COMMONLY ASKED QUESTIONS
"I'm pregnant. Can I still see a pelvic therapist?"
Pelvic therapy can be helpful for women during and after pregnancy. During pregnancy, the weight of the growing baby and hormonal changes can put extra strain on the pelvic floor muscles. This can lead to a variety of problems, including:
Urinary incontinence
Fecal incontinence
Pelvic pain
Painful sex
Low back pain
Difficulty performing usual activities (e.g., exercise, work, playing with other kids, housework)
Occupation-based pelvic therapy can help people participate in meaningful activities and perform roles optimally despite pelvic symptoms or physical limitations. Pelvic therapy can promote and maintain the strength and range of motion of the pelvic floor muscles and improve core activation and stability. It can reduce pain and improve the function of the pelvic and trunk structures, including posture, breathing, and body mechanics. Pelvic therapy can help to prepare the body for labor and delivery. Occupation-based pelvic therapy can facilitate the creation of healthy habits and the prevention of unnecessary complications during pregnancy and postpartum- a time of immense changes physically, emotionally, and socially.
After pregnancy, pelvic therapy can help with a variety of postpartum problems, including:
Urinary incontinence
Fecal incontinence
Pelvic organ prolapse (POP)
Pelvic pain
Painful sex
Diastasis recti (ab separation)
Low back pain
Difficulty performing usual activities (e.g., exercise, work, playing with other kids, housework)
"When should I start pelvic therapy?"
Pelvic therapy can be started at any time during or after pregnancy. However, many women find it most helpful to start during the second trimester of pregnancy. This is when the pelvic structures start to lengthen and stretch, and forces increase on the body due to the weight of the growing baby.
An emerging area in healthcare, some hospitals are now offering pelvic therapy immediately postpartum for physical rehabilitation. Many therapeutic exercises and techniques are immediately safe and effective with the supervision of a skilled occupational therapist. However, nothing should be inserted in the vagina for at least six weeks postpartum, or until the obstetric provider has cleared vaginal penetration at the follow-up visit after birth.
"I'm a mom. Isn't it normal to pee when I sneeze or cough?"
To make informed choices, women must be knowledgeable about their bodies and have access to evidence-based healthcare options. Many women believe that pelvic floor dysfunction is normal with childbearing and aging. These same women are told to do Kegel exercises, but many are unsure whether they are doing them correctly or not. They avoid activities they used to enjoy, like certain types of exercise or jumping on the trampoline with their kids. They rely on wearing pads in their underwear that are uncomfortable and increase the risks of infection. While these issues are common among mothers and older women, they should not be expected or accepted without appropriate education and training. It is never too early or too late to start pelvic therapy. If you’ve never been pregnant, plan to become pregnant, are pregnant or have ever been pregnant, pelvic therapy may be exactly what your body needs to function optimally.
"What happens during a pelvic therapy session?"
During your first pelvic therapy session, your therapist will perform a comprehensive evaluation. This will include written questionnaires and a face-to-face interview to review your symptoms, review your medical history, discuss your previous and current roles and activities, review current medications, and conduct a physical examination such as a posture assessment, muscle testing, and performance analysis.
When appropriate, and with your consent, your therapist may want to complete an internal assessment of your pelvic floor muscles. An internal assessment of the pelvic floor muscles involves the client lying on a table and the therapist inserting one gloved finger into the vagina or anus while having the client complete different types of pelvic floor exercises such as contract/relax, contract and hold, quick flicks, etc. The therapist uses their gloved finger to feel
for tissue abnormalities and to palpate tissue health at rest and with activation. If an internal assessment is indicated, your therapist will talk to you about the purpose of this test, exactly how it will be conducted, and when it will be scheduled. A skilled pelvic therapist will never expect you to complete an internal assessment on your first visit without prior explanation and consent. Remember, you can always refuse, stop, or change your mind about the internal assessment if it makes you uncomfortable or you aren’t ready to do it.
After evaluation and assessment, the pelvic therapist will develop a treatment plan based on your individual needs. Treatment may include:
Education
Cognitive-behavioral therapy
Habit training
Therapeutic exercise
Manual therapy
Equipment recommendations, including binders and compression wear
For patients needing biofeedback and electrical stimulation, these treatments are not yet offered at Maternal Health: Therapy & Wellness, LLC. If you need advice about who does offer these treatments, talk to Christy and your medical provider for a list of options.
"How long will it take me to see results and get better?"
The duration of pelvic therapy will vary depending on your individual needs and symptoms. Many women benefit from as little as six sessions. However, some women may need more or less sessions.
"Is pelvic floor therapy covered by insurance?"
Most insurance plans cover pelvic floor therapy with a doctor's referral. However, it is important to check with your insurance company to confirm your coverage. Unfortunately, Maternal Health: Therapy & Wellness, LLC does not accept insurance. If you want to use your insurance, you must see a different pelvic therapist. If you need advice on who to see, talk to Christy and your medical provider for a list of options.
If you have more questions don't hesitate to reach out to Christy today at info@maternaltherapywellness.com or 812-870-1704.
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