REACTION PAPER

Healthy & Safe Pregnancy

Kegels during Pregnancy
The benefits of kegel exercises while expecting
By April Underwood

It's impossible to speak about exercise during and after pregnancy without
placing some focus on Kegels and the pelvic floor muscles. In pregnancy
recovery, the pelvic floor muscles should receive top priority. The strength of
the pelvic floor is important in maintaining the integrity of the inside
passages and the position of the organs they support.

The pelvic floor muscles control the flow of urine, the voluntary contraction
of the vagina and the anal sphincter as well. The pelvic floor is composed of
several layers of muscle suspended like a hammock at two points: the front
and the back of the pelvis. The pressure of pregnancy increases the
likelihood that the pelvic floor will sag just as a hammock does.

Healthy Pelvic Floor

A healthy pelvic floor has tone and elasticity. However, if after childbirth
these muscles are neglected, they sag below the horizontal line and with the
help of gravity, continue to sag downward. Excessive sagging over a long
period of time can result in serious structural changes and possible
impairment of function, namely the bladder, uterus, bowel and their
contents. Common problems associated with pelvic floor weakness include:

• You or your partner may feel nothing during intercourse.

• You may have difficulty retaining a tampon.
 • Prolapse of the uterus. Over time, the uterus can begin to herniate
through the vaginal opening, similar to the way upholstery padding
protrudes through a chair when its supportive base is defective.
• Urinary incontinence, or the involuntary escape of urine when you
laugh, cough, sneeze, lift or run.

Not all problems with the pelvic floor are related to childbirth, so I
discourage self-diagnosis and urge you to visit your doctor if any unusual
symptoms persist.

Exercise throughout your pregnancy and after is always an excellent course

of action. However, because the pelvic floor is not exercised intentionally
during sports or basic physical activity, special efforts must be made to give
it a workout.

Pelvic Floor Exercises

The pelvic floor muscles form a figure eight, as they are slung in loops
around the vaginal and urethral sphincter in front and the anal sphincter at
the rear. The pelvic floor works as a coordinated whole. Kegels, or pelvic
floor exercises, involve contracting this unit as a whole. However, our main
focus is on the frontal aspect of the two sphincters: the sphincter which
controls the flow of urine and the voluntary contractions of the vagina. These
exercises involve lifting up and drawing in the muscles.
Exercise No. 1: Basic contract and release
Lay on your back, side or front with legs apart and chest relaxed. Draw up
the pelvic floor. You should feel the sides of the sphincters become tight and
the inside passages become tense. Concentrate on the frontal sphincter
surrounding the urethra and the vagina. Place one hand over the pubic bone
and think about tightening the birth canal as high as the level of your hand.
Hold for two or three seconds and then completely relax.
Exercise No. 2: The elevator
Place yourself in any comfortable position. Imagine that you are riding in an
elevator. As you ascend to each floor, try to draw up the sphincter muscles a
little more without losing any of the tension that you have been
progressively accumulating. Make it a smooth ride up and a smooth ride
down, releasing completely at the end. Always end your pelvic floor
exercises with a contraction to return the pelvic floor to its supportive
resting state. Quality is more important than quantity. Do at least 50 a day
during pregnancy and postpartum and 50 a day for the rest of your life. The
best part is, no one has to know you're doing them. Kegels can be done
during virtually any activity.

Reference:http://www.pregnancytoday.com/articles/exercise-in-
pregnancy/kegels-during-pregnancy-27/2/

Insight

We are not concern only to the client’s pregnancy but also with the
client’s well being after pregnancy. Kegel’s exercise is really an important
health teaching point that we have to give to our clients. This really helps to
prevent complications like uterine prolapse.
 EVALUATION

My Experience

This is my second rotation in a psychiatric facility. I had my duty

before in Mariveles. There, the patients are really different from the patients
we have here in Metropsyche. There in Mariveles, not all of the patients’
needs can be given to them. Most of them were abandoned by their own
family because of DENIAL that one of their family member is somewhat
mentally ill. Some of them also were being treated like an animal before
being admitted. That’s why; our clinical instructor showed us how to treat
these clients as our extended family. This way, we can render care and give
love to them. Here in Metropsyche, I also felt the same way for them. Maybe
they have their own family but not all. That is why, I am glad to see them
participating in the games we prepared for them in the grand socialization.

Institution

Metropsyche is one of the hospitals that, for me, are such a wonderful
place for those people that were mentally ill for treatment. They can really
give the clients’ needs.

Clinical Instructor

Dra. Emiliana M. Dator is a kind person. She treats us very well. She
also reminded us important points in our stay in Metropsyche. I am thankful
that she is one of my clinical instructors in RLE because of her positive
attitude towards us.
 PHYSICAL ASSESSMENT

Client: Mr. Robert De Guzman; 41 years old

BP 120/80 mmHg

Head

Skull

• Rounded smooth contour

• Absence of nodules and masses

Face

• Symmetric facial features; symmetric nasolabial folds

• Symmetric facial movements

Eyes and Vision

Eyebrows

• Hair evenly distributed; skin intact

• Symmetrically aligned

Eyelashes

• Equally distributed

Eyelids

• skin intact

• close symmetrical
Conjunctiva

• shiny, smooth and pink

Pupils

• Black in color, equal in size

• Round smooth border, iris flat and round

Peripheral visual fields

• When looking straight ahead, client can see objects in the periphery

Ears and Hearing

Auricles

• Color same as facial skin

• Symmetrical

• Mobile, firm and not tender

• Pinna recoils after it is folded

Hearing

• Normal voice tones audible

Nose

External nose

• Symmetric and straight

• Air moves freely as client breathes through the nares

Mouth

Lips

• Uniform pink in color

• Soft, smooth texture

Teeth

• Missing teeth

Tongue

• Central position

• Moves freely

Neck

Neck muscles

• Equal in size; head centered

• Coordinated, smooth movements

Lymph nodes

• Not palpable