TUPLER TECHNIQUE^® PERFECT PUSHING^®

 

 

EVERYBELLY® Should be checked for a diastasis recti!          (find a licensee near you) PREGNANT WOMEN Description of Program Conception of Perfect Pushing BAKS Basics Sheet (pdf) Pushing Articles by Julie Tupler, RN Perfect Pushing Products PR Articles Television Endorsements

 

PUSHING WITH A DIASTASIS

A diastasis recti can make pushing in labor very difficult to do.  When the muscles separate the weakened connective tissue is now supporting the uterus instead of the muscles if they were together.  The uterus, being top heavy from the growing baby, will thus tilt forward. When it tilts forward the cervix will move out of alignment with the vaginal canal creating a detour in the babies passage through the birth canal.   

PURPOSE OF PROGRAM

The Tupler Technique® teaches women “perfect pushing” by teaching them how to push with their strengthened and splinted abdominal muscles  while relaxing their pelvic floor muscles that they have strengthened and stretched during pregnancy.  Not only does it get the baby out faster, it also prevents the diastasis from getting larger and damage to the pelvic  floor muscles.

Just like any marathon, pushing during the marathon of labor is a learned skill. You cannot teach someone a new skill when they are in pain! Pushing must be learned and practiced during pregnancy so it becomes second nature during labor.

The best way to learn this program is by watching the Tupler Technique® Perfect Pushing® DVD.  It is especially important to watch this DVD if  you plan to work with a licensed provider of the Tupler Technique. ®    If you watch it before your first session, whether it be a private session or a class, it will make it much easier to understand the program.  The Tupler Technique® is a lot of information. If you come prepared with a basic understanding of the program, you will be much more successful in getting the results you want.  

The Coming Contractions Pain management CD, if listened to during pregnancy, will help women deal with their pain better during labor.

RESULTS

In the Maternal Fitness® six week workshops taught from 1995 to 2009,   our clients would be checked for a diastasis in the first and last class. We found in 90% of our clients that the diastasis got smaller as their bellies got bigger! The published research from Columbia University Program proved that the pregnant women who did the  Tupler Technique® had a smaller diastasis than the control group of pregnant women who did not do this program. 

Having a smaller diastasis during pregnancy from doing the Tupler Technique® resulted in:
No back pain or disappearance of back pain
Faster and more effective pushing in labor
Faster recovery of abdominal muscles
Faster recovery from a c-section

SPLINTING DURING PREGNANCY

Women can wear a splint during their pregnancy. If they are uncomfortable wearing this, they can just hold a splint when doing the seated and back lying exercises starting in week four of the program.  It is especially important to hold a splint when pushing in labor.  Bringing the muscles together will put  the uterus in the proper position.  

DESCRIPTION OF PROGRAM

The Tupler Technique® foundation program is six weeks. The full program runs over eighteen weeks.   During the first six weeks you will learn the 4 step Tupler Technique® and then in week six of the program you will learn how to incorporate the Tupler Technique® into any exercise routine. You can do this program at any time during your pregnancy. However, the bigger your belly gets, the harder it will be to do the exercises. Even doing it a couple of weeks before you deliver will be helpful. You can start the seated exercises within 24 hours of giving birth. A great time to do them is while feeding your baby. You can also start wearing the splint right away if you had a vaginal birth. If you can a c-section you must wait six weeks until the stitches have healed.

There is a very specific protocol of what you need to be doing over the first six weeks.  This is clearly spelled out on a weekly basis in the Tupler Technique® Guidebook. To support you in following this protocol, licensees will see you in week one, end of week three and week six of the program. They teach this program individually or in a group workshop.  If you are planning to work with a licensee, it is recommended to watch the Tupler Technique® Perfect Pushing ® DVD first before starting to work with them. There is a lot of information to learn, so doing this will make the program work better for you. 

The 4-Step Tupler Technique® is:

1. Tupler Technique® Exercises (Elevator, Contracting& Headlifts)
2. Splinting with the Diastasis Rehab Splint®
3. Using your abdominals correctly with activities of daily living
4. Getting up and down correctly

To support you in getting the full benefit of the program, it is important to have the following items:

• Tupler Technique®Perfect Pushing® DVD 
• Diastasis Rehab Splint®
• Tupler Technique® Guidebook
• Coming Contractions pain management CD

The purpose of the six week program is to not only strengthen your abdominals for pushing in labor but to make your diastasis smaller. Yes, you can make your diastasis smaller during your pregnancy as your belly gets larger!  

