After seeing a pelvic floor physical therapist nine months after my first birth, I left the appointment wondering why I had waited so long to go. I had listened to trusted podcasts and read articles about the benefits of pelvic floor physical therapy (PT), yet when I started experiencing some of the common postpartum symptoms, I didn’t make an appointment myself.
Pelvic floor therapy can be used to help women struggling with urinary incontinence, chronic pelvic pain, painful sex, difficulty with bowel movements, and endometriosis. My main symptom was urinary incontinence—feeling like I needed to pee even when I had just gone, unintentionally peeing after (or during) a hard workout like running, or unintentionally peeing when I sneezed. Although I wasn’t peeing my pants much, it started to affect my daily life. I would go to the bathroom before relatively short car rides and make sure I didn’t drink liquids on road trips just so I wouldn’t be uncomfortable. Not a huge problem, to be sure, but it wasn’t something I had struggled with before having a baby.
When I had complained about my symptoms to older friends or family members who had had kids, most echoed a similar tune along the lines of “it’s just part of having kids.” In the true nature of the selfless women moms are, there seemed to be a martyr-likeness to it—that this was something all moms experienced but just had to deal with. Like pregnancy symptoms or the pains of birth, it seemed like most moms just believed pelvic floor problems were an unfortunate price to pay for the incredible gift of having children.
Ultimately, I decided to go to pelvic floor PT even though I was nervous because, thankfully, I had researched enough to know my symptoms weren’t normal. Sadly, many women don’t know about pelvic floor PT—so they falsely assume their postnatal problems are there for good. I didn’t know much at the time about pelvic floor PT, but I knew enough to know that what I was experiencing didn’t have to be that way. I wasn’t going to let my fear of a little awkwardness keep it that way.
To my surprise, my experience wasn’t the awkward encounter I had thought it would be. In fact, I gained so many benefits from pelvic floor PT that I began telling all my friends about it and encouraging others to go too. It helped me so much that I wish I had gone sooner. Now that I’ve had two babies and gone to pelvic floor PT postpartum and prenatal, there are a few things I wish I could tell my pre-PT self.
01. It’s not as awkward as I imagined.
I was so nervous before my appointment. I’m actually quite a modest, private person—certainly not someone who I imagined would be writing an article like this. I’m someone who imagined having another woman checking out my lady parts could not not be awkward.
But my physical therapist was incredibly professional. It didn’t seem awkward—almost like this was her job or something. I left my first appointment wondering why I had put this off for nine months for fear of it being awkward.
02. Not all pelvic floor problems can be solved by doing Kegels.
When I started experiencing pelvic floor dysfunction (my urinary incontinence) I just assumed I needed to strengthen my pelvic floor—i.e. do more Kegel exercises. As someone who worked out through my entire pregnancy and even focused specifically on pelvic floor strengthening, I thought I could heal my own issues by doing more of those exercises. I even considered buying an online postnatal pelvic floor-targeted workout program that promises results rather than investing the money in physical therapy. I thought I just needed to work harder.
So, you can imagine I was surprised—and really glad I went to in-person physical therapy—when on the first day my physical therapist told me I needed to relax my pelvic floor. My “homework” was taking deep, diaphragmatic breaths every day to help relax my pelvic floor. It turns out, my urinary problems were due to my hypertonic pelvic floor—basically that the pelvic floor muscle was already contracted, so it couldn’t flex even harder to help with bladder control. Kegels would only have made my problem worse at the time, and I wouldn’t have known that had I not gone to PT.
03. You might see improvement right away!
I was surprised and relieved (no pun intended) to learn that I saw immediate improvement after getting pelvic floor therapy. I almost couldn’t believe it—it seemed too simple that I might see improvement from a diagnostic appointment and doing deep breathing exercises. This was especially shocking considering I had previously had a mindset that this was a part of postpartum life and that these issues wouldn’t improve much even with PT.
After my second birth, I went to PT proactively and preventatively at seven weeks postpartum. Everything seemed to be going well and I wasn’t experiencing the symptoms I had after my first baby. So I was a bit taken aback when a few weeks later (while still going to weekly PT!) I felt pelvic floor heaviness. When I told my pelvic floor therapist about this, again, she got to the bottom of it quickly: the waistband of the jeans I had started wearing in the last few days was too tight. Just like that, I stopped wearing those jeans and my issue cleared up!
It’s no wonder pelvic floor therapists go through so much schooling to become so skilled at detecting what the problem might be and finding a plausible solution. They can diagnose a problem and, in some cases, suggest a solution that works immediately!
04. Your physical therapist can work with what you have.
I told my physical therapist I needed to minimize cost since PT wasn’t included in my insurance coverage. By being upfront with her about what I could afford, she recommended I attend PT once a week for the first few weeks, then drop to once a month. For my specific pelvic floor issues and situation, she said it would benefit me to come to PT less frequently over a longer course of time rather than to go a couple of times a week for a few weeks then not at all. If you’re worried that PT might cost too much, talk to your pelvic floor therapist (or a potential pelvic floor therapist) about possible options and solutions for treatment planning.
05. If you don’t find a good fit for pelvic floor therapy, keep looking.
Unfortunately, not all my friends have had the same experience. Like finding a therapist, you might need to do some shopping around for a pelvic floor therapist you like and feel comfortable with. Ask around with friends who have children, and ask a provider you trust if they have any recommendations. I was lucky enough that my midwife (whom I love) referred me to someone who was an immediate match.
Whatever your condition of pelvic discomfort, if you suspect pelvic floor therapy could help you, I would encourage you to seek out a specialist in your area as soon as you’re able. As I learned from personal experience, there is no good reason to delay taking good care of yourself.