June 12, 2023

The Ultimate Guide to Prenatal Pelvic Care: How to Support Your Body During Pregnancy

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Pregnancy can be one of the most magical and transformative times in a woman’s life, but let’s face it – it can also come with a whole host of aches, pains, and discomforts. From back pain to sciatica to headaches and more, it can feel like your body is going through the ringer.

But fear not, because we’ve got a secret weapon for you: prenatal pelvic care (aka physical therapy). 

That’s right, mamas – physical therapy isn’t just for athletes or people with back injuries. 

In fact, more and more pregnant women are turning to pelvic PT to help them feel better, more comfortable, and more aligned during their pregnancies.

I only wish I had known about pelvic PT when I was pregnant. I think it could have helped me out so much, especially with my first baby who was in all kinds of wrong positioning. However, I am realizing the benefit of such care now.

But what is prenatal pelvic PT care, exactly? How does it work, and what can you expect from a session? And perhaps most importantly, is it safe for you and your growing baby?

I’ve got you covered, mama. Today I’m chatting with a pelvic physical therapist to answer all your questions!

From common misconceptions to specific treatment techniques, we’re diving deep into everything you need to know about this powerful and natural way to support your body during this incredible journey. So grab a cup of tea, sit back, and get ready to learn everything you ever wanted to know about prenatal physical therapy from one of my favorite people, Dr. Karinda Polk!

Tell us about yourself! How did you become interested in obstetric and pelvic wellness, and what drew you to this area of practice?  

I remember whenever I was in my final year of physical therapy school— we had a guest come speak about Women’s Health. At the beginning of the lecture she asked who in the class could see themselves working in this realm. I slowly raised my hand as I looked around the class and realized I was the only one holding my hand up in the air. I honestly hadn’t thought much more about it until I became pregnant with my daughter in 2019.

As an “expert” in regards to how the human body functions together, it bothered me not understanding how a growing baby factored into the equation. My body that I once felt connected to now felt foreign. I obsessively researched everything going on in my body and how to support these changes. As birth approached (in the middle of the pandemic), I felt zero support by the medical system in regards to my natural childbirth desires. Praise the Lord, I was led to a doula who saw and heard me in this season of isolation and helped advocate for me leading to and in the birth room.

Long story somewhat short: there were many things that happened in pregnancy, the birth room, and trauma to my body that are the story behind the Lord calling me to open Perfect Peace Physical Therapy. I never want anyone to feel alone or confused about changes in their body during pregnancy, labor, or postpartum. My story is simply why I do it.

Can you explain what pelvic care is and how it can benefit pregnant women?

As pelvic PT’s, we are experts in assessing the whole body and how it moves together, but furthermore, we have the unique skill set to also assess the internal components at play as it relates to supporting your body. The pelvis is the cross-section for the entire body and if something is off at this region, it can truly impact the whole body.

Pregnancy places increased demand on the pelvis and with proper assessment and intervention of the pelvic floor and connecting it to the whole body, you can have a pain-free and leak-free pregnancy.

Furthermore, it is vital to assess pelvic floor readiness as it relates to birth of your baby. We like to give the analogy of a stop light— the pelvic floor’s job during labor and delivery is to RELAX and give the “green light” to baby during labor. A non-relaxing pelvic floor giving the “red light” may cause birth complications.

What are some common pregnancy-related conditions that you treat with pelvic PT care?

• Low back, pelvic girdle, and hip pain

• Sacrum and tailbone pain

• Pelvic heaviness / pelvic organ prolapse

• Constipation

• Urinary leakage

• Diastasis Recti

• Wellness: assessing uterine ligament balance, pelvic girdle alignment, pelvic floor coordination, and strength to support body throughout pregnancy and prepare for labor

What are some common misconceptions about prenatal pelvic care, and how do you address them with your patients?

1. Pelvic floor physical therapy = kegels.

My response: It is more important to understand how the pelvic floor works in conjunction with the whole deep core system and then connecting that to the whole body for functional strengthening as opposed to isolated kegels. Furthermore, I find MANY women to have a lot of tension within their pelvic floor.

Without assessment and appropriate treatment, performing numerous kegels can actually make symptoms worse.

2. Pelvic floor therapy involves just laying on the table having internal assessments at each visit.

My response: Yes, an internal assessment is valuable and we encourage each lady to allow us to perform internal work during our sessions together; however, our number one priority is that you feel comfortable and our second priority is that we are effective.

To make you comfortable, we will give you our recommended plan for the day, but you are the one who is in control of what we actually do. In order to be effective, we must treat outside of the box.

With this being said, there are sessions you will attend where NO internal work is performed.

3. If I am not groomed or on my period, I need to reschedule my appointment.

My response: Hair and bodily fluids don’t bother us. We are in this field for a reason— we enjoy caring for you. Please do not think twice about what things look like “down there”.

4. I am not sure I can afford it.

My response: Your body is worth the investment. We will work with you to formulate a plan that works best for your budget. We have ladies that come see us weekly, some biweekly, and some monthly. Each visit, we assess where you are in relation to progress you’ve made (we should see positive trends at each visit) and we wean down frequency based upon your progress. Our job between each session is to equip your toolbox with exercises and strategies to implement so you don’t need us forever. 😉

Remember: YOU are in control of your plan of care. We are here to give you our professional recommendation.

What qualifications and certifications do you have in prenatal PT care, and how do they make you uniquely qualified to treat pregnant women?

I have my CAPP-OB through the American Physical Therapy Association (APTA) which signals I am an expert assisting women with how to support their bodies during pregnancy, during labor, and into the postpartum season. Furthermore, I have had additional basic and advanced training in the pelvic floor through the APTA and Herman & Wallace, including dry needling of the pelvic floor, which I love to use in my postpartum population.

What tips or recommendations do you have for pregnant women to help them maintain good health throughout their pregnancy?

1. Exercise is medicine! Stay active.

2. Seek out at least an initial evaluation with a pelvic floor specialist to understand how you can better support your body during pregnancy and how to prepare for labor.

3. You were not made to do it alone. Identify the people in your support team (spouse, family, friends, doula, midwife, OBGYN, chiropractor, counselor, etc.) and know when to reach out to them.

How frequently should pregnant women see a pelvic floor PT during their pregnancy, and is it necessary to continue care after giving birth?

Ideally, we recommend that our ladies do monthly check-ins with us throughout pregnancy. We certainly may recommend more or less visits depending upon how you’re presenting. In between each visit, we equip you with a home program so you don’t feel lost during the in-between.

We offer a birth prep class to prepare for labor and delivery around 36 weeks with your birth partner. We recommend being seen 2-3 weeks postpartum. At this appointment, we discuss your birth, concerns, and goals for the postpartum season. We perform an external assessment of your body (holding on an internal assessment until clearance from your birth provider) and begin working on strengthening because being a momma isn’t easy! Postpartum care entails 4-6 visits for ladies who we saw throughout pregnancy, but sometimes more if there was excessive stress on the body.

Our goal is for you to back to every single thing you desire within an appropriate timeline. Don’t buy into the lie of doing nothing for 6 weeks and then everything after 6 weeks.

Where can we find you online?

Best way to book an appointment or request a consult call is at our website: www.perfectpeacept.com. We are also present on Instagram (@perfectpeacept) and Facebook (Perfect Peace Physical Therapy).

I hope this post has left you feeling informed, empowered, and excited! Remember, pregnancy is a time to celebrate and honor your incredible body, and PT care is one of the many ways you can support it on this journey. So go forth, mamas, and keep being the amazing, powerful, and beautiful women you are – with a little extra help from a wonderful Pelvic Physical Therapist!



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