1 00:00:00,240 --> 00:00:09,039 Speaker 1: Oh, baby, baby, belof I need you, Oh how I 2 00:00:09,119 --> 00:00:13,000 Speaker 1: need you? What do you expect? As a production of 3 00:00:13,119 --> 00:00:17,160 Speaker 1: My Heart Radio, I'm your host Heidi Murkoff, and I'm 4 00:00:17,160 --> 00:00:19,760 Speaker 1: a mom on a mission, a mission to help you 5 00:00:19,800 --> 00:00:27,120 Speaker 1: know what to expect every step of the way. Sure, 6 00:00:27,280 --> 00:00:30,000 Speaker 1: you've had a vagina your whole life, but how much 7 00:00:30,080 --> 00:00:33,400 Speaker 1: do you really know about it? If you're like most women, 8 00:00:33,800 --> 00:00:37,559 Speaker 1: not all that much beyond some of the obvious stuff. 9 00:00:38,080 --> 00:00:42,320 Speaker 1: Chances are you know even less about the miraculous muscles 10 00:00:42,360 --> 00:00:46,680 Speaker 1: that support your vagina. Along with your uterus, your bladder, 11 00:00:47,040 --> 00:00:52,239 Speaker 1: and your bowels, your pelvic floor muscles. Not surprisingly, your 12 00:00:52,280 --> 00:00:56,120 Speaker 1: pelvic floor muscles are pretty pivotal when you're pregnant and 13 00:00:56,160 --> 00:00:59,240 Speaker 1: when there's a lot more that meets supporting. And even 14 00:00:59,280 --> 00:01:02,560 Speaker 1: if your baby doesn't end up exiting the building via 15 00:01:02,640 --> 00:01:06,800 Speaker 1: your vagina, pregnancy can take a toll on your pelvic floor. 16 00:01:07,319 --> 00:01:11,240 Speaker 1: Pee when you laugh for cough, had hip back, pelvic 17 00:01:11,400 --> 00:01:16,440 Speaker 1: or pubic pain or pressure, that's your pelvic floor muscles talking. 18 00:01:17,120 --> 00:01:20,480 Speaker 1: It's time to listen up and to listen to today's guest. 19 00:01:20,800 --> 00:01:23,679 Speaker 1: You may have heard of the vagina Whisperer, but her 20 00:01:23,720 --> 00:01:27,000 Speaker 1: real name is Sarah Reardon, and she's a pelvic floor 21 00:01:27,080 --> 00:01:30,200 Speaker 1: therapist and she's a mom of two boys, so she 22 00:01:30,319 --> 00:01:32,920 Speaker 1: and her pelvic floor have been there and done that. 23 00:01:33,120 --> 00:01:36,560 Speaker 1: Today she'll talk about pregnancy aches and pains, what's normal, 24 00:01:36,880 --> 00:01:40,640 Speaker 1: what's not, and how to prepare your pelvic floor for childbirth, 25 00:01:40,920 --> 00:01:46,959 Speaker 1: postpartum and beyond. So welcome Sarah, Hi, Heidi, Thanks for 26 00:01:47,000 --> 00:01:49,160 Speaker 1: having me, Thanks for being here. And I have to 27 00:01:49,160 --> 00:01:54,000 Speaker 1: say our vaginas and pelvic floors also, thank you. Happy 28 00:01:54,040 --> 00:01:57,400 Speaker 1: to be of service. I have to say it's the 29 00:01:57,440 --> 00:02:01,080 Speaker 1: first person to say penis on national televisi. I'm really 30 00:02:01,200 --> 00:02:05,840 Speaker 1: jealous about your title. How did you become the vagina Whisperer? 31 00:02:06,320 --> 00:02:09,119 Speaker 1: So it was actually a title given to me, so um. 32 00:02:09,160 --> 00:02:12,359 Speaker 1: I started in the field of pelvic floor physical therapy 33 00:02:12,440 --> 00:02:15,400 Speaker 1: right out of grad school in two thousand seven, and 34 00:02:15,720 --> 00:02:18,480 Speaker 1: there weren't a lot of pelvic floor physical therapist back then. 35 00:02:18,600 --> 00:02:21,480 Speaker 1: And I would see my college friends every summer and 36 00:02:22,080 --> 00:02:23,799 Speaker 1: I would end up in the hot tub with their 37 00:02:23,840 --> 00:02:27,560 Speaker 1: moms talking about bladder issues and leakage. And all of 38 00:02:27,560 --> 00:02:30,120 Speaker 1: my friends said, she's like the vagina whisper. And then 39 00:02:30,160 --> 00:02:32,480 Speaker 1: when I started my Instagram account a few years later, 40 00:02:32,520 --> 00:02:35,440 Speaker 1: it was for that group of friends. So I kind 41 00:02:35,440 --> 00:02:37,760 Speaker 1: of started, you know, just as a joke, and then 42 00:02:37,800 --> 00:02:40,919 Speaker 1: here we are, you know, four years later. Today we're 43 00:02:40,919 --> 00:02:44,480 Speaker 1: going to focus on caring for your pregnant pelvic floor 44 00:02:44,720 --> 00:02:47,640 Speaker 1: and all the wise in house. But before we get 45 00:02:47,639 --> 00:02:50,720 Speaker 1: into that, can you give us just a little bit 46 00:02:50,760 --> 00:02:53,959 Speaker 1: of pelvic floor? One oh one? Like, what's down there 47 00:02:54,000 --> 00:02:56,800 Speaker 1: on the floor? Why is it there? Why do you needed? 48 00:02:57,040 --> 00:02:59,360 Speaker 1: I mean, is it a case of you don't know 49 00:02:59,400 --> 00:03:02,400 Speaker 1: what you god till it's gone. So a little bit 50 00:03:02,440 --> 00:03:04,239 Speaker 1: of all of those things, And I think this is 51 00:03:04,240 --> 00:03:06,400 Speaker 1: a great place to start because a lot of people 52 00:03:06,520 --> 00:03:09,200 Speaker 1: don't know what is the pelvic floor, what does it do, 53 00:03:09,480 --> 00:03:11,760 Speaker 1: and how the heck is their physical therapy for it. 54 00:03:12,400 --> 00:03:16,799 Speaker 1: So all people have a pelvic floor, female, male, all genders, 55 00:03:16,800 --> 00:03:19,359 Speaker 1: and the pelvic floor is actually a basket of muscles 56 00:03:19,400 --> 00:03:21,799 Speaker 1: that sit at the base of the pelvis. So we're 57 00:03:21,800 --> 00:03:24,119 Speaker 1: all familiar with, you know, the bones of the pelvis, 58 00:03:24,120 --> 00:03:26,200 Speaker 1: but at the very basis a hammock of muscles that 59 00:03:26,320 --> 00:03:30,760 Speaker 1: support your organs like your bladder, your rectum in females 60 00:03:30,960 --> 00:03:34,160 Speaker 1: uterus and ovaries and males to prostate, and those muscles 61 00:03:34,160 --> 00:03:36,800 Speaker 1: support those organs and they also have stinkers that help 62 00:03:36,800 --> 00:03:39,400 Speaker 1: hold in p hold in poop and then assist with 63 00:03:39,480 --> 00:03:42,280 Speaker 1: vaginal birth and vaginal intercourse. So how do you know 64 00:03:42,920 --> 00:03:45,920 Speaker 1: if you need to see a pelvic floor therapist? Is 65 00:03:45,960 --> 00:03:49,640 Speaker 1: it something that should be routine for all pinnor women? 66 00:03:49,880 --> 00:03:53,200 Speaker 1: Is it covered by insurance? Is it something your your 67 00:03:53,240 --> 00:03:56,720 Speaker 1: doctor should refer you or your midwife? Right, so, you know, 68 00:03:56,800 --> 00:03:59,480 Speaker 1: we see folks coming in if they find us online, 69 00:03:59,520 --> 00:04:02,120 Speaker 1: if they hear about us from our friend or oftentimes 70 00:04:02,120 --> 00:04:05,080 Speaker 1: referred by physicians O b G, y m s and midwives. 