Pregnancy is an incredible journey. As you settle into all the changes happening inside you, so many questions can come up! While Dr Google can sometimes help, especially when looking up, “Is X normal in pregnancy?”, the questions that come up around pregnancy and birth can be overwhelming and confusing. Some common questions I hear from my patients are..
What kind of exercises are safe for me to do?
Can I actually prevent tearing?
Do I have that ab separation thing? (Diastasis Recti)
What is my pelvic floor and how do I know if it’s doing what it should?
How do I push??
What can I realistically expect postpartum?
I LOVE getting these questions. As a medical provider, I truly believe education is empowerment. In the case of pregnancy, birth and postpartum, this couldn’t be more true. The more we know about our bodies, what changes may happen along the way, what birth may look like, and what to expect in those early days postpartum, the better prepared we can be to handle them head on.
How can Pelvic Floor PT help me in pregnancy and into birth?
Help you connect with your abdominals and pelvic floor muscles as they take on more load
Your pelvic floor and abdominals take on a lot of changes during pregnancy. Keeping them strong and mobile can make sure they stay healthy. This can prevent things like diastasis recti (abdominal separation) and pelvic floor dysfunction (leakage or prolapse) into the postpartum period.
Optimize pelvic mobility and symmetry
Everyone has postural tendencies and asymmetries- it’s human! Working on your specific asymmetries can help to optimize the pelvic outlet for birth and help to prevent aches and pains from creeping in.
Reduce the “normalized” aches and pains of pregnancy
So many aches and pains become “normalized” in pregnancy. From sciatica, to SI joint pain, to pubic symphysis pain- these can all be either reduced or prevented with physical therapy. Oftentimes, pains come about when there is an instability or weakness happening in the pelvis. Pregnancy can highlight these issues, but addressing the underlying problems can help prevent or reduce these pains. You don’t have to suffer!
Educate you about exercise given your specific background and current state
Staying active during pregnancy is extremely helpful to you and your baby! Exercise recommendations from the internet and instagram can be confusing. We make it easier by tailoring recommendations to your specific needs. We make sure you feel comfortable with whatever we discuss to take the fear and confusion out of it.
Review pushing and make sure you feel comfortable with how to drive force through the pelvic floor
I get the question all the time- how do I “Push” this baby out? We will review techniques to make sure you feel comfortable with creating force through the pelvis effectively. We will review different pushing positions and strategies for labor and delivery as well.
Review perineal tissue “stretching” to help connect and prevent tearing of the pelvic floor
Studies have shown perineal tissue stretching during pregnancy can reduce more severe tearing during birth. We will review techniques for this to make sure you feel comfortable with experiencing tissue stretch in the pelvic floor prior to birth. We will also discuss how some of these techniques can be helpful during the pushing phase of birth as well.
Educate about what red flags to look for in those early days postpartum
I will say it again- education is empowerment! We will talk about what the first days to weeks of postpartum can look like and what to expect. We’ll discuss things to look for that may tell you the body needs more rest or a change of activity so that you can prevent injury before it happens.
Improve wellbeing - being prepared eases tension along the change
I hear this from my pregnant patients a lot- having all of this information makes the birth process less scary and more empowering. Birth is amazing and you deserve to know how to advocate for yourself every step along the way.
When to come in?
A little goes a long way! Unless you’re having specific ailments or issues, I usually recommend coming in for a baseline evaluation around the 20 week mark. We can get a good feel for how your body has accommodated the pregnancy up until that time, and give you food for thought/ exercises to go home with as the pregnancy progresses. If all is well at that point, I usually like to check in at 32-34 weeks to start to review perineal tissue work, see how the pelvic floor and abs have kept strong, and advise any adjustments to exercise. From there, we can do 1-3 more sessions closer to the end of the third trimester to review pushing, labor techniques, and work with manual therapy to reduce tension in the pelvis to help prepare for birth.
Dr. Alicia Ferriere, PT, DPT, FAFS, PRC
Dr. Alicia Ferriere owns Fortify Physical Therapy in Maplewood, NJ. She earned her doctorate from Columbia University and has several other professional certifications. She specializes in pelvic floor, prenatal, and postpartum health. Her holistic approach to physical therapy emphasizes personalized care and patient education. Alicia’s expertise has been featured in Women's Health Magazine, Dance Magazine, and the Healthful Woman podcast.
To learn more, visit www.fortifypt.com and follow @fortify_pt on Instagram.
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