Pelvic Floor Health During Pregnancy & Postpartum

By: Jamie Wallace, CLD

Our second special guest speaker in our series of virtual support for our clients during the COVID-19 pandemic was Stephanie Perez, PT, DPT. Stephanie is a physical therapist at TherapySouth in the Huntsville/Madison area. She specializes in pelvic floor therapy. She has recently launched her virtual therapy support called Empowered Wellness. Stephanie is married with 3 children. 

Stephanie Perez, PT, DPT

Stephanie says that pelvic floor therapy should have more awareness especially after the birth of a baby. Issues with the pelvic floor are often dismissed and perceived as a normal change in women’s bodies after having a baby. Peeing on yourself when coughing, sneezing or jumping on the trampoline with your kids, or painful intercourse are just a few examples of symptoms that pelvic floor therapy can improve.

Surprisingly, many patients respond well to education and instruction in self care with pelvic rehabilitation. 

Some common conditions treated with pelvic rehab include:

  • Urinary Incontinence
  • Urinary urgency and frequency
  • Painful bladder syndrome
  • Urinary hesitancy or delay 
  • Incomplete emptying or retention
  • Urethral pain
  • Overactive bladder
  • Fecal incontinence (tears during birth can be a factor)
  • Fecal urgency
  • Painful defecation
  • Constipation, diarrhea, loose stool
  • Irritable bowel syndrome
  • Anal fissures
  • Hemorrhoids (often common after a long pushing stage during birth)
  • Pain in tailbone 
  • Groin Pain
  • Sacroiliac Pain
  • Pain with intercourse
  • General genital pain
  • Pudendal nerve pain
  • Vulvar Pain 
  • Chronic pelvic pain
  • Perineal pain ( can be related to episiotomies or tears) 
  • Pain with orgasm
  • Inability to tolerate penetration
  • Prostatitis Pain (men)
  • Erectile dysfunction

As you can see, women aren’t the only ones that could benefit from pelvic rehab, some issues in men could also be related to a weak pelvic floor. 

These are just a few of the common complaints that Stephanie sees. She says that pain can affect many things in life and you do not have to live with it permanently.  Pelvic rehab can help you to avoid medications or surgery and live a normal day to day life without discomfort. 

Stephanie says she leaves up to her patient as to how much hands on therapy they would like. Following the initial visit, you will be informed of examination findings and options for treatment. You will be provided suggestions for a home program or self-care, so that you can actively participate in your healing process.  She can also communicate with your primary provider as appropriate.

Research is clear that many physicians do not ask about pelvic dysfunction and most patients are embarrassed to bring it up. It is important to be open and honest about your concerns. You can ask for a referral to see a pelvic rehabilitation provider. Many medical providers are not aware of this specialty. There is no referral required by insurance for initial consultations but if you feel you will need treatment, you will need a referral. 

We asked Stephanie her recommendations to protect the pelvic floor and have an easier postpartum recovery after birth. She suggests diaphragmatic breathing which she goes into more detail on, in her blog, and strong hips and glutes. Diaphragmatic breathing after delivery is essential as well! She also discussed a bit on how she can help with symphysis pubis dysfunction (SPD) which causes pain and discomfort in the pelvic region during pregnancy when the pelvic joints shift or move unevenly. 

Our last question for Stephanie was what did she recommend on the ideal fitness regimen for pregnancy and postpartum? 

Ideally, whatever makes you happy and makes you feel good about yourself. Start slow and build your way up when appropriate and released by your medical provider. Find a good postnatal program that focuses on core strength, glute strength, and pelvic floor strength and coordination. Rebuild your foundation. She recommends a  six-week rehab before fully returning back to pre-pregnancy workouts without problems. PTs can help you come up with a plan and there are also basic videos on youtube for strengthening. 

Stephanie offers a free 20 minute phone consultation to discuss your needs. You can visit her website for more information.

You may also visit to find a pelvic rehab practitioner near you. 

We would like to thank Stephanie Perez for taking the time to speak with us. We learned so much and are excited to get the info to our clients and the community. 

Please help us spread the importance of pelvic floor health by sharing this blog!

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