Talk to me about pelvic floor damage and what you did to address it.

[Anonymous]

Thanks so much

[Anonymous]

I had some damage from pregnancy/labor. Not terrible, but stress incontinence limited running,jumping, other activities where I might leak. I tried PT twice but it didn’t help. I had urinary sling surgery combined with diastasis repair last year and it’s much better. Not perfect but close to leak free.

[Anonymous]

Pelvic floor physical therapy for 2 years with 4 providers. Had imaging to confirm muscle damage. Consulted several urogynecologists and a colorectal surgeon. Planning to have surgery once my kids are older and I’m not lifting them.

[Anonymous]

I came out mostly unscathed but I did do 4 months of pelvic floor PT. This was during COVID so a lot of it was by video. Don't do pelvic floor PT virtually! You need a therapist to physically assess you (yes, inside the vagina). My in-person sessions were much more valuable. I never had incontinence (except during pregnancy a couple times) but I did have overly clenched pelvic floor muscles (hypertonic) that couldn't relax easily. The sensation is basically a clenched fist. No dysfunction, intimacy-wise, except feeling overly tight, which is not as pleasant for the woman as it might seem! I actually thought I had "looseness" issues until I saw a PT in person, who confirmed it was actually stuck in "tightened" mode.

I am a small woman in every sense and had a large baby. Thank god I was induced early because the baby would not have fit and could have done REAL damage. I did not tear much (1st degree) but I did push for a long time, 4+ hours, which in retrospect I would have cut off much earlier and opted for a C section.

[Anonymous]

Anonymous wrote:I had some damage from pregnancy/labor. Not terrible, but stress incontinence limited running,jumping, other activities where I might leak. I tried PT twice but it didn’t help. I had urinary sling surgery combined with diastasis repair last year and it’s much better. Not perfect but close to leak free.

Thanks so much for sharing your experience. I am assuming your birth experience was vaginal. Were you told about the potential PT damage by your care providers?

[Anonymous]

internal & external PT

ITR Physical Therapy locations in McClean, Annandale & bethesda

Michelle Kenway online great book and exercises can follow for free online. Ask your dr if appropriate before starting. Super easy but so helpful.

[Anonymous]

Anonymous wrote:I came out mostly unscathed but I did do 4 months of pelvic floor PT. This was during COVID so a lot of it was by video. Don't do pelvic floor PT virtually! You need a therapist to physically assess you (yes, inside the vagina). My in-person sessions were much more valuable. I never had incontinence (except during pregnancy a couple times) but I did have overly clenched pelvic floor muscles (hypertonic) that couldn't relax easily. The sensation is basically a clenched fist. No dysfunction, intimacy-wise, except feeling overly tight, which is not as pleasant for the woman as it might seem! I actually thought I had "looseness" issues until I saw a PT in person, who confirmed it was actually stuck in "tightened" mode.

I am a small woman in every sense and had a large baby. Thank god I was induced early because the baby would not have fit and could have done REAL damage. I did not tear much (1st degree) but I did push for a long time, 4+ hours, which in retrospect I would have cut off much earlier and opted for a C section.

Thanks for sharing your experience. I definitely plan to go to PT. I am.conflicted on when to decide I have had enough and choose C section.

[Anonymous]

Anonymous wrote:internal & external PT

ITR Physical Therapy locations in McClean, Annandale & bethesda

Michelle Kenway online great book and exercises can follow for free online. Ask your dr if appropriate before starting. Super easy but so helpful.

Thanks so much. I am seeing by obgyn soon and will ask her about PF care and worst outcomes she has seen.

[Anonymous]

Anonymous wrote:Pelvic floor physical therapy for 2 years with 4 providers. Had imaging to confirm muscle damage. Consulted several urogynecologists and a colorectal surgeon. Planning to have surgery once my kids are older and I’m not lifting them.

Wow 4 years!

[Anonymous]

I had 2 vaginal deliveries and second degree tears both times (in different directions). I also have a level 2 prolapse (out of 4) that was diagnosed when my second child was 6. I have some incontinence from time to time but it's not terrible. I've done pelvic floor PT but haven't been willing/able to make time to do the exercises due to too much going on in my life over the last 6 months so I've essentially quit PT. My symptoms aren't bad enough for me to have clear goals that would be easy to tell if I'm making progress from doing the PT homework so I've just decided it is what it is for now.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I came out mostly unscathed but I did do 4 months of pelvic floor PT. This was during COVID so a lot of it was by video. Don't do pelvic floor PT virtually! You need a therapist to physically assess you (yes, inside the vagina). My in-person sessions were much more valuable. I never had incontinence (except during pregnancy a couple times) but I did have overly clenched pelvic floor muscles (hypertonic) that couldn't relax easily. The sensation is basically a clenched fist. No dysfunction, intimacy-wise, except feeling overly tight, which is not as pleasant for the woman as it might seem! I actually thought I had "looseness" issues until I saw a PT in person, who confirmed it was actually stuck in "tightened" mode.

