Birth Journeys: Lifting the veil on the birth experience
Did your childbirth experience go as planned? Then The Birth Journeys Podcast® is for you! We share powerful and transformative birth stories that illuminate the realities of childbirth. Hosted by a labor nurse and prenatal coach who specializes in transformational coaching techniques, this podcast goes beyond traditional birth narratives to foster healing, build trust, and create transparency between birthing individuals and healthcare providers.
In each episode, we dive into essential topics like birth preparation, debunking common misconceptions, understanding hospital procedures, and promoting autonomy in the birthing process. We also bring you the wisdom and insights of experienced birth workers and medical professionals.
This is a safe and inclusive space where every birth story is valued, honored, and deserves to be heard. Join us in exploring the diverse and unique experiences of birth givers, and discover how transformational coaching can empower your own birth journey.
Contact Kelly Hof at: birthjourneysRN@gmail.com
Birth Journeys: Lifting the veil on the birth experience
Katie Bayer: Transforming Postpartum Recovery with Pelvic Floor Therapy
Can pelvic floor therapy be the missing piece in postpartum recovery? Join us in this enlightening episode as we sit down with Katie Bayer, PT, DPT, owner of Transition Physical Therapy and co-founder of Behive Wellness. Katie shares her deeply personal journey through a twin pregnancy, a premature delivery at 33 weeks, and the emotional rollercoaster of a NICU stay. Her experiences, culminating in a VBAC (vaginal birth after cesarean), have shaped her dedication to specializing in pelvic floor therapy for pregnant and postpartum women. Listen as Katie recounts the vital role family support played in her recovery and how her challenges have fueled her mission to aid mothers on their own paths.
Discover the critical yet often ignored importance of pelvic floor physical therapy in postpartum care. Katie shines a light on the gaps in standard PT education and emphasizes the need for integrating pelvic floor awareness into core training. She offers practical, realistic advice for new mothers on how to seamlessly incorporate pelvic floor exercises into daily routines. By tailoring strategies to meet individual needs, Katie underscores the effectiveness of manageable and functional approaches, aiming to make postpartum recovery more attainable for every mother.
Explore how Katie and Megan McCutcheon, a perinatal mental health therapist, have joined forces to create a collaborative perinatal care center. This space offers a comprehensive support network for expectant and new parents, fostering a community that addresses both the physical and emotional aspects of postpartum care. From the development of the online Bundle Birth Course to the emphasis on rest and recovery, Katie and Megan's center provides essential resources to make the perinatal period less overwhelming. Tune in for invaluable insights and support strategies that aim to revolutionize postpartum care and ensure mothers feel supported every step of the way.
Work with Katie! https://www.transitionphysicaltherapy.com/
Join the Bump & Beyond Online Community for moms & moms-to-be!
Coaching offer
Kelly Hof: Labor Nurse + Birth Coach
Basically, I'm your birth bestie! With me as your coach, you will tell fear to take a hike!
Connect with Kelly Hof at kellyhof.com
Medical Disclaimer:
This podcast is intended as a safe space for women to share their birth experiences. It is not intended to provide medical advice. Each woman’s medical course of action is individual and may not appropriately transfer to another similar situation. Please speak to your medical provider before making any medical decisions. Additionally, it is important to keep in mind that evidence based practice evolves as our knowledge of science improves. To the best of my ability I will attempt to present the most current ACOG and AWHONN recommendations at the time the podcast is recorded, but that may not necessarily reflect the best practices at the time the podcast is heard. Additionally, guests sharing their stories have the right to autonomy in their medical decisions, and may share their choice to go against current practice recommendations. I intend to hold space for people to share their decisions. I will attempt to share the current recommendations so that my audience is informed, but it is up to each individual to choose what is best for them.
Hello, today I have with me Katie Bayer, pt, dpt. Katie is the owner of Transition Physical Therapy in Vienna, virginia, and a pelvic floor pregnancy and postpartum specialist. She loves helping women prepare for birth and recover in postpartum, along with assisting them at any point along their pelvic floor journey. Katie is a mom to three girls twins, 13 years old, and a singleton, 10-year-old. Her own pregnancy and postpartum story, including her own VBAC, set her on a path to treating others going through the same experiences. Her goal is to arm people with information and help them to prepare for birth and postpartum and beyond. She, along with Megan McCutcheon, is also the co-founder of Beehive Wellness, a collaborative space with multiple holistic providers who support women and families, especially during their perinatal journey.
Speaker 1:Katie, welcome and thank you for joining me. Thank you, I'm so happy to be here. Yeah, it's been a long time coming, but we finally made it happen. Yes, I'm glad happy to be here. Yeah, it's been a long time coming, but we finally made it happen. Yes, I'm glad to be here now. I love it. Well, I want to hear about your twin pregnancy and then your VBAC, and then how that affected your body and how you made the choice to help women along their motherhood journey.
