This is Episode 21 of the Juna Women Podcast, The Postpartum Vagina (Pt. 1) with Marcy Crouch.
The Juna Women Podcast is a weekly discussion where Juna Founder, Sarah Kuhn, talks to Moms about their health, work, parenting, and all the different ways they’re keeping it together.
The Postpartum Vagina
In this episode Sarah talks with Marcy Crouch, a women’s physical therapist specializing in the pelvic floor.
First, they talk about postpartum care in the United States and the rise of Pelvic Floor PTs specializing in pelvic floor therapy.
One of the reasons for this change is that a lot of celebrities are now openly talking about their pelvic floor issues.
We’re also talking a lot more about the challenges that come with postpartum, the judgement of our postpartum bodies, and figuring out, “Why didn’t anyone tell me it might hurt to poop after having a baby?”
As a result of these conversations women are starting to advocate for themselves and seek help for their postpartum journey. This SHOULD start with asking your medical provider for a referral to Pelvic Floor Physical Therapy at your 6 week postpartum visit.
So, what is the pelvic floor?
The pelvic floor is a group of different types of skeletal muscle that lie at the bottom of our pelvis.
If you think about the public bone, as like a ring, it’s like a circle of bones.
The pelvic floor sits like a hammock basically underneath that, that goes from front to back.
From your pubic bone, right where your pubic hair the muscles attach to the back of that.
Then they attach to your tailbone and up the tailbone.
Front to back and then side to side, they go from your sit bone to your sit bone.
Within the pelvic floor muscles in women, there are three holes: the urethra, the vagina, and the rectum.
Because of how these muscles are oriented in the body, they basically are considered the floor of the core. They’re holding everything up. If we didn’t have a pelvic floor. There would be no bottom to our trunk.
Why The Pelvic Floor Is Functional
There are three main functions of the pelvic floor.
The first one is support. The Pelvic Floor is responsible for lifting us up against gravity and supporting our pelvic organs, the bodyweight of our intestines, and if you’re pregnant, your baby.
The second function is continence. Within the pelvic floor muscles, there are round muscles that are responsible for closing down the urethra, bladder, rectal and anal openings. As the rectum is filling with poop and as the bladder is filling with urine, those muscles and their sphincters turn on to ensure nothing slips out. When these muscles aren’t working efficiently, that’s when you get incontinence.
The third function is sexual — the pelvic floor helps with orgasm. The pelvic floor muscles help create the rhythmic contraction required for orgasm. It also contains all the nerves of the pelvic girdle and the skin of the labia.
The pelvic floor is the only type of muscle that lies across our body. Because of this, we don’t ever really get to rest it. The demands on this group of muscles are exponential.
Pelvic Floor During Pregnancy And How It Affects The Postpartum Vagina
During pregnancy the mechanical demand of those muscles is substantial. They hold us up against the increase in weight over a 9 month period. Then during labor, their primary responsibility is to get out of the way.
They have to move and stretch to the circumference of the pelvic bowl so baby can descend through the birth canal. Add to that, if there is tearing or injury during labor, it only increases the load on the pelvic floor.
After birth, most women expect the pelvic floor to continue to function, but it’s been through so much over an extended period of time, that like any other muscle, it needs proper rehabilitation.
This episode is filled with so much more information about how to take care of your pelvic floor during pregnancy as well as postpartum.
If you already know you need pelvic floor physical therapy – you can find a physical therapist near you by following this link.
Show Notes From The Postpartum Vagina
7:30 – Pelvic Floor PT has grown and in recent years. Find out what women were doing who had issues with their pelvic floor before we started talking about this topic more openly
12:45 – How little women know about the pelvic floor before becoming pregnant and having babies
19:25 – When you may want to seek the care of a Pelvic Floor Physical Therapist
23:00 – What is the pelvic floor? An overview for beginners.
32:49 – The things women can do during pregnancy to strength and prepare for labor.
37:11 – Perineal Massage.
40:37 – Diaphragmatic breathing.
54:39 – Tearing. Sometimes the skin between the vagina and anus (the perineum) might tear or be cut by a doctor or midwife to allow the baby out. This is called an episiotomy
About Marcy, The Down There Doc
Marcy Crouch, PT, DPT, CLT, WCS
Marcy L. Crouch, PT, DPT, CLT, WCS received her Doctorate in Physical Therapy from the University of Southern California in 2010.
Upon graduation, she completed a Women’s Health Residency program in Dallas, TX where she focused on all aspects of pelvic floor dysfunction, pregnancy and postpartum musculoskeletal issues, and breast cancer rehabilitation.
After, she obtained her WCS, which identifies her as Board Certified Clinical Specialist in Women’s Health Physical Therapy.
Lastly, Marcy has taught pregnancy and sexual health courses in the community, as well as continuing education courses for physical therapists both nationally and internationally. Connect with Marcy.
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