor. So this is why it is important to understand what's going on with your pelvic floor, to not just do kegels and maybe make it worse than what it was you know before. Um, so from the way I work with my clients I have them go to a pt anyways, but what we do together on the pelvic floor I assess, like each muscle on the pelvic floor, I take them through some exercises that they can do on their own, and so we do some specific exercise and they tell me what they feel. Do they feel like it's contracting right away or do they feel like it's nothing is happening, or do they feel that that kind of gentle contraction that we are looking for? So from there, it gives me an idea of what muscle we need to strengthen and what muscle we need to relax, kind of, and knowing that they all work together anyways. But it's important to kind of being able to pinpoint what we can do because, depending on that, we use specific exercises to be able to engage one or another one muscle. So that's really very important.

Leslie Abraham: 30:40

And one other thing is that if you have been diagnosed with diastasis recti, which is the separation happening at your abdominal midline between your two rectus abdominis, and that is something that happens to 100% of women during pregnancy. That's not something unusual. You don't have to stress about it when you're pregnant. The only thing you have to work on when you're pregnant is being able to manage the intra-abdominal pressure. So usually we make you do some specific breathing exercise where you learn to really engage that deepest core layer of your abdominal wall, to kind of train it, and it helps to recover I will say, faster, but like with quotes around it after giving birth. So that's one thing. And so when you have that, when you keep it after giving birth for more than six weeks and after that and it depends on the width of the gap, it depends on the quality of the tissue Do we have still resistance in the gap or do we feel like really going down and it's super smooshy. We also take a note of where the esthetis recta is located. That's not something that we hear a lot talking about, but it has a lot of importance, because when it's above the umbilicus, we work on certain muscle and then when it's down the umbilicus, we work a different way. So it's very important to understand that as well.

Leslie Abraham: 32:10

And so when we have that usually we also have bad posture habits that we develop during pregnancy and that we keep with us for a long time if we don't pay attention. And so those muscles are already like super long, that your rectus abdominis are lengthened by about 15 centimeters by the six or seven months of pregnancy. So it's a lot. And so when you give birth you still have that. They're not shortened right away. And so when you kind of really like rounding your shoulders forward and bringing your lower rib closer to your iliac bones, your hip bones, you're kind of shortening the space in your abdominal box. And so your two kind of muscles that are like elastic bands that have been super stretched, they're kind of flappy, like you know, at them at your abdominal wall. And so each time there is pressure or you have that bad posture or you do some exercises, you're pushing against the abdominal wall. That does that kind of coning that we see sometimes. But you're also pushing down on the pelvic floor, and so when you have issues with the pelvic floor already you have really issues to kind of, you know, manage that kind of pressure. Your abdominal muscles are not working the way they should be doing and your pelvic floor muscle neither maybe. So that can cause more urinary leaks. Each time you move.

Leslie Abraham: 33:29

It's not about even just sneezing or coughing, but like transitioning from one position to the other or just walking, or just like maybe bending over to grab something from the floor, and you feel like you're leaking every time, and I hear that a lot. It's not something unusual, but this is a normal, even though it's common. This is something that we can address and we hear that a lot on social media, you know, and it's like a joke or whatever but that you can recognize that you are a mom, because every time you sneeze or cough or whatever, you pee yourself. And this is not a person of motherhood, Absolutely not. We have to really change the narrative here, because this isn't the case and it does so much harm to us. When we kind of you know, joke on that, of course we can recognize it and, just like you know, laugh about it rather than being ashamed, but it means that there is something happening and we need to take care of it and there are plenty of solutions for that. So that's very important as well.

Leslie Abraham: 34:29

So that's why, really, pelvic floor recovery is one of the cornerstone of your recovery. Postpartum, there is that and abdominal recovery. Abdominal recovery Even if you don't have diastasis recti. These muscles have been thinner, longer, weakened, so we need to be able to make sure that we have core muscles that are functional, that are doing what they are supposed to do, and that we have this nice integrity in your abdominal wall. And and so we do that through.

Leslie Abraham: 35:03

There is a lot of posture work that go with it. From what I just explained, you understand why and this is such a missed opportunity. Most of the time you are being told to just go to the gym and you know, do some abdominal workouts or whatever. But even though you do the right exercises for diastasis recti meaning breathing based, and they look very different from your usual, you know crunches or sit-ups or whatever. Even if you do that, but if you don't pay to your everyday attention, to your everyday posture, yeah, you won't see result. Like truly honest here, you won't see result.

