PELVIC HEALTH INFORMED

LABOR, BIRTH

&POSTPARTUM
WRITTEN BY AYESHA BHONSLE
 UNDERSTANDING

YOUR LABOR
HI GUYS!

I AM A DOCTOR OF PHYSICAL
THERAPY SPECIALIZED IN PELVIC
HEALTH AND ORTHOPEDICS, AS
WELL AS A MAMA WHO
RECLAIMED HER BALANCE.
MY GUIDE IS ALL ABOUT
EMPOWERING YOU IN YOUR
TRANSITION TO MOTHERHOOD.
ENJOY!

LOVE, AYESHA

I WOULD LOVE FOR YOU TO PRINT THIS OUT AND BRING IT WITH YOU TO THE
HOSPITAL, REVIEW IT WITH YOUR BIRTH PARTNER, AND HAVE THEM
REFERENCE IT WHEN THEY AREN’T SURE OF HOW TO SUPPORT YOU.

SECTIONS INCLUDE:

HOSPITAL CHECKLIST LABOR STATIONS ABDOMINAL MASSAGE

PERINEAL TEARS PUSHING POSITIONS REACTIVATE PELVIC
STAGES OF LABOR C-SECTION CONSIDERATIONS FLOOR
HOW TO BREATHE SUPPORTING LACTATION ANTI ANXIETY TOOLS
PAIN MODULATION POSTPARTUM FIRSTS

YOU AND YOUR PARTNER ARE YOUR BIGGEST ADVOCATES AS YOU BRING
YOUR BABY INTO THIS WORLD.

REMEMBER TO TUNE OUT AND LISTEN TO YOUR INTUITION.

DO NOT BE AFRAID TO ASK FOR WHAT YOU WANT

AYESHA BHONSLE AMERICARE PHYSICAL THERAPY

 CHECKLIST

HOSPITAL
YOUR VERY OWN CHECKLIST TO PACK *JUST THE RIGHT* AMOUNT
CHECK OUT MY AMAZON STOREFRONT: HTTPS://AMZN.TO/3ELPAOJ

LABOR POSTPARTUM

ESSENTIAL OILS & DIFFUSER PERI BOTTLE

TEA LIGHTS (ELECTRIC) DEPENDS ADULT DIAPERS

COOLING CREAMS (CHINA GEL) BELLY BINDER*

BIRTH BALL AND/OR REBOZO HEALTHY SNACKS

ROBE & LOOSE FITTING

CHAPSTICK/GUM/MINTS
CLOTHING

BREASTFEEDING BABY

PUMPING/NURSING BRA CUTE CLOTHES

YOUR BREAST PUMP PACIFIER

NURSING PILLOW SOUND MACHINE

EASY ACCESS NURSING

VELCRO SWADDLES
DRESS

NIPPLE BUTTER NAMETAG/PROPS

*ABDOMINAL SUPPORT CAN BE HELPFUL IN THE FIRST FEW WEEKS POSTPARTUM IF YOU
ARE IN SEVERE PAIN OR CAN'T MOVE SECONDARY TO WEAKNESS. IF YOU ARE NOT
FEELING THIS WAY, AVOID THE BINDER AND WORK ON GENTLE CORE ENGAGEMENTS

AYESHA BHONSLE AMERICARE PHYSICAL THERAPY

 PREVENTING

PERINEAL TEARS

START AT 34 WEEKS AS LONG AS NOT ON PELVIC REST

USE COCONUT OIL OR A WATER BASED LUBRICANT WITH THE WAND

LAY ON AN INCLINE OR STAND WITH ONE LEG UP

PULL WAND BACK TOWARDS 3, 6 AND 9 O CLOCK

PERFORM FOR 5 MIN, 4 TIMES A WEEK

 3 STAGES

OF LABOR

E 1
G
A THE CERV IX RELA XES AND THIN S FOR YOU
ST

TO FULL Y DILA TE (10 CM) AND ACHI EVE

100% EFFA CEM ENT (+2 PELV IC STAT ION) .

