Get insight on what a pelvic floor specialist can do for you in the transition from pregnancy to motherhood. Join me and Kristine Godsil of Active-Core, PT pelvic floor specialist and discover what to do for best healing from delivery. Insights on sleeping positions, best body mechanics for feeding and what red flags to be aware of.
Episode Transcript
Welcome back to first breaths to first steps. I’m Beverly Garrison newborn health coach. And I’m here today with Kristine Godsil. She’s a Colorado physical therapist. We’re both located in the colorful state of Colorado. She practices orthopedic physical therapy, pediatric physical therapy, but her specialty is in pelvic floor physical therapy.
When I was pregnant, I was like ” really you can use a physical therapist during this time?” They have all these great resources now a day. It’s awesome to have Kristine with us today. Welcome. Thank you. It’s great. Kristine started with her current company active core in March of 2021. And due to wanting more one-on-one time with her patients, she made that transition. Her passion is not only getting patients pain-free, but really problem solving and figuring out what’s causing our pain or dysfunction as well as giving us great tips and tricks of how to get these individuals back to health.
Today we thought we would talk about that timeframe immediately after moms have delivered. I like to label this discussion, rest, renew, and relationship. Kristine, let me have you start us off by talking to us about what is a pelvic floor specialists, physical therapist, and how can we get some pelvic floor recovery immediately after delivery? Absolutely. Pelvic floor physical therapy, it really all entails any urinary ,bowel or sexual health. If you’re having any dysfunction or pain or , aren’t sure what’s going on in any of those realms or systems, it’d be a good time to come in to see a PT. We could figure out. If we’re the first stop, if it’s truly muscle driven or if you’re having any ligament restrictions or at least getting into the next set of hands, that would be helpful.
Back in the day, my babies are 21, 19 and 17. We didn’t always talk a lot about, my body I’m really struggling with this, or you even have questions about your sexual health. We really. Didn’t talk about that. It’s really nice to identify for our clients and our moms in particular, there is someone that can give you good advice and walk you through some scenarios and help you game plan and make, a solution that’s gonna work for you because I think there’s so many times where we think those kind of topics are taboo. And a lot of moms, don’t even talk about that with their OB GYN or their primary care providers. So I think it’s great pelvic floor for sure. Absolutely. That’s where I always tell my clients too, that there’s no information, that’s too much information. I meet them wherever they’re at. Like you’re saying, it’s a topic that’s taboo and in some cultures or in some families, there’s a spectrum to it. I tell them to them you’re not going to hurt my feelings if one that you. Really dive into the question, or you want to take a step back and maybe wait till the next session that you don’t feel comfortable enough.
I’m here for wherever you’re at on that journey. And we’ll put those pieces together yeah. I spent a majority of my clinical career in pediatrics, so not a lot of women’s health, but I think we treat a lot of women in pediatrics because we’re there with mom. Talking to them. We have a baby and our first recheck tends to be at four to six weeks. A lot of times we have a lot of questions beforehand. It is nice to find out who is the pelvic floor specialist in your area, or who does that type of work so that if you do indeed have an issue or a problem, you know where to go.
It’s easy. It’s like going to the pediatrician or going back to your GYN or, to seek extra care with lactation. It’s knowing that those people are out there and that we really do have that resource in the community super helpful.
Can you talk to me. What your thoughts are on pelvic floor recovery immediately after delivery. What does that look like? Things should moms be doing? Zero to six weeks, cause that you write your next checkup after you deliver, baby is at that six week point, unless you have something else going on, people go on before that. That six week mark is meaning that those tissues, whether it’s a vaginal delivery, whether you’ve had a C-section, those tissues should be healed. Your scar should be completely healed or come together and we should be able to see. Allowing for some movement or some stress onto those tissues. That doesn’t mean that we can’t do anything before. But what that looks like is making sure we do get enough rest and recovery, like you’re saying. Zero to two weeks, I generally have it of making sure that walks stay just around the house. And are as tolerated.
You can lean into some deep breathing if it feels comfortable, what that does is initiate that ebb and flow of your diaphragm and pelvic floor. And that stay for either vaginal delivery or C-section. Then when we’re getting to that, halfway point of that six weeks, so three to six week is when I start to initiate light kegels or pelvic floor contractions, like deep abdominal contraction. Initiating those things, not going a hundred percent, but making sure you can feel it . And doing light repetitions, throughout your day, hours or weeks. Those are the. And then the last set of it is that you can start to integrate a little bit of light exercises with those things.