71 00:04:05,720 --> 00:04:07,400 Speaker 1: The way that you should see one is that if 72 00:04:07,440 --> 00:04:10,880 Speaker 1: you have any issues with bladder health like urinary leakage, 73 00:04:11,000 --> 00:04:15,720 Speaker 1: overactive bladder difficulty emptying your stream, chronic urinary trucked infections, 74 00:04:16,279 --> 00:04:20,880 Speaker 1: pooping issues like constipation, fecal incontinence, or sexual health with 75 00:04:20,920 --> 00:04:24,520 Speaker 1: respect to painful intercourse or the inability to have intercourse 76 00:04:24,640 --> 00:04:28,200 Speaker 1: or painful orgasms. So the muscles play a role in 77 00:04:28,279 --> 00:04:30,640 Speaker 1: bowl health, bladder health, and sexual health, but they also 78 00:04:30,760 --> 00:04:34,040 Speaker 1: go through a huge transformation during pregnancy and birth, as 79 00:04:34,080 --> 00:04:37,520 Speaker 1: you and I both know. So that's really where I 80 00:04:37,560 --> 00:04:40,320 Speaker 1: feel like physical therapy should be standard care for women 81 00:04:40,440 --> 00:04:44,760 Speaker 1: during pregnancy to prevent issues, help them prepare for childbirth, 82 00:04:44,800 --> 00:04:47,680 Speaker 1: and then postpartum to help with recovery. So helveic for 83 00:04:47,839 --> 00:04:51,040 Speaker 1: physical therapy really falls under physical therapy. So if your 84 00:04:51,200 --> 00:04:54,240 Speaker 1: insurance covers physical therapy, which most of them do, and 85 00:04:54,279 --> 00:04:56,479 Speaker 1: you find a clinic that does take insurance, and you 86 00:04:56,520 --> 00:04:59,160 Speaker 1: can absolutely go and see a physical therapist and it's 87 00:04:59,160 --> 00:05:02,359 Speaker 1: covered under insure rents. Oftentimes some clinics or what we 88 00:05:02,400 --> 00:05:06,120 Speaker 1: call out of network, which means they don't contract with insurances, 89 00:05:06,160 --> 00:05:08,480 Speaker 1: but we provide you or receipt or what we call 90 00:05:08,520 --> 00:05:10,880 Speaker 1: a super bill that you can send into your insurance 91 00:05:11,120 --> 00:05:13,960 Speaker 1: for out of network reimbursement. So there are a lot 92 00:05:14,000 --> 00:05:16,279 Speaker 1: of options out there to help support moms if you 93 00:05:16,320 --> 00:05:18,599 Speaker 1: have insurance, and also if you're working with a therapist 94 00:05:18,600 --> 00:05:20,760 Speaker 1: who doesn't accept it. And you know, I talk a 95 00:05:20,839 --> 00:05:24,200 Speaker 1: lot about keygels, and in fact I'm doing them right 96 00:05:24,240 --> 00:05:27,120 Speaker 1: now because I can't talk about them without doing them. 97 00:05:27,720 --> 00:05:32,200 Speaker 1: But can you explain from a physical therapists perspective, how 98 00:05:32,320 --> 00:05:36,440 Speaker 1: keegel's work, who they're right for, and how we can 99 00:05:36,480 --> 00:05:40,080 Speaker 1: make sure we're doing them correctly. It's a great question 100 00:05:40,240 --> 00:05:44,080 Speaker 1: that could be an entire episode because but to start 101 00:05:44,120 --> 00:05:47,160 Speaker 1: with the basics. Keegels are contractions of the pelvic floor. 102 00:05:47,240 --> 00:05:49,159 Speaker 1: So when we think about a muscle in our body, 103 00:05:49,200 --> 00:05:52,080 Speaker 1: like our bicep, you bend your elbow and your bicep 104 00:05:52,120 --> 00:05:55,920 Speaker 1: contracts with the pelvic floor. A kegel is like you're 105 00:05:55,960 --> 00:05:59,279 Speaker 1: squeezing and lifting that hammock of muscles. So you're closing 106 00:05:59,279 --> 00:06:02,120 Speaker 1: the sphinc or where you're an exit, closing the anus 107 00:06:02,120 --> 00:06:04,280 Speaker 1: where gas or poop exits, and kind of you know, 108 00:06:04,400 --> 00:06:07,040 Speaker 1: lifting up. My favorite queue to tell people is think 109 00:06:07,080 --> 00:06:09,840 Speaker 1: about your sipping up a smoothie with your vagina, because 110 00:06:09,839 --> 00:06:12,320 Speaker 1: it's not a tightening, it's really kind of a pulling 111 00:06:12,360 --> 00:06:15,800 Speaker 1: up and lift and it's a totally weird que but 112 00:06:15,880 --> 00:06:19,240 Speaker 1: it somehow works. Um, So you know, that's just strengthen 113 00:06:19,279 --> 00:06:22,279 Speaker 1: the pelvic floor. And you bring up a great point, Heidi, 114 00:06:22,440 --> 00:06:25,200 Speaker 1: that not everybody maybe needs to do strengthening. A lot 115 00:06:25,240 --> 00:06:27,200 Speaker 1: of us have weakness, but a lot of us also 116 00:06:27,240 --> 00:06:30,320 Speaker 1: have tension, and kegels would not be the appropriate exercise 117 00:06:30,320 --> 00:06:33,680 Speaker 1: for that person, so they need to relax instead. Yes, 118 00:06:33,880 --> 00:06:36,200 Speaker 1: and I would say that a lot of folks out 119 00:06:36,200 --> 00:06:39,440 Speaker 1: there have pelvic floor attention and need to relax before 120 00:06:39,480 --> 00:06:42,440 Speaker 1: they start strengthening. That's a great point. Does that mean 121 00:06:42,480 --> 00:06:45,000 Speaker 1: that a mom moves already had a baby or two 122 00:06:45,440 --> 00:06:48,880 Speaker 1: will benefit more from keegeles than the first time mom that. 123 00:06:49,040 --> 00:06:50,680 Speaker 1: I think it's hard to say. We do know that 124 00:06:50,800 --> 00:06:54,120 Speaker 1: more often we have weakness postpartum, because again, if we 125 00:06:54,160 --> 00:06:57,440 Speaker 1: think about those muscles like a hammock, a hammock holding 126 00:06:57,560 --> 00:07:00,800 Speaker 1: an avocado and week ten is different than hammock holding 127 00:07:00,880 --> 00:07:04,200 Speaker 1: a watermelon in week forty. So just by the course 128 00:07:04,240 --> 00:07:07,960 Speaker 1: of pregnancy, our muscles get lengthened and relaxed and aren't 129 00:07:08,000 --> 00:07:11,800 Speaker 1: as supportive or strong. However, again, a lot of folks 130 00:07:11,840 --> 00:07:15,520 Speaker 1: still have tension after a cesarean birth, after paraneal tearing, 131 00:07:15,560 --> 00:07:19,480 Speaker 1: there can be muscle tension. Um Again, keels may not 132 00:07:19,560 --> 00:07:22,080 Speaker 1: be the first thing to start with. So we see 133 00:07:22,120 --> 00:07:24,559 Speaker 1: second time moms a lot who want to prepare for birth. 