GO TO THE HOSP ITAL WHE N:

REGU LAR, PAIN FUL CON TRAC TION S
1 MINU TE EACH , AT LEAS T EVER Y 5 MIN FOR
MOR E THAN ONE HOU R
(511 RULE )

ST
AG
UTERINE CONTRACTIONS INCREASE IN
STRENGTH, THIS IS WHERE YOU ARE

E
PUSHING BABY DOWN AND OUT

DON'T PUSH UNTIL YOU ARE FULLY EFFACED

& DILATED AS THIS CAN CAUSE FATIGUE AND
2
SWELLING OF THE CERVIX

E 3 AFTER THE BABY IS BORN, WAIT 2-3 MIN

G FOR DELAYED CORD CLAMPING. THIS
A INCREASES NUTRIENT RICH BLOOD FLOW
ST

TO BABY, INCREASING IRON STORES TO

REDUCE ANEMIA RISK

THE PLACENTA IS EXPELLED

WITHIN 30 MINUTES
MILD, LESS PAINFUL CONTRACTIONS
CONTINUE, YOU WILL HAVE TO PUSH
GENTLY ONE MORE TIME TO
DELIVER THE PLACENTA

YOU WILL BE ASSESSED FOR PERINEAL TEARS, AND APPROPRIATELY REPAIRED WITH STITCHES

AYESHA BHONSLE AMERICARE PHYSICAL THERAPY

 WHAT TO EXPECT

STAGES OF LABOR
BIRTH AFFIRMATIONS

"MY BODY IS MADE FOR THIS," "MY BODY IS STRONG AND CAPABLE.”

"BABY KNOWS WHEN IT’S TIME." "I WILL GO IN WITH AN OPEN MIND."

EARLY LABOR
CRAMPING SENSATIONS.
AROUND 0-3 CM
CONTRACTIONS MAY BE 10+ MINUTES APART.
CAN LAST HOURS OR DAYS

EARLY ACTIVE LABOR

AROUND 3-5CM DILATED
CONTRACTIONS ARE USUALLY 4-10 MINUTES APART
GO TO THE HOSPITAL WHEN YOUR CONTRACTIONS ARE 5 MIN
APART, 1 MIN LONG AND HAVE BEEN HAPPENING FOR 1 HOUR

ACTIVE LABOR

AROUND 6-8CM DILATED

CONTRACTIONS ARE 2-3 MINUTES APART

TRANSITION
SHORTEST PHASE (30 MINUTES TO 2 HOURS).
SYMPATHETIC NERVOUS SYSTEM HORMONES FLOODING
(FIGHT OR FLIGHT)

AYESHA BHONSLE AMERICARE PHYSICAL THERAPY

 BY STAGE

BREATHWORK
CHECK OUT MY INSTAGRAM HIGHLIGHTS FOR BREATHWORK VIDEOS

LABORING DOWN
UP BREATHING: (BETWEEN CONTRACTIONS)
1:2 BREATHING = 4 SEC IN, 8 SEC OUT
TO CALM SYSTEM DOWN BETWEEN CONTRACTIONS

DOWN BREATHING: (DURING CONTRACTIONS)

1:1 BREATHING
DURING ACTIVE CONTRACTION
“J BREATH” OR OPEN GLOTTIS BREATH
BREATHE OXYGEN TO BABY

ACTIVE PUSHING
PUSHING BABY DOWN AND OUT

J BREATH” OR OPEN GLOTTIS BREATH

DEEP O'S
HUMMING
BREATHE OXYGEN TO BABY
THINK ABOUT ROWING OR PULLING SHEET AGAINST
PARTNER TO HELP YOU PUSH / ENGAGE YOUR CORE BETTER
RELAX YOUR JAW, FLUBBERIZE YOUR LIPS, PULL BACK
INSTEAD OF PUSH DOWN WITH YOUR ARMS

CROWNING
QUICK BREATHS TO PUSH BABY OUT
“SKULL SHINING BREATH”
BLOW – BLOW – PUSH
WARMTH TO PERINEUM CAN BE HELPFUL HERE

OLIVIA WILSON WORKBOOK

 TECHNIQUES FOR

PAIN MODULATION
PRACTICE THESE WITH YOUR BIRTH PARTNER IN THE WEEKS LEADING
UP TO LABOR SO YOU BOTH FEEL COMFORTABLE WITH WHAT FEELS
GOOD AND WHAT DOESN’T. HAVE YOUR PARTNER REFER BACK TO THIS
DURING LABOR TO HELP REDUCE YOUR PAIN