Once we feel that that’s comfortable and make sure that we feel that Kegel or contraction, or that deep abdominal, you can start doing light bridges, light squatting other ones that I do are like marching, in that four to six weeks realm the why there are different variations of zero to two, three to six. I’m sure you can relate in pediatrics is that there’s no hard line. Because it’s based on, where you’re meeting a child for a milestone, same for mamas. If you don’t feel like you’re comfortable or you’re getting pain of trying to do a Kegel at three weeks, Give yourself a couple more days.
Maybe your scar is healing in a certain spot that where you’re contracting. Don’t use those as hard and fast rules. Make sure you’re listening to your body so that you can start that healing process and make sure you’re getting that rest that you need. Sure. I think sometimes, well, Live in Colorado.
So we’re in the land of quite fit people. And sometimes I feel like there’s this unrealistic expectation of I’ve had this baby, so I should be going back to normal, but it’s a major health event, even if you didn’t have a C-section or a surgery, right. That poor pelvic floor sometimes, , takes a little bit of abuse.
Ripping or needing an episiotomy or things like that can really change our recovery plan and how things progress. You bring up a really good point on, take a little time that’s allowed it’s okay. And that, , not having just a unrealistic expectation of that timeframe.
As far as C-sections, what sort of restrictions activity-wise do you guys have moms follow within that first couple of weeks, time period after delivery? Yeah. Like any abdominal surgery. Cause if you think, if you kind of walk it back, right. A C-section is a major abdominal surgery.
Thinking of those restrictions, you’re not going to want to do any excessive bending, twisting, anything like that. Most of the time they limit the weight of your baby. I always like to tell the story, my sister, she had a C-section her son was premature. He went home at four pounds. And when they gave her that spiel, she was like my baby or anybody else’s , what’s that realm or ones that justification. I always like to level it, if you think about a weight restrictions, usually about eight to 10. Generally babies. Aren’t more than that either. And think that a gallon of milk is about eight pounds, so nothing heavier than that.
Putting into something a little bit more tangible that way, again, it’s leaning into that recovery period, making sure that you’re not getting any sort of pulling. Different things to look out for, scar healing making sure that there’s no infection. Making sure bandages or stitches are healing. Well. Those things are staying on properly. Or that are opening up. And then we’re looking into, to is sensitivity. Is there any pain, is there any numbness, , because generally at that six week appointment we’re going to be looking into making sure if the tissues feel the same and then are those tissues moving the way that they should.
How can we initiate all of that with massage? You bring up a good point because that is the general statement that we hear is that, don’t lift anything more than your baby and babies come in different sizes, packages, whatnot, so pounds, and that visual of lifting a full gallon of milk. That’s a really good piece of information to tuck away for us to go, okay , my baby. Six pounds, seven pounds. That’s about it. Moms are given driving restrictions. So first couple appointments to get your baby in at least right after discharge.
A couple of weeks after that, that you weren’t driving for those. If you’ve had a C-section. Making sure you have a helping hand like what you’re touching on. Somebody dragged knew somebody who walk babe up the stairs, saying you need to go to the apartment or walk into the house.
What a minor activity can be performed safely, right after delivery. And when do you suggest stepping up activity? Yeah, usually it’s after that zero to two weeks.. Making sure that walking’s comfortable. And when I have people start a walking program, during that first bar, that second week, Of trying to go outside, go around the block or something for, five minutes.
And if that feels okay the next week, then let’s bump it up by five minutes. I usually have that a nice additive. Around 20 to 30. Depending on how your body’s responding and making sure that that’s comfortable. And then we talked about adding some light squatting or sit to stands or bridging in that four to six week period.
Again, that’s mainly to win that. Solar isometric pelvic floor contraction feels okay. Or that deep abdominal one feels. Okay. Just gauging it based on how your body feels, because I’ve had some patients that they initiate those Kegels or that deep abdominal contraction at week five. , They’re just there. They couldn’t feel it before, couldn’t it or didn’t feel okay enough. It felt off. They just waited and they mainly focused on walking so gaging it to you cause that’s okay. It should be tailored to you.
A lot of differences amongst us as moms. And not only is every mom different, but every pregnancy within the same mom is different. What you may have been able to do your first or second pregnancy, you may not be able to do your third pregnant. At the same time point.