Speaker 2:Yeah, so when I first became pregnant. So we got pregnant pretty easily. We had been dating a long time, got married and I just kind of figured I don't know why this is going to take a while, it's just like start now. And at the time I wasn't a pelvic floor physical therapist, so I was just kind of a regular PT and knew surprisingly little even as a physical therapist, about pregnancy, about postpartum, about really nothing about the pelvic floor. So I'm going into this, you know, pretty blind early on.
Speaker 2:So we got pregnant and it was very much a surprise that it was twins. They actually missed twins on the first ultrasound. So at 12 weeks we luckily my husband was there for that one we had another ultrasound and it was like, oh, did the doctor tell you there are two? Because we had our ultrasounds shipped out to the local hospital actually where I worked. So that was a big moment and that was actually the day that I was announcing to my coworkers I was pregnant. So I came down and just like bawled and just was really honestly, like I say, you know, I'm going to someday tell my daughters. It was a very scary, emotionally charged day when we found that out and it was just shocking. I think we were just in shock for a good long while and then, you know, we settled in and the actual pregnancy of the two was actually easier, partially, I think, because I ended up going early. So I felt pretty good, I was 33 weeks and I felt like in the middle of the night I felt pretty good, I was 33 weeks and I felt like in the middle of the night maybe one of them had kicked my bladder and I peed but my water broke and pretty quickly progressed.
Speaker 2:And then, because they were small, the doctor was really good, I have to say I did like that practice. You know he really wanted me to understand why a C-section he felt was the best route, because they were little and baby B was transverse. And so they said we really just feel like this is best, you know, for babies. And I said, and I knew, you know, going in with twins, the chance of having a C-section was higher, no matter when they came. So I think I was just mentally prepared for that and so and it was just quick Now I know I go through labor very quickly.
Speaker 2:So actually they had put the spinal in and I was. You know they were getting ready and prepping me and baby A was coming out. So baby A had decided to start her little delivery. So they actually had we had 20 people in the room so like, basically, you have, each baby has a staff, has a whole team. So we had, through the you know, the sheet in front of you, the drape that they put up and they had to kind of put her back in to then deliver her via C-section. And then you know, baby B is very quickly, one minute later delivered and they went straight to NICU. So it's kind of a quick, you know, kiss and go moment. Looking back, I mean, obviously it's scary anytime your baby is going.
Speaker 2:It was early and going to the NICU and they did need support but they really were fine. Like when I talked to a friend who's a NICU nurse later, she's like, oh yeah, they were just like feeder growers, they just needed time. So they were there for about a month, three weeks and four weeks for each of them and then came home on heart monitors, which was stressful. That was probably. The NICU was stressful, but if anything, you know, I had just recovering from a major surgery and I could sleep. I woke up to pump and then I went back to bed. So it was kind of. You know, the silver lining to it all was that I actually had more time to recover. So we just kind of did the daily drives. You know, I would go a couple of times a day and my husband would go after work at night and then, you know, once they were home, we had some family support, which is great. Both of our families came down, both of our moms stayed for a bit, and that's that was very welcome. They're very good and just helpful where they need to be. But we lived in a place without family and so you know, they couldn't stay forever and that was challenging to have that.
Speaker 2:But you know, I would say the first year is a blur I'm not going to go too far out of like the you know, the birth journey, but my twins are like you know, what do you remember and what were our first words? And I'm like, honestly, I don't know, I didn't write it down. I was in a blur. We were just trying to keep them on schedule. I wrote down everything because I couldn't remember anything and it was just. It was just a lot of schedule maneuvering and just kind of trying to keep them, you know, somewhat together to keep sanity.
Speaker 2:So we, our original plan was to do, like you know, every couple of years, you know, have a kid. But for us it pushed the second pregnancy a little later. So my youngest was three and a half years after the twins and that was a very nerve wracking first ultrasound, I will tell you, because we didn't plan on having twins the first time and we were nervous about that second one because they missed it on the first. We were the new practice, we had moved to the Northern Virginia area for this one and so they looked a long time to make sure there was only one. And so that was definitely just a relief, you know, just to be able to have kind of a single pregnancy and kind of hope for a more standard or whatever that means, kind of normal delivery and birth.
Speaker 2:But I was diagnosed with gestational diabetes with her, so that was just. I mean, it was challenging in some ways because you know you have to monitor everything and you have to eat very healthfully. But then because you eat really healthfully, like you don't gain as much weight and you just feel a little bit better, and I exercised, and you know, by the end of the twins pregnancy we were living in New Jersey and I was like pizza every day, you know, ice cream. It was great. But with this one it probably was good in some ways that it forced me to be a little bit healthier.