134 00:07:24,720 --> 00:07:27,120 Speaker 1: Oftentimes they have weakness, but then they also may have 135 00:07:27,160 --> 00:07:29,440 Speaker 1: tension and want to kind of just prevent some issues 136 00:07:29,480 --> 00:07:33,480 Speaker 1: along the way. So we've talked about just about every 137 00:07:33,680 --> 00:07:37,400 Speaker 1: pregnancy symptom at some point in this show, and I 138 00:07:37,440 --> 00:07:42,280 Speaker 1: can say pretty much most of them suck. Most of 139 00:07:42,280 --> 00:07:47,320 Speaker 1: them are not a fan of pregnancy symptoms. UM. Maybe 140 00:07:47,320 --> 00:07:51,240 Speaker 1: with the exception of bigger boobs or better hair um, 141 00:07:51,320 --> 00:07:53,480 Speaker 1: but a lot of the hair. The hair is definitely 142 00:07:53,520 --> 00:07:57,360 Speaker 1: a good side effect of pregnancy. But let's get into 143 00:07:57,440 --> 00:08:00,520 Speaker 1: some of the symptoms that might be impacted by your 144 00:08:00,600 --> 00:08:03,400 Speaker 1: pelvic flour. And of course there's peeing, and there are 145 00:08:03,440 --> 00:08:07,240 Speaker 1: lots of reasons why you p up a storm when 146 00:08:07,280 --> 00:08:09,880 Speaker 1: you are pregnant. I mean, there's all those hormones. There's 147 00:08:10,400 --> 00:08:12,760 Speaker 1: the position of your uterus, which is one of the 148 00:08:12,800 --> 00:08:15,600 Speaker 1: reasons why you piece so much early in pregnancy. And 149 00:08:15,840 --> 00:08:18,440 Speaker 1: you know, if you're peeing a lot, or you have 150 00:08:18,600 --> 00:08:22,520 Speaker 1: that urgency all the time, or you're having burning sometimes 151 00:08:22,520 --> 00:08:24,600 Speaker 1: you might have a U T I. So there's lots 152 00:08:24,600 --> 00:08:28,200 Speaker 1: of different reasons. But what is normal and what is 153 00:08:28,240 --> 00:08:31,840 Speaker 1: not when it comes to pregnancy p and how is 154 00:08:31,880 --> 00:08:35,240 Speaker 1: it related to your pelvic floor? Yeah, urinary function is 155 00:08:35,240 --> 00:08:37,000 Speaker 1: a big one when it comes to pregnancy, and we 156 00:08:37,080 --> 00:08:39,960 Speaker 1: often do find ourselves going more often again because of 157 00:08:39,960 --> 00:08:43,560 Speaker 1: pressure on the bladder, more fluid in our bodies. Urinary 158 00:08:43,640 --> 00:08:45,880 Speaker 1: leakage is a common symptom, but I wouldn't say it's 159 00:08:45,880 --> 00:08:49,240 Speaker 1: a normal symptom. So when you start experiencing urinary leakage 160 00:08:49,280 --> 00:08:52,160 Speaker 1: with a call for a sneeze or with exercise, it's 161 00:08:52,200 --> 00:08:54,760 Speaker 1: those muscles aren't holding in p as well as we 162 00:08:54,760 --> 00:08:57,240 Speaker 1: would want them too, So that means there's a muscle issue. 163 00:08:57,920 --> 00:09:00,400 Speaker 1: And that's when I would really say start working with 164 00:09:00,440 --> 00:09:03,440 Speaker 1: a physical therapist, because that means that's not necessarily going 165 00:09:03,480 --> 00:09:07,760 Speaker 1: to get better after childbirth and then postpartum, and so 166 00:09:07,800 --> 00:09:10,120 Speaker 1: it's something that you want to start addressing what it happens, 167 00:09:10,600 --> 00:09:13,160 Speaker 1: and it won't necessarily just go away. So I think 168 00:09:13,240 --> 00:09:16,360 Speaker 1: urinary leakage is probably the most common. Another common issue 169 00:09:16,440 --> 00:09:19,960 Speaker 1: is prolapse. So this is sounds scary, and it's not 170 00:09:20,040 --> 00:09:22,400 Speaker 1: as scary as it sounds, but the bladder shirts to 171 00:09:22,480 --> 00:09:25,320 Speaker 1: kind of drop down a little bit into the pelvic 172 00:09:25,320 --> 00:09:28,560 Speaker 1: floor muscles, so it feels like pressure, heaviness, something's falling out. 173 00:09:29,120 --> 00:09:31,480 Speaker 1: That's again common because of all the pressure from above, 174 00:09:31,679 --> 00:09:34,040 Speaker 1: or if we have a high intensity athlete who does 175 00:09:34,120 --> 00:09:37,439 Speaker 1: running and jumping, it's just more pressure over time. That's 176 00:09:37,480 --> 00:09:40,680 Speaker 1: another common bladder symptom that people may experience. How common 177 00:09:40,800 --> 00:09:43,040 Speaker 1: is that and how would you know? So we go 178 00:09:43,120 --> 00:09:46,920 Speaker 1: often based by symptoms and then of pressure, heaviness, back pain, 179 00:09:47,160 --> 00:09:49,120 Speaker 1: it feels like there's a tampon in your vagina when 180 00:09:49,120 --> 00:09:51,600 Speaker 1: there isn't And then we do a pelvic floor assessment 181 00:09:51,600 --> 00:09:53,880 Speaker 1: where we look through the vaginal opening, asked them to 182 00:09:53,920 --> 00:09:56,120 Speaker 1: bear down, and we can often see the kind of 183 00:09:56,120 --> 00:09:58,679 Speaker 1: the wall of the vagina where the bladder is supported 184 00:09:58,760 --> 00:10:01,520 Speaker 1: kind of pushing through. So you can tell by symptoms 185 00:10:01,520 --> 00:10:04,960 Speaker 1: and then again confirm with an evaluation, because lots of 186 00:10:05,040 --> 00:10:07,640 Speaker 1: pregnant women and you know, when they reach you know, 187 00:10:07,679 --> 00:10:11,959 Speaker 1: maybe thirty five, thirty six weeks, they're feeling that pressure anyway, 188 00:10:12,000 --> 00:10:15,720 Speaker 1: they're peeing a lot again anyway, but the leaking. Is 189 00:10:15,760 --> 00:10:19,160 Speaker 1: there really a way to train a pregnant bladder to 190 00:10:19,360 --> 00:10:22,960 Speaker 1: do new tricks like cold in p you'd be surprised 191 00:10:22,960 --> 00:10:25,520 Speaker 1: how to the pelvic floor can always do new tricks. So, 192 00:10:25,679 --> 00:10:27,760 Speaker 1: I mean, it's it's gonna be hard, But I think 193 00:10:27,880 --> 00:10:29,439 Speaker 1: a lot of what we want to do is help 194 00:10:29,520 --> 00:10:33,280 Speaker 1: prepare women also for postpartum. So teach them to contract, 195 00:10:33,640 --> 00:10:36,360 Speaker 1: tighten those pelvic floor muscles before a call for a sneeze, 196 00:10:36,360 --> 00:10:39,360 Speaker 1: so they get in the habit of doing that, so 197 00:10:39,440 --> 00:10:42,679 Speaker 1: postpartum they already have that maneuver in place. Teaching them 198 00:10:42,679 --> 00:10:44,960 Speaker 1: how to pee without pushing, So a lot of times. 199 00:10:45,080 --> 00:10:47,240 Speaker 1: A lot of moms are power peers, which means they 200 00:10:47,240 --> 00:10:49,720 Speaker 1: sit down and they like push really hard when they pee, 201 00:10:50,040 --> 00:10:53,240 Speaker 1: and that can cause more weakness so in muscles that 202 00:10:53,280 --> 00:10:55,400 Speaker 1: may already be weak. So we teach them to sit 203 00:10:55,559 --> 00:10:58,320 Speaker 1: and breathe and relax so that they don't cause more 204 00:10:58,400 --> 00:11:00,600 Speaker 1: weakness to their muscles. So teach them a lot of 205 00:11:00,640 --> 00:11:03,480 Speaker 1: really basic things that maybe no one's ever taught them, 206 00:11:03,760 --> 00:11:06,720 Speaker 1: but can help prevent issues from getting worse as well. Huh, 207 00:11:06,840 --> 00:11:09,439 Speaker 1: that's a lot of new tricks I just learned. Although 208 00:11:09,480 --> 00:11:12,360 Speaker 1: I'm not sure I ever pushed when I was paying. 