PAIN SCALE 1 2 3 4 5

01 PELVIC COMPRESSION
02 IF BABY IS HIGH: COMPRESS LOWER

03 IF BABY IS LOW: COMPRESS HIGHER

04 JAW RELEASE
05 FLUBBERIZE YOUR LIPS
06 SCALP MASSAGE
07 FOOT MASSAGE
08 BACK MASSAGE
09 ESSENTIAL OILS
DIFFUSER OR UP TO FACE FOR A MORE
10 POTENT PAIN RELIEVER

YOUR CHOICE OF PAIN REDUCTION TECHNIQUES:

AYESHA BHONSLE AMERICARE PHYSICAL THERAPY

 PELVIC
STATIONS
UNDERSTANDING HOW YOUR BABY MOVES THROUGH YOUR PELVIS HELPS
YOU TO UNDERSTAND HOW TO MOVE IN LABOR

CHECK OUT THIS VIDEO TO SHOW YOU THE IMPORTANCE OF PELVIC

MOBILITY AS YOU DELIVER YOUR BABY.

THE NEXT FEW PAGES WILL HAVE MOVEMENT OPTIONS FOR YOU FOR
EACH STATION OF LABOR THAT YOUR BABY MAY BE IN. THIS IS GREAT FOR
LABOR STALLS, OR FINDING NEW POSITIONS OF COMFORT.

YOU CAN ASK YOUR PROVIDER TO TELL YOU HOW EFFACED YOU ARE TO
KNOW WHICH STATION YOUR BABY IS IN.

AYESHA BHONSLE AMERICARE PHYSICAL THERAPY

 PELVIC STATION

MOVEMENTS
ASK YOUR MEDICAL TEAM WHAT STATION YOU ARE IN TO CORRELATE
TO PELVIC MOVEMENTS

NON EPIDURAL:
SQUATTING, TOILET, ON ALL
PELVIC INLET FOURS KNEES APART
-2 TO -1
EXTERNAL ROTATION EPIDURAL: KNEES APART,
FEET TOGETHER ON
PEANUT

AYESHA BHONSLE WORKBOOK

 PELVIC STATION

MOVEMENTS
ASK YOUR MEDICAL TEAM WHAT STATION YOU ARE IN TO CORRELATE
TO PELVIC MOVEMENTS

NON EPIDURAL: LUNGING,

ON ALL FOURS WITH ONE
LEG UP
MID PELVIS
0
EPIDURAL: SITTING UP IN
ASYMMETRICAL MOVEMENTS
BED WITH ONE LEG ON
PEANUT

AYESHA BHONSLE AMERICARE PHYSICAL THERAPY

 PELVIC STATION

MOVEMENTS
ASK YOUR MEDICAL TEAM WHAT STATION YOU ARE IN TO CORRELATE
TO PELVIC MOVEMENTS

NON EPIDURAL: SITTING, ON ALL

FOURS KNEES CLOSER THAN
PELVIC OUTLET FEET/ KNEELING, SQUATTING
+1 TO +2
INTERNAL ROTATION EPIDURAL: SIDELYING WITH
KNEES TOGETHER FEET APART

OLIVIA WILSON WORKBOOK

 PUSHING

POSITIONS
WHILE BIRTHING BABY, YOU HAVE MORE OPTIONS THAN LAYING ON YOUR
BACK. EXPLORE THESE MOVEMENTS BEFORE YOUR TIME COMES TO FEEL
COMFORTABLE WITH THEM

LITHOTOMY KNEELING SIDELYING

STANDING SITTING SQUATTING

ON ALL FOURS WATER

OLIVIA WILSON WORKBOOK

 CONSIDERATIONS

C-SECTION
THERE ARE MANY DIFFERENT REASONS A C-SECTION CAN OCCUR.
IF THIS IS THE SAFEST WAY TO DELIVER YOUR BABY, REMEMBER TO
PRACTICE ACCEPTANCE AND EXCITEMENT TO MEET THEM REGARDLESS OF
HOW THEY COME INTO THE WORLD.