Speaker 2:With that pregnancy, because of the gestational diabetes, the with that pregnancy, because of the gestational diabetes, the practice that I was in I didn't love. Now, looking back, I think I would have gone with somebody else had I known more about them. But they were a large practice and they just kept kind of scaring me a little bit into like, oh, this baby's going to be a linebacker. You know she's going to be huge. Actually we didn't know what we were having. So the baby's going to be huge, baby's going to be a linebacker. And you know she came two weeks early, which I'm glad for.
Speaker 2:It was like after 33 pregnancy. Like 38 weeks felt like forever, but she was, you know, seven, four. She wasn't a huge baby and she maybe would have been, you know, closer to eight had she gone to extra two weeks, but who knows? But anyway, so that pregnancy was actually much harder on me and the gestational diabetes I'm sure was contributing. But I also had really bad varicosities in my leg. I worked full-on compression hose the entire pregnancy, which at the end of any pregnancy is so hard to get on, but I literally could not have like worked or walked around without them. So it was totally worth it. But not easy, and so physically this one really took its toll on me, much more so that it felt like the twins did, and you know I'm three and a half years older as well, so I'm sure that contributed. So she came the same in the much the same way in the middle of the night, more like 430. Water broke. I always had the pop in the gush.
Speaker 2:So with each pregnancy I kind of had the very obvious start and then, you know, call the doctor, they say take a shower, count your contractions. So I shower and I can't count my contract. I'm like am I bad at this? I don't know what to do. It's not, I'm not. The math isn't working out. I think I was basically just in like full on labor, no contract. They were just like one long contraction really quickly, because when I got to the hospital an hour later I was eight centimeters. They're like why weren't you here earlier? And I was like I had no reason to be here earlier. Like I didn't feel like I was in labor, so and then I had her. You know, basically from beginning to end it was like four hours, so it was 430 to like 830 in the morning.
Speaker 2:So I think the only reason because the hospital I delivered at is known for C-section and not good about VBACs, but she just came so fast and furious there was really no other option and she, you know, was able to be delivered pretty easily. So it was hard, I mean, it's challenging. I did get an epidural, even though it was fast. That was my plan and it worked, but I'm not sure how intense it was. So I felt much of it, but it was what I wanted.
Speaker 2:It was that, you know, I wanted the VBAC.
Speaker 2:Had I had the C-section, that would have been fine too, but I really was hopeful for the VBAC and so I was glad to get that.
Speaker 2:And she came right home and it was nice having just one baby to hold and I have to kind of schedule, you know, around a second baby and breastfeeding was easier. I never the twins never really got breastfeeding, and so it was nice just to have one, you know, to be able to do that which I wanted to do. So, yeah, so those are my birth journeys, birth stories, and you know, I think I'm not sure we'll talk about all the things I've learned, but I just know like through my experience, I realized how little I knew about everything, and I'm a profession that you know, as a physical therapist. I feel like I should have known more and so, god, there's so much now that I would go back and do differently now that I have this breadth of knowledge that I have now and that really all that whole entire journey really both of them is what inspired me to kind of go on and learn the kind of pelvic floor pregnancy portion of physical therapy.
Speaker 1:Yeah, that's so important. I feel the same way. I feel like I mean, even now there's not a lot of knowledge within the medical field, it's just starting. People are starting to send people to pelvic floor physical therapy, but then I still hear people talking about oh, do your Kegels, and I'm like I think we've moved past that.
Speaker 2:No, we have. That's what we learned in nursing school, right, and even that there's so much nuance of whether you even should do Kegels, I mean. But I was in stirrups after the second pregnancy and mentioned something about you know leakage or something which I didn't have a big issue with. It's like ah, you can do Kegels, but it doesn't work. I was like great Thanks, that's the only speech I got about anything postpartum and it was like great.
Speaker 1:Yeah and not helpful. So my I guess my question as far as, like the pelvic floor physical therapy is what do they teach in PT school?
Speaker 2:Because I find that not many physical therapists that aren't specialized in pelvic floor really know to even pay attention to it. I will say, when I graduated in 2007, nothing, you know, I'm trying to think back Was the anatomy even like referenced? It probably was, but like never in, let's say, cadaver lab, which we look at everything, we definitely didn't dissect that. It really wasn't spoken about at all. I think it's better now, but I also think the people who are choosing to go into it earlier are actually entering these courses, these extra courses, while they're in school, versus getting the knowledge in school.
Speaker 2:I'm sure there are some schools that are better. I just, and to be fair, I think that the physical therapy degree you're supposed to graduate as an entry level and pelvic floor therapy is this extra training, but I think more attention needs to be paid to it, not as a like pelvic floor internal, this whole other separate, very specialized thing, but the pelvic floor is a part of our core, it's central to our body, it's a sump pump for vessels, it's all of these things that everybody needs to pay attention to. So I do wish and hope now that it's being paid attention to more. It wasn't when I was in school.
