Latest / Arrivals: A Birth Story Podcast / Low intervention hospital birth, the power of pelvic floor PT & the importance of birth “prehab”

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Low intervention hospital birth, the power of pelvic floor PT & the importance of birth “prehab” · Arrivals: A Birth Story Podcast

• Merelise Wilson: Hello and welcome to the Arrivals podcast. I'm your host, Merelise Wilson. And today I have Amy Meehan with me. Yes, yes, yes. Excited to be here. Thank you for having me. I'm so excited to hear. Amy is a mom, a business owner, a physical therapist, and specifically specialize in women's health. And so I'm so excited to talk to you, ⁓ hear your birth stories and hear how your profession has shaped your birth experiences, what your preferences were, everything. All things, yes. I definitely have after. Three kids, how far apart? 12, just turned nine, and then 18 months, which is wild. I love it. All different experiences going from very much not really knowing what I'm doing to kind of slowly seeing how my birth stories change from just the knowledge and the education that I honestly had to seek out for myself, which is kind of sad actually. It is. I can relate to that, absolutely. So I guess let's start with your first birth with your oldest daughter. I know it's so funny. It seems like eons ago because she is 12, 12 and a half, sixth grade. Send out the prayers into the universe, please. That's where we are right now. the good vibes. I'm like, can we put her back in? No, can't. No, it was awesome. Got pregnant fairly easy with her, had a great pregnancy. Of course, the first trimester just, right. And then. ⁓ I was like, this is great. Pregnancy is suiting me well. I'm a PT. I know all the things. I'm going to do my exercises. I'm going to work out. I mean, I was running, doing CrossFit. I mean, I had great, great fit pregnancy. It was fantastic. And then it was good at my OB appointments, didn't have any gestational diabetes. Like I really had a good, healthy ⁓ And then when it came time, even when I started having contractions or what I thought was contractions, I'm like, I don't know what to do now. I just felt like at every appointment, I'm like, well, how will I know? They're like, ⁓ you'll know. But then in reality, you start having contractions. You're like, is this it? I didn't even know what timing my contractions was with my first. Wow. Like it was like that. And I have an older sister. I was one of the first in my friend group to kind of have kids, have an older sister. She had just had her second. ⁓ was there for both of the babies. So ⁓ knew what that entailed. But I just didn't think to ask the questions. ⁓ I didn't know what I didn't know. That's what's so hard. You when you go to a doctor's appointment, an OB appointment when you're pregnant and they say, what questions do you have? I don't know what I know. I know. You were going to tell me, right? Yes, exactly. And I think that's my favorite thing now with Revelle is now we have people like yourself that will be like, you have to go see Amy. You have to go see Revelle And we'll have people come and sit in our chairs and are like, my friend said I absolutely had to be here and I don't know why I'm here. And I'm like, oh my God, I'll tell you everything. what I would have given. that for like my first birth to get from my OB or my midwife or something. So I started contracting at home at nighttime, usually is when it starts. mean, my contractions were like 20 minutes apart. And did you have a birth plan going into it? No, did you know that was just, I was just winging it. I was like, let's go. Surely everybody does it. How hard can it be? Right. And everybody's like, ⁓ yeah, it hurts and this. And so you just think, all right, I'm going to go in. I'm gonna tell the doctor I'm having contractions, they're gonna give me an epidural and we just push the baby out. Like that's literally all I thought this was. So that's what I did. And I'm like, okay, I'm gonna have contractions. And I call and I'm like, okay, I think I'm having contractions. And they asked me, well, how long have they been going on? How long are they lasting? How far apart are they? And I'm like, I don't know. And so then we didn't have like the apps and stuff, right? I feel like I'm so old, but I'm not. You're not, you're really not. And so I'm like timing it. I'm like writing them down. And so finally I'm like, okay. They're like, when they get to be, you know, the rule is like five minutes apart, lasting at least one minute for long as an hour. So I did that and then I just roll up to the hospital. Didn't call them back, nothing. Now it's like three or four in the morning and they're like, ⁓ well we didn't know you were coming. We're going to sit you in the waiting room. And I was like, okay, cool. I didn't know any better, right? I'm at Northside. And so we did our tour and all of that, so we at least knew where to go. But I remember sitting in the waiting room, still filling out paperwork. And I'm like, I think I'm having contractions. They were still like 15 minutes apart. I mean, like it was crazy. Very minimal. Get to my room, they hook you up. You think you're just like bed bound at this point. Like you just don't know any better. So they have the monitor on me. They hook you up to the IV. And so I sit there. And they're like, OK, well, mean, you're having contractions. They're still like 12 minutes apart. Do you want to go home? And I'm like, first birth, you're like, I am not going, I can't go home. I'm to have a baby. It's going to come right now, right? You just have no idea. And you've already put on the hospital gown. Yes, yes. You're like, oh, I don't want to feel so anticlimactic to go and then leave and come back. a lot. I think at that point, I was like 39 in a couple of days. So it was, you and I'm like, it's time, it's time. So it's like, we'll just give you some Pitocin. I'm like, that sounds good. What's that? So I take my IV, they hook me up with some Pitocin and then I'm like starting to have contractions. And the great part with this is one of my best girlfriends was a labor, no she was a NICU nurse at Northside. And she comes down and she's like, I just remember walking in and you were like gripping the side of the bed. It was only four centimeters. I had no idea what was happening to my body because contractions hurt. They're supposed to. And Pitocin contractions hurt more too. Yeah. And she's like, I think you need your epidural. And I'm like, ⁓ yeah, sure. Okay, I guess that's what I need. So she called for the epidural. came, gave me the epidural, and then you just laid there. And they didn't flip me. So only one side was numb. And then I'm like, I still feel some stuff, you know? And all I felt were lower, one-sided contractions that were like a two out of 10. But I didn't think I was supposed to feel anything. And they're like, oh, well, we'll just give you some more. I'm like, why not? Sounds good. And so now, same thing. They're like, flip me on that side, so you gotta rotate to get all the, you gotta shake it all up a little bit, right? And so they lay me on, this is on my left side now, and they had souped me up so much, now my hand, I have no function on my hand. Oh my God. It was wild. I've never heard that. Oh yeah. Wow. So now I'm freaking out, cause it's like I know enough to like freak me out, but not enough to ease my mind. So now they're like, okay, well let's time to push. And I didn't know what I was doing. I know how to push. just checked and they were like, you're 10 centimeters, time to push? And so it was like, got my epidural. just, don't remember much at that point. And then they just kept coming back and checking and can't get up now. second, like bolus that I had, and I remember trying to hold my leg and I was like, grab my good hand kind of thing. wish you could see Amy's hand right now. It's little limp like noodle. And it was like, I just hooked it underneath my leg. My husband's on one side and I'm just like, Grunting and bearing down and then three and a half hours later. That's wild. Oh That is insane. I just chills like imagining you pushing for three and a half hours That's like that's like like should be illegal. Yes, like that should be illegal. Oh my god, and so Finally, my sweet little Maddie girl made it into the world super cute. Happy healthy. She was how big was