Because of pelvic floor physiotherapy I no longer pee when I sneeze.

You know I’m always going to keep it real with you, dearest reader! Being a life-giver has real affects on this body–we’re not robots nor elastic bands that just ‘snap back’ into place after 9+ months of growing and shifting. Remember that.

In a bit I will welcome guest writer Rabia Mirza, Registered Physiotherapist including Pelvic Floor and Certified Personal Trainer, to tell us exactly why we NEED to be caring more about our pelvic floor health. She is an expert! But first, allow me to tell you my story.

Now let me backtrack a bit here…

…I actually started going to pelvic floor physiotherapy DURING pregnancy.

That’s right! Even before the peeing-in-my-pants thing. I was having a pretty ‘normal’ pregnancy. Radical eh, seeking healthcare proactively?! I know. We’re not really taught that we can–and I’d argue should–do that! At least I wasn’t.

If you’re thinking you don’t need to see a pelvic floor physiotherapist because you don’t have symptoms… I will argue that if you have a growing baby inside your uterus–putting weight and strain on your pelvic floor because *gravity*– you should see a pelvic floor physiotherapist. And of course, it goes without saying that if you DO have symptoms…definitely make an appointment, love! Read on to hear more about this from a professional shortly.

Back in university when I was studying midwifery, I was lucky enough to have a guest lecture about the importance of pelvic floor health (and thus physiotherapy), so I was already familiar with this concept.

Seeing a pelvic floor physiotherapist during pregnancy can help on so many levels, namely the 4 P’s: Preventative, Physical exercise, Pain, and Preparation for labour.

Wow! (Source: https://westendmamas.ca/benefits-pelvic-floor-physiotherapy-pregnancy/)

Shortly Rabia will go through some of the juicy details and benefits of pelvic floor physiotherapy, and you can also visit the link above to learn more. But seeing the physiotherapist in pregnancy got me feeling in control of my present and future health, and even potential outcomes (to *some* extent!). 

Me in my ninth month of pregnancy.

 It was so empowering to proactively care for my health and well-being, with a provider who *THRIVES* off of seeing birthers be proactive.

My physiotherapist taught me how to effectively BREATHE (again: wow! I didn’t realize how much of an effect the way I breathe has on my pelvic floor health!). She also taught me how to make that breath-pelvic floor connection stronger in my body and mind. Prenatal yoga was also wonderful for this.

And you know those ‘Kegels’ that everyone talks about? Well I could trust my pelvic floor physiotherapist to teach me how to do those, EFFECTIVELY. This helped me later on in pregnancy when I did experience some of those embarrassing (but common!) symptoms like losing control of my bladder.

In my labour and birth, pelvic floor physiotherapy had prepared me and my body for what was to come.

That awesome breath-pelvic floor awareness I had built prenatally through my pelvic floor physiotherapy sessions truly helped me in labour. It taught me how to be aware of the tension I was holding in my pelvic floor, and how to release it. That ultimately played a role in helping me shorten my labour and meet my baby sooner! What a true gift.

Pelvic floor physiotherapy in the postpartum period: my experience

After the birth, there was some injury sustained to my urethra area (and I say that in the most loving way… I didn’t expect immaculate birth!). My pelvic floor and core muscles also felt very wobbly and weak. Makes sense–everything was shifted around and there was no longer a giant uterus balloon taking up a bunch of space and putting pressure on everything! Aaaaand I pushed a baby out of me.

Going back to pelvic floor physiotherapy regularly, after the first six weeks I took to heal on my own, was something I looked forward to. Again, I was taking my health seriously. Especially since our society teaches people with female reproductive organs to stay in the dark and in shame about it. 

Now, since I had been taught how to do Kegel exercises effectively PREnatally…

…They were now easier to do POSTnatally, despite things feeling rather wonky and weak down there. It would have been like trying to learn how to play tennis with a limp arm, I think! This way I had some muscle memory to help me.

My pelvic floor physiotherapist, who happens to be Rabia, also kept me very in the loop with exactly what exercises I could and should be engaging in, and how to engage the core properly during every day movements (like picking up my baby) to avoid accidental further damage (I had some abdominal separation). 

Here’s yet another benefit: improvement of sex after baby.