Speaker 1:Yeah, all I remember is my professor in nursing school saying that she does Kegels at Red Lights.
Speaker 2:And that's all you need to know. That was all I got.
Speaker 1:Yeah, that's probably more than most. I feel like I was lucky because we had a Pilates studio down the street from me in New York that I went to and I did like private classes because I knew I had back problems and so I knew that I needed to help strengthen my back, but they focused on the pelvic floor. That's good, yeah. So I feel like I got a lot of pre-pregnancy help, but the problem was I felt like when I was pushing it's the opposite, so it would have been helpful to know how to release my pelvic floor so that I could push my baby out and we moved away. So then after that, I just kind of didn't do anything, and I wish that I had, because after my second was born, I really needed pelvic floor physical therapy and I went ahead and got it, but I just feel like I could have done more at home, and the physical therapist that I went to she was lovely, but she hadn't had kids, so she was very receptive to my feedback of like this is overwhelming I'm not doing the exercises.
Speaker 1:I love the suggestions you're making. However, it's not being worked into my life, and so then she was great about asking me okay, well, when you're doing, what are you feeling, like the heaviness, and I'd be like running up the stairs, and she'd be like, oh, blow out when you're running up the stairs. And that was a game changer. And then the same thing for, like, when you're sitting down or standing up, you know, having the right pelvic tilt and the blowing out and the making sure that you're not bearing down. And it was the practical things that were so helpful for me because, honestly, at that stage in your life it's so hard to do the exercises you're supposed to do. Yes, so I'm sure you have a lot of insight into that.
Speaker 2:Yes. So it's funny because, as a new grad before I got into this, but even just like a fresh graduate, you're like everyone must do their home exercises. Come on, let's be diligent, let's check these off three times a day. Two sets of 20. And over time, as you learn more and definitely doing what I do and treating who I treat, I just ask them first, what is your bandwidth right now? Like what do you actually have space for?
Speaker 2:If you're fresh postpartum, I know it's not much because you're not sleeping. If you have a toddler, there's zero time. It's your first, it's still there's just there's so many layers to it, and so you have to meet them where they're at, because otherwise you're not going to get them better by telling them to do stuff they're just not going to do. So I like to offer, if you feel like you have time and someone says, yeah, I might be able to eke out some time, here are some things you can do Other than that. Let's just either just work on the functional things like you're talking about, or when you're standing at the microwave, can you do this like one little thing. Or when you're doing this, can you do this one little thing and try to like infiltrate it into your day, which, honestly, for most people that's the best way to do it. But especially in this time period where you just you're not going to get 30 minutes even if you have it, most won't give themselves 30 minutes to just be like. I'm going to go on this run, I'm going to ignore all the crying, I'm going to lie here and do my pelvic floor PT.
Speaker 2:And you know, if somebody says they can do that, great, like that's, we can mold to that too, but the majority don't. Or they say they will and they can't, which is no judgment. No judgment Like I never. I think people, people come in and they're like I feel so guilty, I didn't do my home exercises, and I'm like, okay, that's fine. Well, how do you feel? You know, like if we really are still feeling bad, let's really try to sneak them in somewhere and see if it helps. But let's just take each day, each moment like. This is a stage of life where this is what it looks like. You don't have a lot of time, so what can we realistically do or fit in?
Speaker 1:Yeah, and not that it's ideal, but you can fit them in more later. You know, like it's kind of a lifestyle change rather than let's get the pelvic floor taken care of immediately after birth.
Speaker 2:Yes, and that's also what I tell people. This is a journey from here until you die. Really, like you know, we're going to have this pelvic floor. Right now is a really good time, a really important time, to really address some issues. You're in this perinatal period where you're making and delivering humans, your hormones are all over the place, and then we have this gap where you'll have hopefully a little more time to pay attention. But it's not like, oh, we stuck that pin in, we did pelvic floor physical therapy, we're better, and then the rest of your life.
Speaker 2:You don't have to think about this stuff. Like the stuff I'm teaching people. I'm like this, really, this is like forever stuff for the most part, especially all of the functional things and then exercise. I really just tell people let's try to integrate what we've taught you here into whatever you like to do, because if I tell you yoga is great for you and you hate yoga, you're not going to do it. So what do you like to do? And let's try to marry everything together. But then I'm trying to keep this person in front of me out of a nursing home for incontinence or not having UTIs, and that's what kills you in the end, because that is ultimately that's what sends us into nursing homes and increases our death rate.
Speaker 2:So my goal is now, but forever learning lifelong things that also are just more easily infiltrated into your life versus a task you have to do and check off every day.
Speaker 1:Yeah, that's so important.
