Birth Through the Pelvic Floor: A Pelvic Physical Therapist Perspective
Written by Dr. Betty DeLass, PT, DPT
Birth is a physically demanding activity. Period.
You need to mentally, emotionally, spiritually and physically train for it. It is one of the most taxing athletic events of your life… and many of us do it multiple times!
Personally, I have completed marathons and ironmans and let me tell you, giving birth is just as hard, if not harder, than doing these things!
(This statement is not meant to scare or frighten, but rather put into perspective the demand that labor and delivery has on the body).
As a pelvic PT, I went into pregnancy and labor/delivery with an intentional mindset. I was training for another athletic event. I read up on all the books. I took childbirth education classes (actually every single one that was offered… yes, nerd alert!) I learned how to do a perineal massage on myself. I practiced deep squats and breathing. I exercised, stretched and did prenatal yoga. I practiced mindfulness and coping strategies. I was training for pregnancy, birth and postpartum recovery.
Let me tell you… whoa, that it was quite the event when it actually decided to happen! (With my first I was a week and a day overdue! And it felt like I was waiting forever to go into labor).
I remember waking up in the middle of the night thinking… hmmm…. pretty sure these are contractions. Woke my husband up, got up and started laboring at home on my exercise ball and turned on my Jesus music. A few minutes later, I told my husband that I think we should go to the hospital, things were kinda getting intense… and then, I immediately threw up…
Yep, definitely time to go!
We arrived at the hospital after the longest car ride of my life as contractions increased in intensity with shorter intervals in between. I was thrilled to find out that I was 7 cm dilated. Sweet! I can do this! So I thought.
An hour went by…
Then another…
And another…
Until I was exhausted…
This is so hard. This is the hardest thing I have ever done. I am so tired. NO I AM BEYOND EXHAUSTED. I can’t do this anymore. I quit.
Then….
Finally…
After 14.5 hours of laboring… SHE WAS HERE!!
In the blink of an eye, my exhausted body forgot all the sweat, tears, pain, perseverance and hard work the second she was placed on my chest. Similar to crossing the finish line of a marathon or ironman.
Joy, and sheer exhaustion raged through me.
Thankfully, my second daughter was a tad bit faster with a 3.5 hour labor. So, I wasn’t quite as exhausted. H
owever, my pelvic floor was not as happy the second time around with how fast she came out! Let’s just say my second left a bigger mark on my pelvic floor from a rehab perspective.
Postpartum recovery was hard. Where is my body in space… Abs… what are those? Oh no... I have a mom-butt (pancake buns)… Did I just pee myself? Am I ever going to sleep again?
I cannot believe we just let moms go home and tell them at 6 weeks they are “cleared.” I need to change the world…we can do so much better, we can prepare better, we can birth better, we can recover and rehab better.
I am going to change the world one vagina at a time.
Going through two unmedicated vaginal deliveries myself was the catalyst to Reborn Pelvic Health & Wellness changing the standard of care before, during, after and beyond birth.
A pelvic revolution has started. Let’s dive in a little more.
Being pregnant and giving birth (regardless of medication, no medication, vaginal delivery, or c-section, hospital, birth center or home birth) is one of the biggest changes that will ever happen to a person’s body.
Your rib cage expands. Your abdominal muscles get stretched. Your hips widen. Your pelvic floor supports a bowling ball of a human GROWING INSIDE OF YOUR UTERUS!!
Any underlying sub-clinical dysfunction that may have been going on gets exposed with a magnifying glass while pregnant.
You get stripped down to skin and bones postpartum and have to rebuild strength, coordination and endurance.
Recovery after delivery takes time. Period. It’s THE NUMBER ONE BIGGEST change in your body. BIGGER than SURGERY!
During a vaginal delivery, the muscles in your pelvic floor stretch 3.5 times their length. There are no other muscles in the body that do that. During a c-section there are more than 7 layers that are surgically cut and sewn back together. These are both major musculoskeletal events.
Meanwhile, you still have to pee and poop, take care of the baby and many other tasks all while recovering. For all other major musculoskeletal surgeries or injuries like knee surgery or shoulder surgery you start rehab immediately and continue for months and months. Additionally, you can use crutches or a sling to let it recover. With birth your bowels and bladder still work daily and don’t get a true ‘rest.’
Most people after giving birth do nothing. They wait until 6 weeks postpartum to be “cleared.” Then, try to resume activity, running, lifting and intercourse.
THIS IS NOT OK! THIS IS NOT THE STANDARD OF CARE! THIS IS GARBAGE CARE!
How have we at Reborn Pelvic Health & Wellness changed the standard of care?
We see our patients before, during and after pregnancy. We set you up for success from the get go. We teach you how to stay strong and mobile during pregnancy. We keep the common (but not normal) aches and pains away. We help you prepare for birth so that you can have the best chance of success at a smooth and safe labor and delivery.
We teach you how to use your hips and pelvis to your advantage during labor. We teach you how to do perineal stretching. We teach you how to get your pelvic floor to lengthen and get out of the way. We optimize the pelvis to allow for a vaginal delivery or a VBAC (vaginal delivery after c-section) by addressing limitations in your body. Planning for a c-section, no worries, we help with that too!
Then postpartum, we help you get your rib cage and pelvis back into position. We get your core and pelvic floor back ‘on-line’ and activating properly to support your body’s movements. We retrain movement patterns so you can lift a car seat and give your kids a bath without low back pain.
We make sure your pants stay dry even when you cough, sneeze, jump or run. We address any scar tissue sensitivity, pain, adhesions or restrictions. We make sure you can have intercourse without pain. We fundamentally and progressively load and exercise so that you can return to the activity that you love to do without pain, fear, or embarrassment.
We provide true pre-hab, prep, and rehab during the biggest musculoskeletal change of your life.
This is the pelvic revolution. This is standard of care. This is becoming Reborn.
We love to set our patients up for success throughout this process by teaching them about their bodies. We want you to be the experts of your own body from the inside out. If you are interested in optimizing your pregnancy, birth and/or postpartum journey be sure to reach out. Remember it is never too late to start! There is always room to improve and optimize :)
You can find us and contact us at www.rebornphw.com or call us at 801-216-3117.
