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Bound for Healing: Postpartum Abdominal Binding

Across both Eastern and Western cultures, various traditional postpartum practices have been embraced to facilitate the mother’s recovery (Fuller & Jordan, 1981; Dennis et al., 2007). This recognition is well-deserved, considering that nurturing and delivering a baby is an extraordinary accomplishment.

WHAT IS POSTPARTUM ABDOMINAL BINDING?

After being discharged from the hospital with the standard thick Velcro abdominal binder, Bengkung (abdominal binding) emerged as a traditional practice commonly offered to mothers in Singapore. This method typically involves applying a rigid cotton cloth with multiple ties and wrapping it around the torso from between the breasts to the pelvic bones. Advocates claim that it supports uterine involution, aids diastasis recovery, reduces water retention and provides posture support.

As we delved into the literature to gain a deeper understanding of this practice, it became apparent that there is limited evidence available to inform our clinical judgement, particularly within the postnatal population.

WHY PERFORM POSTPARTUM ABDOMINAL BINDING?

Abdominal binding has been employed to facilitate pain relief, support wound healing, and enable early mobilisation in populations undergoing abdominal surgery, including those who have had c-sections (Gustafson et al., 2018; Ghana et al., 2017). Additionally, its application has been associated with a reduced need for pharmacological interventions, thereby minimising potential side effects such as constipation (Gustafson et al., 2018). In a study by Zhang et al. (2014), ridged binders were found to increase intra-abdominal pressure more effectively than soft binders in individuals who had undergone elective or emergency laparotomies. However, there was a greater increase in intra-abdominal pressure with the belt in place (McGill, Norman & Sharratt 1990).

Using the analogy of an hourglass, applying excessive pressure around the waist can distribute pressure both above and below. For postpartum individuals, this pressure may be directed towards the c-section scar, pelvic floor, or diaphragm. While I am not opposed to the practice of abdominal binding (Actually a big fan of the postnatal massage it comes with), it’s worth noting that there is limited literature supporting its use in the postnatal population. However, its rationale can be understood.

RECOMMENDATIONS HOW TO PERFORM POSTPARTUM ABDOMINAL BINDING.

  • Choose a soft binder that allows for movement and does not restrict your breathing. Consider options like the Solidea and SRC ranges (Check out sizes available at our clinic!)
  • When wrapping, start from the bottom and move upward to minimise downward pressure on the uterus, c-section scar, and pelvic floor structures.
  • The firmness of wrapping should feel like a warm hug, supporting yet not constricting.
  • If you feel pressure or heaviness, notice a bulge, or experience leaking, seek the guidance of a women’s health physiotherapist.

HOW LONG SHOULD I WEAR AN ABDOMINAL BINDER?

Abdominal binding is not a long-term solution. As your healing progresses, and in collaboration with your physiotherapist, initiate a deep core training programme. This programme aims to activate the appropriate muscles, facilitating the healing of diastasis recti, alleviating symptoms of pelvic floor dysfunction, and providing support to the lower back and pelvis.

If you would like to discuss postpartum abdominal binding or book a postnatal assessment, please call or WhatsApp us at 9780 7274, or email us at help@embracephysio.sg to see a qualified women’s health physiotherapist.

Feel free to look through our website, where you can learn about other women’s health conditions we treat. This is a safe space where we can discuss how we can help you with physiotherapy.

Note: While I am a physiotherapist, I am not your personal physiotherapist. The contents of this website are for informational purposes only and are not intended to serve as personal medical advice.

References:

Dennis, C-L, Fung, K, Grigoriadis, S, Robinson, GE, Romans, S & Ross, L 2007, ‘Traditional Postpartum Practices and Rituals: A Qualitative Systematic Review’, Women’s Health, vol. 3, no. 4, pp. 487-502. Available from: https://doi.org/10.2217/17455057.3.4.487. [2019/10/08].

Fuller, N & Jordan, B 1981, ‘Part IV: Maya women and the end of the birthing period: Postpartum massage‐and‐binding in Yucatan, Mexico’, Medical Anthropology, vol. 5, no. 1, pp. 35-50. Available from: https://doi.org/10.1080/01459740.1981.9986974.

Ghana, S, Hakimi, S, Mirghafourvand, M, Abbasalizadeh, F & Behnampour, N 2017, ‘The Effects of Abdominal Binder on Wound Healing and Consumed Pain Medications After Cesarean Section: A Randomized Control Trial’, Iranian Red Crescent Medical Journal, vol. In Press.

Gustafson, JL, Dong, F, Duong, J & Kuhlmann, ZC 2018, ‘Elastic Abdominal Binders Reduce Cesarean Pain Postoperatively: A Randomized Controlled Pilot Trial’, Kansas journal of medicine, vol. 11, no. 2, pp. 1-19. Available from: PubMed. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29796155

McGill, SM, Norman, RW & Sharratt, MT 1990, ‘The effect of an abdominal belt on trunk muscle activity and intra-abdominal pressure during squat lifts’, Ergonomics, vol. 33, no. 2, pp. 147-160. Available from: https://doi.org/10.1080/00140139008927106.

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I’ve been working with Brenda Lee since the start of my pregnancy, through to my post partum recovery. Brenda is knowledgeable, patient and encouraging. I felt comfortable at every consult and I leave with a peace of mind too knowing that I don’t need to stress about remembering what exercises to do too but can check an app for my tailored program. The program is manageable even throughout my breathless third trimester days and as a new mum with little time on my hands. The clinic is also well equipped, not just to help with stretches and strength exercises, but also for doing mum things when you have to bring baby. There’s a diaper changing station and comfy chairs at the reception if you need to nurse + the team are just lovely with babies. Sometimes you just gotta bring baby and it helps so much to be welcomed here.

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[Appointment Booking and Administration] The process of scheduling an appointment was straightforward, thanks to their user-friendly website. Denise was exceptionally accommodating when I needed to make changes to my appointment for valid reasons. She astutely advised booking future appointments well in advance due to high demand, ensuring I wouldn't face long waiting times. [Consultation Experience] I visited Embrace Physiotherapy for postnatal physiotherapy sessions. My consultations with Brenda felt as comfortable and familiar as catching up with a long-lost friend. Previously, I had difficulties with cervical-related procedures, but Brenda's guidance in breathing and relaxation techniques significantly eased my discomfort, making experiences like pap smears with my gynecologist much more bearable. Moreover, Brenda's expertise in alleviating bodily tension was remarkable, and her instructions for follow-up exercises were incredibly beneficial. Our 45-minute sessions were packed with valuable advice, extending beyond physiotherapy to include practical motherhood tips. I wholeheartedly recommend Embrace Physiotherapy. It's not just a place for physical healing; the emotional support and affirmations I received had a profound impact on my mental well-being. While I was initially sad to be discharged, I left feeling empowered and cared for in a space that's truly by women, for women.

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