Speaker 1:Before we move on, I know I want to talk to you about how you prep people for birth because, I mean, I just happened into Pilates so I had no idea that what I was doing was a good thing to prepare for birth. But I've heard that a big part of what can exacerbate the issue in the postpartum period is how you sit while you're breastfeeding. Like you spend so much time breastfeeding. How do you address that with moms? I know you're trying to go through the specific points of the day and try to focus on how to be better in those points. What about breastfeeding? What are some?
Speaker 2:Yeah, so any kind of feeding. So you're spending many hours in this position, especially initially. There's just a lot of time spent sitting, generally Early on. I like to recommend a variety. So if you have a couple stations in your house, that's ideal because it just gives you a variety. Our body just likes variety.
Speaker 2:It doesn't like being in one place for too long. If you have one station, that's fine, but you need to have support, and I don't just mean a boppy. So people come in, they have their like pretty glider and they have their one boppy and then they try to breastfeed and then they're in pain because it just doesn't offer enough support. You want something that is super supportive, probably shoving a couple of pillows behind your back. I think I ended up. I hated the Boppy. I eventually used it with like two or three pillows, but you just need like. You want like all the pillows, just like. Put them all in your little space and it's not going to look pretty, I think. Like you know, on Pinterest or Instagram you see these like beautiful little nursing areas. Just shove it filled with pillows and support yourself so that you're not bending down because you're not going to be.
Speaker 2:Our bodies aren't meant to be in one passive position for long periods of time.
Speaker 2:So I say, assume you're going to get tired and start to collapse, but if you're supported then at least you're, you know, in a good position.
Speaker 2:Move as you can so, like you know, little movements like rocking your hips, call it seated cat cows, you kind of once baby gets a little bit more accustomed and you're not putting all your attention to like just trying to keep everything going with the breastfeeding it's easier.
Speaker 2:But creating a little bit of movement, trying to have a variety of how you're sitting, which way you're propping, which breast you're starting with Sidelining, is great if the baby can do it, because it just gives you again just a variety of positions. Plus you can be a little bit more neutral and then not that like hunch forward position and I would say you definitely want to see a lactation consultant if there's any issues, because if there's issues you're just going to constantly be battling and you can't think about your posture if you're battling and trying to get your baby to feed. So I would say, just like all the ugly pillows everywhere, support, you know, don't worry about looking pretty, and then, as much as you can, have a variety of positions, including in sideline, and then get some help if you need it just so that the actual task can be as quick as it can be and as efficient as it can be.
Speaker 1:I'm just having like these flashbacks of breastfeeding all night long with my son. That was just attached to me. I had the my Breast Friend and I would put it on like an inner tube. I'd have it all the way up to here because I don't have large breasts, so we had to be right all the way up and then just stacked with pillows in the smack middle of the bed because he didn't want to ever stop and I was like basically up all night trying not to fall asleep, and so I had all that stuff next to me to try to avoid dropping him, like I had every everywhere, and I would just clasp my arms and just anytime that I'd start to feel myself relax and let go, I'd startle myself awake.
Speaker 1:It was awful, I mean, of course, my pelvic floor was destroyed by the end of that 16 month period. Yeah, it's hard on it. Yeah, it's really bad, and I had no idea at the time that that was contributing. I just really tried to just get to the point where I could stay upright and not drop him. Yep, because it was like if I could put him down for an hour he'd be up in an hour and it just got to the point where it wasn't sustainable and I couldn't I mean half the time. We just end up there, because as soon as I'd wake up I put him down.
Speaker 2:But it's hard and I say like there's ideal, obviously, and then there's real life and there's sometimes where if you, if your baby's always like that, you have a choice. I mean, it's in the middle right, like I feel like you can try to get help for certain things. So maybe something would have helped that journey if you had I don't know hired a lactation sleep consultant, something maybe not, because sometimes just that it just is what it is and so it's like you know, is there something you can do? Let's like look into that, let's see if that would help.
Speaker 2:If there's not, okay, what can we do to work within this framework that you have and that isn't going away anytime soon and it's not always pretty, but we kind of make it as good as we can and then maybe clean up a little bit after. But there's a lot. There's a lot of small things you can do how you hold, you're not breastfeeding, what can you do, like, when you get up, what are some things you can do. So there's little things you can add in to make it a little bit easier.
Speaker 1:Yeah, Just like you said you as a physical therapist, me as a nurse it was amazing, Even in my second pregnancy and birth, how little I knew and I mean like financial constraints as well. It's like you know, can I have somebody come take the baby and help them sleep, or do I just suck it up and deal with it? And I feel like I was just of the belief that I had to suck it up and deal with it, and I think a lot of moms think that. But at this point, even five years later, I feel like there's so many more resources that are affordable and insurance covers more now, like lactation and pelvic floor physical therapy, whereas it was hard to find five years ago for me to have something that my insurance would cover. So it's just interesting now that there's so much more out there and I think it's really important that we're encouraging moms to utilize their resources and they don't have to tough it out and there's not really a whole lot of benefit from toughing it out if there are now resources that are affordable.