Leslie Abraham: 35:39

So it is very important to to have that kind of program or work with that kind of person that understands really the full picture it is. It is really key and when you do that you can see results fairly quickly, especially when you act fast after giving birth. If you waited some years, maybe two, or sometimes I have ladies coming to me 10 years after giving birth. We can still have some result. We can still, you know, develop stronger muscle and more functional. But it takes a bit longer, like full disclosure on that. It's never too late, but it's better, of course, if we can act fast just after giving birth.

Nika Lawrie: 36:19

Better of course, if we can act fast just after giving birth. So I had two follow-up questions you answered. One of them was is there a time when it's too late? And you said it's never really too late, but the sooner the better. My second follow-up question for you, then, is are there things if women aren't necessarily able to go get a PT or a doula or someone like you to help them? Are there things that they can do at home today that will help them with the pelvic floor and also with their posture and their abdominal muscles, healing those, tightening those up?

Leslie Abraham: 36:57

Absolutely so. The type of program that I teach is exactly what you need, because we take care of everything For pelvic floor. It will never be as good as with the PT full disclosure on that and the reason is your PT is supposed to be able to go right in and work on the deeper layers of your pelvic floor and do some massage or some activation. So that's why I really you know stress out that it is super important, even though you did that type of exercises, to still see a PT. You can also buy like a biofeedback machine. That's something that helps as well, but there is a right way to do that, so it's important to have someone that really explains you how to use it. That's better. Um, I will stay away from I mean, I'm not a huge fan of kegels, and especially when we do them without thinking about breathing at the same time, because the physiology, your, your pelvic floor, is reacting to breathing, and so that's the way I like to work on it. But I know like even a lot of pts are not doing that. But that's my way of working anyways, because I like respecting the physiology, and so I prefer doing it like that. Uh, that's why doing key goals isn't necessarily the solution, especially if you don't know if you have an hypertonic or a weak pelvic floor, if you've never been really assessed, you don't know. So by doing just key goals you can really do more harm than good. So it's important to recognize the signs. If you have, like, let's say, hip pain, back pain, pain during intercourse, if you have trouble having bowel movements, maybe you have an hypertonic pelvic floor Can be that can be something else, but that's you know a clue that maybe it's that. So if you feel that you have that, maybe it's time to go see a PT to at least be assessed. That's, you know, the number one thing. And after that you know, and anyway, adding the kind of program that I'm doing to your um session with the pt, it's always a good thing because we are going through more sessions together that you will do with your pt, so it kind of keep you on top of doing still your exercises the right way, and so you will see more results and your pt will be able to move faster as well in the treatment, which is always a good thing.

Leslie Abraham: 39:23

So these exercises you can do at home. You don't need fancy equipment. What I use is just like a yoga strap yes, a Pilates ball, you know, and that's it. That's the type of equipment that you need, and like a TheraBand for strengthening, but so it's super easy. You just need the mat. Most of the exercises are lying on your need and like a theraband for strengthening, but so it's super easy. You just need the mats. Most of the exercises are lying on your back and on your side. So if you begin to do that like maybe four weeks after giving birth or six weeks, it's still fine because you don't have to move that much.

Leslie Abraham: 39:53

And by doing this type of exercises you're working on your abdominal recovery. You're working on protecting the pelvic floor, so learning how to handle the pressure and not putting more pressure on the pelvic floor, so not doing more damage. So that can help with urinary leaks, that can help with hip pain, that can help with that type of thing. But really to go to the root cause, you have to go and see your PT again, but that can already improve your symptoms and for some women the symptoms just went away. I don't want to say that's the cure all, because that's not and I truly believe into teamwork when it comes to health, but that is already a step in the right direction and just by doing that you will see tremendous results, and those I mean for my program.

Leslie Abraham: 40:40

When I work one-on-one, I usually do six weeks and this is where I have all my results, so it's fairly quick. When we do one-on-one, because we can personalize everything, so it's even more efficient. So, yeah, beginning with just you know, breathing, reconnecting to your body, first being able to really engage and learn how to engage the deeper layer of your core, adding more muscle to the mix. That are more superficial, but we work a lot on isometric contraction, which is a type of contraction of the muscle where there's no movement but the muscle is still working hard.

Leslie Abraham: 41:18

We work a lot on what I call intentional exercise. So we visualize in our head that there is a certain movement happening and so we are able to engage the muscle to do that, but in fact there's no movement happening. Super strong, super efficient work a lot on that and all the breathing exercises that we do. We breathe a certain way so we protect the pelvic floor when we move. So important to be able to do that and that's something that we stay with you for life after if you want to still use these type of exercises to work on your core. Later on you can, and it's super efficient. So that's usually what it looks like when you are doing these exercises at home. So that's usually what it looks like when you are doing these exercises at home.