Maddie girl Maddie was seven pounds ten ounces. Okay I had second degree tearing. had prolapse. had hemorrhoids. wound up having constipation, ⁓ painful intercourse. mean, you name it. I had it go back for my sixth week and I'm like, the shit hurts. Like what is, what is going on right now? ⁓ the funny part, I remember my mom was in the delivery room. She was like, very like kind of in the back. She didn't want to alarm me. My sister was in there and I remember my mom coming home with me, like driving home. And I was in the shower and I was like, I think we need to go back because I don't know what I'm doing and I hurt really bad. And she was like, yeah, that's not how it works. you're just, this is where we are. So I go to that six week follow-up thinking like, okay, we're going to do this. We got this. And then it told my, it was my midwife at the time that I was seeing at this larger practice. And I said, I am just like not feeling okay. Like everything hurts. I like, it's now I'm probably six plus weeks. And she's like, well, give it six months. You just had a baby and I'm like, I cannot give my body six months of feeling like this. No. And so in my mind, I'm like, okay, I have my doctorate in physical therapy. Like we had one lecture on pelvic floor rehab. I was going to say at this point, were you focusing on pelvic floor or what PT were you specializing in? I was thinking, and that was not, I was just like outpatient orthopedics. So I was treating all the knees and the hips and all the things that you think, because you're in your 20s when you're in PT school, if you go right after you graduate. And then you get this one lecture on pelvic floor and it's like lube and dilators and all the things. And you're like, this is not why I went to a T-school. They're not selling it well. No, not at all. Not at all. And so you're like, where's that one lecture? So you're like fishing through all your stuff, trying to find it. And so I found someone in Atlanta and I went and it was in like a dock in the box, like orthopedic. And I just remember going in, fearful anyway, did not put me at a peace of mind and a sports clinic, mind you. And she was treating this like football player with me. ⁓ my gosh. So I'm in a room and she's like, go ahead and undress. I'm going to finish up with him. I'll be back to do your assessment. And I go in and I'm in like the paper gown with stirrups and everything, which is awful. And the guy's doing wall ball on like right above my door. And she's like, comes in and she's like, just try to relax. And I'm like, my door is going to swing open. This was awful. And so I left crying. Oh my God. And I that until it was about six months postpartum. And then I just went to my husband crying and was like, something has to change. Like we cannot let women go through this birthing experience without any support. And that's how we created Revelle. And I'm going to guess actually too, if you want to. Yes, that's how we met is I went to go see Amy when I was postpartum with my second. I suspected I had ab separation, but I just had a lot of other symptoms and just I just really wanted to make sure I was in a good place, just knowing what my body had been through. And so I went to see Amy and someone had recommended Revelle and I walked into this space and it was, it's the most beautiful, calming, loving, peaceful space. The total opposite of what you're describing. And that is why it is that way, right? It's like no stirrups. Tables are heated, soft linens. nice colors, dim lighting, like private, so very like we want you to come in and feel at peace because that's what we deserve. And that is just not what I got through any of my birth experience. It was like, OK, you feel like you're at like a meat counter like number 42. And so again, that's why Revelle got started. And then finally, I got up the courage to be like, I think I want another baby. Can I do that again? I'm like, I know so much more now. ⁓ all my pelvic floor work out of the way. We created Revelle, childbirth educators. I was like, I cannot do this again without knowing. And then I set forth to say, I'm gonna do my best to not let any other woman experience what I experienced. So you started Revelle with a newborn, basically. Pretty much. I did not realize that. ⁓ yeah. Wow. ⁓ yeah. It was like grassroots. I mean, I was just determined, right? And so then three and a half years later. got pregnant with my second and I'm like, we're going to do it differently. I did not switch practices just out of comfort. Sweet, sweet Macy. She was my big girl. She was eight, six, but very easy. Very similar pregnancy. Obviously with a toddler, it's a little bit different, right? Yes. You're a little bit more tired. Yes. And then, Again, going back and forth with the doctor, everything was fine. And then finally, it was kind of like, what are the expectations? I'm like, this is kind of how I want to do things at this go around. I'm like, I would like my epidural, but I would like to wait until I'm in active labor between six and eight centimeters. They're like, OK, sure. They didn't give me any pushback, but they didn't recommend any of this stuff with my first. And I said, OK, I would like to try X, Y, and Z before I get the epidural. I want to be able to walk the halls. I want to be able to get out of the bed. I don't want to have constant monitoring if I can help it." And they're like, oh, yeah, we can do that. So the second birth, much different. But isn't it so crazy that like you would, the only reason you knew about that is because you'd taken upon yourself to learn about it. Yes. And then it's great that they were okay with it. They didn't push back, but why are we not talking about this? Yeah. Proactively and I think it's like it's out of ease and so I've been I've been in this practice now for a while and been able to have like the privilege to talk with lots of OBs and midwives and nurses and everything and it's just like they The nurses are told what to do and so when people like well my nurse didn't let me and I'm like I understand that however Nurses are to take orders from their attending right, right? And so you still have to advocate no matter what And you have to go in mentally, not with a rigid plan, but knowing my body, things could go this way, they could go that way. Like what are my options gonna be? Do I have any hard nos? Like am I okay with forceps? Do you even know what forceps are? For me? You shouldn't be finding out when they're asking you you're okay with having With the salad tongs, right? You're like, oh, what are we doing? They're like, oh, these are to stick into your vagina and get your baby out. You're like, I'm gonna go hard pass. personal preference for me, right? Or it's like, okay, if my cervix isn't soft, do I really want pitocin? Like, can you tell me where my cervix is? Like that just wasn't a conversation with my first. And so the second go around, I was still very much mentally terrified ⁓ give birth without an epidural because I thought that it was actually pushing the baby out that was gonna be the most pain. ⁓ thought it wasn't. That was almost a relief. ⁓ And I think that's what's so crazy. And that's one of my big things I talk with a lot of my patients. I'm like, from my experience, it's not the baby exiting that everyone fears, right? When you might have some tearing or some this or some that I'm like, that is just a blip on the radar versus those contractions that you have during, you know, transition, which is between eight and 10 centimeters. Had sweet little Macy Kate. She was, like I said, she was my big girl. Didn't have, I think I had like a grade one tear. Right, right toward the time before. Do you remember what point you got the epidural with her? I think I was able to wait till about six centimeters with her. So that was like my goal. But then I still had preached into me when I was in the hospital, like, well, you should just probably get it because we know the anesthesiologist is available, which in my head, I'm like, that is, I know if I can that, that's bullshit. You know, I mean, it is. So I should be working around you. right. Not like, ⁓ are you available? Pencil me in at noon. You know, like that's not how this works. And so I probably could have gone a little bit longer. same thing. was it was more of like a fear for me. ⁓ the cool thing with this go around is I knew