February is heart health month! According to the FDA (1), heart disease is the leading cause of death in women in the USA. Luckily there are ways to help reduce this risk such as eating a heart healthy diet, managing your health conditions, knowing the signs of a heart attack (they can be different from the “classic” chest pain and left arm pain), and getting the facts about daily aspirin use (it’s not right for everyone). But there’s more to it than that.

Did you also know that pregnancy is a “natural stress test” for our bodies?

From the American College of Obstetricians and Gynecologists (ACOG) Committee Opinion regarding Optimizing Postpartum Care (2):

“Complications such as preterm delivery, gestational diabetes, gestational hypertension, preeclampsia and eclampsia are associated with greater risk of arteriosclerotic cardiovascular disease. Pregnancy is therefore a natural 'stress test' identifying at-risk women, but because these conditions often resolve postpartum, the increased cardiovascular risk is not consistently communicated to women…. women should be counseled that these pregnancy disorders are associated with a higher lifetime risk of maternal cardiometabolic disease.”
*See below for definition of medical terms.

What this means is that the ACOG has identified a gap in communication between OBGYNs and Primary Care Providers, so speak up! When you are done with postpartum OBGYN care, make sure your family doctor knows about any pregnancy-related issues, even if they have fully resolved. Ask your doctor about how to keep your heart healthy as you age, because some pregnancy complications identify an increased risk.

A common (but not normal) condition we see postpartum is stress urinary incontinence, or leaking urine when you cough, sneeze, exercise or have a really full bladder. Incontinence can not only be embarrassing, it’s not good for your heart!

According to the National Association for Continence (3), up to 20% of women stop exercising because of stress urinary incontinence. This means that you’re not getting that heart-healthy cardio in, and we know that is a big factor when it comes to heart disease.

What can you do? Get an appointment with a Pelvic Health PT! We are experts in figuring out why your pelvic floor isn’t functioning properly. It could be too weak, but it could also be too tight. Pelvic floor muscle is similar to other skeletal muscles in our bodies, like our calves, and you wouldn’t treat a weak calf muscle the same as a tight one, right? Which means that  Kegels aren’t always the answer for pelvic floor issues. One study showed that with verbal cuing alone, only 40% of women performed a Kegel correctly and 25% of women actually performed a contraction that would promote incontinence! (4) If you’re not sure you’re doing it right, get checked. There are also a host of factors that influence your bladder control, like what you eat, drink, and your level of stress for example. Our bodies work as a whole system, not individual parts, so a holistic approach to health is important.

If you have ever had a baby (even if it was 10, 20, 30 or more years ago) you should be sure to include a Pelvic Health PT in your care team. It’s not only crucial for pelvic health, but also for heart health!

Take care of your hearts, Mamas, your love is what makes the world go ‘round.

Medical Definitions:
Gestational diabetes: diabetes during pregnancy
Gestational hypertension: high blood pressure during pregnancy
Pre-Eclampsia: high blood pressure with signs of damage to another organ system, most often the liver and kidneys
Eclampsia: a rare but severe complication of pre-eclampsia where high blood pressure results in seizures during pregnancy
Arteriosclerotic cardiovascular disease: build up of fats, cholesterol and other substances on artery walls
Cardiometabolic disease: includes heart attack, stroke, angina (chest pain), vascular disorders, insulin resistance, diabetes, non-alcoholic fatty liver disease
(1) https://www.fda.gov/consumers/womens-health-topics/heart-health-women
(2) https://www.acog.org/-/media/Committee-Opinions/Committee-on-Obstetric-Practice/co736.pdf?dmc=1&ts=20180521T1500071627
(3) https://www.nafc.org/bhealth-blog/dont-quit-exercising-because-of-urinary-incontinence
(4) https://www.ncbi.nlm.nih.gov/pubmed/1872333