Speaker 2:Yeah, and I think there's definitely like cost is always a factor. So you know, whether it's me or somebody else, I totally appreciate that. I think just culturally in our country, and I was very much like I'm, and I still this is a personality trait that I have to constantly kind of check in, that I am independent to a fault, I don't want help, I'm on my own, I'm good, no, I'm good. And so I think it's taking help from friends when they offer, you know, like no, no, no, we got it, we're good, we're good and you know, taking family, you know, if you want them there, taking whoever offers anything, even if you don't have a lot of good friends or family in the area. Your neighbor stops by, take it. You know, like, you know other cultures, in the first 40 days some women are literally not allowed to get out of bed and it's like we'll just flock, like women neighbors, family flock to them and they don't do anything. And you know they're shocked when they come here and it's like, oh, that doesn't exist and I don't know, we can't rewrite American history. That's not going to be the way. Probably we're not going to shift that severely.
Speaker 2:I think we need to understand that this is a time where if you're not giving yourself some time to sleep, to sit, not allowing some help in, it's like longer to physically heal.
Speaker 2:I talk to people about like you need to sleep and they're like, oh well, I need to do other things. I'm like you won't physically heal as fast. Your whole thing, your pelvic floor, everything won't feel as good. We're not going to be doing any intense work until, like, physical work, until you're sleeping, like I don't want you doing any kind of working out, until you're getting a good four to five, six hour chunk because you can't, your body is going to, it's going to give up on all the healing and try to go to all this other stuff you're trying to do. And as far as you know the cost thing, you know. I also think it's a framework of like what we think about as being important no-transcript address it now, and that's definitely true for public floor but even just thinking about like getting a little bit of extra help, like you'll be yourself back to work, back to more efficient mode quicker. So sometimes it's just a matter of viewing things a little bit differently, I think.
Speaker 1:Yeah, I agree. I think also some of it's just the overwhelm, Like you go to find resources to help you and then you're just like I don't know which one's going to help me. Yeah.
Speaker 2:Don't even know what to go with. No, because Google is overwhelming. I mean, there's just too many options and who the heck knows what's good and that's. You know, I'm probably getting ahead of myself, but that's what we kind of wanted here at Beehive was not only providers but like we have like a network of cards to be like OK, this person isn't here, but here's an option. Here's a person we know and met and we seems really good because Googling at 3 am for a lactation consultant like you said, it's overwhelming and you're exhausted and how can you think straight to like make a pretty important decision?
Speaker 1:Yeah, and that's why I think both of us are involved. I had the babysitter people on here, amy and Lindsay, and I really hope that they go nationwide, just because moms need it. We need a service registry and we need curated recommendations and so that we're not up on that, because all of us have done it. All of us have been up all night Googling who's going to help us, and I think that's why we all do what we do right now, because we don't want anybody else to go through that 100%.
Speaker 2:Yep.
Speaker 1:So we've talked about postpartum. How do you prepare for birth?
Speaker 2:Yeah. So it's funny because when I first got into doing pelvic floor, I really really thought more about that postpartum period. That's kind of what gets all the attention. But the more I did it and the more I worked with people, there's so much you can do to mentally, physically and just like on a knowledge level, prepare. So when you think about going into labor, think about being pregnant. I mean thinking back to when I was pregnant.
Speaker 2:I think most people don't even know what your pelvic floor is Like. You hear the word, but what the heck? What is that? Like a floor in your pelvis, like what is this? And oftentimes people are told to like kegel their babies out, and it's just obviously the opposite. Yeah, our pelvic floor does not push a baby out, and so there's things we can work on.
Speaker 2:So basically, my approach to pregnancy, for birth prep, is you want to open and release things. So, yes, we want to be strong. That is a part of the kind of pregnancy prep If somebody definitely has some weaknesses. But my primary thought process when someone's coming to me for birth prep is what is tight, what needs to be opened, because baby needs to get down into pelvis, baby needs to get through and out. So that's, you know, abdominals, that's looking at the diaphragm, because if baby's kind of getting shoved, you know, in certain places it's just less likely for them to be in a good position. So I want there to be an optimal kind of release and opening throughout the entire kind of canister we call it, like diaphragm, all the way to pelvic floor. If you've had a C-section when you're prepping for a VBAC, you definitely need scar work. If you haven't done it, and as your belly grows, we need to work on that scar tissue because it's like a block. You know you have this tissue that can just stay tight and kind of prevent baby from being able to drop down.