I did know a little bit about laboring down. Yeah. So if I couldn't be up moving during labor to help with those contractions and optimize those contractions, I said, can you guys like put me in like an upright position? ⁓ So Northside gave me like the throne, you know, and they're like, let us know if you feel pressure. And I was like, you got it sister. then I was on my side with a peanut ball for a little bit, but I think being able to labor down, I went from three and a half hours of pushing and my husband looked at me he's like, babe, we can't do that. We can't do that again. He was like 30 or under and he was like dead straight in the face. He's like, we got this. 28 minutes later, I had her. That's amazing. And such a better recovery. Right? Still very similar symptoms. Found one of my girlfriends who partnered with me, like had her treat me after my second. And just the rehab and the whole process mentally, game changer for me. I found with that second baby, most of the time, no matter what your birth experience was, the postpartum with the second is almost always better just because you know what to expect. Yeah. Yeah. And I just think the mentality, of like, I was so down on myself after my first that, you know, and you don't know, even the mental health aspect, I probably did deal with some postpartum anxiety and just like, like sucked all of that in. And then a lot of that actually came out after my second, because I was almost like open to like feeling my feelings. Do you what I'm saying? And so how to get some help for some postpartum anxiety. And I think that's probably why I waited another eight years before I had another one, right? and then decided, we done? I'm not as young as I used to be, neither is my husband, but like, I felt like I was done and I said, okay, I'm gonna give myself a year and we're just gonna live life. And if we do, we do, if we don't, we don't. And then it was like October of 24. And then mentally it had like closed up shop and then I get pregnant. I've told so many people your story. I love it. And I'm like, I think mentally I was like, okay, just just I have my two girls, it's fine, we're good. And so I almost went into like a little bit of a depression being like, oh crap, like, I don't know how to do this. It's been so long. And I said, no, I'm changing the script this time. Like this is going to be my birth. know way too much. I've heard too many birth stories. I know how I want this to go. And I'm going not necessarily to control, but I'm going to guide this in the way I want to go. is a great way to put it. Switch practices, midwife, concierge. Again, I had the luxury to be able to do that, this go around. it was gonna be one of two providers at my birth. As opposed to like six or seven or. Right, and just the unknown. And I think I just, was trying to eliminate some of the fear that I had with birth by, again, I can't control the actual action of my birth, but I can control like, where are my providers? Where are my birth, yes. So it was a midwife and her partner. One of the two of them were gonna be at my birth. my appointments, I could get in, get out super easy. Did they allocate more time on your appointments? That's what I've heard. It was so easy. It was so great. I had one scare with my blood pressure and instead of shipping me off to the hospital, they were like, okay, you're pregnant with your third, you run a business, your husband is in a different country, let's give you five minutes, which I don't feel like I would have gotten that elsewhere. And so she's like, I'm turning the lights off and I'm going to put some music on and I'm going to prop your feet up. C and five and she comes back blood pressure completely normal. That's so great. And so it's just like being able to kind of have someone on your side, right? And that continuity of care, like understanding your background and the context, like knowing that your husband works, you know, he often is traveling for work, knowing that you're building a business. Yeah. Just knowing more about your patients because you have fewer of them and you're seeing less providers. Yeah. That continuity is so important. It was great. It was really, really great. And then She's like, okay, kind of talk me through. We actually had a conversation about birth. She's like, okay, what do you want? And I said, I kind of want it to be a little hands off. I'm a very pro hospital birth. Like I said, I know too much for me personally, but I just didn't want to be poked and prodded if I didn't need to be poked and prodded. I was actually really fearful to have a lot of the medications because I was afraid that was going to exacerbate my anxiety. and I have two older girls that looked to me for everything and I just knew mentally I had to be 100 % for them. And so that was my driving mentality of like, don't want medication. I don't want Pitocin, I don't want morphine, I really didn't want anything and it was for them. Mom has to be on her A game because they're at that age now where they're gonna remember everything. So were they at the birth? They were not at the birth, but they like, They knew enough to where my water broke at home with this one. was 39 weeks. I blame it. We went on the boat like the night before. Got you all docked. Got me prepped and ready. But we were like bouncing around. The girls are back there like surfing behind the boat. And I'm like, I'm exhausted. And my husband's like, well, here sit on the swim platform and use the restroom. He had like plopped me down in the water. And so I do my business and I was like, babe, you gotta help me back up. So he pulls me up by my life jacket and he didn't get my butt cheeks like on the swim platform. And I just go, no, I like fall first to the water. And he's like, what happened? I'm like, you gotta like, I'm, I'm like front heavy. And so I swear that and bouncing around in the boat probably was like jiggled him down just enough. And so the next night we're sitting at dinner and I'm like, I just don't feel so great. He's like, let's go lay down. I was right at 39 weeks. And I forget your, so your first was born right around 39. 39 and some days. She was three days early. The second was, she was due on the 23rd, had her six days early. Okay. So you've always been a little early. You've never had to be induced. You've always, other than the Pitocin Right. Yeah. I feel like with my first, probably, I would consider that an induction because Lord knows. And so I like go and lay down and then my water has never broke before and I'm laying in bed and I feel like that pop. It's like a physical. internal pop and you're like, was that more water? Maybe, like I know enough now, right? And so I stand up and was like, absolutely that, my water just broke. And so my husband's on the front porch, it's July, we have like big front porch and he loves to go out there and drink his little Jack or whatever. And I go out and I'm like, hey babe, I think my water just broke. And so he goes into like full panic mode, right? He was like, okay, let's call your sister, we gotta do it. And I'm like, it's fine. Because remember, we'll call the midwife. and tell her and she's like, great, just chill, relax, wait, call me when you start having contractions. We really want things to start progressing within 24 hours. So chill. Something that I didn't know until, so my water broke with both of mine. ⁓ awesome. But something I didn't know before I had children is that your water breaks and contractions might not start. They might not. For quite a while. And writers never told me that. No. It was just like, you hear about the shot clock a lot, like 24 hours after your water breaks. I like, that's the only thing you hear. no one really had told me that you might not get to contractions started for hours. And that's normal. Yeah, think mine, was a couple hours before mine did. lot of go straight to the hospital when their water breaks, you don't But then what, right? You're like, it's all about the contractions. And I think that's the education that a lot of people miss. And I think this is, my husband was like, you're just like really chill. And I'm like, well, I just, know what my body's trying to do. And that's one of the biggest things I think during some of our sessions when we talk like, we see a lot of birth prep and a lot of it's education and getting these women to understand