FOCUS ON WHAT YOU CAN CONTROL

WHAT TO ASK FOR IN YOUR C-SECTION

CLEAR DRAPE
IMMEDIATE SKIN TO SKIN
ASK FOR A PLAY BY PLAY OF YOUR BIRTH
MUSIC OF YOUR CHOICE

WOUND HEALING

GLUE, TAPE OR STITCHES RATHER THAN STAPLES

PAIN MODULATION: ICE, TENS ON EITHER SIDE OF SCAR
GENTLE MASSAGE AT LOW BACK, RIBS, UPPER ABDOMEN

MANAGING MOVEMENT

PILLOW AGAINST ABDOMEN TO BRACE WHEN COUGHING, SNEEZING, MOVING

BED EXERCISES: ANKLE PUMPS, HEEL SLIDES, GLUTE SQUEEZE, ARMS OVERHEAD
WALK AS SOON AS POSSIBLE

CORE WEAKNESS

HUFF INSTEAD OF COUGH

ABDOMINAL BINDER FOR 2 WEEKS OR AS NEEDED
PELVIC TILTS AND DIAPHRAGMATIC BREATHING

SCAR MOBILITY

VITAMIN E, SILICONE AND SCAR MOBILIZATION ONCE HEALED

GEL CUPS
THORACIC ROTATION: THREAD THE NEEDLE, OPEN BOOK STRETCH

AYESHA BHONSLE AMERICARE PHYSICAL THERAPY

 SUPPORTING

LACTATION
REVIEW THIS CHART TO PREPARE YOU FOR BREASTFEEDING

PRINCIPLES SKIN TO SKIN BREATHWORK VISUALIZE EASE

Expel milk every 2-3 Babies are very tired

hours to build your initially, especially if
Bring baby to breast in
FREQUENCY supply, even if baby they came early. Don't
the first hour after
OF FEEDINGS isn't properly latching be discouraged if you
delivery
(via pumping or have to supplement
nursing) right now

Oatmeal, flaxseeds, Fenugreek, Avocado,

Protein rich foods,
DIET chia seeds,, sesame oil, Beets, Squash, Carrots,
bone broth
ghee Sweet potatoes

if baby is latching well, A stash can be helpful You will produce the
you don't have to start for getting some extra most milk in the
PUMPING pumping for a few hours of sleep for mornings, pump this so
weeks unless you someone else to feed you can stash some
want to build a stash baby away

Nipple butter to Silverettes are

Appropriate flange size
decrease pain with antimicrobial, anti-
PAIN Get measured by
chafing and dryness bacterial, and anti-
SUPPORT lactation consultant in
(this should improve inflammatory to
the hospital
with time) promote healing

Can use the Boppy as a

Always bring baby to
C around the side of Can nurse in a wrap as
POSITIONING breast with pillows
your body for more baby gets used to it
underneath
comfort

EXERCISES

AYESHA BHONSLE AMERICARE PHYSICAL THERAPY

 POSTPARTUM

FIRSTS
BOWEL
URINATION SEX
MOVEMENT
PLEASE WAIT TILL
YOUR SCAR TAKES TAKE COLACE FOR AT
YOU ARE CLEARED
TIME TO HEAL, URINE LEAST
FROM YOUR
IS ACIDIC AND CAN 1 WEEK POSTPARTUM
PHYSICIAN AT 6
FEEL LIKE YOU'RE
WEEKS POSTPARTUM
BURNING DOWN ENSURE YOUR DIET IS
TO PREVENT RISK OF
THERE CLEAN AND FULL OF
INFECTION
FIBER & WATER

USE ICE PACKS TO IF SQUATTY POTTY IF THE SCAR

HELP WITH HEALING POSITIONING FEELS CONTINUES TO BE
INITIALLY (IN LIKE TOO MUCH PAINFUL, TRY
UNDERWEAR) PRESSURE, LEAN VAGINAL
FORWARD FROM MOISTURIZERS, SCAR
WITCH HAZEL PADS YOUR HIPS WITH MOBILIZATION, AND
ARE SOOTHING YOUR BACK STRAIGHT LUBE

IT IS NORMAL TO
GO WHEN YOU FEEL HAVE DECREASED
ALWAYS SIT ON THE READY. LIBIDO IN THIS PHASE,
TOILET RATHER THAN ESPECIALLY IF YOUR
HOVERING. GENTLE PUSHES: PERIOD HASN'T
"MOO TO POO" RETURNED AND YOU
ARE STILL NURSING