209 00:11:12,600 --> 00:11:15,760 Speaker 1: I'm gonna have to think about that. So speaking of 210 00:11:15,800 --> 00:11:19,600 Speaker 1: things that are literally impacted by pregnancy, of course, you 211 00:11:19,600 --> 00:11:23,760 Speaker 1: know where I'm going. Constipation, Yes, and it's there for 212 00:11:24,200 --> 00:11:27,560 Speaker 1: a good reason. It's a purposeful symptom like most are 213 00:11:27,720 --> 00:11:31,319 Speaker 1: in pregnancy, and that's the slowing down of digestions so 214 00:11:31,400 --> 00:11:35,240 Speaker 1: your baby can absorb more nutrients. Also, you might be 215 00:11:35,320 --> 00:11:39,680 Speaker 1: taking iron, and iron can be constipating. And you know, 216 00:11:39,880 --> 00:11:42,760 Speaker 1: we know all about and we've heard over and over 217 00:11:42,880 --> 00:11:46,679 Speaker 1: about staying hydrated and eating the right foods, you know, 218 00:11:46,720 --> 00:11:51,880 Speaker 1: foods that are high end fiber, taking magnesium, but well, 219 00:11:51,880 --> 00:11:54,600 Speaker 1: we often don't talk about is how the pelvic floor 220 00:11:54,760 --> 00:11:57,960 Speaker 1: is associated with pooping, and clearly it is, so would 221 00:11:58,000 --> 00:12:00,600 Speaker 1: you like to enlighten us a bit us? And I 222 00:12:00,679 --> 00:12:03,880 Speaker 1: love talking about poop because I don't think we realize 223 00:12:03,880 --> 00:12:06,960 Speaker 1: the you know, no pun intended impact it has on 224 00:12:07,000 --> 00:12:09,200 Speaker 1: our health. I mean, if you take a good poop, 225 00:12:09,280 --> 00:12:11,720 Speaker 1: you're the rest of your day is can be amazing. 226 00:12:11,760 --> 00:12:13,440 Speaker 1: But if you don't take a good poop, then you're like, 227 00:12:13,600 --> 00:12:16,040 Speaker 1: all right, I'm already grumpy and it's eight am. So 228 00:12:16,520 --> 00:12:19,320 Speaker 1: you know, your pelvic floor muscles, just like with your bladder, 229 00:12:19,440 --> 00:12:21,920 Speaker 1: your pelvic flor muscles have to relax in order to 230 00:12:22,000 --> 00:12:25,640 Speaker 1: empty the balls where poop is kind of stored, and 231 00:12:25,679 --> 00:12:28,600 Speaker 1: if those muscles are not relaxing, well, it will get 232 00:12:28,640 --> 00:12:32,000 Speaker 1: backed up. What happens during pregnancy is again your colon 233 00:12:32,080 --> 00:12:34,920 Speaker 1: is slowing down, the poop gets really hard and difficult 234 00:12:34,920 --> 00:12:38,040 Speaker 1: to empty. So now I've got this really painful baseball 235 00:12:38,080 --> 00:12:40,760 Speaker 1: of poop and your muscles aren't relaxing to get it out, 236 00:12:40,800 --> 00:12:43,720 Speaker 1: and it can be excruciating. And that's another thing that 237 00:12:43,760 --> 00:12:48,679 Speaker 1: can lead to hemorrhoids, to fishers, to prolapse. So all 238 00:12:48,720 --> 00:12:52,040 Speaker 1: of the tips you mentioned probably taking natural call magnesium 239 00:12:52,120 --> 00:12:55,920 Speaker 1: is one of my favorites, staying hydrated, you know, avoiding 240 00:12:56,679 --> 00:12:59,360 Speaker 1: constipating foods, but a lot of us want carbs and 241 00:12:59,400 --> 00:13:02,080 Speaker 1: sweets and things like that. But the proper way to 242 00:13:02,160 --> 00:13:05,280 Speaker 1: poop is also helpful. So we teach folks to put 243 00:13:05,280 --> 00:13:08,480 Speaker 1: a little stool under their feet when they're pooping, so 244 00:13:08,520 --> 00:13:10,840 Speaker 1: that their knees get above their hip heights, so it 245 00:13:10,840 --> 00:13:13,120 Speaker 1: puts you in a squat, which is the best position 246 00:13:13,120 --> 00:13:16,080 Speaker 1: to relax your pelvic floor. And then we also teach 247 00:13:16,160 --> 00:13:19,160 Speaker 1: them to exhale when they're pushing poop out versus holding 248 00:13:19,160 --> 00:13:21,800 Speaker 1: their breath. When you hold your breath, you almost tighten 249 00:13:21,920 --> 00:13:23,839 Speaker 1: up a little bit, which makes it harder. So we 250 00:13:23,880 --> 00:13:26,040 Speaker 1: teach them to exhale and breathe out with their feet 251 00:13:26,040 --> 00:13:28,120 Speaker 1: on that stool. And that can make a huge difference 252 00:13:28,160 --> 00:13:31,240 Speaker 1: during pregnancy pooping. And it's really easy to remember because 253 00:13:31,280 --> 00:13:34,200 Speaker 1: stool for your stool, stool for your stool. You got it. 254 00:13:46,280 --> 00:13:51,200 Speaker 1: I would say everybody hurt sometimes, right, but pregnant women 255 00:13:52,080 --> 00:13:54,600 Speaker 1: seems to hurt a hole up more than anybody else, 256 00:13:54,920 --> 00:13:58,840 Speaker 1: especially in the third time ster that load you're carrying 257 00:13:59,000 --> 00:14:02,760 Speaker 1: gets bigger and heavier and pregnancy can be a pain, 258 00:14:03,040 --> 00:14:05,360 Speaker 1: a lot of pains. Yeah, it's a pain with a 259 00:14:05,480 --> 00:14:09,440 Speaker 1: purpose because your body is getting ready for childbirth. But 260 00:14:09,640 --> 00:14:12,560 Speaker 1: that's still must we accept it. Why does it happen? 261 00:14:13,200 --> 00:14:15,040 Speaker 1: What can we do about it? That is such a 262 00:14:15,040 --> 00:14:17,400 Speaker 1: great question, and you really nailed it that we don't 263 00:14:17,440 --> 00:14:19,400 Speaker 1: have to accept it. I think so often we hear 264 00:14:19,440 --> 00:14:22,680 Speaker 1: that leaking part of pregnancy, back pain, part of pregnancy, 265 00:14:22,720 --> 00:14:24,960 Speaker 1: pooping problems. But there are so many things that we 266 00:14:24,960 --> 00:14:27,960 Speaker 1: can do to help that we're just not automatically made 267 00:14:27,960 --> 00:14:30,920 Speaker 1: aware of. And that's where I think physical therapists are 268 00:14:30,920 --> 00:14:33,400 Speaker 1: really trying to advocate that there is support and help 269 00:14:33,520 --> 00:14:36,640 Speaker 1: for people during pregnancy. So we talked a little bit 270 00:14:36,640 --> 00:14:39,440 Speaker 1: earlier about the pelvis as that ring of bones and 271 00:14:39,480 --> 00:14:42,520 Speaker 1: then the muscles are at the very base. Well, you 272 00:14:42,520 --> 00:14:44,600 Speaker 1: have your abdominal muscles in the front, which we know 273 00:14:44,680 --> 00:14:48,640 Speaker 1: are getting stretched out, lengthening and offering you less support 274 00:14:48,760 --> 00:14:51,920 Speaker 1: during pregnancy, which can contribute to back pain and postural changes. 275 00:14:52,440 --> 00:14:54,600 Speaker 1: And you also have little ligaments in that pelvis in 276 00:14:54,640 --> 00:14:57,000 Speaker 1: the very front at the pubic bone and in the 277 00:14:57,080 --> 00:15:00,360 Speaker 1: very back at the sacrum, and those ligaments are getting softer. 