We live in a culture obsessed with talking about women's bodies until, of course, they actually biologically use them.

At that moment, everyone goes prudishly silent, as if a taboo has been broken, or culture seeks to censor, revealing a social undertone that sees women’s bodies as unnatural or by their nature too explicit to discuss and depict plainly.

In this way, on our TV screens, menstrual blood becomes a more ‘hygienic’ blue liquid, and post-pregnancy incontinence becomes a light-hearted normalised ‘oops’ moment.

On the one hand, there is undoubtedly a benefit in ads normalising and validating post-pregnancy incontinence; however, by suggesting that a 30 something-year-old woman should have to wear a pad for incontinence, the marketing of the product isn’t providing a solution to the problem; it is only implying in subtext: ‘this is now a part of your life; buy our product to save yourself the embarrassment’.

“There is an assumption or perception amongst our society… That we should simply tolerate these things… Sadly, literally millions of women are doing exactly that.”

Wendy Powell, founder of MUTU System, a pre and postnatal wellbeing program for mums, doesn’t think women ‘should get used to it’ and said that while urinary incontinence, prolapse, and painful sex are common pelvic health issues amongst pregnant and postpartum women, they shouldn’t be tolerated as an inevitability of pregnancy.

“There is an assumption or perception amongst our society, whether we're talking to your friends, mum, sisters, fitness instructors, or even doctors, that this is normal. That if you've had a baby, that this is something you should expect… That we should simply tolerate these things and put up with them. And sadly, literally millions of women are doing exactly that”, she said.

Ms Powell explained that the massive impact of these symptoms is that not only do they affect many women’s “comfort and dignity”, but they can lead to the development of severe mental health conditions.

“Urinary incontinence doubles the risk of post postnatal depression, that is not strictly surprising, these are issues that impact our day-to-day relationships, life and work.”

The connection between mental health and postpartum health was documented in research conducted by MUTU System of the women studied:

  • 87% of women dealing with a pelvic floor issue said it affected their mental health at one stage.
  • 41% of women studied said they have taken time off work for postpartum health issues but did not feel comfortable discussing it with their employer.
  • 30% said pelvic health affected their performance at work.
  • 36% said they felt anxious or embarrassed in the workplace.

A part of the problem why women are suffering from these symptoms is that they are under-reported, stigmatised, and unsurprisingly are embarrassing. But also, because as Ms Powell commented, there “is a missing link” in women’s postpartum aftercare.

She added: “The most common thing we hear amongst new moms is why did nobody tell me that it would feel like this, that it would look like this, or that would happen… There is a gap in provision that has always been there. Literally, mum leaves hospital, and if she's lucky, she'll be given a leaflet with some pencil drawings of how to do pelvic floor exercises.”

Addressing this gap in support, MUTU System provides medically recommended online evidence-based exercise and support programmes for mothers and hosts a community-led by trained pelvic health and exercise specialists.

Over a 12-module online programme accessible on the phone or via a computer, women are trained in techniques that allow women to take control of the way their body works and feels. As Ms Powell commented: “We have proven benefits, and can massively improve symptoms from diastasis recti, which is a core condition where the abdominal muscles separate post-birth, to incontinence, prolapse, painful sex, and also very much with mental health.”

NHS trial

Over the last year, MUTU System has been leading a pilot study in conjunction with Norfolk & Norwich University Hospital NHS Trust (NNUH). The pilot had the objective of digitally supporting pregnant women and new mums who were unable to attend their face-to-face NHS consultations for pelvic health issues and discomfort.

The study comprised of 110 patients from NNUH, and results from a survey conducted after MUTU System’s 12-week programme found that:

  • 95% of women saw improvements in bladder weakness.
  • 91% saw diastasis recti improvement.
  • 95% felt better about their body function.
  • 76% of women claimed to feel physically stronger.
  • 59% felt more self-confident.
  • 40% felt mentally stronger.

The study also reportedly achieved excellent results from the get-go and was able to identify symptoms that the NHS physio team were unaware of, according to Ms Powell: “We saw great results after three weeks, which is really encouraging for any woman because obviously from a compliance point of view, a 12-week program sounds a bit ominous.”

“And because we were asking questions about all of their symptoms about for example, about mental health and painful sex, the physio team would say ‘oh, my goodness, we sent these women to you for diastasis or incontinence, but we didn't even know they were dealing with prolapse symptoms or that intimacy was painful. And you've not only identified that, but you fixed it as well.’”

The trial's success has opened up further opportunities for MUTU System to work with the NHS and they have previously been selected for the NHS Innovation Accelerator (NIA) Fellows programme. The NIA initiative supports the scaling up of selected health innovations intending to meet national health strategies and targets.

And as MUTU System scales up, more and more women will be able to feel better about their bodies, but also hopefully, the conversation around postpartum health and mental health will shift from being considered a niche or taboo subject to something that is regarded as normal and part of life as having a baby.