TAKE YOUR TIME, USE WARM WATER YOGA STRETCHES

PRACTICE WITH THE AND INTERNAL
DIAPHRAGMATIC PERIBOTTLE, PELVICWAND
BREATHING GENTLY DAB DRY RELEASE IS HELPFUL

CHECK OUT MY AMAZON STOREFRONT FOR SPECIFIC PRODUCT RECOMMENDATIONS

AYESHA BHONSLE AMERICARE PHYSICAL THERAPY

 POSTPARTUM

ABDOMINAL MASSAGE
STIMULATING BLOOD FLOW TO THE ABDOMEN CAN BE HELPFUL IN
DIASTASIS RECTI RECOVERY AND LOW BACK PAIN
THIS DECREASES STRESS, IMPROVES CIRCULATION, IMMUNE FUNCTION,
AND CAN AIDE IN SLEEP

WARM OIL
SESAME, COCONUT,
JOJOBA AS A CARRIER WITH PREFERRED ESSENTIAL OILS
SAFFRON OIL (CAN BE HELPFUL FOR STRETCH MARKS)

GENTLE CIRCLES AROUND THE ABDOMEN

SKIN ROLLING AND PULLING
MOVE OVER RIB CAGE AND OBLIQUES
GENTLE STROKES IN ALL DIRECTIONS

VAGINAL DELIVERY C-SECTION

CAN START
CAN START
4 WEEKS POSTPARTUM
1 WEEK POSTPARTUM (STITCHES SHOULD BE CLOSED)

AYESHA BHONSLE AMERICARE PHYSICAL THERAPY

 RE-ACTIVATE YOUR

PELVIC FLOOR
AROUND 3-4 WEEKST POSTPARTUM, YOU CAN TRY THESE EXERCISES.
REMEMBER TO FEEL YOUR BODY AND IF YOU'RE NOTICING ANY PELVIC
PRESSURE OR HEAVINESS, STOP THE MOVEMENTS

CONTINUE TO TAKE WALKS OUTSIDE IN NATURE DURING THIS PERIOD

YOUR BREATH IS THE MOST IMPORTANT HERE

INHALE TO FEEL PELVIC FLOOR RELAX AND DESCEND
EXHALE BACK TO NEUTRAL
INHALE TO PREPARE
EXHALE TO SQUEEZE AND LIFT PELVIC FLOOR UP
INHALE TO LET IT GO
EXHALE TO NEUTRAL
REPEAT 5X IN EACH POSITION

AYESHA BHONSLE AMERICARE PHYSICAL THERAPY

 PRINCIPLES

AYURVEDIC
TO STAY CONNECTED WITH YOUR INNER SELF, YOUR CHANGING BODY AND
ANXIOUS MIND DURING THIS TIME OF GREAT TRANSITION

GROUNDING
WALK BAREFOOT ON THE EARTH FOR AT LEAST 10 MINUTES PER DAY
WRAP YOUR BABY ON YOUR BODY AND INTRODUCE THEM TO THE WORLD
AROUND YOU

WALK ALONG NATURAL BODIES OF WATER, LISTEN TO THE WIND HIT THE
WATER

ALLOW THE LIGHT AND WARMTH OF THE SUN TO PERMEATE YOU, CLOSE
YOUR EYES AND VISUALIZE WHAT YOU WANT IN LIFE

ABSORB YOURSELF IN NATURE, VISUALIZE THE TREES AND NOTICE THE

BEAUTY AROUND YOU

GAZE INTO THE STARS AT NIGHT, A BREATH OF COOL, FRESH AIR CAN DO
WONDERS

EAT LOCALLY GROWN, FRESH AND ORGANIC FRUITS, VEGETABLES AND

GRAINS

PERFORM INFANT MASSAGE TO BOND WITH YOUR BABY

TAKE TIME TO REST (42 DAYS/6 WEEKS), ESTABLISH YOUR BOUNDARIES

WITH THE PEOPLE AROUND YOU

ASK FOR HELP

TAKE 2 HOURS PER WEEK TO DO SOMETHING ALONE

SHATAVARI IS A GREAT HERB TO INCLUDE IN YOUR DAILY RITUAL FOR

POSTPARTUM HORMONAL SUPPORT

AYESHA BHONSLE AMERICARE PHYSICAL THERAPY