Success Story: From Birth Prep to Birth Success at PHRC

In Pregnancy/Postpartum by Molly BachmannLeave a Comment

By Molly Bachmann, DPT, PHRC San Francisco

 

Suzy came to Pelvic Floor PT during her second pregnancy in hopes of addressing some recent heaviness she had felt in her vagina. She also complained of urinating every hour and waking up two to three times a night to urinate. She hoped to prepare her body for birth and postpartum as well. 

 

As she had progressed throughout her pregnancy she had been told these things should be expected but she didn’t realize that some of these symptoms could go away completely, even though she had experienced them since the birth of her first child. 

 

After our exam, we identified some tightness in her deep pelvic floor muscles, some weakness in her pelvic floor muscles and hip muscles, and decreased endurance. 

 

We started with three simple things: timed voiding, looking into a pelvic wand, and three exercises.

 

I had Suzy set a timer for every 45 minutes. When the timer went off, I asked that she get up and go to the bathroom whether she felt the urge or not. I encouraged her to really try to avoid using the bathroom other than when the timer goes off. 

Once she decided to purchase the pelvic wand, I advised her to bring it into the clinic and I would show her how to use it.

For the exercises, I prescribed supine Hip Adduction Isometric with Ball, Supine Bridge with Pelvic Floor Contraction and Supine 90/90 Overhead Dumbbell Raise. These were designed to improve the power of her pelvic floor contraction and coordination with other pelvic muscle groups.

Suzy returned four weeks later and reported that she had no leaking of urine and that the heaviness she had felt improved drastically. When we checked her pelvic floor, her strength had improved as well as the tightness in her pelvic floor. 

That session we updated her timed voiding to every 90 minutes during waking hours and taught her how to use the pelvic wand on her own. When it was clear she knew how to use it safely, I asked her to use it three to four times a week for five to eight minutes at a time. Because her strength had improved, we changed her home exercises to Tall Kneeling Hip Hinge, Hooklying Eccentric Sit Up and Copenhagen Hip Adduction with Chair.

Suzy then returned three weeks later and was in the final stages of her pregnancy, just a couple of weeks from the baby’s due date. At this time, she had no leaking, her urinary frequency was better than it had been before pregnancy, she no longer woke up at night to urinate, and did not feel any heaviness. Because she had such success, we changed our focus to preparing her pelvic floor for birth.

We practiced multiple breathing styles to identify which ones gave her the most amount of pelvic floor relaxation and power from her abdomen. She did really well with a “fogging of the mirror,” “MMMM” sounds on exhale and “WWAAAHHHH” sounds on exhale. I asked that she practice these at home just two times a week in multiple positions so that it felt instinctual when she was in labor. 

To prepare her pelvic girdle, we practiced a Hip External Rotation Stretch, Adductor rocks,  Deep Squat with Pelvic Floor Relaxation, Half Kneel Lateral Lunge and 90-90 rotations hip rotations. 

Two weeks later, I got an email from Suzy that she had had her baby and despite an unexpected induction, she had no pelvic floor pain and the birth was uncomplicated! She pushed so easily that the doctors were impressed and she would be in for a check up at the six week mark!

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We are excited to announce Molly will be helping PHRC open their 11th location in Columbus, OH in September of 2023. Join the waitlist and be the first to be contacted!

Are you unable to come see us in person in the Bay Area, Southern California or New England?  We offer virtual physical therapy appointments too!

Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.

Melissa Patrick is a certified yoga instructor and meditation teacher and is also available virtually to help, for more information please visit our therapeutic yoga page

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