Pelvic Floor Physical Therapy in Pregnancy

Babies and Bumps

October 29, 2023

I started Babies & Bumps in 2013, but the first time we partnered with a pelvic floor physical therapist was three years later when we expanded to Buffalo. Truth be told, I’d never heard of pelvic floor PT before this provider reached out to me. And like so many discoveries I’ve made through my work with B&B and my own experiences with my two babies, I was astounded by the fact that these health care professionals existed, that my doctors didn’t make me aware of them, and that there are so many potential benefits to working with one.

Fast forward another seven years, and I’m delighted to share that we typically have at least one pelvic floor physical therapist (and sometimes more!) at every Babies & Bumps event we host. We also partner with them to host seminars and demonstrations, so you can learn more about the pelvic floor, therapy, and things you can do for yourself at home to support your pelvic floor health.

I realize some of the issues related to the pelvic floor may be embarrassing to talk about. But trust me, these folks are doing what they do because they’re passionate about helping people. They’ve seen it all, and understand that it can be a lot for some patients to muster up the courage to talk about very personal topics – for instance, pain during intercourse or incontinence. They’ll create a safe and judgement-free space to help you gain an understanding of what you’re experiencing and collaboratively help you manage pain, discomfort, and other issues.

One of the things I’ve noticed lately is that when people are having these conversations, they tend to be more reactive and focused on addressing issues during postpartum recovery (or beyond) that resulted from pregnancy or birth. I certainly don’t want to discount the importance of this kind of care and support! But I also want to make sure we’re having a conversation about how we can be proactive, potentially preventing some of these issues from happening in the first place.

I spoke with Dr. Rachael Elizabeth Miller PT, DPT, WHC, PCES, who specializes in serving pregnant and postpartum mamas in Detroit, to get a better understanding of some of the benefits of pelvic floor physical therapy. Her goal with all of her prenatal patients, is to help them be strong and feel their best as their body is going through all-the-changes during pregnancy, birth, and postpartum recovery.

Just in case you’re like I was back in 2013 and need to get up to speed on what the pelvic floor is, here’s a run-down for you. It’s a powerful layer of muscles that sit like a hammock at the base of your pelvis, supporting your uterus, bladder, and bowel. It plays a crucial role in pregnancy and birth, helping to maintain the position of your growing uterus and to assist during the birth of your baby. A strong and flexible pelvic floor also aids in preventing issues like incontinence and pelvic organ prolapse during and after pregnancy.

Pelvic floor PT can involve all sorts of modalities, including exercise, biofeedback, and electrical stimulation, as well as manual therapy, which involves gentle internal and external techniques. And, Dr. Rachel adds, “treatment plans are tailored to meet each individual’s needs and comfort levels.”

Here are some examples of pain, discomfort, and other changes that can be alleviated or managed during pregnancy by working with a pelvic floor physical therapist like Dr. Rachael.

  • Pelvic pain: discomfort or pain in the pelvic region due to your growing uterus and hormonal changes. Pelvic floor PT can help manage and reduce this pain through targeted exercises and stretches.
  • Lower back pain: common in pregnancy due to additional weight and a shift in your center of gravity. Therapy can help in improving posture and relieving back pain.
  • Urinary incontinence: hormonal changes and increased pressure on the bladder can lead to involuntary urine leakage. Strengthening the pelvic floor muscles can help manage this issue.
  • Pelvic girdle pain: pain due to the misalignment or stiffness of pelvic joints. Therapy can assist in realigning and improving the flexibility of these joints.
  • Mobility changes: due to the loosening of ligaments. Stability exercises and other personalized techniques can help to enhance flexibility and movement and reduce discomfort.
  • Diastasis recti: a condition where the abdominal muscles separate during pregnancy. Therapists can provide exercises to help manage and minimize this separation.
  • Postural changes: as baby grows, postural changes are common, which can lead to discomfort. Therapy can help you maintain optimal posture and alignment to reduce stress on the pelvic area.

It’s worth noting that working with a pelvic floor PT before some of these issues start presenting themselves is a worthwhile investment! If that seems like too much for you, I suggest looking around for a reputable PT, checking your insurance coverage, getting established as a new patient, and having your first appointment to make sure you click with the provider, feel comfortable in their space, and are confident you’re being heard. That way, if you decide that you would benefit from this kind of care, all you have to do is schedule an appointment.

Another aspect of pelvic floor PT during pregnancy that can be beneficial is preparation for birth – both with exercises and education. Dr. Rachael’s goal is to give mamas the tools and skills they need to feel empowered and protect their pelvic floor during birth. Birth preparation can include learning how to use different positions and movements, and safely teaching pelvic floor muscle massage, as well as education on push and breathing strategies, comfort measures, and mindfulness strategies. When you’re searching for a pelvic floor physical therapist, be sure to ask if they offer services related to birth preparation.

Establishing a relationship with a pelvic floor PT during pregnancy can also make it easier for you to take a proactive approach to your postpartum recovery. I suggest asking about recommendations for a postpartum treatment plan and getting those on the calendar as soon as baby arrives.

If you’re in the Detroit metro area and are interested in Dr. Rachel and her services, you can learn more by visiting her website or following her on Instagram.

Founder & President, Babies & Bumps

Monica Infante

Monica founded Babies & Bumps in 2013 to inform and empower new and soon-to-be parents. Over the past decade, B&B’s footprint has grown to include 13 cities – today, she and her team plan, promote, and produce more in-person maternity events than any other series in the U.S. Babies & Bumps also offers digital resources and hosts online events throughout the year to serve parents everywhere. She lives in Rochester, NY with her husband and two children.

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