Nika Lawrie: 42:05

So that's perfectly something that you can do as well. I love that. Yeah, I think there's so many tools available to us. It's just a matter of us taking that, you know, feeling empowered to take care of ourselves and take health seriously. So I love it. I have a couple quick fire questions for you, but before I get to that, two things. One I just want to commend you for the work you're doing. I think it's so, so important. You were absolutely correct. As we've discussed, there is a huge gap of support and care for women here in the US, being all over the world, but specifically here in the US, as we've been talking, you know, and I think anything we can do to help, uh, women and families as a whole, you know, heal and bond after childbirth is so, so important. So I just commend you for the work you're doing.

Leslie Abraham: 42:49

Thank you Appreciate it.

Nika Lawrie: 42:50

Yeah, so the my second thing before we get into the quick fires uh, where can listeners connect with you? How can they find you and uh users services, if it's right for them?

Leslie Abraham: 43:00

Yeah, absolutely so. You can go on my website, bonjourbabynet so it's B-O-N-J-O-U-R-B-A-B-Y-E-Znet. Same thing on Instagram at bonjourbabyla. That's where I spend the most time. I will give you the link. I also have a free Facebook group where I do once a month ab rehab session and a poster session, so that's something that you can take advantage of, and I also have my podcast, and Nika was a guest on the podcast as well. Thank, you.

Leslie Abraham: 43:32

The Bonjour Baby podcast and so, as I said, I have guests and we talk about everything postpartum recovery and parenthood so it's a nice resource. It's really a way to find answers to your questions when you don't know what to do and when you aren't sure. You can turn on to the podcast and you might be able to find some answers to these questions.

Nika Lawrie: 43:55

Perfect, love it. I'll link to everything in the show notes just to make sure it's as easy as possible as well. So, leslie, are you ready for the quickfire question? Yes, okay, perfect. So the first one is what is your favorite or most impactful book, podcast or documentary, and why? My favorite book? Sure yeah, book, podcast or documentary.

Leslie Abraham: 44:17

All time, I don't know. Oh, it's so hard. Okay, my favorite book. It's like a childhood hook. It's like, um, how do you call that in in the US? Um, little Women. Yeah, it is really my favorite book. I read it times and times and times. And why? Because it's all about women empowering, and I guess that's why I loved it at the time and I still love it. Yeah, so we need more of that, absolutely, and I think it resonates with me. Uh, so much so yeah love it.

Nika Lawrie: 44:49

My next question for you is what is your best either toxin-free or eco-friendly living tip um very close to my heart.

Leslie Abraham: 45:00

Uh, favorite tip switch your and it's so important, switch all your um bathroom essentials. That's really my number one thing, because I had so much issues with skin sensitivities and we have so many endocrine disruptors that we have to be aware of that. So that's my number one tip. You know, don't even think about it twice and just do it.

Nika Lawrie: 45:24

Absolutely. Throw out those phthalates and parabens. Get rid of them. Love it. So, leslie, my final question for you today what does living consciously mean to you?

Leslie Abraham: 45:35

That's a very good question.

Leslie Abraham: 45:37

It's being aware of you know of who we are truly, you know really deep, recognize that and honor it by the way we live. And that's a journey that I'm still on and I think it's a life journey kind of, you know, just kind of silencing the nose of society that wants us to do this and that and that and we need to do that to be successful or whatever. But just recognize that, okay, as a person, I feel better when I have my alone time or I feel better when I'm working with the team or whatever it is, and honor that in way you live, in the way you work and you know kind of advocate with it and find your spot here so you can feel happy. Because that's something that I've been struggling with the past years, that's something that I'm working on and it does such a difference and I felt that's how you can really find yourself in the end and be conscious, you know, of what's around you and just not, you know, not living your life, but having kind of life you know, imposed on you.

Leslie Abraham: 46:48

So, yeah, I found that something very important to do, so so important.

Nika Lawrie: 46:52

Love it Well, Leslie. This has been phenomenal. I'm so grateful for you coming on the show and sharing all of your knowledge with us. I think it's so important, so thank you.

Leslie Abraham: 47:01

Thank you so much, Nika, for having me. It was a pleasure to talk with you today.

Nika Lawrie: 47:04

Absolutely.