Lynn Schulte: Mastering Postpartum Recovery with Pelvic Health Techniques

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Hello, today I have with me Lynn Schulte.

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Lynn is a pelvic health physical therapist for over 30 years and she is the principal instructor and founder of the Institute for Birth Healing.

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She has successfully healed thousands of women from all the issues women experience after birth and is now teaching courses to body workers to help them do the same.

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She found a common birth pattern that shows up in the pelvis after birth and knows how to effectively release these patterns.

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Knowing we are more than just our bodies, lynn works on all levels physically, energetically and spiritually with women to help them access their full potential.

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She also teaches body workers how to work with energy of the body and how to access and use your intuition in your body.

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Work sessions, she offers a certification process to help birth professionals become birth healing practitioners.

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Lynn holds a Bachelor of Science in Physical Therapy from St Louis University in St Louis, missouri.

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Lynn, welcome and thank you so much for joining me.

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Thank you so much for having me, Kelly.

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I love any opportunity I get to talk and share what I know.

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I'm really excited because I just I remember being very challenged after my births and trying to figure out what was going on with my pelvic floor, and I'm excited to learn about these patterns that you've picked up on and how we can work through them.

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Yeah, yeah.

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It's super important and not a lot of people are talking about this, so that's why I'm so passionate about getting this idea and these ideas out into the world.

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Because it does.

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It helps moms so much more in the recovery after birth.

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Yeah yeah, nobody wants their pelvic floor hanging out of their body.

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Right and there's a reason it is.

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Can you tell me a little bit about how you got into this?

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Yeah, Well, you know, I know you do birth stories on your podcast and my birth stories everybody asks me well, did you get into this?

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Because your birth story was really bad and it was like no, I actually had really beautiful births, seven and eight hours of labor and I actually, after the first birth, I was so lit on fire after the baby came out that I was like I have to do this, I have to work in the birth field, and I don't know, do I need to become a midwife or a OB or a labor nurse?

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What do I need to do to work in this arena?

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Because it just lit a fire in me.

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And then I went back to taking care of baby and raising baby and raising family and I was doing women's health physical therapy at the time.

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But I really didn't get into working with the pregnant and postpartum population until about 10 years later, when I moved from Seattle to Boulder, Colorado, I had to start my practice all over again and that's when I was just seeing postpartum women.

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And what was unique about that is that most pelvic health therapists they see a variety of clients and so for me, when I was just starting out, I was only seeing postpartum women.

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That was the only thing that was coming into my clinic and that is what allowed me to find these patterns in the body, because everybody laying on my table would have the same rotation of their pelvis to the same direction.

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And I just got curious with that.

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I'm like what's causing this rotation?

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And I realized that it was the movement of the sacrum and what was happening in birth.

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And then I just started palpating the pelvis and the pelvic bones and I was surprised to find that our sit bone, the bones that you sit on, are called our ischial tuberosities, and one was more splayed out to the side than the other.

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And I'm like doesn't the baby come right in the midline?

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You know why am I finding it Like in my brain?

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I'm like babies come out in the midline and the pelvis opens up in the middle and the baby comes out right.

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Well, that wasn't what I was finding in my mom's pelvises and I kept finding right side ischium splayed and then I found that the sacrum was way back from where it should be and it just got me so curious.

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So I started studying more what are the mechanics of birth and what happens to the pelvis, and I realized that the ischial bones, your sit bones do splay apart and your tailbone does lift backwards to open up the pelvic outlet for a baby to come on out.

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And then, as I started to investigate and inquire with my clients and ask them, like, what position were you in when the baby came out?

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Laying on their back Right?

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A lot of them, but some of them would say, oh, I was on my left side, and when you're on your left side, that left side pelvis is anchored to the, so it can't move.

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So the right side has to move more, Right ischium has to open up more, and that would cause that asymmetry of the pelvis.

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If a person had a leg bent up and the other leg a little more straight, that would cause that side to splay out more.

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And so I just started putting together and asking people what position were you in when the baby came out?

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And then I'd go palpate their pelvis and I would find what I thought I would, based on the mechanics of what I know about the pelvis and the body.

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And so I figured out how to release those patterns and how to get the bones back to their original position after birth.

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And moms were getting out of pain in one session and they'd been seeing chiropractors and massage therapists for months and their pain was just lingering.

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And this all started in 2009, 10.

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So then I was finding all these patterns and learning all this stuff about the postpartum body and I started putting on YouTube all these you know, ideas and patterns that I was finding in the body, and I started getting emails from women all over the world saying, oh my gosh, I have exactly what you're talking about.

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Do you know someone who could help me?

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And I was like, well, you could try a pelvic floor physical therapist, but they don't know what I know, because I learned this all on my own.

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And then I just realized it's like gosh, I'm having such great success with what I know and what I'm doing in the postpartum, with the postpartum body.

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I need to start teaching this, and so I started in.

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2016 is when I founded the Institute for Birth Healing, and I've been traveling the world teaching other practitioners, other body workers, how to support pregnancy, how to support the body to prepare it for labor and then how to recover it afterwards.

