Pelvic Health Check In: A Must Do During Pregnancy

This month’s blog is written by Practically Perfect Physical Therapy’s newest hire, Dr. Emily Fitzpatrick. Emily has her Doctorate in Physical Therapy from Stockton University.

While at Stockton University, she completed clinical experience under the guidance of Dr. Mora Pluchino, who sparked her passion for pelvic rehabilitation and pediatrics. She is currently pursuing her Pelvic Rehabilitation Practitioners Certification through the Herman and Wallace Pelvic Rehabilitation Institute.

As a former collegiate athlete and avid yogi, she understands the importance of balancing life while honoring your body’s needs. Emily prides herself in creating an environment which fosters a holistic, patient-centered, safe environment for healing. She values your personal goals and honors your comfort zone. Emily will work with you to craft an individualized plan of care which best addresses your therapeutic needs.

Emily is mother to her baby daughter, born in August 2022, and is currently transitioning back into her professional PT career! She has worked in pelvic health, acute care, and pediatrics. She is also a certified Yin yoga instructor. In addition, she teaches yoga and Mommy + Me workout classes for places local to the community. Emily is excited to join the Practically Perfect team!

Fun Facts about Emily:

*She and her husband have a bullmastiff/lab rescue, Louie who is their biggest baby

*She was the goalie for the Stockton University Field Hockey team in college, Go Ospreys!

*She is a beach person no matter the season

Emily treats at Practically Perfect Physical Therapy two evenings a week to accommodate those who need after work or after school hours. She also treats all day on Fridays. She feels comfortable treating most diagnoses, and treats all ages and genders, but her love is the pregnancy and postpartum time frame of a person’s life. 

Emily shares with us….

Pelvic Floor Physical Therapy: A “Must Do” in Pregnancy

Pregnancy comes with an array of “dos” and “don’t’s,” which can be extremely overwhelming, but trust me on this: a MUST DO is pelvic floor physical therapy. 

I have always felt passionate about prenatal care, and during my pregnancy I realized how lucky I was to have the knowledge I did as a pelvic health physical therapist. It is sad to say, but the reason I felt so lucky to have this knowledge is because while navigating the healthcare system during my pregnancy, I saw first hand how many gaps in care there can be. I am here to say that working with a pelvic health physical therapist can bridge SO many of those gaps. 

So, really, why is this such a “must do?” The simple answer is your body is changing, and learning the ins and outs of this evolution will make all the difference as you grow and birth your baby. 

As your body grows an entire human being, a lot can happen to your body. Yes, I know this might seem obvious, but did you know that you do not need to become just a witness to these changes? Instead you can become an active participant.

While I was pregnant, I had pain with sex. Sadly, my provider, whom I had felt well cared for by, simply told me, “It will probably get better after you have the baby.” Why would I wait patiently and suffer for 9 months on “probably”? The fact of the matter is, I know this is not her area of expertise, but I am so lucky it was mine. So I was thankful the mask on my face hid my shock and simply requested a script for Pelvic Floor Physical Therapy Evaluation and Treatment. 

I left thinking about all the others that walked into her office looking for a solution and walked out waiting on a “probably.” So if you are reading this and you, or the pregnant person you know, is waiting for their 9 months to be up for X,Y and/or Z to get better, PLEASE stop waiting and get help from a pelvic health therapist. 

Unfortunately, this can be the world around us. Maybe our family and friends and sometimes even our health care providers tend to respond to complaints of pregnancy with, “That’s pregnancy for you.” But it really does not have to be. If you are feeling uncomfortable, having pain, experiencing urinary incontinence or constipation (and many many more things), pelvic floor physical therapy can help with that! And yep, it is as easy as simply requesting a referral to get help. 

I, a pelvic health PT myself, felt the benefits of physical therapy first hand. I am thankful for my time spent in therapy with Dr. Mora because we navigated so many things together: pain, sex, exercise, swelling, and most of all she helped me build confidence in myself and my body at every stage.

The beauty of seeing a pelvic health physical therapist is that pregnancy is our wheelhouse. Sometimes when navigating the health system, practitioners may hold back on treatments or simply do not treat pregnant people because of lack of knowledge or experience with this unique patient population. But now you know exactly who to see. We have the knowledge and clinical expertise to work with you in any and all stages of pregnancy (and beyond)!

Are you reading this thinking, “My pregnancy is going well and therefore I would not benefit from seeing a therapist”? We are here to tell you that it can still be beneficial for you regardless of how well your pregnancy feels! Everyone at Practically Perfect STRONGLY believes that pelvic floor care is necessary during pregnancy, during the birth preparation process, and in the postpartum period, whether that is days after delivery to months or years after giving birth. It is never too early and never too late. The goals and work may just be different!

Remember when I talked about being an active participant in your pregnancy?