Speaker 2:And then the pelvic floor. It's a combination of making sure that there's the ability for it to lengthen and to open, but it's also for the person to connect to it, cause like, how often do we touch our pelvic floor? How often do we even know what that feels like to? I mean, you kind of can feel what a Kegel feels like. Most people don't know how to lengthen or open their pelvic floor, and then we do look at pushing a little bit, but as long as the person knows how to activate their core properly with breasts, which we work on. I don't go into that too much because it just becomes so overwhelmingly automatic as you do it and you really have no choice but to push once you feel like you have to push. So we go over a little bit of the core mechanics. But really that pelvic floor opening lengthening, that sometimes includes internal work. But if someone doesn't want it or can't have it for some reason doesn't have to. There's other ways to kind of get around it. But to me that's the best way because it's feeling. What does it feel like when this area is open and feel stretched? Okay, can I access my breath to allow it to release even more? What does that feel like?
Speaker 2:And then, talking through the different positions of your hip and your spine to open both the top of the pelvis and the bottom of the pelvis. So earlier in labor you do certain things to open the top of the pelvis, later in labor there's just hip and sacrum or spine positions to basically allow that bottom part of your pelvis to open up better. And then how do we apply that to different positions? So even if you have an epidural, you can still be in different positions, especially if you have a doula. I mean the more people in the room the better. But you know, nurse and partner can help you get into all fours, can help you definitely into sidelining.
Speaker 2:Birthing on your back is not evil, but it just shouldn't be forced upon you. So if you end up there, that's fine. I've had people come in feeling really guilty that they birthed on their back and I was like, well, why, you know? And they were like, well, I was just so tired, I just felt like the best place. Well, that's fine. But here are some, you know, tips to get it to the point where you can open up your sacrum a little bit better so it's not getting squished on the bed.
Speaker 2:So kind of just basically talking through all the options, having them practice it somewhat when they're pregnant and then really trying to hone in the fact that it's not a plan. It is kind of like your preference. I always say you're going to maybe like certain positions and certain things. You're going to get into the delivery room and you're going to hate all those things. You're going to want something different and that's fine. And as far as like even the positions and the hip and the back, I'm like here's the black and white of it. When this happens, this happens in your pelvis. But you know what, if you're late in labor and you want your knees in the other position and it feels good to you honor what's happening in your body, we give you the script. But you know, go off script based on how you feel, and then if you have an epidural, you really can't feel anything. Then you can kind of stick to the script and at least you have some guidance that way.
Speaker 1:Yeah, that's also important.
Speaker 2:no-transcript well, it depends because everybody you know, depending on when you're coming in for pregnancy, you can have some pain or swelling or issues. So you know that's always considered and sometimes we don't even do truly internal. We're kind of a little bit more on the outside, really, just kind of at the opening of the vagina, versus really going inside. But yeah, you definitely can, as long as there's no cervical issues. Basically I tell patients if you're allowed to have penetrative sex. We're doing a lot less than that. So as long as that's safe, we're good. We generally would get a prescription from a provider anyway because they're being seen by them. But I have zero concerns and I feel like there's so much benefit.
Speaker 2:There's always like a discussion of when to start and some people don't do until third trimester.
Speaker 2:I usually start within the second and I avoid the first trimester, not because I actually think it does anything, but because there's a higher risk of miscarriage anyway.
Speaker 2:And if we do internal work and you miscarry, I truly don't believe there's the cause of it.
Speaker 2:But if you link those two things then I feel like pelvic floor PT will always be a little bit of a challenge for you and I don't want anyone to ever feel like A they did something to themselves or like made a choice, you know, to do something to themselves, or I don't want them to ever link the two things because I think it's so important. So that's honestly the only reason I really avoid it. But once they, I mean we have plenty of time so there's no rush really either. But if somebody has pain, whether they have something like called vaginismus, which is just tightness and pain without having a baby, so without a postpartum issue or if they have previous scarring, perineal tear and scarring we definitely want to be doing internal, especially if they haven't done anything before, to try to release and open some of the scar tissue or address some of the pain and whatever the cause of it is, so that they feel more comfortable going towards a vaginal delivery, if that's what they want.
Speaker 1:Okay, last thing that's coming up for me perineal massage.
Speaker 2:Yes or no? Okay, so I would say evidence and my anecdotal whatever advice would be yes during pregnancy, a thousand percent Do. I think it helps in the end stage where they're like you're, you're crowning and you're rubbing. I think evidence is mixed, but mostly no, I'm generally not there and they can decide if they want that, but they can consent to it or not. I do think there is value and I think it's a combination of things.