You will see that the guidebook goes to 18 weeks. That is because the seated contracting exercises continue to progress from week six to week eighteen.  After 18 weeks you then maintain at this level until you deliver. 

CONCEPTION OF PERFECT PUSHING

Julie was teaching at a New York health club in 1989. Because she was a Registered Nurse, they asked her if she wanted to teach the prenatal class.  When the women in the class found out she was a nurse, they started picking her brain about labor.  It had been a while since she was in labor and delivery, so she decided to learn more about labor and delivery and became a Certified Childbirth Educator. Once certified, she realized two things. Childbirth education is taught at the end of pregnancy and only prepares your mind.  She thought you would not run in a race and not train. Why would a woman do the hardest thing she will ever do in her life….labor..and not prepare both her mind and body! So she started Maternal Fitness® in 1990. Her purpose twofold: To prepare women early in pregnancy and to prepare both the mind and the body.  Just like a marathon, it was important to prepare the muscles that would be used (abdominals and pelvic floor) and to practice the skills needed (relaxation & pushing) for all stages of labor.  The program proved to be very successful in “preparing women for the marathon of labor.” So in 1996 she wrote her first book Maternal Fitness® and produced a CD for pain management called “Coming Contractions.” The book was updated in 2006 and  has set the standard for prenatal exercise. Midwife and childbirth educators all over the world  use it as a textbook  and refer their clients to it. The foundation of the Maternal Fitness® Program was the BAKS Basics.  (To download this sheet click here.)  She then produced the Maternal Fitness® DVD in 2001. In 2010, it was time to update the program.  Reading through all the letters from moms about their births, it became clear that learning how to push effectively was most important to them.  Pushing correctly not only got the babies out faster, it also prevented the diastasis recti from getting larger as well as prevented stress to the pelvic floor.  So the Tupler Technique®Perfect Pushing® was conceived!

PUSHING ARTICLES BY JULIE TUPLER, RN

Besides writing the Maternal Fitness® book, Julie has written several articles on pushing in labor with the Tupler Technique®. 

• Baby Talk Fit for Delivery
• Midwifery Today Exercises for Second Stage
• Nursing Spectrum Preparing for the Marathon of Labor
• Midwifery Today Back to Basics
• Fit Pregnancy Mamas Got Muscle
  

TUPLER TECHNIQUE® PERFECT PUSHING™ PRODUCTS

Labor is essentially two stages. Dealing with the pain in stage one and pushing out the baby in stage two. Pain management and pushing are “learned” skills. You cannot learn these new skills in labor when you are in pain.  Research says that it takes around 21 days to learn a new skill so that it becomes a habit ingrained in neuromuscular pathways.

To prepare for the marathon of labor you must practice two essential skills. Pushing and relaxation for pain management. The Tupler Technique® Perfect Pushing® DVD teaches pushing with the Tupler Technique®. The Coming Contractions CD teaches pain management through relaxation for labor.  The Maternal Fitness® book teaches you all the changes your body goes through during pregnancy and how to safely exercise with those changes.

Pain management in labor is about surrendering to the pain. This can be achieved through learning how to relax with moment to moment focus on the breath and birth visualizations. Through the process of behavior modification, if you listen to the Coming Contractions CD throughout your pregnancy, when you hear it in labor your body will relax.

Relaxation, in general, improves the immune system and calms the central nervous system. During pregnancy, it
maximizes blood flow to the uterus, placenta and fetus. During labor and delivery, it continues to optimize
blood flow to these organs and makes uterine contractions more effective.