278 00:15:00,640 --> 00:15:03,600 Speaker 1: Because we want the pelvis to expand to accommodate the 279 00:15:03,640 --> 00:15:07,400 Speaker 1: growing baby, but that also means a little less stability, 280 00:15:07,440 --> 00:15:10,440 Speaker 1: a little more loosey goosey joins, and that can cause 281 00:15:10,480 --> 00:15:13,400 Speaker 1: pain with you know, getting out of bed, rolling over, 282 00:15:13,640 --> 00:15:16,040 Speaker 1: getting out of the car, you know, bending over to 283 00:15:16,080 --> 00:15:18,920 Speaker 1: pick up a toddler. And there are things that can help. 284 00:15:19,000 --> 00:15:21,600 Speaker 1: We really encourage people to learn how to use their 285 00:15:21,640 --> 00:15:23,880 Speaker 1: core muscles when they're doing those day to day activity, 286 00:15:24,040 --> 00:15:26,960 Speaker 1: so kind of doing a little pelvic floor and pulling 287 00:15:27,000 --> 00:15:30,040 Speaker 1: in their bellies to give them some core support. We 288 00:15:30,080 --> 00:15:32,040 Speaker 1: also teach people how to get out of bed so 289 00:15:32,120 --> 00:15:34,480 Speaker 1: they're not like hiking up with their abs, they're rolling 290 00:15:34,560 --> 00:15:37,320 Speaker 1: to their side, and you know, how to get out 291 00:15:37,320 --> 00:15:39,120 Speaker 1: of a car by keeping their knees together so that 292 00:15:39,200 --> 00:15:41,920 Speaker 1: not stressing the pubic bone. And then also I really 293 00:15:42,040 --> 00:15:44,840 Speaker 1: encourage folks to wear these little belly supports, you know, 294 00:15:45,720 --> 00:15:48,320 Speaker 1: that is so helpful. It's literally just like a little 295 00:15:48,360 --> 00:15:50,720 Speaker 1: back breath or a little belly support, but it takes 296 00:15:50,720 --> 00:15:52,760 Speaker 1: some of the weight off so that you're not carrying 297 00:15:52,760 --> 00:15:55,320 Speaker 1: this heavy load all the time and you have something 298 00:15:55,320 --> 00:15:57,840 Speaker 1: that can help make it more comfortable. So that can 299 00:15:57,920 --> 00:16:02,120 Speaker 1: definitely give your backup break Now, the hip pain, especially 300 00:16:02,200 --> 00:16:05,600 Speaker 1: at night, is super uncomfortable for a lot of bombs 301 00:16:06,040 --> 00:16:10,680 Speaker 1: and getting into a comfortable sleeping position, which you would 302 00:16:10,720 --> 00:16:14,000 Speaker 1: say is lying on your side with a pillow between 303 00:16:14,040 --> 00:16:16,560 Speaker 1: your knees down to your ankles, so it's kind of 304 00:16:16,640 --> 00:16:19,160 Speaker 1: sandwich the whole way through your shins um. I like 305 00:16:19,240 --> 00:16:21,440 Speaker 1: to have one to two pillows under your head, so 306 00:16:21,480 --> 00:16:23,760 Speaker 1: sometimes we need a little bit more support under the head, 307 00:16:24,200 --> 00:16:27,040 Speaker 1: a little small pillow underneath a belly, especially during the 308 00:16:27,080 --> 00:16:30,680 Speaker 1: third trimester. And then I always needed something behind my back. 309 00:16:30,760 --> 00:16:32,680 Speaker 1: I tended to roll into my back a lot, so 310 00:16:32,680 --> 00:16:34,760 Speaker 1: when I would kind of get into my cozy position 311 00:16:35,040 --> 00:16:37,320 Speaker 1: on my side with all of my pillows, i'd have 312 00:16:37,400 --> 00:16:39,640 Speaker 1: my partner like shove a pillow behind my back. So 313 00:16:39,680 --> 00:16:41,320 Speaker 1: if I kind of rolled over in the middle of 314 00:16:41,400 --> 00:16:44,240 Speaker 1: the night, I was just still like sideline a little 315 00:16:44,240 --> 00:16:46,360 Speaker 1: bit versus all the way on my back. So that 316 00:16:46,480 --> 00:16:49,960 Speaker 1: just gave me some more options. And again, if that 317 00:16:50,080 --> 00:16:52,480 Speaker 1: hip is in a position where it's kind of cranked forward, 318 00:16:52,760 --> 00:16:55,480 Speaker 1: or you know, your knees are pressed together, over time 319 00:16:55,520 --> 00:16:57,520 Speaker 1: those muscles get tight and tense, which can lead to 320 00:16:57,600 --> 00:17:00,480 Speaker 1: hip paint. But using some pillows for adjustment really help. 321 00:17:00,680 --> 00:17:02,440 Speaker 1: Was there room for your partner on that bed with 322 00:17:02,480 --> 00:17:05,080 Speaker 1: all those pillows? We got a bigger bed. Okay, good, 323 00:17:06,359 --> 00:17:12,119 Speaker 1: we upgraded to a king Okay. So um, what exercises 324 00:17:12,119 --> 00:17:18,159 Speaker 1: should pregnant women avoid that might exacerbate those pains in 325 00:17:18,200 --> 00:17:20,440 Speaker 1: the back end? Hips? Are there any you can really 326 00:17:20,480 --> 00:17:23,800 Speaker 1: exercise all throughout pregnancy? Some things to start avoiding kind 327 00:17:23,800 --> 00:17:27,240 Speaker 1: of right around the second trimester, or crunches, double leg 328 00:17:27,280 --> 00:17:30,040 Speaker 1: list when you're lying on your back, most exercises lying 329 00:17:30,080 --> 00:17:31,680 Speaker 1: on your back. We try to encourage you to lie 330 00:17:31,680 --> 00:17:33,960 Speaker 1: on your side just to avoid any compression down on 331 00:17:34,440 --> 00:17:38,560 Speaker 1: you know, your vessels down below baby, but really holding 332 00:17:38,560 --> 00:17:40,680 Speaker 1: off on anything that causes that kind of sit up 333 00:17:40,840 --> 00:17:43,119 Speaker 1: maneuver with your abdomen because that will cause it to 334 00:17:43,800 --> 00:17:46,520 Speaker 1: stretch and lengthen and sometimes lead to a separation called 335 00:17:46,520 --> 00:17:49,359 Speaker 1: the diastasis recti, which looks like a little football or 336 00:17:49,520 --> 00:17:52,800 Speaker 1: coning at the midline of your belly. So that's helpful. 337 00:17:52,920 --> 00:17:55,879 Speaker 1: And then you know modifications if you're doing planks, you know, 338 00:17:55,960 --> 00:17:57,720 Speaker 1: get down on your knees and do planks. If you're 339 00:17:57,720 --> 00:17:59,520 Speaker 1: doing push ups, to them on the wall instead of 340 00:17:59,520 --> 00:18:02,760 Speaker 1: the ground. And then avoiding like deep lunches, where you 341 00:18:02,800 --> 00:18:04,840 Speaker 1: might stress some of those joints that are a little 342 00:18:04,840 --> 00:18:07,280 Speaker 1: bit more lax. Like we talked about earlier, a lot 343 00:18:07,320 --> 00:18:11,600 Speaker 1: of moms complain about severe pain in their pelvis in 344 00:18:11,640 --> 00:18:16,000 Speaker 1: their hips, and how do you know when it's time 345 00:18:16,119 --> 00:18:19,119 Speaker 1: to get help for that. I always recommend by the 346 00:18:19,160 --> 00:18:22,960 Speaker 1: way that you go see a pelvic for therapist. That's 347 00:18:23,000 --> 00:18:26,200 Speaker 1: always my go to. But how do you know it's 348 00:18:26,240 --> 00:18:29,400 Speaker 1: not something more serious like pelvic girdle pain that can 349 00:18:29,480 --> 00:18:34,120 Speaker 1: be excruciating. I feel like your entire pelvis is ripping apart. 