The Standard of Care: Pelvic Floor Physical (Occupational) Therapy

Written By: 

Dr. Betty DeLass, PT, DPT 

Owner/Founder of Reborn Pelvic Health & Wellness



Shouldn’t Pelvic Floor Physical (Occupational) Therapy Be The Standard Of Care?


And it is. Period.

Unfortunately, it is not common knowledge that pelvic floor physical (or occupational) therapy is the standard of care during pregnancy, postpartum and beyond. 

Many people think they don’t need it, and sadly, many more people don’t even know that it is an option.

However, thanks to social media and a generation of birthing people who are more and more vocal about it all, pelvic floor therapy has gained some awareness and has become more of a “buzzword” lately.

Let’s take a look at the standard of care for ACL reconstruction (ligament in your knee) and rotator cuff repairs (tendons in your shoulder). 

When do you start physical therapy??? Before surgery and then immediately the day after surgery…

How long do you do rehab??? 2-3x a week for 6-9 months…

Are you following me…???

You grew a human…not a ligament or a tendon. A WHOLE HUMAN BEING for 9+ months, that changed your body rapidly in many, many different ways. You gave birth, either vaginally or via a c-section (which, by the way is a major abdominal surgery!!!). Then, you were sent home, responsible for sustaining another human life, while you recovered. You are just expected to continue on like nothing happened to your body.


So yes, the standard of care for pregnancy and postpartum is pelvic floor therapy. Just like any other major musculoskeletal event/change that may happen to your body. 

Growing a human IS THE BIGGEST MUSCULOSKELETAL CHANGE IN YOUR ENTIRE LIFE. It affects multiple areas of your body. More than an ankle sprain. More than low back pain. More than an ACL reconstruction or a rotator cuff repair.

Some of us do it multiple times.  

The standard of care has changed for birthing people. Pelvic floor rehab/therapy is the standard of care before, during, after and beyond pregnancy. It’s time for this to be public knowledge. It starts with YOU! It starts with US! Together!

Benefits of pelvic floor therapy before, during and after pregnancy:

  • Before Conception
    • Helps eliminate pain with penetrative intercourse, difficulty inserting a tampon or menstrual cup, or painful/uncomfortable pelvic exams with a provider.
    • Improve function from painful periods, constipation issues, or history of abdominal surgery.
    • Eliminate leakage with coughing, sneezing or jumping.
    • Address back, hip, SI joint or tailbone pain so that it isn’t an issue when you do get pregnant. 
    • Address any mechanical infertility signs and/or symptoms.
    • If you have perfect pelvic floor health. A preconception visit with our therapist would be an assessment to get a baseline and help you learn more about your own body. We will teach you what is normal and what is not normal. This will set you up for success in the long run and improve your function during pregnancy and postpartum. It will also give you and your provider a baseline of where you were at prior to becoming pregnant and giving birth. We want to empower you to be the expert of your own body! 
  • During Pregnancy:
    • Managing aches and pains that start to show up. Pregnancy has a way of bringing out orthopedic conditions that are hidden below the surface, or what is known as subclinical findings that then become clinical. Oftentimes, the symptoms that reveal themselves during pregnancy are highlighting areas of your body that need attention from your musculoskeletal system as your body is changing rapidly. We can get to the root of the problem and help you resolve it for good!
    • Low back pain, pubic symphysis pain (SPD), SI join pain, sciatica, etc. during pregnancy are common, but they don’t have to be. We can literally help with all of those things! No need to wait until you are no longer pregnant. What is common is not normal, andyou can get rid of it or avoid it entirely.
    • Round ligament pain and treatment.
    • Diastasis Recti (abdominal separation) and helping with pressure management.
  • Birth Prep:
    • It is a common misconception that the pelvic floor needs to be strong to help with the delivery of the baby and that you need to do your “kegels” to prepare for birth. A strong pelvic floor is great, but, more importantly, your pelvic floor needs to be able to move out of the way for the baby to come through in a vaginal delivery. 
    • Perineal stretching/massage. We help you learn how to do this yourself or with your partner. 
    • Decrease risk of tearing. By helping you learn about your body, stretching the pelvic floor, education about birth position, and pushing prep with real time feedback, we can help decrease the risk of tearing.
    • Optimizing the fascia (connective tissue) in your body for the baby to be in a good position and/or for attempting a VBAC (vaginal delivery after c-section).
  • Postpartum Recovery and Beyond:
    • When to integrate scar massage for perineal tearing or c-section scarring to improve mobility and decrease pain.
    • How to reconnect back to your breath, core and glutes for appropriate activation and stabilization work.
    • Building a solid foundation of movement for parenting. Utilizing good body mechanics for lifting car seats, baby wearing, feeding, etc. 
    • Return to sexual activity, making sure you don’t have any pain or discomfort.
    • Appropriate progression of return to exercise and return to high impact-jumping, lifting, running, etc.
    • And many many more!!!

Pelvic Floor Therapy is the standard of care for anyone before, during, after and beyond pregnancy. Advocate for yourself and others. You deserve it!

Learn more about what to expect at your first visit here.


Dr. Betty DeLass, PT, DPT 

Owner/Founder of Reborn Pelvic Health & Wellness


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