Speaker 2:So is it because we're stretching the tissue and we're opening everything? Maybe that's a part of it, especially if there's scar tissue. I think that is a part of it. I also think it's the connection of your brain to the area as you're doing it to understand. Okay, this is an area where I'm going to send my brain to open, release and I think honestly, it's probably a lot more that, especially with somebody who is their first child To me. A lot of the pelvic floor work I do yes, it's oftentimes to release things half the time is to connect to it, it's to find it with your brain, is to be able to access it with your breasts and it's be able to get that mind, body connection to this area that, for many reasons, I think is often ignored within ourselves.
Speaker 1:So it's not necessarily massage as we term it. It's more like mind-body connection.
Speaker 2:Yeah, it's a little bit of both, but I would say everybody benefits from the mind-body and then some people would benefit from the actual stretch. I think it just depends. But if you have scars too, I think, why not open it? Let's let these tissues open and release as much as we can beforehand. But I think everybody benefits from that connection piece.
Speaker 1:That's so interesting, yeah, and the scar tissue I find interesting too, because the more I learn about baby's choice of positioning because it's not like a conscious choice, it's a reflex, right? So your baby's going to put themselves in the position that their little reflexes tell them to go. So if it's like if there's something tight over here, they're going to move in a different direction. So like if it's the rooting reflex, they're going to go like that and so they get into this wonky position. And I find it interesting because I had an appendix surgery that was very big when I was in my twenties and I had no idea that it could affect my pregnancy and both of the kids were occiput transverse. And I'm wondering yes, 100%.
Speaker 2:I would bet money. I can't tell you that surgery, especially even when it goes well, how many hip you know, back pregnancy issues come along with that and we're like, oh, it's just an appendix, no big deal it is. It's a big surgery and it affects things and if you've had any scar, it sounds like you probably had a lot of scar tissue. I would, yes, I mean yes, a hundred percent.
Speaker 1:Yeah, I have opposite side hip problems, opposite side back problems, like everything. Everything went wrong. I feel like after the surgery I couldn't even feel my core muscles anymore, it's insane. And the same thing kept happening after each pregnancy. I couldn't reconnect with my core. It took me like a year or two. I finally got to the point where I'm like, okay, there they are.
Speaker 2:Yeah, and I think you know people think about like what you do in pregnancy and postpartum with PT. Yes, we're treating your pregnancy and we're treating your postpartum body, but we're treating your body before that. That now is here. So, like anything that carried with you, like your scarring, any old back injury, any old, whatever it is, it's still there and it's just layered now. So we have to treat all of it. So, like you came to, you know, pregnancy PT, there would be a ton of scar work done, you know, there just to help prepare that area to again open and release.
Speaker 1:Yeah, that's a nice little shout out to all moms. Hey guys, if you've ever had abdominal surgery, please go get pelvic floor physical therapy before you get pregnant.
Speaker 2:Yeah, or when you get pregnant I mean before, before or whatever yeah, or during all of it.
Speaker 1:Just make besties with your pelvic floor, Definitely Well. Is there anything else that we didn't cover that you wanted to talk about?
Speaker 2:No, it's a little bit more about kind of the beehive you know that we have here. So Megan McCutcheon is a perinatal mental health therapist and we met when I was opening my business in 2021. And we just immediately connected as just like like minded people and friends and we have just had a vision for this place where we wanted many providers like we were talking about like not Googling, you know, at 3 am let's have a place that has providers present and has a network of people to refer to, and so we opened that this past September and then before that we kind of existed as an online entity and we created a birth prep course, kind of from a PT mental health flange so it's not replacing traditional birth prep course kind of from a PT mental health flange so it's not replacing traditional birth prep. It's just like a nice additional piece that kind of gives you the layers and we give you different tools and I talk about that.
Speaker 2:You know what I was talking about as far as your hip and your back and kind of ways to open and release and then a little bit of a kind of a early postpartum advice as well. So we have that online for anybody who kind of wants a different slant or approach to their birth prep and it's an easy kind of modular, take your time kind, of course. Basically, my mission and Megan's mission is really just to help people during this time. It is overwhelming and it's okay to ask for help and to find the people that will make your life easier and if I'm a part of that journey, that's great. If you need something different, like I think, we just are trying to help people just have a little bit easier time, because it's a lot you know and we've been through it and we know and we're not on the complete other side of it, but our kids are kind of get a little older, so we have a little bit of ability to step back and try to guide people through it a little bit.
Speaker 1:Yeah, I love that, and those of you who have listened to other podcast episodes have heard Megan on here multiple times talking about perinatal mental health, so it's the same course that Megan has talked about the birth model. Yeah, and it's just kind of a way just to approach birth to the body. And we're going to be putting that link in the show notes as well. Thank you Well, katie. Thank you so much. I'm so glad we finally got to do this.
Speaker 2:Yes, me too. Thank you for having me. This was great. I'll do it anytime. I always like talking about helping people, so