their bodies, right? Like you, I'm gonna do this one day and we'll have to work together of like, I wanna get women to like give me a 30 second description on what contractions feel like. Because Lord knows what we would get, right? I mean, cause you just, it's something you almost can't describe. You can't describe that in words, but it's just getting women to understand their bodies. Like when you think contractions. Do we know what's contracting? Do we know why it's contracting? Like in my head, I think, okay, contractions, great. The uterus is a muscle. That muscle contracts from top down. Baby's head is low sitting on my muscular cervix. Every contraction is manned to a face thin and dilate open that cervix. So what can I do to maximize these contractions so I have less of them? because you're going to have contractions until you get to 10 centimeters and have that baby. And the moment that baby exits, they almost immediately stop, which is wild. And so I was like, OK, I'm not having contractions yet. I'm to go take a bath. I'm going to go tell my girls, right? Because like I said, they're at that age where they knew enough. So I go up into my oldest daughter's room and I'm like, hey, babe. I think my water just broke and she just burst into tears. She was like, is it time? Is it time? Are we going now? I said, I'm gonna stay home. Aunt Dee Dee's gonna come get you guys. And she's so excited. And then I walk into my other little girl's room, because it's like nine o'clock at night. I walk into my other daughter's room. She's seven at the time. And I'm like, hey, Mase Mase, mommy's water just broke. She was like, are you about to have the baby right here? She doesn't quite get it yet. I'm like, no, you guys are gonna go here. Mommy's gonna go to the hospital in a little bit. And she was like, ⁓ thank goodness, that would have been messy. Kids. The things they say. And so that's just their personalities too. Yeah, she's definitely right. So we did, my sister came and got them. We chilled out the house for a little bit and now it's like 3 a.m. and it's like, I'm on my ball next to my bed. I'm like trying to chill. You we have our stuff packed. Was your water actively leaking? Because with my second one, it was like really messy. So like the first probably two or three hours, I'm like, I can't, I have like, puppy pads and underwear and all the things. I mean, it's like I just had a towel at the very end. You kind of just have to walk around with like a bowl between your You pretty much do. So I got in the bathtub and that helped. And then I got into the shower after that because then I felt gross being in bathtub. But that just kind of helped me just relax. And that's the other thing that a lot of women don't know is in my head, I'm like, optimize contractions. We want this to continue to progress. It's all about progression. Right. Well, there's hormones that come into play with that. So oxytocin is the main driver of your uterine contractions, hence pitocin, the synthetic form. And so what helps promote the production of oxytocin? Melatonin. We can't pop melatonin, but our bodies naturally produce melatonin. So what can I do to help stimulate that melatonin? Well, what do I do at nighttime? I love to take a bath. I love a good lavender, I love a good Epsom salt. I love a good book and dimmed lighting. Yes. And my white noise, like, which is from the baby monitors after kids, you just like keep it in the room. My kids don't even have monitors anymore. And so like that really curates that nighttime experience for me. But what if we did that in the hospital and why are we not? Because on the flip side, what inhibits the production of oxytocin? Adrenaline, bright light. Hello, hospital. Strangers. Yes. Right. Beeping noises. like the anxiety, the anticipation, right? And so I always tell everyone when you get to the hospital, you get to where you're going to give birth, like recreate that. And I have so many good friends that are doulas and I'm like, you have to give them the science. Yeah. This isn't woo woo birthing. Right. This isn't woo woo. Right. This is to help your body get into the state that it needs to be in. Yes. to help you progress. It is science. It's hormonal. It's science. Yeah. So at home, I got to about six, seven centimeters. I mean, no, I didn't. That's a lie. Six to seven minutes apart with my contractions. Get to the hospital. Guess what? They're like seven, eight now. OK. Because I still was kind of anxious getting there and everything. So why did you decide to go at point? My sweet husband, he was like, like, am I sleeping? Am I staying up? Like, I'm tired. I don't know. Like, it was honestly, I went to the hospital for him. I feel like I hear that so often. They're nervous Nellies He just says like, again, it's like three o'clock in the morning. He's like, I'm afraid to go to sleep. Like, should we go? Like, I don't know. What do you want to do? And I'm like, we can just go. We mother everyone. Let's be honest. It's not just our kids that we mother. And so we go. I mean, we're walking in. He's like carrying all my stuff. You can tell he's kind of panicking. Called the midwife. She met me there. She's hanging twinkly lights in my room. She's getting the birth ball. That's amazing. Was this at Northside again? This was at Wellstar in Roswell. you literally walk into the floor. You can park and walk 100 feet and you're in the hospital. It's wild. That's awesome. Wild. I didn't know they did that. Sweetest nurse ever. Again, still following rules. My midwife comes in and she's like, all right, let's hook you up to the monitor. I think it was 20 or 30 minutes. We have to do continuous monitoring for 30 before we can take it off and just do intermittent. OK. Great. And did you have doula with or just your midwife? Me and the hubs. Yeah, I did have some of my doula friends come over and do like a crash course. Yeah. More so for him than me, because I actually teach childbirth education courses, but he would take instruction much better from someone else. I know. And so he did great. We figured out what I liked. He figured out how to help me with shoving the ball here and there and all the things. Right. yeah. ⁓ yeah. He's like, OK, we don't want this and we want this. Right. Which was great. Yeah. So. get into Wellstar, I have my ball, I change into my robe, she turns the lights off, she's literally tacking twinkle lights behind my bed. And did you bring your own robe and stuff? I did, I brought my own. That's something people don't know is you don't have to wear the hospital gown. And I'm not gonna keep it after anyway. You know, like those things are $12 on Amazon and I'm comfortable. Yeah, get a soft robe. Yes, and I'm all slippers, I have my playlist and I'm like listening to my like, you know, worship music to start. I was just like in my zone, right? We have the little sound machine in the corner. I mean, it was just very chill. He's trying to sleep on the uncomfortable couch. He's like, just let me know if you need me. I am, I'm just like rolling and walking around the room and just in my zone for however long. And so with this one, did you plan to not have an epidural? I mentally went in and was like, cause again, I'm like, I don't want any drugs. I don't want any pharmacological management if I can help it, right? Like if you need to stop my bleeding, obviously. So if I don't absolutely need it, I don't want it. That was my mentality. did do sort of mental preparation? ⁓ So for me, a lot of mine was I kind of take what I teach every single day. ⁓ When we talk the importance of breath work, ⁓ when like, ⁓ my practice, try to take like, OK, I know that this connects to this and this connects to this. And I'm like, you need to breathe because it's gonna help calm your nervous system. Whereas in my head, I'm like, if we can get you to get the diaphragm to descend, that's going to activate cranial nerve 10, which is your vagus nerve that's in charge of your flight or flight. Like that's where my head goes. So it was like, I took those things that I knew and were teaching and everything into my own birth. And so I said, okay, my breathing is everything. Like it truly is everything. Your mental head space and the clarity that you have is everything. I had my birth comb, I had my TENS unit, I had my cooling rag, I had all of my things. And then same thing, those aren't just to say