Dr Phoebe’s Mum Tum Bootcamp

When I was pregnant, my midwife taught me about pelvic floor exercises in my first appointment. She emphasized that a healthy pelvic floor was important in the labour and delivery process, and in preventing stress incontinence both during pregnancy, and thereafter. Being a doctor, I was already familiar with this concept and I thought I did my exercises religiously. That didn’t stop me from having some pelvic floor dysfunction after childbirth. I also developed its dreadful twin – diastasis recti abdominis. It took months of research, and seeing different pelvic floor therapists, both privately and on the NHS, before I started to make some progress.

Relating with other women, I found that many people think that ‘leaking urine’ when we sneeze is normal after having children. There are even glamourised adverts for incontinence underwear sporting young women. I didn’t want this to be me. I wanted my body to be functional, and thankfully, I found a great therapist.

I moved from Nigeria to the UK. I often think about home. For instance, in my first few months, I frequently converted costs of purchases to the local currency. I would buy something for X pounds, and think, “Hmm, that costs Y naira.” So it was only natural for me to think about how women in Nigeria fare with these issues. I did my medical training in Nigeria and I can’t remember meeting any (or any mention of) pelvic floor therapists even though I worked in a couple of Obstetrics and Gynaecology jobs. I began to wonder if we have some, and if we do, are the public aware?

I have a social media platform where I post health educational content, so I did a video on diastasis recti abdominis which I titled The Real Reason Why You Can’t Get Rid of Your Mum Tum. (I didn’t coin this term; it was already in use). It was very important to me that people understood that pelvic floor dysfunction and diastasis recti are associated with many problems in women especially chronic back pain, incontinence, painful sex and prolapse. It is not just about having a flat tummy. Many women live decades after childbirth and living with these conditions long term can be debilitating to physical, psychological and social health. The feedback was overwhelming. Many women reached out to me and told me they were hearing about these issues for the first time. They also told me about their personal struggles.

Then came coronavirus. Due to the pandemic, many countries were instituting some form of lockdown – Nigeria and the UK included. Even though I continued to work full time throughout, the MRCGP exam I had been preparing for got postponed so it appeared as if I had more time on my hands. I started to think that this would be a good time for women to learn about their bodies and start their healing process. When it comes to making changes, one prominent obstacle is lack of time. I figured people may have more time (compared to pre lockdown) to devote to their health. I therefore organised a four week teaching programme where I taught extensively about these issues and how to heal them. 

I advertised the programme on my social media page. The only criteria needed were: living in a developing country, and having had a pregnancy – regardless of the outcome. I wanted a maximum of 20 women because I wanted to be able to support them individually. I didn’t want anyone to get left behind. I took down the advert after 18 women responded. I didn’t want to get overwhelmed as I was still working fulltime myself and had my family responsibilities. I asked them to tell me privately what issues they were struggling with and why they wanted to join my programme. I did this because I wanted to know how to support them. It ended up serving a dual purpose – when I noticed halfway through the programme that some people were not engaging as much as they were at first, I read their (anonymised) reasons for joining in the first place. This served as a morale boost and was welcomed by all.

I added all the women to a private Facebook group where I posted educational and exercise videos I pre-recorded. I taught them about pelvic floor dysfunction and diastasis recti; how they develop, how they cause problems, what we can do to avoid aggravating them, and what we can do to start the healing process. I also taught exercises and other dietary/lifestyle modifications to aid the healing process. Other times, I posted texts, memes, and gifs, to motivate them and remind them to look after themselves.

Once a week, we met via live zoom meeting to troubleshoot problems that they were having on their recovery journey, and to reinforce learning. They could ask me any question either privately, or during the zoom meetings. I invited three speakers to these sessions at various times – a pelvic floor therapist, a dietitian, and a mind coach. I wanted to look after my ladies holistically. I was going to pay these women for their services, but because I wasn’t making any money from this programme, they all gave their time and knowledge for free. I was humbled by this. My budget dropped from a few hundred pounds to fifteen – money spent on zoom subscription and video-editing software.

Though it was a short programme, most of the ladies reported improvement in their symptoms including back pain, painful sex and stress incontinence. For all of them, it was empowering to learn about their bodies. They were encouraged to keep practicing what they had learnt.

I also learnt a lot. I learnt about the goodness of my fellow women who keyed into my vision. I witnessed the restoration of joy when sex is no longer painful, when pain is not a constant feature of one’s day. I did much more video editing and poster design than I had ever done in my life. I enjoyed breaking down information into small chunks so that the lay person can understand. I delivered information in short bursts and laid emphasis on key areas over time such that they were all able to follow. I enjoyed being a motivator. I saw the ladies supporting one another. I saw friendships blooming. I am still in touch with most of these ladies and I feel somewhat protective of them. They all thanked me for my efforts.

All these feelings make me consider doing this programme again. It was supposed to be a one-off, but it feels great to help so many ladies despite our geographical barriers.