Why see a Pelvic Floor Physical Therapist during pregnancy?

Physical Therapy can address your concerns and provide you with education to prevent issues.

I am a huge advocate of pelvic floor physical therapy during and after birth for EVERY woman. No pain? No issues? Let’s prevent them please. Also, it’s is hard to know what is normal and what isn’t. Is peeing every half hour just part of pregnancy? (Answer: usually not) How hard should I exercise? (Answer: This depends, but generally in regards to your heart rate the surprising answer is you can do more than you did pre pregnancy if you are sedentary and less if you are a super athlete.) Providers often gently brush aside any concerns because they don’t want you to worry. A physical therapist can help you address these concerns and prevent them from becoming issues.

Seeing a therapist in the first trimester is shown to reduce pain and dysfunction later.

We know that seeing a qualified physical therapist during pregnancy is most helpful if it happens early. How early? First trimester is ideal, however I once saw someone one day before she gave birth. She came back convinced that what we did in that session allowed her to have a smooth, natural labor.

Seeing a pelvic health specialist prepares you to have a baby.

I myself was amazed at how my baby seemed to magically flip after a PT session during my second pregnancy. This could have been luck and we don’t claim to be able to flip babies, however it makes sense if we address restrictions such as loss of joint motion or tightness of the myofascial structures then the body will feel better and the baby might just have a little more space to move around. During birth, initially the pelvic bones need to open at the top of the pelvis called the pelvic inlet. Then, for the baby to come out the bones widen at what is called the pelvic outlet. These motions are the opposite of each other. Ideally for a smooth birth your body needs to have enough mobility in the tissues to allow for both openings. Exercise and manual therapy can address any immobility and prevent pregnancy related pain. As a PT, I can assess and address mobility and movement patterns that may affect labor progression or pain. Based on our findings I will educate you what to do before and during birth to assist with the baby moving down.

Therapy can give you insight on what to do for YOUR body during birth.

I not only educate you, but I can talk with your doula, support person, and birth team about specifics that may assist in labor. Many people think their nurse, doula, and/or midwife will be there, however often times they don’t know how to help or are too busy to assist you when you need it most. For example, if I noted in our sessions decreased mobility or your tendency towards a left anterior pelvic rotation I can teach you or your team positions or places to pressure during the birth itself to assist when labor doesn’t seem to be progressing. I can also teach you assists that help during different phases of labor. I incorporate techniques from spinning babies, body ready method, and personal experience to find what works for you.

Pelvic Floor Physical Therapy involves a full body assessment, hands on care, education, and exercise.

So what will physical therapy look like? PT for birth prep will usually involve a detailed assessment of posture, movement patterns, strength, tissue/joint mobility, and your pelvic floor function. Follow up sessions will involve education and treatment to address your specific needs. This may include manual therapy, exercise, and education. Manual therapy addresses ligament, pelvis, spine, and fascia mobility to decrease pain and possibly facilitate a smoother birth. Exercises will address strength, core recruitment, timing, and mobility. We will practice movements in therapy sessions that you can use during labor. This will allow you to rely on your intuition not your frontal lobe during the actual birth. Education will help you feel confident in your decisions and give you tools throughout the birthing process. The end goal will be to guide you to have the smoothest birth and recovery possible.