like, ⁓ those are distractions. Well, they truly are. Take it again, science, our body can only handle so much input. Our sweet little brains can only handle so much input. So if you give all of the input from your uterus and all of that discomfort, and that's the only input you're giving your brain, it's only gonna focus on that discomfort. It's very hard to manage that. But there's something really cool called pain gate theory. So the brain can only tolerate, like I said, so much input. So why don't we flood it with additional inputs? So that's why a tens unit is good. Transcutaneous electrical stem. It's just like on the surface. It almost feels ⁓ like a little numbness and tingling with the little pads. People have probably seen it before. I wish it was used more often. ⁓ it's amazing. It's amazing. Put it on your back, bracket around that nerve that goes to your... I mean, it's great. So very, very easy, something simple to do, 20 bucks on Amazon. And you don't have to be a doctor to have one. No, absolutely not. You can get it off Amazon. Simple, easy instructions to YouTube, but if you need to, I mean, it's super easy. Birth Calm. You are taking a calm that has, we'll say, 25 points and putting it into your hand, which is the most sensitive area of your body. And you are giving it, squeezing it in your hand, and you're giving yourself 20 fine point inputs, now going to your brain. Yeah. Then you have this sensation of cold. The sensation of cold travels faster to the brain than the sensation of pain. So now your brain is being flooded with all these additional inputs. So it almost kind of masks the pain from the contractions. That's a win-win right there. And I always say, take your non-pharmacological pain management strategies and it's to get you through one more contraction. That's it. If we can postpone medical intervention, the less likely you're going to have additional medical interventions, time and a place for them. So that's what I did. I'm rolling on my ball. I'm starting now. They did check me. They didn't check me until I was six centimeters. Was I begging for the epidural? Of course I was because most of us do. And at that point I look at my husband, I'm like, I don't think I can do this. And the midwife looks at him and was like, well, we know what she said she didn't want to do. And so they knew this. did not want any drugs. The midwife and my husband both knew. And they're like, OK. Now it's their role to help me get through one more contraction. Here we go, babe. And you feel it. They're like waves. I tell everybody they're like waves. It's like you feel it coming on and you're like, oh no, not again. And then it peaks and then it totally comes down and you get like a little second of reprieve then you feel it creeping up again. And then if we can increase that input during the peaks of contractions. I mean, granted, you're still saying very, a lot of choice words, least I was. I was like, oh no, here it comes again. And then I'm like, oh shit, you know, all the things. And so, but it did, it got me through one more contraction, one more contraction. And then finally I was just exhausted. couldn't be upright anymore. I was like, I just want to get in the bed. I'm so tired. How long had it been from? Let's see. So I got there at like, like 3 AM. This, it went fast. I got there at like 3 AM. I had him at like, 530. Okay, ⁓ so this is fast. Yeah, so this was progressing really fast. So I get there. I'm chilling for maybe 30 minutes. I think I got there. I was the way my contractions were. I was probably like four, but manageable. Yeah. And then they checked me when I was like, this really hurts. And they're like, I was at six, but she's like, I could actively, she's like, I can actively feel your cervix dilating. She's like, you're progressing really, really fast. She was like, just keep going. I'm like, I don't think I can do it. I think I need the epidural. And they're like, well, you need to take a whole bag of IV fluids. before that. And I was like, that's fine. And I'm like kind of getting discouraged at this point. Like, I really wanted to do this. My husband's like, it's okay. Like you still have time to take it. So now my contractions, I have no reprieve. It's one after the fact. I mean, and now I'm having to do that very like visceral breath of like that, like almost a moan and like a vibratory breath to just like try to get through them. And then they break, I kid you not, for like 10 seconds. I mean, it was just one wave after the next. And the midwife looked at me and she's like, this is transition. She's like, you're about to meet your baby. And I was like, okay. And then I was like, how much more of the IV bag of fluid? My husband goes, you've had about a fifth of it. And then I started pushing like five minutes later. And so got through transition. And that to me was like, That was it. And I look at my midwife, she's just sitting calmly on the edge of my bed and I said, I think I need to push. Slid down on my side and five pushes later. Wow. It's amazing. Yeah. So you pushed, she was birthed or he was birthed. was a boy. Yeah, third was a boy. You pushed on your side the whole time. my side. And it's so much easier. I had so much control. The nurse at one point was like holding my leg in a funny position and I was like, I don't really like that very much." And she's like, okay, where do you want it? I was like, pull my knee down. And it worked beautifully. And so five swift pushes and he was out. And then the midwife's like, you have a tiny little like labial, maybe a tear. She's like, I mean, I'll put a stitch in it if you want. And I'm like, ah, since you're down there, you might as well. But it's, it's amazing how as soon as I had him, stopped. That's, that's been my experience 100%. All the contractions stopped. And you're like, I just had a baby without, without medication. This is crazy. And you feel like I can do about damn anything now. I mean, it was wild. I was exhausted and they lay him on my chest and they're like, finish it. You know how you have to birth your placenta, which I don't even remember that. they stitch up my one. She was like, we're done. ⁓ I just remember laying there being like, ⁓ my gosh. And then this is the kicker is I went in completely unmedicated. Right. But in the hospital you get, it's very protocol. ⁓ so they come in, I'm baby heaven now, you know, I'm like, my God, I'm exhausted. Right. I just pushed a baby out. He's on my chest. ⁓ Still have IV in and they are about to start pushing pitocin. Right. For your contractions, ⁓ your uterus contract. Yeah. Yeah. So to stop bleeding, right. Cause that postpartum or I say postpartum, ⁓ you know, you have the baby, sometimes they'll push a little bit of pitocin. Pitocin will help the uterus contract. which helps constrict the blood vessels to help with some postpartum bleeding and hemorrhage. Great, great if I needed that. But then I looked and asked the nurse, I'm like, well, am I bleeding excessively? And they're like, well, let us measure it really quick. And you're like, well, thanks, you know? And my husband caught that because we had some form of preference, I'll say, when we went in. He was like, wait, wait, wait, wait, wait, what do you mean pitocin? She hasn't had any, why are we giving her pitocin now? And I think he didn't really know why. In my head, was like, okay, if I need it, that's fine. He at least knew, Patosin, I know that word. I know she doesn't want it. I'm going to advocate. Or I'm at least going to say, hey, pause. Let's talk about it. Yes. I mean, and was. It was legit like medicine is here about to hook up. And he's like, whoa, whoa, does she need it? And then the midwife's like, oh yeah, let me just measure your bleeding really quick. And they just slide something underneath your tissue, see how much you're bleeding, right? And if it's a certain mill, then yes, you should probably have it. And if it's not, she's like, no, I mean, you're bleeding looks. Just fine. And so that was like a really quick catch. But if he wouldn't have, we wouldn't have talked about that and throwing out those words, he would have had no clue. Yeah. That's why it's so important to have a doula or a husband or a partner who knows your preferences and is involved in the prep process. Yeah. Yeah. It doesn't even have to be like, tell people, if it's a sister. Like just get someone else