350 00:18:34,400 --> 00:18:37,760 Speaker 1: So a little bit about that, absolutely, and ideally I 351 00:18:37,760 --> 00:18:39,840 Speaker 1: think this is where we want to change the narrative 352 00:18:39,840 --> 00:18:42,440 Speaker 1: for pregnant moms that if you are having sciatic pain 353 00:18:42,560 --> 00:18:45,720 Speaker 1: or pubic bone pain, we know that, Okay, let's send 354 00:18:45,720 --> 00:18:47,960 Speaker 1: that mom to see a pelvic PT and literally within 355 00:18:48,000 --> 00:18:49,880 Speaker 1: one to two sessions it can be such a quick 356 00:18:49,920 --> 00:18:52,600 Speaker 1: fix so they don't get to the point of debilitating pain. 357 00:18:53,240 --> 00:18:56,960 Speaker 1: But my rule of thumb is if something is, you know, painful, 358 00:18:57,119 --> 00:19:00,600 Speaker 1: and it's causing distress in your life, if it's causing 359 00:19:00,680 --> 00:19:05,199 Speaker 1: psychological or physical angst changes and it's affecting you, then 360 00:19:05,240 --> 00:19:08,000 Speaker 1: it's worthy of your attention. It's worthy of you seeking 361 00:19:08,080 --> 00:19:10,400 Speaker 1: care for it. A lot of the times, I think, 362 00:19:10,600 --> 00:19:12,120 Speaker 1: you know, I can speak for myself as a woman, 363 00:19:12,160 --> 00:19:13,800 Speaker 1: as a mom, I think I just have to deal 364 00:19:13,840 --> 00:19:15,960 Speaker 1: with stuff and I don't have time for it. But 365 00:19:16,000 --> 00:19:18,800 Speaker 1: when it starts impacting my quality of life of socializing 366 00:19:18,800 --> 00:19:21,600 Speaker 1: with friends or having endemoucy, use my partner, playing with 367 00:19:21,640 --> 00:19:24,400 Speaker 1: my kids, that's something that I really should be addressing, 368 00:19:24,440 --> 00:19:25,800 Speaker 1: no matter if it's a one out of ten pain 369 00:19:25,880 --> 00:19:28,080 Speaker 1: or a ten out of ten pain. Absolutely, and you 370 00:19:28,119 --> 00:19:31,200 Speaker 1: know you can be strong but still ask for help. Yes, 371 00:19:31,520 --> 00:19:34,280 Speaker 1: I think that that's really what takes strength, is saying 372 00:19:34,560 --> 00:19:38,520 Speaker 1: I need help exactly. You can use that in you know, 373 00:19:38,640 --> 00:19:40,760 Speaker 1: when it comes to pains, when it comes to other 374 00:19:40,800 --> 00:19:43,320 Speaker 1: pregnancy symptoms, that also when it comes to your emotions, 375 00:19:43,359 --> 00:19:46,400 Speaker 1: don't forget you can be strong and ask for help. Absolutely, 376 00:19:46,840 --> 00:19:51,080 Speaker 1: painful sex. There are reasons for painful sex that really 377 00:19:51,119 --> 00:19:54,840 Speaker 1: you know that might not be involving your pelvic muscles. 378 00:19:54,880 --> 00:19:59,040 Speaker 1: Maybe you have an infection for instance, you know, having 379 00:19:59,040 --> 00:20:02,520 Speaker 1: had sexual trama in your life that can cause painful sex. 380 00:20:03,040 --> 00:20:07,199 Speaker 1: Is this something that you hear about a lot? You know, 381 00:20:07,400 --> 00:20:09,880 Speaker 1: the research is really showing us that one in four 382 00:20:10,359 --> 00:20:13,359 Speaker 1: women will experience painful sex at some point in their lifetime, 383 00:20:13,359 --> 00:20:16,560 Speaker 1: which is a pretty astounding number. And I think I 384 00:20:16,640 --> 00:20:19,359 Speaker 1: share that to let women know that it's much more 385 00:20:19,400 --> 00:20:22,159 Speaker 1: common than we realize, and we're just not talking about it. 386 00:20:22,480 --> 00:20:24,880 Speaker 1: And we read a lot that you may have increased 387 00:20:24,880 --> 00:20:30,000 Speaker 1: libido or increased sexual desire or more vaginal lubrication during pregnancy. 388 00:20:30,040 --> 00:20:33,320 Speaker 1: But if you're not having that and you even have pain, 389 00:20:33,920 --> 00:20:36,399 Speaker 1: you start to think, is something wrong with me? Is 390 00:20:36,440 --> 00:20:39,480 Speaker 1: everybody else like this? And some of the common causes 391 00:20:39,520 --> 00:20:41,600 Speaker 1: we see of painful sex or some of the things 392 00:20:41,600 --> 00:20:45,040 Speaker 1: you already mentioned hip pain, back pain, it's difficult to 393 00:20:45,080 --> 00:20:46,919 Speaker 1: get into some of those positions and just kind of 394 00:20:46,920 --> 00:20:51,080 Speaker 1: awkward and uncomfortable. The other thing is muscle tension. You know, 395 00:20:51,200 --> 00:20:54,200 Speaker 1: these are muscles that if they are tighter tense, it's 396 00:20:54,200 --> 00:20:57,360 Speaker 1: gonna make it difficult for something to enter the vagina. 397 00:20:57,480 --> 00:20:59,920 Speaker 1: It can feel like something's getting bruised or is tender. 398 00:21:00,119 --> 00:21:03,359 Speaker 1: With deeper insertion, you can have pain afterwards, so that 399 00:21:03,400 --> 00:21:06,600 Speaker 1: can be uncomfortable. And even if they're scar tissue from 400 00:21:06,600 --> 00:21:11,600 Speaker 1: a previous cesarean birth or a previous perennial tear, that 401 00:21:11,640 --> 00:21:14,119 Speaker 1: can also be a cause of pain even during pregnancy. 402 00:21:14,520 --> 00:21:19,280 Speaker 1: So if one and for experience it probably far fewer 403 00:21:19,359 --> 00:21:22,000 Speaker 1: actually get treatment for it. In that right, it shouldn't 404 00:21:22,000 --> 00:21:24,480 Speaker 1: have to hurt. It should never hurt. And you know, 405 00:21:24,520 --> 00:21:26,880 Speaker 1: I think even we start to think, oh, well, maybe 406 00:21:26,880 --> 00:21:29,280 Speaker 1: it's a little bit normal, but it doesn't necessarily just 407 00:21:29,320 --> 00:21:32,120 Speaker 1: go away. I mean, I am a pelvic for physical therapist. 408 00:21:32,119 --> 00:21:34,480 Speaker 1: I've had two kids, and even this year I started 409 00:21:34,520 --> 00:21:36,560 Speaker 1: experiencing painful sex and I was like, Okay, I need 410 00:21:36,600 --> 00:21:38,119 Speaker 1: to go see one of the therapists in my office. 411 00:21:38,160 --> 00:21:40,320 Speaker 1: I need to get worked on I've been doing too 412 00:21:40,400 --> 00:21:44,080 Speaker 1: much cycling. And it was you know, four sessions. But 413 00:21:44,160 --> 00:21:46,159 Speaker 1: and I was so grateful that I knew this, But 414 00:21:46,359 --> 00:21:49,000 Speaker 1: it goes to show you. You know, everyone's pelvic floor 415 00:21:49,000 --> 00:21:51,440 Speaker 1: is susceptible to pelvic floor issues. We just don't always 416 00:21:51,440 --> 00:21:54,200 Speaker 1: know where to get help. So um, it should not hurt. 417 00:21:54,359 --> 00:21:56,800 Speaker 1: And if you are having pain with sex, I would 418 00:21:56,880 --> 00:21:59,199 Speaker 1: encourage you to report it to your medical provider and 419 00:21:59,240 --> 00:22:02,080 Speaker 1: seek the help of physical therapists. Certainly men would if 420 00:22:02,080 --> 00:22:06,480 Speaker 1: they had painful I think about that all of the time, 421 00:22:06,720 --> 00:22:09,640 Speaker 1: and even with respect to like periods and menstrual health, 422 00:22:09,720 --> 00:22:12,920 Speaker 1: and like if a quarter of their lives were affected 423 00:22:13,000 --> 00:22:16,520 Speaker 1: by their periods or something in their public floor, it 424 00:22:16,560 --> 00:22:19,320 Speaker 1: would be a different story. I'm not male bashing, by 425 00:22:19,320 --> 00:22:23,040 Speaker 1: the way. I'm just supporting my mom's sisters here. I'm 426 00:22:23,040 --> 00:22:25,720 Speaker 1: with you now. The separation that you spoke of, a 427 00:22:25,800 --> 00:22:29,880 Speaker 1: lot of people associate the separation of your