Tldr; 

Coming to see a pelvic floor therapist is important so you have:

• Rapport with a provider and a place you trust to return to after delivery
• A better understanding of the pelvic floor and its role in delivery
• The knowledge and skills to prevent stalls as you move through the delivery process
• A provider to help you navigate any aches or pains that arise

In the rehabilitation medicine world we think of treatment in two camps: proactive & reactive. With proactive care, patients are seen prior to any symptoms or issues popping up, as where reactive care is in response to the onset of pain or other pelvic floor issues. 

Regardless of whether you are coming for proactive or reactive care, establishing care with a provider before you deliver is the most ideal!

In my almost 13 years of treating, I have noticed a trend of patients who come in after delivery and state either A) they wish they knew more about pelvic therapy before delivering or B) they wish I knew what their pelvic floor felt like before they delivered to know if the issues they are having were there before or came from delivery.

With my patients who did see us before they delivered, they tell us that coming back after delivery is like coming back to tell a friend all about how things went. 

While we are working towards the best possible outcomes, we are the provider to hold space as you share the tough parts of the delivery process. Pelvic floor therapy is already such a vulnerable time, it is helpful to have good rapport with your therapist when sharing about your delivery journey. 

Having to meet someone for the very first time during your postpartum phase can feel like a lot - mentally, emotionally, and physically. (And if you are reading this and didn’t find pelvic floor therapy until after delivery that is OKAY! We will still make space and work to ensure you feel as safe and supported as possible to share as we build rapport with you!)

So what do we work on during pregnancy? Let’s break this into proactive and reactive care since we already laid that foundation.

Proactive Care

When patients come to Pelvic Pride without any pain or symptoms, we will use our evaluation time to establish their baseline. This means a full medical history, review of current movement routine and delivery goals, as well as a hands-on assessment to look at pelvic floor muscles for tension, tenderness, weakness, or difficulty coordinating. We also check for signs of prolapse, look at breathing mechanics, and test your range of motion, strength, and flexibility of your abdominals, low back, hips, lower extremities. 

Treatment will include addressing any significant findings and working through our intentionally designed push prep to ensure you are ready for each phase of labor and delivery. We make sure to cover perineal massage, how to breathe, and how to push - regardless of if you are having an unmedicated or medicated birth. We will review movement techniques to prevent delivery stalls and discuss the recovery expectations for delivery after c-section so you are well prepared. 

Reactive Care

It is not uncommon for pregnant patients to experience pubic symphysis pain, sacroiliac (SI) joint pain, pelvic floor pain, pressure, or heaviness, and low back pain. 

With reactive care we will assess and address any aches or pains you are experiencing while providing you the treatment and skills to manage your symptoms. We will also discuss the use of supportive devices like an SIJ belt or belly band, how taping can help with diastasis recti, and the importance of managing intraabdominal pressure if you are experiencing pelvic floor heaviness or pressure. 

Each treatment will be aimed at helping you become as pain/symptom-free as possible and maintain the movement level you would like to have throughout pregnancy. We will also work through everything laid out in the proactive section above but through the lens of understanding the challenges you have had during pregnancy so far. 

In both proactive and reactive care, we will make sure you have a thorough understanding of the pelvic floor’s role during pregnancy and delivery. This helps to dispel the myth that you don’t need pelvic floor therapy if you deliver via cesarean or if you aren’t having any pain or leakage.

In the end, our goal at Pelvic Pride is to make sure you feel seen, heard, and empowered & leave our clinic with the tools you need to rock your delivery! We will be here to help you out on the other side! 

Looking for treatment for pregnancy in Maryland?

At Pelvic Pride Physical Therapy & Wellness, we are THE clinical experts at working with pregnant patients whether you are dealing with pelvic floor issues or just want to come in and establish your baseline, so you are in the right place!

We are conveniently located in the Federal Hill & Roland Park neighborhoods in Baltimore MD. Fill out our contact form & our Patient Care Specialist will reach out to you ASAP!

Next on Your Reading List

• What Causes Diastasis Recti in Pregnancy?
• Postpartum: When Should I See A Pelvic Floor Physical Therapist?
• Okay, But Like Really, How Awkward is Pelvic Floor Therapy?