on the same page as you. Exactly. Like that was on my birth plan, complete unmedicated. It's only there for you. Right. Yeah. ⁓ that to me was like, good job, babe. You know, like that in my head, was like, way to go. That's awesome. But my recovery, the wildest thing after having two babes with an epidural, my second, I remember getting up like... and you're like, bam, be on ice. You're like, you know? Because your legs are still so numb from the epidural. That epidural was beautiful. Like, I could still feel a little bit like that's what I wanted. But I remember getting up and then I just bled all over the floor. I was mortified. I'm like, what's happening? And then they have to help you into the wheelchair and then they wheel you to mother, baby. And it was just like such a foggy postpartum. remember being like, You get the shakes, like the postpartum shakes that no one talks to you about, right? lot of that's coming down from some of the epidural medication where you are literally shaking, your teeth are chattering. ⁓ And it could be like drastic change in hormones coming down from the medication, like the exact, like all of that can come into play. ⁓ No one told me about that with my first, I thought I was dying. ⁓ And they're handing me this baby and I'm shaking and everybody's trying to give me a blanket and I'm like, I'm not cold, I just can't stop shaking. ⁓ And then and it was all from the epidural. Second, I knew about that. Get into the hospital or get into the wheelchair. And I'm like, oh my gosh. So, but just such a fogginess after that. And then with the third, they're like, okay, you ready to go? I legit like get up and like, they still want to take you to the wheelchair, know, but you're like, get up and you just walk. And you're like, it doesn't hurt that bad. I mean, that doesn't feel great, right? And then I had such a clear head and had such a better postpartum recovery. I think truly because I let my body do what it wanted to do. And I didn't have, I wasn't like pumped full of a of medication. ⁓ Crazy. From baby one to baby three and to have like two completely different birth experiences is like wild. It's amazing. It's absolutely amazing. something that I've heard you talk about before is prehab, which you and I have talked about as well. It's like, there's this you know, expectation when you're going to have a major surgery or run a marathon or you're training for something incredibly physically demanding that you prepare for it. You prepare your body, you prepare your mind, you do all these things. And we're not encouraged to do that with birth, which is so insane because it's one of the most important psychologically, physically experiences you'll have in your life. And yet we're, you know, we're given no preparation. So I'm curious with your practice, how, what you recommend people do Pre-birth? Yeah. Or even pre-pregnancy? Yeah. Pre-pregnancy, during pregnancy, and post. Yeah. What are the things that you recommend? I think every woman, if you have ever had a menstrual cycle, I think you need to have your vulva and pelvic floor assessed, right? Just to say, ⁓ OK, that's what it's supposed to do. Great. Because it affects pee poo and sex. Pretty important topics in my world, right? You know, sometimes. the order will flip flop, right? Depending on the day. Depending on the day, time of day. ⁓ But then you really think about that, like, of times we've been constipated, times we've given ourselves a hemorrhoid or something like that, right? Like, we've all been there before, even pre-kids. That time where you laughed so hard or jumped on the trampoline that you leaked, right? That time you had a really painful intercourse or you felt like a deep, like, aching in your pelvis. Like, I just think every woman needs to know. And so during, like, pre-pregnancy, it's all about just understanding. You have a vulva, that is what you see in the mirror. Can you pick yours out of a lineup? That's my like one thing I always say. I'm like, you should be able to see all these vulvas and be like, mine is the third one from the right. Just like, you know, your nose or your You got it. You got it. And you should be like, ⁓ yeah, I do know that like I have a little asymmetry between my left labia minora and my right. Like you should know that. You should know where your clitoris is. You should know where your clitoral hood is. You should know where your vestibule. Like you should know where everything is. Right? Because I had a 35 year old woman a couple months ago say, I was today years old when I realized you didn't pee out of your clitoris. And she has three kids. Wow. That's a big deal. Yes. ⁓ so I know it makes me really sad. pre pregnancy, it's all about understanding. If you have any sort of dysfunction, absolutely. Let's check everything out. We want to know, can the muscles contract? ⁓ they relax? Can they coordinate with the other muscles of what we call the core, which is the abdomen and back and pelvic floor and the diaphragm. And I do think there's this perception too that you don't need pelvic floor physical therapy until you're pregnant or even postpartum. And so I really want everyone to know that if you're a woman and you have had a period, you should go see It really is like, it's almost you go for a well woman visit and they just scrape your cervix and they're like, oh, see you later. This is kind of how we see it. It's almost like a well woman visit to be like, wow, your skin looks fantastic or, oh, wow, you actually have... some clitoral adhesions. Did you know that? Right? Let's not wait until you're having difficulty with orgasm before we address this. Like there's so many things that go into play. But then during pregnancy, it's things change so drastically. Everything changes. And so we actually look at the body as a whole. Yes, we focus mostly on like the pelvic floor, the exit to which baby is going to potentially come out of. Right. But we need to also understand its function. So if we, and I'll give you like perfect scenario. 20 weeks, you're out of that first trimester ick, usually. Your body has changed, but not so drastically to where you're extremely uncomfortable. But you might start having some hip pain, pelvic low back pain, because it's changing enough. So we need to establish what ⁓ the function of you right now. What's the baseline? Yeah. Where's your alignment? Does your pelvis have good alignment? ⁓ your core? Can your core engage appropriately? ⁓ Are you only engaging your six pack muscles? Are you engaging your deep core? Right? Cause all of that is going to set you up for a very good postpartum recovery. That's the goal. And so at 20 weeks, it's a baseline. This is where you are. Everything's working great. You're not having any issues. Perfect. Then we work on our foundations. Then from there we say, okay, the pelvic floor is not just supposed to contract. It's actually supposed to close and lift, but it's also supposed to fully relax. That has to time with the breath work. Inhale, diaphragm descends, pelvic floor lengthens, exhale, it all elevates together. That should also co-contract with the abdomen. That's what we're checking. Once we've established those foundations, right, now we're probably close to like 30, 32 weeks. That's when we're like, okay, now it's all about lengthening of the pelvic floor. So if you think like, if you make a little U shape with your hand and you take a fist and you put it right at that U shape, that U and pushing that fist out, That U is what really expands. That is the pelvic floor. Okay. So as that fist is coming through that U space, the pelvic floor really should stretch. That's what we're teaching now is we're teaching the muscles that stretch is okay. Because if you've ever gone to yoga and you haven't been to yoga in a while and they're like, let's touch your toes. Right. It's like you can do, you're trying so hard, but you're actually like gripping and holding because it doesn't feel good. I was going to say, what do do when you're in pain? Yeah. And so we're just teaching that the muscles, the stretch is okay. To say, okay, I can tolerate this. Let's get some more length and more flexibility in the muscles. We're not stretching out your vagina. The vagina is like a shape shifter anyway. You know, I mean, it really is. It's like an accordion. And so you hear like, I didn't tear my vagina. You tore your