abdominal muscles 428 00:22:30,040 --> 00:22:33,840 Speaker 1: with a postpartum sometimes gets diagnosed, sometimes it doesn't even 429 00:22:34,400 --> 00:22:40,240 Speaker 1: but you mentioned um doming and coraine shapes, which you 430 00:22:40,240 --> 00:22:42,840 Speaker 1: can also get when you're having bracts and hicks. Though, so, 431 00:22:42,880 --> 00:22:44,359 Speaker 1: how do you know the difference, How do you know 432 00:22:44,440 --> 00:22:47,199 Speaker 1: you have a separation, and is it too early to 433 00:22:47,359 --> 00:22:51,119 Speaker 1: start thinking about healing it? So during pregnancy, one of 434 00:22:51,160 --> 00:22:53,199 Speaker 1: the telltale signs is that you know, I tell we 435 00:22:53,280 --> 00:22:55,040 Speaker 1: have people lying on their back and they do a 436 00:22:55,040 --> 00:22:57,760 Speaker 1: little curl up. Their legs are straight, they're lying on 437 00:22:57,800 --> 00:22:59,919 Speaker 1: their back and they curl up their head and shoulders 438 00:23:00,000 --> 00:23:02,080 Speaker 1: off the ground. And if you look down at your 439 00:23:02,119 --> 00:23:04,760 Speaker 1: tummy and you see like a little cone in the middle, 440 00:23:04,800 --> 00:23:06,600 Speaker 1: you'll know exactly what it looks like. It looks like 441 00:23:06,640 --> 00:23:09,520 Speaker 1: a little red loaf in the middle of your tummy. 442 00:23:09,560 --> 00:23:12,600 Speaker 1: That's likely a separation of your abdominals and there's a 443 00:23:12,600 --> 00:23:16,200 Speaker 1: little bit of pressure coming through behind it, So it's common. 444 00:23:16,480 --> 00:23:19,200 Speaker 1: There's research to show seventy to ninety Some studies show 445 00:23:19,240 --> 00:23:21,680 Speaker 1: a hundred percent of women have it during pregnancy, which 446 00:23:21,720 --> 00:23:23,919 Speaker 1: I think that that's a little bit of inflated number, 447 00:23:24,480 --> 00:23:27,080 Speaker 1: but it shows us that the pressure isn't being managed well. 448 00:23:27,720 --> 00:23:30,720 Speaker 1: And I think about diastasis rector your abdominal separation the 449 00:23:30,720 --> 00:23:33,840 Speaker 1: same way I think about proaps or pelvic floor weakness. 450 00:23:33,880 --> 00:23:36,199 Speaker 1: The hammock is getting stretched. But are there things that 451 00:23:36,240 --> 00:23:40,560 Speaker 1: we can avoid to minimize that, Not doing the sit ups, 452 00:23:40,680 --> 00:23:43,480 Speaker 1: not getting out of bed, curling up, you know, watching 453 00:23:43,480 --> 00:23:46,439 Speaker 1: your core exercises, and then learning to kind of tighten 454 00:23:46,480 --> 00:23:48,959 Speaker 1: and engage those muscles during day to day activities when 455 00:23:49,000 --> 00:23:51,320 Speaker 1: they could be getting stressed. You know, that's one way, 456 00:23:51,400 --> 00:23:53,520 Speaker 1: and then Brexton Hicks is a little bit later. We 457 00:23:53,600 --> 00:23:57,040 Speaker 1: typically have that happening during third trimester. The Brexton Hicks 458 00:23:57,040 --> 00:23:59,199 Speaker 1: would just be showing you that it's there versus it 459 00:23:59,320 --> 00:24:02,000 Speaker 1: causing it. So it just kind of shows you, well, 460 00:24:02,040 --> 00:24:04,680 Speaker 1: there's more pressure in the tummy. You may see it happen. Yeah, 461 00:24:04,760 --> 00:24:09,000 Speaker 1: they are not fun sometimes not fun. Ever, I don't 462 00:24:09,040 --> 00:24:12,040 Speaker 1: think that's true. That's true. Well, they can be entertaining 463 00:24:12,080 --> 00:24:15,479 Speaker 1: to watch, like at least they were for me, but 464 00:24:15,880 --> 00:24:33,159 Speaker 1: they definitely were not fun to experience. So you also 465 00:24:33,240 --> 00:24:36,920 Speaker 1: work with women on how to prepare for birth. Yes, 466 00:24:37,400 --> 00:24:40,119 Speaker 1: what do you think helps most when you're trying to 467 00:24:40,119 --> 00:24:44,280 Speaker 1: get your body ready for the big day? Should you 468 00:24:44,320 --> 00:24:48,479 Speaker 1: get a birthing ball, should you do stretches? What are 469 00:24:48,520 --> 00:24:50,840 Speaker 1: your best tips? So I think a patient of mine 470 00:24:50,840 --> 00:24:53,640 Speaker 1: actually put it best when she said, gosh, it's actually 471 00:24:53,840 --> 00:24:56,280 Speaker 1: nice to learn what to do before you actually have 472 00:24:56,400 --> 00:25:00,000 Speaker 1: to do it. And during birth, what we are asked 473 00:25:00,000 --> 00:25:02,440 Speaker 1: skiing women to do, our birthing person to do is 474 00:25:02,480 --> 00:25:05,679 Speaker 1: to relax their pelvic floors and open them up so 475 00:25:05,720 --> 00:25:07,720 Speaker 1: that a baby can come on down the birth canal. 476 00:25:08,160 --> 00:25:10,919 Speaker 1: But if we've never been taught, first of all, we 477 00:25:10,960 --> 00:25:13,080 Speaker 1: don't even know that there are muscles down there sometimes, 478 00:25:13,320 --> 00:25:15,440 Speaker 1: and if you've never been taught how to relax them 479 00:25:15,480 --> 00:25:19,080 Speaker 1: and voluntarily push them open, and you're in the middle 480 00:25:19,119 --> 00:25:22,320 Speaker 1: of this really vulnerable birthing situation, it's a really difficult 481 00:25:22,320 --> 00:25:25,679 Speaker 1: thing to do. So during our childbirth preparation and we 482 00:25:25,760 --> 00:25:28,119 Speaker 1: do this virtually and we also do it in person, 483 00:25:28,440 --> 00:25:30,800 Speaker 1: is that we teach women a couple of things. We do. 484 00:25:30,920 --> 00:25:33,040 Speaker 1: Teach them how to do parenneal massage, which is kind 485 00:25:33,040 --> 00:25:35,760 Speaker 1: of softening the tissue at the base of the vaginal opening. 486 00:25:36,160 --> 00:25:38,119 Speaker 1: That's in an effort to just help relieve some muscle 487 00:25:38,160 --> 00:25:40,320 Speaker 1: tension if they do have tightness down there or some 488 00:25:40,400 --> 00:25:43,080 Speaker 1: previous card. Can we talk about that real quick before 489 00:25:43,080 --> 00:25:46,520 Speaker 1: you may do it? Sounds like a crowd pleaser, you know, 490 00:25:46,680 --> 00:25:51,480 Speaker 1: massage peneum, but lots of moms just can't get behind 491 00:25:51,520 --> 00:25:55,240 Speaker 1: the idea. Can you just give us a little tutorial 492 00:25:55,560 --> 00:25:58,280 Speaker 1: on peranneal massage and would you say it's a d 493 00:25:58,440 --> 00:26:02,280 Speaker 1: I Y project or you know, should you enlist a 494 00:26:02,400 --> 00:26:05,560 Speaker 1: friend kind of thing? Both you can do both, so 495 00:26:05,840 --> 00:26:07,640 Speaker 1: you know, at the start of COVID a year ago, 496 00:26:07,680 --> 00:26:10,040 Speaker 1: we actually did an online course teaching people how to 497 00:26:10,080 --> 00:26:12,600 Speaker 1: do this because all of the childbirth classes were canceled 498 00:26:12,640 --> 00:26:15,320 Speaker 1: and so it really showed us that, wow, people really 499 00:26:15,359 --> 00:26:17,879 Speaker 1: don't know how to do this. And the paradeum is 500 00:26:17,920 --> 00:26:20,560 Speaker 1: the area between the vaginal opening and the anal opening. 