by Sarah Coombs, MOT, OTR/L, RYT

There is a social media trend at the moment along the lines of “5 Things I would NEVER do as a _____”. I’m not a fan of “never” doing something, so here is my spin: 5 Things I WOULD do as pelvic floor occupational therapist, knowing what I know now.

My birth & postpartum experience with my daughter is what set me off on my journey into the world of pelvic health, and given what I know now, I would do some things very differently (and did in fact do them differently with my second pregnancy.)

Yes, it’s true, you can keep doing many of the things you were doing pre-pregnancy! And despite the outdated notion that you should never start anything new in pregnancy, you can do that, too. There are phenomenal athletes who continue lifting, running, and doing all sorts of things with perfectly healthy pregnancies. But the question is: at what point are you doing something just to continue doing it versus choosing an activity to support your changing body in pregnancy?

For me, it was vinyasa yoga that I was quite frankly stuck on doing until the very end. In fact, I distinctly remember doing a modified vinyasa practice when I was past the 40 week mark.

And yes, while there's nothing necessarily wrong with modifying & continuing a vinyasa practice in pregnancy, but the way I continued to practice wasn’t actually serving me.

In hindsight, I would have done a lot more prenatal yoga to meet the needs of my changing body & allowed myself to slow down and during that last trimester.

A hospital birthing class will teach you the stages of labor, sure. Maybe a few tricks for comfort measures. But let’s be real, it’s mainly going to teach you about the hospital policies and the interventions they commonly use.

Don’t get me wrong, there are times where birth does truly warrant medical intervention. If you're birthing at a hospital it’s also incredibly important to learn about different interventions that could be presented as an option well before you’re going into labor. But if your hope is for less intervention, then take a class on what happens in birth without interventions.

Now, if you’re the kind of person who’s like: “I want that epidural the second I can!” or, "I'm okay with whatever my doctor decides", there's no shame in that, and a hospital birthing class might be a perfectly fine option for you.

"Purple pushing” is the pushing you see in the movies where the person holds their breath and then bears down with all their might. And for a long time it’s been coached by hospital staff because it can be an effective way to get a baby out in a shorter amount of time. However, this is most certainly not the only way to push and unfortunately it does set us up for a higher risk of tissue damage if we are using it as a strategy for a long period of time. Unless your body: 1. automatically wants to push that way OR 2. the way you’ve been pushing for quite some time has not been effective and you need to change it up, I wouldn’t suggest this as your go-to strategy.

If you're not sure what the other strategies are, this is a great reason to work with a pelvic floor occupational therapist or pelvic floor physical therapist in pregnancy! Our practice offers birth prep sessions where we provide individualized feedback with different pushing strategies to help you practice before the big day.

Like many who have come before me, I spent all my time researching all the baby things. Towards the end of pregnancy I was in full-on nesting mode, preparing my daughter’s nursery.. that she actually didn’t spend any time in until she was about 4 months old.

I get it, looking at baby stuff is super exciting and fun! And I also think it’s natural to go into nesting mode at the end of pregnancy. But it turns out I didn't need an animal themed nursery. I really needed an experienced birth doula to help support me above and the most important thing of all: POSTPARTUM HELP.

Friends, we were not meant to take care of newborn babies all alone, and in many other parts of the world there are still structures in place around postpartum care where a new mother would never, EVER be left alone to recover and care for a newborn by herself. This is a recipe for poor maternal health outcomes, isolation, and things like PPD/PPA.

I remember asking my midwife at my 6-week postpartum visit what I should do now that I was “cleared” for exercise- to which she said, “well just don’t go crazy!” No referral to pelvic floor OT/ pelvic floor PT or even a recommendation of where to start. And so I did what most of us do: I tried to jump right back into a vinyasa yoga practice 6 weeks after a major abdominal surgery. (Note: I do not recommend this.)

Like many others, I didn’t know any better, and shame on the medical system for abandoning us all like this. After ending up up with all kinds of hip and pelvic pain, I thought: there must be a better way! What am I missing? And thus began the start of my new career path.

Six weeks postpartum is not enough time for anyone to be fully "cleared" for exercise, but it's also overwhelming at knowing where to start. This is why working with a pelvic floor OT or pelvic floor PT in postpartum is so beneficial. Rooted Pelvic Health & Wellness specializes in pregnancy and postpartum, which means that we can give you the 1:1 feedback and customized plan that YOU need. No two people are alike, so cookie cutter programs usually don't cut it! If you're currently pregnant and thinking ahead, or are early postpartum yourself, reach out today to schedule an evaluation.