From the eastern to the western worlds, there are many traditional postpartum practices adopted to support the recovery of the mother (Fuller & Jordan 1981; Dennis et al. 2007). Rightly so, as growing and birthing a baby is the most amazing feat of mankind.
WHAT IS POSTPARTUM ABDOMINAL BINDING?
After being discharged from the hospital with the hideous thick velcro abdominal binder, Bengkung (abdominal binding) is one such traditional practice and is commonly on offer to mums in Singapore. It usually involves the application of a ridged cotton cloth with many ties that wraps around the torso between the breasts and pelvic bones. It is reported to aid the involution of the uterus, support diastasis recovery, reduce water retention, and provide posture support.
As I embarked on searching for literature to better understand this practice, it quickly became apparent that there is not a great deal of evidence out there to guide my clinical judgement, especially in the postnatal population.
WHY PERFORM POSTPARTUM ABDOMINAL BINDING?
Abdominal binding has been used to aid pain relief, support wound healing and allow for early mobilisation in abdominal surgery populations (including C-sections) (Gustafson et al. 2018; Ghana et al. 2017). There is also less need for the use of pharmacology and as such, reducing potential side effects of these (e.g. constipation) (Gustafson et al. 2018). Zhang et al. (2014) showed that ridged binders increase intra-abdominal pressure more than soft binders in men and women who had undergone elective or emergency laparotomies. And in weightlifters, wearing of an abdominal belt during a lifting task showed lesser erector spinae muscles activity during a breath-hold compared to wearing a belt only. 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, if we apply too much pressure in the middle (around the waist), pressure can be distributed above and below. If you’ve just given birth, that pressure can be directed towards your C-section scar, the pelvic floor, or towards your diaphragm. Whilst I am not against the practice of abdominal binding, (I am a big fan of the postnatal massage that goes with!) there isn’t a great deal of literature to support it in the postnatal population, but its use can be rationalised.
RECOMMENDATIONS: HOW TO PERFORM POSTPARTUM ABDOMINAL BINDING.
- Choose a soft binder that allows for movement and does not restrict your breathing. I like the Solidea and SRC ranges (I can measure you up at the clinic).
- Regardless of the binder, wrap from the bottom up to minimise downward pressure on the uterus, C-section scar and pelvic floor structures.
- The firmness of wrapping should feel like a warm hug, supportive at the right spots but not strangulating.
- If you feel pressure, heaviness or notice a bulge or experience leaking, seek the guidance of a Women’s Health Physiotherapist.
FOR HOW LONG SHOULD I WEAR AN ABDOMINAL BINDER?
Please remember that abdominal binding is not a long-term solution. As healing allows, in conjunction with your physiotherapist, commence a deep core training program to help activate the right muscles to aid the healing of diastasis recti, reduced symptoms of pelvic floor dysfunction and to support the lower back and pelvis.
Note: Although I am a Physiotherapist, I am not YOUR physiotherapist. Information contained on this website is for informational purpose only and is not intended to serve as individual medical advice.
If you would like to discuss postpartum abdominal binding or book a postnatal assessment, please call/WhatsApp on 9780 7274 or get in touch over email.
You can also visit our website to learn about other women’s conditions we treat through physiotherapy and how we can help you.
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.