The last thing that I wanted to touch base on was immediately after talking about best positions for moms, when they’re sitting, when they’re holding their babies and, or feeding, can you address some of those.
Yeah, absolutely. Best positions generally I think for breastfeeding or any sort of feeding. Whether it’s bottle or breast is, is making sure that you’re comfortable. That’s hard sometimes, especially if it’s a middle of the night feed. You’re like, I’m not going to go grab three pillows for this.
But make sure and have what set up best for you. Use that boppy pillow. I think. Well, I think that’s, that’s just for babe. It’s really for mom do of making sure that your arm supported, it’s not completely holding baby upright. If you are sitting upright, if being in a more reclined position is comfortable so that you don’t feel like you’re putting a lot of weight on that mid or upper back we’re not getting a lot of tension in the shoulders.
They’re not coming in while we’re feeding making sure that they have support. I’ve had people play around with side lying as well. For breastfeeding, that’s a great option. Let’s you get some rest puts baby in a great position to, and that way your muscles aren’t overworking, especially during those night feeds.
Figuring out for you. Is it more comfortable being reclined? Is it a side sit and making sure you find the stretches that work for you. If you feel like you’ve sat in a wonky position for the last 20, 30 minutes, get out of it, , get a nice side body stretch. Stretch out your neck while your shoulders. You’re not holding onto that tension. You and I have talked before, about the importance of pillows. I love pillows, smaller pillows, any pillow you can get. It helps to get us in a good position, especially with feeding. Good thing to remember is bring baby up to you and not you down.
It gives you better body mechanics, and you will feel better later doing. I love the Boppy and I love little pillows that you can also use in addition to the boppy, just to get that perfect position. It doesn’t seem too bulky if you can get, I don’t know if you remember back in the day when you used to fly and be able to get a pillow and a blanket, but smaller pillows, a little pillow.
In addition to that, Bobby sometimes can really put that little baby in a much better position for you that you’re not having to. Contort your body to fit that need you got it. You’re talking about different sizes of pillows cause sometimes those aren’t readily available or you can’t find a perfect size. I’ll have people play around with different towel rolls. Washcloths to hand, to bath, to beach towels. Depending on what that means looks like and how you need to form it to , whether it’s your side, . Just underneath the arm. That can be an easy fix and something you already have laying around.
I like to advise, mom’s , get your feet up after a delivery. If you’re sitting, especially daytime feeding and maybe you’re in a part of your house where there’s a couch, get your feet up, helps to decrease all that fluid, pulling down to our lower extremities to both our legs and our ankles. Sometimes that can help reabsorb , and decrease some of that swelling that we see in that situation.
What about positions for sleeping right after delivery? Do you have any suggestions for that? Yeah, similar to any of those during pregnancy.
We already talked about how, even if there’s a mama, that’s more active we have that bounce back mentality. Granted sometimes that happens for women and kudos to you, but sometimes it does not. And that’s okay. I feel like you’re still having some of that fluid or you still have some of that extra weight , making sure you’re meeting your body where it works at.
Like, you’re saying pillows, man. They, they do it all and we can show them some to kind of combo of those. Now that you can be more back sleeper, laying supine, you can do that. And feet up whether it’s on a wedge, whether it’s just underneath your knees, whatever’s most comfortable and makes you relax down to cause getting that relaxation, not just to the body, but the pelvic floor is also huge.
Making sure you’re comfortable in those positions. I always kind of joke with you, Kristine, that I’m your old friend, but I think even just reminding moms, even when you’re getting up, from a laying down position, sometimes rolling to your side, helping to push up and not necessarily straining those abdominals or expecting that they’re going to work as well as they did before. Be nice to yourself, meet your body where it’s not exactly what you said, meet your body, where it’s at. Yeah. A true log roll, I feel like they teach that for any back surgery or any total hip, total knee. How to get out of bed properly. I don’t know if that always happens before you exit especially after a C-section, but roll onto your side, have your feet hang off and then push yourself up. No reason to do a major crunch or sit up to get out of bed. Yeah, it puts way too much pressure and I know it won’t feel good. Give yourself a break. Exactly.
Well, Kristine, I really appreciate you being with me here today. I think we covered some great things as far as immediately after delivering. Rest renewing your body. And talking about that relationship of healing. I appreciate your time. If any of you listening found the information that Kristine and I talked about helpful, you can contact me in the link below and until next time 📍 be well.