perineum or your pelvic floor muscles or the tissues around it. And so then at that point, once we've been able to figure out, wow, I can actively relax my pelvic floor. Then we start our perineal prep, is usually around 34 weeks. That's when we get in and we kind of stretch that U shape. So we look at it like a clock. So the space between vagina and anus, that's your perineum, or your perineal body. And then up top, we call that 12 o'clock, that's like your urethra and clitoris. We're gonna stretch from like that bottom of that U. We're gonna stretch from four o'clock to eight o'clock. And so we start working on not only stretching the muscles, but the tissues around there. And then we teach you guys how to do it at home. All you're doing is teaching the muscles that stretch is okay. Then once you've established, wow, you have really good foundations, you can lengthen, you know what a contraction, a good contraction feels like, your muscles can tolerate stretch. Guess what I'm gonna do now? I'm gonna teach you how to breathe and appropriately bear down on your pelvic floor or pushing. I don't even like to use the word pushing because pelvic floor's only role is to get the hell out of the way. That's all we're teaching it. Is to say, hey, sure, we'll move. And cause your body really does. does the rest it. The uterus is pushing the baby out. And so now we just have to encourage that lengthening and then appropriately bearing down like we do during or should be doing during bowel movements to just create space and apply a little bit of pressure. Yes. When we hold our breath, we increase our pressure in our abdomen. It's not really doing anything to our pelvic floor except putting extreme pressure. That's when we see things like prolapse, when we see things like increased tearing. So we are legit one finger pad right at the pelvic floor inside of the vagina and say, show me what you think pushing is. And we're like, that's beautiful. ⁓ my gosh, this is great. Or we're like, that's not going to get a baby out. Let's try this again. And we'll start to time it and coordinate that with the breath. That's pre-hab. And then we do that perineal prep weekly from 34 until you have that baby. And so within the sessions, we're like, OK, do you know what laboring down is? Let's talk about the peanut ball. If you're feeling back labor, try this. your partner can provide a double hip squeeze here or a sacral press here or ⁓ you don't like being in quadruped, let's do this and sitting on the ball instead. And so we start talking all this labor prep as well. So then when you go in, we've talked, what's Pitocin, what's this, what's that, what's laboring down? And so you go in and you at least know what to do for your body. I remember I'll never forget when I was giving birth to my first son. And I did not have an epidural and I was vocalizing and I had read all the things and I knew the importance of breath work. And the OB who was there said, stop breathing basically. I was doing what I wanted to do, but it felt natural, which was moaning. You know, as I was contracting and pushing. And she was like, don't make so much noise. And she didn't say it like in the sense of like, you're annoying me, but it was like, that's not how you should be doing it. And I remember even though I knew better, I still was like, the doctor is telling me not to. Yes, it's so important that breath work. If you think about it, you think about yoga and how you breathe with movements and it feels good and it's natural and your body opens. Well, I can tell you this. In the past three or four years, I've probably had at least six if not seven midwives, OBs and NPs in the OB field come and see me and being like, I don't know what you're doing, but I got to know what you're doing. because something's helping. Wow. Like, you know, or we'll have patients to be like, they were so impressed with my pushing. Yeah. Or like, they couldn't believe I couldn't tear considering that I have a history of pelvic floor over activity or had a previous tear. Yeah. Yeah. And then we've actually started tracking a lot of that because it is makes such a difference. Yes, it does. It makes such a difference. And it's so cool to see the outcomes and people are thrilled. As they should be. It's amazing. I mean, these are these are the results we should expect. It shouldn't be the reverse, which it is, is that we, as women, expect to pee after we have a baby when we laugh. We expect for there to be pain. We expect for maybe our sexual experience to change. We already have hormones and perimenopause on the horizon. Don't be throwing anything else on me. It's already hard enough. I think that for whatever reason, there's this perception that it should just be hard. Yeah. Like your mom now. Sorry. We're kind of martyrs. You know, our society, unfortunately, it's like, okay, you need to work like you don't have kids, but you need to take care of your kids like you don't have, you know, work to do, which is absolutely unacceptable. And so for us, the way we think about it is if you can prepare your body, especially with your first, you ain't busy. You think you're busy. You know what I'm saying? It's comical, right? You think you're busy. I think back to college, remember how busy we were in college? I'm so busy. I'm not going to squeeze in this workout. have to meet someone from Margaritas at four. I don't understand how I can study again. then you go to grad school and you're like, ⁓ I'm busy. And then you're like, ⁓ my gosh, do you have like your first baby? And you're like, this is comical. And now have three and now the house is batshit crazy all the time. Right. But yeah, I think it's just if if we can plan during that pregnancy. fitting it in just like you fit in anything. Like if you can go get your nails done, you need to come see us at least for 30 minutes to an hour. Priorities ladies. And your body's going to thank me later because now we've been doing this long enough that we have women that didn't have this before. And the one thing they're like, I wish I would have known. I know. And what's so cool too about you were saying how you teach people how to push is this applies. when you have an epidural too. I think a lot of people think that a lot of this prep work and stuff is more so if you want to give birth more naturally or without medication. I was speaking to someone recently who did pelvic floor therapy and then she gave birth with an epidural and she said, and I remembered in my preparation, I knew how to push. And her pushing was so much more effective with that epidural. And it's okay, epidurals are fine. Yeah. They're there for a reason. Absolutely. It hurts like hell. You know what? I was asking for it too. Yeah, same. And so I think that's, there's like, you have, I think people think you have to do it this way or you have to do it this way. It's or nothing. No, absolutely not. Now, if you can wait till about six to eight centimeters to get that epidural, your body now is progressing. You're an active labor. the likelihood you're gonna continue to progress is higher, the likelihood that you're gonna need another epidural or you're gonna need other intervention is lower. And so that's really what we push for. If you want that epidural girl, you get that epidural. If you want to chill and put your makeup on girl, you do you, right? Because that's completely okay. But I promise you, right? It's like, I would say it's like moving around your house at nighttime, right? You've done it enough. to where you you gotta like step around the corner so you don't hit your toe. If you practice this stuff enough, it's like walking around your house in the dark. Even though you can't see it, even though you can't feel it, you're still gonna be able to do it. Because you've trained yourself appropriately. Or training for a marathon, which by the way, I would never choose to run a marathon. I did choose to one. I'm really surprised that I wanted to give birth without an epidural because I normally, like I'm not someone who would ever run a marathon or anything. But you know, from what I've, heard and read with other people who have, you train your mind, you train your body, know it, x, it's really hard for me because I've won this a million times. Every time. you know that you're going to get through it. Similarly, you know that at seven to eight centimeters dilated, it's going