A pelvic health therapist can guide you through each stage of pregnancy, supporting not just you but your pelvic floor, too. From navigating safe exercise adjustments to learning how best to get into and out of bed, strengthening your pelvic floor (and other muscles, too!) to prepare for birth and postpartum, we have got you covered. 

So do this for yourself, and that baby growing inside as well! Dr. Mora always quotes the phrase, “Self care is not selfish; you cannot pour from an empty cup!” In order to be the best parent to the baby you are bringing into the world, taking care of things like your bowel, bladder, sexual, physical and emotional health can help you do this!

What can pelvic floor therapists help with during pregnancy and postpartum?

The list goes on and on, but here are a few of my favorite things:

-Safe exercise – Moving during your pregnancy if you were an avid exerciser OR if you would like to start a new routine

-Aches and pains – Pregnancy comes with growing and body changes, and can be uncomfortable, but therapy can help manage this. Just because these things are common does not mean we have to accept them as normal, AND we can make them better!

-Functional mobility and posture – Pregnancy changes a body every single day, and having someone help you manage these changes can be invaluable 

-Addressing incontinence – No one should leak pee ever. Let us help you get control!

-Relieving constipation – Pooping should be easy. If it is not, we can help you! This will make your pregnancy and postpartum recovery much more comfortable. 

-Navigating sex – Sex should never be painful, and should be comfortable AND pleasurable. 

-Prepping for labor and delivery – We offer a specialized class with in person and virtual options to make sure this important education is accessible to all! 

-Preparing for the postpartum body – Birthing a baby changes your body. Knowing what to expect and how to heal your body, and having a guide for this process can help you to feel supported and empowered during this transition phase of life. 

– Lactation support – physical therapists are qualified soft tissue/body work providers. They  can perform ultrasound treatment. They can help to monitor and break up clogged ducts related to breastfeeding or pumping. This will  potentially avoid antibiotics for mastitis (in coordination with your medical provider). 

A few notes from Mora: 

Pelvic health therapists are most often physical and occupational therapists. Both professionals can be very qualified and helpful in different ways. You can use provider finders like this one to research a provider who will feel like a great fit for you! As much as we would love to help you through Practically Perfect Physical Therapy with an in person or virtual visit, we really just want care to be accessible to everyone, and want you to find the best fitting provider for your needs! Check with your insurance and your state, because many states have “script free” PT (and also, not all insurances require a referral)!

We would love to invite you to our next birthing class offering. It is called “Preparing for Your Birth Story,” and there will be an in-person offering on Sunday, April 16th at 10am at Zen Landing Yoga. If you cannot make any of the in person dates, which are typically offered every 2 – 3 months, we also have a fully virtual, recorded option available here. These classes are for birthing parents, and  the birthing person and their support person to attend together. It is an informative, interactive workshop designed to help expecting parents to prepare for the labor, delivery, and the postpartum period for upcoming babies at their own pace. 

The topics reviewed as listed below. 

• Pelvic Anatomy 101
• Perineal Massage
• Signs and Stages of Labor
• What to Expect when Arriving to Deliver
• Labor Activities and Positions
• Comfort Measures
• Possible Complications
• Hospital Bag Prep
• Postpartum Care
• Perinatal Feelings

Still not sure if you need pelvic floor therapy in your life with your pregnancy? Here are some questions to help you decide. If you answer any of these as yes, it is probably worth booking a session. Keep in mind, even if you had these things prior to pregnancy, you should still consider a visit. 

Should I book a pelvic floor evaluation during pregnancy?

• I have pain during pregnancy OR pain that I had prior (hip, back, knee, etc) has continued and/or gotten worse during my pregnancy
• I have urine leakage or the feeling I might leak urine
• I cannot control my gas 
• I have urgency related to peeing or pooping – it frequently feels like I might not make it
• I cannot poop, I have hemorrhoids and/or I have really hard stools 
• I have pain with sex
• I do not enjoy sex as much as prior to pregnancy
• I have “sciatica” or “round ligament” pain
• One-sided movement like stairs, getting in or out of the car, rolling over in bed, or putting on shoes/pants are painful 
• I am set on a specific type of birth experience – example – vaginal delivery, unmedicated, home birth, etc.
• My abdominal muscles “dome” or “cone” when I move or exercise
• My tailbone hurts
• I cannot do the activities I did prior to my pregnancy (including but not limited to: my exercise routine, job requirements, child care, pet care, household activities, leisure activities) 

We are always here to help guide you through your registration, evaluation, and treatment processes. Practically Perfect Physical Therapy strives to have an “at home” feel where you can come to sessions with a skilled provider knowing we will be working to help you feel practically perfect in your own body! Reach out to us for questions. We are here for you at any stage of life, but in relation to this blog, we are happy to help at any stage in the game, from pre-conception, pregnancy, birth prep, labor, delivery and postpartum recovery!

Perfectly Yours,

Dr. Emily and Dr. Mora