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And it has been my joy to know that my students get the same results that I do, and it's so fun for me to hear my students reach out to me after a class and say oh my gosh, all these clients that weren't really progressing.

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I started doing the techniques you taught me and now they're all getting so much better, so much faster.

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And it's like, yeah, it's so cool and so one of the things you know we were talking about the ischial splay, that sacrum lifting backwards.

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Sometimes both ischiums splay apart when the baby comes out and the body can get stuck like that.

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So what I'm recognizing is that the pelvic bones don't always go back to their original position after a baby comes out.

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There are ways for us to help the body to bring those bones back together again, and this is something I just wish everybody after birth would do.

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There's an exercise I have on YouTube.

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It's called how to close the bones after birth, the pelvic bones after birth, and you just do a resistance of your knees together and then resistance of the knees apart.

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So it's super easy.

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You want to do it.

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You don't want to create any pain.

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If there's pain, there's a greater dysfunction going on that they need support.

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But if you could, just after a baby comes on out and after mom and baby settle a little bit, even the next day, just have them there laying on their back, bend their knees up, Just put your one fist between their knees and have them squeeze for 10 seconds as hard as they can without creating pain.

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Have them relax, Put two fists between them and then put your forearm between the knees and then have them put their knees together and you resist them trying to push their knees apart for 10 seconds and then bring the shoulder width apart and have them resist, but you don't let their legs move.

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And then you bring them out even further and you again have them push apart and you hold them there so that they don't move and that uses the leg muscles to help bring those bones back into a more midline position.

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To help bring those bones back into a more midline position and that can help women's pelvic floor muscles be able to respond better.

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It just sets them up onto a path of greater success more quickly after birth.

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If we bones aren't stuck in this open birthing pattern for however long it is and like, the body then doesn't have tissue memory.

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It goes right back where it remembered it was initially, and so the pelvic bones being in what I coined.

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The open birthing pattern can create a lot of different issues for us.

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It can cause our pelvic floor muscles attached to all those bones, so the pelvic floor muscles are unstretched, they're lengthened.

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They're not strong when they're lengthened, and bringing the bones back to a more midline position helps to shorten those muscles so they're able to function better.

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When the pelvic floor muscles are unstretched, the vaginal opening is it should be a circle, but when the muscles are on stretch, then it's more of an oval side to side.

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And that penetration, insertional pain with penetration, with intercourse.

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You just put the bones together, then those muscles can relax and they can open to allow insertion to happen with intercourse.

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A lot of women complain of heaviness vaginally after birth.

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That heaviness could be either two issues.

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It could be dealing with a prolapse, and a prolapse is where the pelvic organs hang down lower than they should be, and the sooner you could get support with that, the better for your body.

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If you are dealing with prolapse or this heaviness usually a prolapse the heaviness will get worse by the end of the day.

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That is a telltale sign that you're dealing with prolapse.

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If you have a heaviness, that is the same when you wake up and when you go to bed at night.

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That's typically more of this open birthing pattern issue.

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Public floor muscles are hanging on for dear life trying to keep your bones together, and so they're working overly hard and that can create a lot of heaviness feeling in that area.

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So if you can do that exercise to bring your bones together again, that can put the muscles on a more slack position.

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They don't have to work so hard and that heaviness goes right away.

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So fascinating.

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I feel like I need to lay down and do those exercises right now.

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Yes, a lot of women do.

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And again, if we could just have everybody who you know has a baby vaginally, just bring their bones together and that's where know has a baby vaginally, just bring their bones together and that's where you know pelvic floor PTs if they know and really understand and know how to work with the pelvic bones, they, they're, they're way more effective with the pelvic floor work because the bones are the housing for the pelvic floor muscles.

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And if the are not in a proper position.

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It just makes it a lot harder for the muscles to be able to work there, and so one of the things that causes this open birthing pattern is when we're in birth.

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Birth can be a very, very challenging experience, as you, I'm sure, have witnessed right, and sometimes it can be traumatic for the person.

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And when trauma is involved, the body's responses are fight, flight or freeze.

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Well, when we're in birth, we can't fight it.

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That baby's got to come out, we can't flight from it, we can't run away from it, and so freeze is the most common response in birth.

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And what's helpful?

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If you are doing these exercises to close the bones and they keep opening up, or you don't feel like this exercise is effective, then that could be a sign that there is a trauma response in your body and you need to address that first.

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And so, working with someone who works with trauma either a trauma therapist or someone who does somatic, experiencing somato-emotional release work Any of the practitioners that I've trained that have done my advanced work or my birth healing intensive program they know how to work with that response in the body to help release it, and to me, when I sense into this.

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It's like the pelvis is holding its breath, like and it hasn't exhaled, and so we need to help it to exhale and know that it's not stuck in that moment in time.

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Because that's truly what happens during trauma is that a part of our body is stuck in that moment in time when the birth happened, when it got to be too much, when it was overwhelming to the system.