I am a small woman in every sense and had a large baby. Thank god I was induced early because the baby would not have fit and could have done REAL damage. I did not tear much (1st degree) but I did push for a long time, 4+ hours, which in retrospect I would have cut off much earlier and opted for a C section.

Thanks for sharing your experience. I definitely plan to go to PT. I am.conflicted on when to decide I have had enough and choose C section.

PP. My #1 piece of advice is don't be a hero. Vaginal birth is not the end-all, be-all and has many costs.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Pelvic floor physical therapy for 2 years with 4 providers. Had imaging to confirm muscle damage. Consulted several urogynecologists and a colorectal surgeon. Planning to have surgery once my kids are older and I’m not lifting them.

Wow 4 years!

It was over 2 years, not 4.

Here is my advice to OP and everything I wish I had known.

1. Talk to your mom and women in your family about their births, and lasting impacts. If they have urinary incontinence, anal or flatal incontinence, bad tearing, instrumental delivery, prolapse, or vaginal laxity (eg looseness). Ask them to be brutally honest. If there are a lot of issues, proceed with caution on a vaginal birth. Eg if mom, grandma and your aunt all had prolapses the genetics are not in your favor.

2. Consider your age. If you are an older FTM (say 33 and older) and only planning one or two
Children, I think a scheduled C section is a reasonable choice. Or you can do a trial of labor but have a low threshold for going to a C section.

3. If baby is not moving down well with pushing or is in a bad position, have a C section. Do not have forceps or vacuum. Tell your doctor you don’t want those and you want them to do whatever possible to avoid an instrumental delivery and an episiotomy.

4. Do pelvic floor physical therapy before birth to work on optimizing chances for a successful vaginal birth. Also do Spinning Babies, One Strong Mama, and see a chiropractor who does Webster technique.

5. Don’t go long past your due date - the last few weeks babies can can like a half a pound a week and get huge. Get induced instead.

6. Have an epidural and get it early. Labor is insanely painful and unless you are a masochist there’s no need to experience bone crushing agony.

7. Don’t push for hours. If you are approaching 1 hour or 2 hours and it’s not getting close, go to a C section. Pushing in excess of 3 hours is really bad for your body and can cause damage to your nerves, rectum, fascia and pelvic floor - each contraction cuts off blood temporarily to the area. It’s ok for a little while but hours of this can cause irreparable damage.

8. Know you can tear in many ways beyond first, second, third, and 4th. You can tear your urethra, labia, clitoris. You can tear inside the walls of the vagina and your anal sphincter. These injuries are things you don’t hear much about but they can and do happen so make sure you see a pelvic floor physical therapist after birth regardless.

9. Know a c section is not a panacea. It can cause many issues including infection, serious blood loss, infertility, placenta issues in future pregnancies.

10. Know there is NO good way for a baby to be born. There are different choices but all have risks and benefits and what is right for you should not be a one size fits all approach but a discussion with your doctor about your unique circumstances.

11. Don’t believe the lies that you should not hear Women’s bad birth stories or that pain in labor is caused by fear. It is normal to have a fear of childbirth - historically it was a leading cause of death among young women and children. Hearing different stories gives you a more realistic idea for the realities of birth thst you don’t get from fake social media pictures of gorgeous women with blowouts and full faces of makeup right after they deliver, Childbirth is hard, painful, and sweaty and bloody work. There will be body fluids and needles. And it can be scary. But you are strong, you can do it, and having a beautiful baby is the reward for your pain and suffering.

[Anonymous]

OP, i had two c-sections and i still needed Pelvic PT to fix issues.

It's not just pushing and labor that can mess up your pelvic floor --being pregnant changes the way we hold our muscles (we are clenching for months), and c-sections often leave scarring that interferes with your muscle movement. For me, the scar was interfering with both my ab muscles and my pelvic floor muscles. my PT was able to loosen and break the scar tissue and I had to do exercises every day to retrain the muscles to work properly. I'm actually still going.

Don't want to scare you, but I really believe every single woman who gives birth should have access to pelvic PT! none of us come out of it unscathed, and PT's are VERY helpful.

follow the vagina whisperer on Instagram.

[Anonymous]

Surgery.

PT did not work. Surgery was miraculous although the recovery was NOT FUN.

[Anonymous]

Anonymous wrote:Surgery.

PT did not work. Surgery was miraculous although the recovery was NOT FUN.

Which surgery and what was your recovery? And who did you use? PP who need surgery.