to be really hard, but you're going to get through it. so, yes. Temporary. Temporary, yes. And I think that's the thing. It's like this is, it's the hardest thing you're ever, like, yes, I ran a marathon. And was that hard? Yeah. This is the thing. Would I want to do it again? No. Yeah. I did a bunch of halves after that, right? Which is fine. And I always just felt like that was just like, okay, great. I did a marathon check. We can move on. That was hard. I did train with my husband. I don't know if that made it harder or what, but mile 20 and 21 always tripped us up. It was more of a mental game. You know, did my quad really hurt? I don't know. Did I really? It was just like, I just was done mentally. And then you still, get through it. We're like, all right, mile 20 is coming. You good? I'm good. You good? You good? Okay. and you keep going. You just keep going. And it ends. Yes, it does. And then you feel it for two weeks. It's just like birth. Yeah. But it's like you put in that prep work beforehand. And I think that's the biggest thing is just ignorance is not bliss. It's just not. Because then on the flip side, there can be so many other poor outcomes that mentally you might not be ready for. That's what we try to minimize. Because postpartum, Not only, you don't need to waste time taking care of you. need to be at your optimal level of function ⁓ now ⁓ priorities and everybody else's priorities shift to that baby. So it's hard to take care of yourself. ⁓ we get a lots of moms that don't do prep work and they don't come and see us until they're three years postpartum and out of the fog. they're like, sex still hurts. And you're like, uh-huh, because your scar is so stuck down, right? Or they're lactating. And they're like, I don't know what's going on. You're like, you're as a desert. Yeah. You have no estrogen right now. You're lactating. And they're like, ⁓ that's what it is. It's knowledge, just knowledge. Just knowledge. What's the most common symptom or issue that women come to you with postpartum? ⁓ postpartum. I'll give you my top three. OK. I would say urinary incontinence, course, painful intercourse, and diastasis, like ab separation. But they all kind of go hand in hand. Usually, it's we almost all have some form of separation postpartum, which is fine. It's more of like just a dysfunctional unit than truly the separation. that unit is about pressure management. ⁓ you think if you have like a little balloon, that's your bladder, and you have a lot of pressure on top of it, that's going to be really hard for that balloon, especially if it's not tied up, to hold all that air. It's going to leak right out. ⁓ the abdomen plays such a vital role with that. And then if anyone's had any tearing or the change in hormones, that can really affect the tissues. It can make the tissues extra dry and have more friction and just make them a little more sensitive, almost like a ripping sensation. We see that, but we actually see a lot of painful intercourse post C-section than anything else. That's so fascinating. Tell me more. So you've had a major abdominal surgery. I encourage everyone to potentially watch a cesarean birth because damn is all I have to say. It is, it's wild. It is. I mean, you're filleted open. ⁓ and you're awake, which is even crazier. I it's, is, I encourage everyone to understand a C-section, even if you're like, I'm going to birth in the woods with the squirrels. ⁓ I'm like, that's fantastic. Let's talk about a C-section. I will talk about it with every single one of my patients. Major abdominal surgery. low on the abdomen, right? What do we do when we're in pain? You've already said it. We tense, we guard, we hold. I've already said the core and the pelvic floor co-contract. So everything now is guarded and holded, rightfully so. And those muscles have a really hard time letting go. Because your core has been cut through. Literally. Yeah. Like seven layers of it. It's so interesting, Amy. I've never thought about it because I a lot of people joke like... Well, at least if you have a C-section, you get to avoid all the vaginal stuff. that's not the case necessarily. Yeah, urinary incontinence, same thing. It's like if you got your abdomen so tight, you've decreased the amount of flexibility in these areas too. so that, again, it's all about function. It's like the whole unit has to function together. And so yes, we'd love to see you pre-pregnancy, figure what everything is. Some people are like, oh yeah, you know what? I was a gymnast and every time I would land from my full, I would leap. That's pelvic floor dysfunction. Yeah. That was me as a ballet dancer. All throughout my teenage years, had incontinence and I remember thinking like, I'm too young for this. And did I do anything about it? No, not until after I had kids. Right. Absolutely. Constipation is another big one. I was going to ask you what is the symptom that people would be most surprised to know is ⁓ pelvic floor dysfunction and you say constipation. I think everybody wants to attribute it to like gut or diet or diet. Yeah. And no, not necessarily. I think a lot of it is like incomplete emptying. The pelvic floor, like if you put a one finger to the sky and you wrap the other finger around it, like that's a pelvic floor muscles. They literally wrap right around the ⁓ ⁓ if you kink that rectum, it is very hard for poop to come out of a kinked rectum. Right. And so you have to think any sort of overactivity or dysfunction down there can cause that. But then if you think you're bearing down and you're actually squeezing your pelvic floor, just like with birth, something's trying to exit and you are closing down the entrance, not letting it open. That is why this is important for birth. And that is why this is important for pooping. And so I think that would probably be the main one that people are like, ⁓ I had no idea. Back pain is another one. Like the low back sacroiliac joint. hip pain even, like lateral hip pain, that can usually be coming from pelvic floor too. It's so fascinating. It's just muscles. Yeah. And it's crazy. Even in PT school, you just like breeze over them. And you're like, what are we doing? There's 13 muscles on there. That's wild. And they're literally responsible for daily functions. Daily and supporting your pelvis, which takes the brunt of everything. Yes. And your little hips. Yeah. Like what is going on? Talk to me too about men and how they can benefit from pelvic floor therapy. I do not treat So I'll give you the knowledge that I do know. ⁓ very good at treating women. ⁓ no, I have colleagues that treat men and a lot of things that they get is erectile dysfunction. ⁓ After prostatectomies, ⁓ any sort of prostate issues is a big one. pre-ejaculatory issues is another one, just general pelvic pain, hip pain is a big one for them. Constipation as well. Constipation as well, yeah. ⁓ then for us, we usually do most of our exams vaginally, but there are some muscles that we have to reach rectally, which again, it's just a different entrance. ⁓ for men, they just do it all rectal. Yeah. Just, thank you. ⁓ right. You you picked your specialty. know, you your specialty. I am ⁓ at what I do. And other than that, I'm like, I know that it is out there and I know exactly who to refer to. ⁓ But yeah, I mean, it's the same thing, pee poo and sex for them as well. Yeah. Yeah. I mean, it's just, yeah, it's just fascinating. Like you said before, so much of what people think is woo woo is not. It is not. is It is very clear. It's yeah. I could about it all day long. Absolutely. I mean, this is, we'll have like part two to talk about all like the nerdy science stuff that I like love to dive into as long as you're ready for it. Right? love it. Absolutely. Well, this has been amazing. I do always like to close out my episodes by bringing it back to birth and asking you to describe birth in three words. Ooh, that's a good one. You should have let me plan ahead. No, I like to surprise people. That's Oh, okay. Magical would definitely be my first. It almost wants to like bring you to tears to talk about it sometimes. Difficult, empowering. I love that. I love that, yeah. Well, Amy, thank you so much for being here. very welcome. It's been a joy to talk to you and spend more time with you. All right, guys. Well, you've been listening to the Arrivals podcast. Until next time. Yay. Yay. Good stuff. Great.