MATERNAL FITNESS® BOOK REVIEWS

• Midwifery Today review
• Amazon reviews for Maternal Fitness®
• Journal of Woman's Health Physical Therapy, Maternal Fitness Book Review

COMING CONTRACTIONS CD REVIEWS

• Fit Pregnancy Summer 1996
• American Baby November 1994
• Midwifery Today Winter 1995

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PR  FOR  TUPLER TECHNIQUE® FOR PUSHING IN LABOR

Articles

• Fit Pregnancy Ready Set Push
• Conceive Magazine Fertile to the core
• Fit Pregnancy Exercise is Essential
• Fit Pregnancy Below the Belt
• Self September Elle Macpherson
• Womens Running The Tupler Technique®
• Prevention Abs Toners During Pregnancy
• American Fitness Birth control
• Shape Pregnancy Guide Working up to the Big Day
• Glamour Learning How to Push

TV

• The Early Show
• Maternal Fitness®

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ENDORSEMENTS

MEDICAL PROFESSIONALS ENDORSEMENTS:

“As an obstetrician/gynecologist and being pregnant for the first time, I joined Julie Tupler's Maternal Fitness class. Julie is a wonderful instructor, she is very patient, encouraging and has perfected her technique. The exercises were relatively easy to learn and they strengthened the abdominal muscles so well that each effort was maximized. I used the Tupler Technique during my labor and the results were remarkable. I pushed for only 23 minutes! I would highly recommend any woman who is facing one of the most natural, wonderful and most challenging experiences of her life to learn the Julie Tupler technique.”
Teresa Lazar, MD (OB/GYN)

"I have been working with Julie Tupler over the past twelve years. I enthusiastically refer my pregnant patients to her Maternal Fitness® Program. In my experience, her clients are well prepared mentally and physically for labor. Her regimen of abdominal exercises makes for more efficient pushing, and for a more rapid postpartum recovery."
Gae Rodke , MD (NY OB/GYN)

"I am writing in behalf of a colleague and friend, Ms Julie Tupler. I have known Ms Tupler for many years and have referred patients to her and her company, Maternal Fitness. I have received only excellent feedback both anecdotally, and of course, by witnessing firsthand, how well my patients respond in labor to her exercise and conditioning techniques. She and her staff have a great method of communicating to their clients so that the women they train feel in control of their bodies, both during and after delivery. She has helped to make a difficult and often frightening experience for many, not only manageable, but enjoyable. I can say this with absolute assurance, since I was one of her clients. Her coaching in abdominal wall strengthening and control played a large role in my wonderful delivery of Zoe Eleni. For all these reasons, I recommend her and her associates at Maternal Fitness wholeheartedly as a part of an excellent ante partum and postpartum education experience.”
Ellen Manos, M.D. (NY OB/GYN)

"An innovative and dynamic program that could be enjoyed by both pregnant and non-pregnant women alike."
Raul Artal, M.D, FACOG
(ACOG- Chair of Scientific Program/Professor and Chairman, College of Medicine, Department of Obstetrics and Gynecology, SUNY Health & Science Center)

Dear Julie,
Please accept the March of Dimes thanks for participating in the Babies and You Video
Series. This project is very important to the March of Dimes because it will allow us to provide important preconception and prenatal health information to individuals in all areas of the country. The videos will be distributed to worksites, community –based organizations and health care providers through our local chapters.
Thanks again for your support of our efforts.
Susan Clifford, Manager, Worksite Programs, March of Dimes

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CLIENT ENDORSEMENTS:

"Just a note to thank you for preparing me both physically and mentally for the “marathon of labor” as you call it. I started late in my pregnancy but the “Tupler Technique” abdominal exercises I learned for pushing and to prevent back problems really worked in labor. I don’t think Flynn could have been brought into the world with twenty minutes of pushing without them. Understanding how to push with a strengthened transverse muscle while relaxing the pelvic floor muscles gave me that mind body connection so necessary in pushing. I feel my recovery was also faster thanks to your program. I have referred and will continue to refer women to the Maternal Fitness Program."
Elle Macpherson (actress, model, mom)