Yes, I said it! I noticed in the postpartum that my vaginal muscles were holding a LOT of tension, therefore causing pain upon insertion. #SorryNotSorry #AllForTheCause #KnowledgeIsPower. So that was another thing that the pelvic floor physiotherapist really helped release and work through.

Rabia really helped my core heal properly. She was so in-tune with the connective tissue and how it was very sticky and jumbled up (my interpretation). She did physical therapy to help it un-stick, and that felt so good afterwards. Additionally, she offered me acupuncture to also help with core healing.

So, my dear and lovely reader, that’s my story. What you’ve just read highlights why I am such a die-hard advocate of pelvic floor physiotherapy from pregnancy through the postpartum. 

Fun fact: Did you know that in France, pelvic floor physiotherapy is one of the cornerstones of postnatal care?

The government subsidizes it for new parents. We are waaaaay behind!! As a result, way too many people think that peeing when they sneeze is just the new normal and sacrifice you make as a parent. I say HOGWASH! And now that you’re reading this blogpost, hopefully you’ll call BS too!

So without further ado, it is my HONOUR to introduce Rabia Mirza, one of the two amazing pelvic floor physiotherapists that have cared for me in the past year. She currently works out of Upper James Physiotherapy in Hamilton, and also has a clinic space in Mississauga! Rabia is passionate about body and pelvic floor optimal health, and does great work in increasing public awareness of pelvic floor health. She is here today to talk about postpartum pelvic floor physiotherapy. Take it away, Rabia! And thank you so much for sharing your wisdom and knowledge here.

What is postpartum pelvic floor physiotherapy? 

Postpartum pelvic floor physiotherapy is a branch of physiotherapy specifically for the needs and concerns of postpartum women. And when I say postpartum women I mean moms in general, there is no time exception for what we consider postpartum!

Our role in your postpartum journey is to make sure that all your needs concerning your pelvic floor are being addressed and cared for. The pelvic floor has a role in bladder, bowel, sexual and functioning and also has implications for low back and pelvic pain.

A pelvic floor examination involves a detailed subjective history and an internal examination of the pelvic floor muscles. After the examination we develop a plan including manual internal therapy, kegel exercises, core exercises and self-management techniques for home.

What happens to the pelvic floor with pregnancy and childbirth?

The greatest changes occur at the pelvic floor during pregnancy and especially during labour. With pregnancy, the pelvic floor muscles are forced to take on more of a load with the growing baby in the uterus and the relaxation of the pelvic bones as your body prepares for childbirth. Sometimes this increased load weakens the pelvic floor muscles and you develop symptoms including pelvic pressure, groin and low back pain, and sometimes urine leakage with sneezing and coughing.  During labour, the pelvic floor muscles act as a gateway and often get injured and torn in the process. The tearing of these muscles should be thought of as a tear in any other muscle in the body, physiotherapy is required for optimal healing!

Although C-section deliveries often don’t cause tearing at the pelvic floor muscles, the accompanying scar at the lower abdomen requires optimal healing and movement. This scar has implications for pelvic and abdominal pain and often requires mobilization.

Do I need postpartum pelvic floor physiotherapy?

The short answer is YES. Even if you aren’t having any symptoms it is still imperative to make sure the pelvic floor muscles are healing optimally. It is also important to check on the pelvic floor and core muscles before returning to exercise to ensure a healthy and safe return to activity.

If you are experiencing any of the symptoms below, pelvic floor physiotherapy is for you!

• Urinary leakage (incontinence) with sneezing, coughing, laughing, jumping
• Vaginal discomfort or pressure
• Pelvic, groin, or low back pain
• Overactive bladder
• Pain with intercourse
• Pain or pressure with exercise
• Diastasis recti (ab separation)
• C-section scar

Where can I go to see a pelvic floor physiotherapist?

To book an appointment with me you can visit Upper James Physio. We offer 1 hour initial assessments and 45 minute follow-up appointments. If you’re not in the Hamilton area I would recommend searching for a Pelvic Floor Physiotherapist online. Because pelvic floor is a speciality, not all physio clinics offer this service. Take charge of your postpartum healing and book in an appointment. 

Final thoughts…

Thank you so much, Rabia, for lending your expertise!

Dear reader, we want to know: Did you know about pelvic floor physiotherapy? Have you had pelvic floor physiotherapy? How was your experience? Drop a comment below, let’s start a conversation about this important facet of health!

MUCH LOVE,
XO Naomi & Rabia

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