What is the Pelvic Floor?
The pelvic floor is a group of muscles and tissues that support your organs, support urine and stool movement, and impact sexual function. Throughout pregnancy and birth, the pelvic floor goes through a number of changes. The muscles can tighten and loosen, the tissue lengthens and the function of the pelvic floor can be compromised through the pressure it undergoes. After birth, changes in your pelvic floor may lead to complications with sex, urination, pain and discomfort. Whether you have a vaginal or cesarean birth, a pelvic floor therapist can be helpful in healing. Both tissue damage around the vagina and cesarean incisions can create complications for women.
Related: Postpartum Resource Planner
Why pelvic floor therapy?
If your shoulder or knee went through as much physical trauma as your pelvic floor does, you would likely receive a referral for physical therapy. It is totally normal to need to “retrain” your pelvic floor after the weight of bearing and birthing a child.
This is even standard care in some parts of the world. According to this article in HuffPost, For decades, the French government has subsidized “perineal re-education,” i.e., physiotherapy that helps strengthen a new mother’s pelvic floor.“This is a kind of physical therapy designed to retrain the muscles of the pelvic floor, including the vagina, and is one of the cornerstones of French postnatal care,” she (French mother and writer, Claire Lundberg) wrote.
For mothers in the US and many other countries, pelvic floor therapy is not standard care and we are often left to hear about it from a friend, a blog, etc. and find our own way. However, it is important to be able to gain confidence and comfort in the pelvic floor after birth. Some women go years without giving the pelvic floor attention and healing and then deal with things like pelvic floor prolapse even 10 years after birth or incontinence for years. While things like peeing while jumping or painful sex may be common, these are not normal and you don’t have to live with it forever. Pelvic floor therapy is designed to help you through these issues.
How to Find a Pelvic Floor Therapist
When looking for a pelvic floor therapist there are a few things you want to consider.
Do you need your therapist to take insurance or will you use private pay?
What days and hours are you able to attend an appointment?
What do you need to feel comfortable at this type of appointment (gender, personality of therapist)
Where to Look for Pelvic Floor Therapist
Maybe you already know a pelvic floor therapist or have a friend who can give you a recommendation, but if you’re starting from square one, let me help you out a bit!
I found that there are a few “databases” online where you can put in your location and look for a provider. Unfortunately, I found the results to be very limited both in number of results and ability to filter and find specialties. Pelvicguru.com and pelvicrehab.com turned up better results, but still felt quite limited.
You can try a Google search in your area. Example: Women’s Pelvic Floor Therapist Columbus, Ohio. This will likely bring up both individual therapists and offices that provide this service. Once you find options, take a look at the website and look at their services, specialties and/or staff to see if there is mention of pelvic floor and/or women’s health.
Sometimes the best information you can get is from finding recommendations from others. If you’re area has a local moms Facebook group, this can be a great place to ask for recommendations. You can also follow the #pelvicmafia on Twitter or Instagram for posts from and regarding pelvic floor specialists.
Your OB/Midwife/PCP Referrals
If you’re experiencing symptoms that lead you to seek out pelvic floor therapy, you can talk about these symptoms to your medical provider. This may be your OB/Midwife and/or your primary care provider. Many providers are not trained in pelvic floor and therefore may not have answers, but you can directly ask them to write you a referral for pelvic floor therapy.
*Note I have had some clients share that they were told there pain/discomfort/worry was “normal” and were not written a referral. Know that there is no degree to which you need to experience these things to warrant pelvic floor therapy. Remember, this is standard care in some areas of the world. If your provider doesn’t believe you need it, but you do, go with your gut and seek out a therapist.
Normalizing Pelvic Floor Therapy
While many parts of the world still do not see pelvic floor therapy as standard postpartum care, many women are speaking up about the importance of this healing. It can be awkward to talk about painful sex, peeing yourself, feeling heavy “down there” and other things that come with pelvic floor complications, but the more we speak up for ourselves and speak with one another, the less awkward it becomes and the more women know they don’t have to suffer with those issues forever.
Many providers and women see birth as the goal in a pregnant woman’s health, but truly the goal should be a supported and healed mother to take care of her new baby.