“I started working with Julie Tupler and Maternal Fitness in my fifth month of pregnancy. I found that I was developing debilitating biomechanical problems: I couldn’t walk without pain, my sciatic nerve was killing me, I had trouble carrying anything that weighed more than five pounds. Furthermore, after 20 years of serious running and participation in many sports, the lack of exercise was also making me depressed. When I told my doctors about these problems, they shrugged their shoulders. I thought it would be easy for me to find an appropriate exercise program, but there really weren’t many options out there. I finally learned of Maternal Fitness from a massage therapist who specializes in pregnant women.
I began seeing Julie once a week for almost 5 months. It was a relief to get an all-body workout, to strengthen the muscles that were particularly stressed by my changing body. Julie tailored the workout to my strengths and weaknesses. At the end of every session, she would do 15 minutes of massage and relaxation. I soon found that my biomechanics were back to normal and that I could walk and go about my business without pain.
We also worked on preparing the muscles that would be most important during the actual childbirth. I worked with Julie on my transverse muscles and practiced breathing properly. When I did go into labor, the work paid off. At just over an hour, my doctor assumed that I must be too tired to continue doing three sets of ten pushes at a time. When she asked if I wanted to go down to two sets, I told her that I’d prefer t move up to four! The baby was born soon after. My doctor was impressed by how strong I was. I think the Maternal Fitness Program is an excellent combination of exercise, education and relaxation. Taking part in the program was one of the best decisions I made. I attribute my good recovery from childbirth to the fact that I maintained optimal fitness during my pregnancy."
Ellie McGrath (marathon runner)

“I have experienced Maternal Fitness both professionally and personally and find it to be an impressive and important service.
As a journalist, I interviewed Julie Tupler about her Maternal Fitness Program and featured her information on the Health and pregnancy page of Glamour Magazine. I also plan to cover other aspects of her program in future issues. As a mother to be, Julie coached me through my second pregnancy. I felt great---very strong and energetic—until the day I delivered. My obstetrician, the labor nurse as well as a medical student who observed my labor were very impressed with my labor and delivery. As the medical student remarked, “I’ve never seen a more controlled labor.” And, it’s true. Julie had prepared me both physically and psychologically for labor. Julie’s expertise as a nurse is solid and she gives women what they really need –information. And with health care reform in the wings, nurses like Julie are going to become crucial to the distribution of health care. I would recommend her Maternal Fitness program to any woman who is interested in fully participating in her own labor and delivery.”
Stephanie Young

"Dear Julie,
Thank you so much for the wonderful classes! I had a great, drug-free labor and delivery. Before the birth my doctor kept telling me ‘anything could happen” and that all the preparation in the world would not necessarily make much of a difference. Little did he know I had an amazing and powerful birth experience and I owe it to you. The transverse work kept me strong and comfortable during the pregnancy, and made pushing more productive. During the pushing phase both my doctor and nurse told me to bear down—which I did for a few pushes. However, it seemed more “natural” to do the exhalation pushing. I was able to squat for the delivery …and it made a big difference. At first I was laying back and the baby kept hovering between +1and -1. Once I started squatting the baby made significant progress in the birth canal and was born shortly after. I pushed for 45 minutes and felt great. Within a few hours after the birth I was working the transverse and doing Kegels. Everyone was amazed at how quickly I got back in shape. I was back in my jeans about three weeks after the birth. I am telling all my friends about you. Thank you and keep up the good work".
Marianna Kulak, NYC

“I just wanted to thank you for creating this program. I had a baby 3 weeks ago and it went really well because of my great transverse muscles! Last spring I took your 1 day continuing education class for professionals (which I greatly enjoyed) and last summer became pregnant. Throughout the pregnancy I continued to teach aerobics (modified) and used the Tupler Technique exercises daily (even taught them to my students, even though we weren’t doing prenatal aerobics). I worked out up until the baby was born, and even though the birth didn’t go as planned, I was able to push out my 10 pound baby boy in 12 minutes! The doc was saying “hold your breath” and I was too busy exhaling to tell her NO WAY (she stopped telling me to hold my breath when she saw how effective my pushes were.) She had settled in for a long night of labor, but the baby popped out after just a few rounds of pushes. Despite the epidural, I was still able to use the techniques I had practiced and didn’t spend hours pushing. Maternal Fitness was very helpful. Thank you so much..”
Jackie Weisberger

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COMING CONTRACTIONS CD

 “It is not easy for me to relax anyway, so learning relaxation for labor was a challenge. Using the guided relaxation on this CD, I actually learned how to calm my anxiety during pregnancy, and it really prepared me for managing the pain of labor.”  -
Susan Hold, NYC mom

“What really, really really, really helped me in labor was your Coming Contractions CD. Julie, it was hilarious. I had these giant old head phones on throughout my labor playing your CD over and over. I would cue it up so your voice talking about each contraction coincided with my own contractions. It was like you were in the delivery room with me. That CD was a godsend. Thank you for everything.”
Miranda, NYC mom

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