501 00:26:21,000 --> 00:26:23,280 Speaker 1: There are a lot of nicknames for it. However, the 502 00:26:23,320 --> 00:26:25,760 Speaker 1: way you massage the paradeum is actually by inserting a 503 00:26:25,840 --> 00:26:29,600 Speaker 1: finger into the vaginal opening and pushing down, so you're 504 00:26:29,640 --> 00:26:32,600 Speaker 1: kind of pushing into that muscle through the vagina. And 505 00:26:32,640 --> 00:26:35,200 Speaker 1: I like to think about the vaginal opening like a clock, 506 00:26:35,440 --> 00:26:38,440 Speaker 1: so you're thinking about from three o'clock all the way 507 00:26:38,440 --> 00:26:41,360 Speaker 1: to nine o'clock that lower half. You insert your finger 508 00:26:41,440 --> 00:26:43,919 Speaker 1: and just kind of push at different points in those clocks, 509 00:26:43,960 --> 00:26:46,280 Speaker 1: pull down, take a couple of deep breaths. It will 510 00:26:46,280 --> 00:26:49,080 Speaker 1: feel a little bit burnie. Once that burning starts to 511 00:26:49,119 --> 00:26:51,560 Speaker 1: soften and the muscle relaxes, you go to another spot 512 00:26:51,600 --> 00:26:53,760 Speaker 1: between three to six until you can kind of sweep 513 00:26:53,800 --> 00:26:55,800 Speaker 1: all the way across, almost like you're making a little 514 00:26:55,840 --> 00:26:59,119 Speaker 1: smiley face. I have folks do it starting around thirty 515 00:26:59,119 --> 00:27:02,439 Speaker 1: four weeks of IVAN. See. You can do it to yourself. Um, 516 00:27:02,480 --> 00:27:03,879 Speaker 1: you can do it while you're in the shower with 517 00:27:03,960 --> 00:27:06,359 Speaker 1: one leg up and like that Captain Morgan position. Or 518 00:27:06,440 --> 00:27:08,720 Speaker 1: you can enlist a partner and friend and have them 519 00:27:08,720 --> 00:27:11,200 Speaker 1: do it to you as well. So a lot of options, 520 00:27:11,240 --> 00:27:13,000 Speaker 1: and it's not a must. You know, the research is 521 00:27:13,040 --> 00:27:16,200 Speaker 1: showing it's variable the effectiveness. But I think any way 522 00:27:16,200 --> 00:27:18,240 Speaker 1: that we can learn how to connect with our bodies, 523 00:27:18,720 --> 00:27:21,479 Speaker 1: learn how these muscles work, is beneficial, and you know 524 00:27:22,320 --> 00:27:25,600 Speaker 1: you will be using these muscles. I mean, unless you 525 00:27:25,680 --> 00:27:29,600 Speaker 1: have a c section, but still those muscles are impacted. 526 00:27:29,680 --> 00:27:33,399 Speaker 1: So I feel either way you win. I agree. I agree, 527 00:27:33,400 --> 00:27:36,160 Speaker 1: And it's something commonly performed during childbirth, so it's it's 528 00:27:36,160 --> 00:27:38,200 Speaker 1: also helpful for them to know what to do prior 529 00:27:38,280 --> 00:27:41,680 Speaker 1: to birth exactly. And if nobody's giving you a perennial 530 00:27:41,840 --> 00:27:45,119 Speaker 1: massage during childbirth, should you ask for one? Is that 531 00:27:45,520 --> 00:27:48,600 Speaker 1: one of the best reasons to have a duela for instance? 532 00:27:48,720 --> 00:27:50,120 Speaker 1: You know, I think if it's something that you feel 533 00:27:50,119 --> 00:27:52,600 Speaker 1: like is effective for you, I don't see why not asking. 534 00:27:52,760 --> 00:27:55,959 Speaker 1: Other things that have been helpful to soften the pyreneum 535 00:27:56,160 --> 00:27:58,680 Speaker 1: are using a warm compress or even a warm wash 536 00:27:58,720 --> 00:28:01,600 Speaker 1: cloth over the area. Uh. And again, you know, back 537 00:28:01,640 --> 00:28:03,639 Speaker 1: to what we teach women what to do to prepare 538 00:28:03,680 --> 00:28:05,520 Speaker 1: for birth, as we teach them how to breathe when 539 00:28:05,520 --> 00:28:08,560 Speaker 1: they're pushing, we're finding that a lot of folks are 540 00:28:08,600 --> 00:28:12,359 Speaker 1: holding their breath when they're pushing, and that's not helping 541 00:28:12,400 --> 00:28:14,639 Speaker 1: the muscles relax to get out of the way. And 542 00:28:14,680 --> 00:28:18,480 Speaker 1: so we're teaching them to push while they're breathing. They're 543 00:28:18,480 --> 00:28:21,520 Speaker 1: not exhausted or they're not giving themselves hemorrhoids and prolapse, 544 00:28:22,000 --> 00:28:26,080 Speaker 1: and they feel like they can effectively relax these muscles. 545 00:28:26,600 --> 00:28:30,000 Speaker 1: Your pelvic floor muscles don't push your baby out. Your 546 00:28:30,080 --> 00:28:32,360 Speaker 1: uterus does. And we just want the muscles to get 547 00:28:32,359 --> 00:28:34,400 Speaker 1: out of the way. And so that's what we're trying 548 00:28:34,440 --> 00:28:37,359 Speaker 1: to help women do well. I guess that's a wrap 549 00:28:37,440 --> 00:28:41,080 Speaker 1: for pregnancy. We just had the baby leave the building, 550 00:28:41,360 --> 00:28:44,520 Speaker 1: so we're gonna pick back up with you when it's 551 00:28:44,560 --> 00:28:47,400 Speaker 1: time to talk postpartum. But we can't thank you enough 552 00:28:47,440 --> 00:28:50,800 Speaker 1: for being on today with What to Expect community. This 553 00:28:50,920 --> 00:28:57,840 Speaker 1: is so great. Thank you so much. Thank Sarah, baby 554 00:28:58,400 --> 00:29:04,680 Speaker 1: baby Off, need you, Oh how I need you. Thanks 555 00:29:04,760 --> 00:29:08,400 Speaker 1: for listening. Remember I'm always here for you. What to 556 00:29:08,520 --> 00:29:11,960 Speaker 1: Expect is always here for you. We're all in this together. 557 00:29:12,640 --> 00:29:15,480 Speaker 1: For more on what you heard on today's episode, visit 558 00:29:15,600 --> 00:29:19,120 Speaker 1: what to Expect dot com slash podcasts. You can also 559 00:29:19,200 --> 00:29:21,800 Speaker 1: check out What to Expect when You're Expecting, What to 560 00:29:21,880 --> 00:29:24,880 Speaker 1: Expect the First Year, and the What to Expect app. 561 00:29:25,400 --> 00:29:28,840 Speaker 1: And we want to hear from you. Connect with us 562 00:29:28,880 --> 00:29:32,160 Speaker 1: on our community message board or on our social media. 563 00:29:32,600 --> 00:29:36,160 Speaker 1: You can find me at Heidi Murkoff and Emma at 564 00:29:36,240 --> 00:29:39,880 Speaker 1: Emma bing W t E and of course, at What 565 00:29:40,040 --> 00:29:44,760 Speaker 1: to Expect Baby Love is performed by Riley Pieterer. What 566 00:29:44,920 --> 00:29:48,320 Speaker 1: to Expect is a production of I Heart Radio. From 567 00:29:48,320 --> 00:29:51,000 Speaker 1: More shows from I heart Radio check out the I 568 00:29:51,160 --> 00:29:55,440 Speaker 1: heart Radio app, Apple Podcasts, or wherever you listen to 569 00:29:55,480 --> 00:30:01,080 Speaker 1: your favorite shows. In my Arms on Don't You Stand 570 00:30:01,360 --> 00:30:07,600 Speaker 1: Kneed Kneed Jo, Baby Little Baby Loo