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That's the trauma response in the body and a part of us gets stuck there and the rest of us continues to live on and the body keeps going back to that moment in time and you'll notice that with your thoughts or your memories, and you'll always go back to the same moment in time in your birth and that's your mind's way of helping you to realize where you're stuck, where you need support.

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And so there's all different kinds of ways that you can work with that, and I can help people do that over Zoom sessions, no matter where you are and we can help heal that and get that energy flowing again and helping your body to relax again after the birth.

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And so just know that.

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Another sign is, if anyone's had a cesarean birth and you can't touch the scar is another sign of trauma.

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Or when you talk about your birth, you tear up about it.

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That emotional response is a sign that there's a traumatic response in your body still, and so I think it's just important to help people to understand why they are the way they are and why they, you know, think about their birth and they get weepy or teary or angry or whatever the emotion is, and that that's a response in your body and it's your body's just wanting support and needing support.

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Know that there is support out there to help heal and no matter what you're dealing with, there's always healing.

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That can happen.

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No matter how long it's been since you've given birth, whether it's two days or 20 years, the body can always heal, and so I just want women to know that and understand that their bodies.

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There's only a couple of things that happen during birth that aren't reversible, and their prolapse can be one of them, but there's different stages of prolapse and that what I find after birth is that after pushing a baby out vaginally, the bladder gets smushed off to a side, the cervix can be a little bit lower than it should be.

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But if we can help get the bladder back into place and we get the cervix to release some of the tension in the cervical ligaments, the uterine ligaments that support it, sometimes we can help get that uterus back into a more optimal position in there, and so a prolapse isn't a true prolapse, it's more of just an organ being out of place a little bit.

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So that's on the more mild side.

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If you open your labia and you have a bulge right at your opening, that's more a true prolapse, and we need to really get a good understanding of what is creating the prolapse.

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Is there a defect?

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Did a muscle kind of tear away from its attachment point?

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Did a ligament or a tendon rupture?

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And so it doesn't have the support system that it needs.

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And what's really important for women to know is that pessary use, more immediately after birth, can be super, super healing to the area, and so there are some, there is some research saying area, and so there is some research showing that pessary use can help heal the tissues in that area, and so we want to get those tissues supported as quickly as possible after birth if there is a sign of prolapse, and so doing so can help actually the tissues.

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It can support healing, and we just don't know if it'll be complete healing where you won't have a prolapse anymore, or if it'll just support it.

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But you still have issues with the organs not staying in their more upright position.

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They're more in a saggy downward position in their body, and so prolapse is one of the issues that we just can't.

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There's no good surgical option, no good surgical repair that can happen, and pessary is your best option for supporting those organs.

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The only other issue that can happen during birth is and we really want to try to avoid this is complete disruption of this pubis joint, so that's your pubis bone in the front, and that usually happens when baby's not in the best position coming through the pelvis, and so baby gets stuck and the larger part of baby's head is coming through that pelvis, and then you hear a loud pop, and that can be a complete disruption of the ligaments that hold those two bones together.

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If we have complete disruption, where there's no ligamentous support to that pubic bone, there's really nothing that we can do other than maybe put a belt on it to try to support you or go have surgery to stabilize that joint again.

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But if the ligaments have completely ruptured, there's not, you know, healing doesn't really happen to that joint.

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So you need to find a way to stabilize it best you can.

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So those are things that we would love to avoid happening and really that happens by us preparing our bodies for birth better and making sure that baby's in a good position and baby's head is down, but not just down, but right in the middle, going into the midline of the pelvis, the inlet of the pelvis, and not heading off into a hip or you know, and baby not being on one side of the belly all the time.

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Baby can have both sides of the belly and there needs to be even movement of that uterus side to side.

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That tells us that we've got even uterine ligaments in there and when we have tension or tightness, baby goes where there's space.

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So if baby's only hanging out on one side, it's because that's where there's space, and we need to create more balanced, even space in that abdominal area for baby to get into the best position to enter into the pelvis.

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And the other thing that we need to really focus in on for better births is to make sure that our pelvic floor muscles have nice, even, springy tone, and springy tone that can lengthen when you go to push.

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One of the biggest factors that cause the greatest tears is when women are trying to push a baby out and they tighten their pelvic floor muscles, and so it's so important that you practice this prior to going into labor.

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Really, figure out how do you push in all different positions.

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You can have your partner insert their fingers in vaginally, and I would recommend two fingers going in vaginally.

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Don't push down.

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If you think of that vaginal opening as a clock, right at six o'clock is the rectum.

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So don't push down at six o'clock, but just spread your fingers on either side of the rectum.

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And how do you know you're on a pelvic floor muscle?

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You have your partner do a contraction and if it moves underneath your fingers, you know you're on a muscle.

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And then you want to just have them practice.

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Okay, put, put your fingers in as far in as you can and don't create pain, though If there's pain, then go get support and help.

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But with your fingers on those pelvic floor muscles, have your partner just push them out and see what happens.

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80% of the time in my clinic, people tighten instead of bearing down and it's like, okay, that's the opposite of what you want to happen.

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Do you realize?

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When you're contracting your pelvic floor, it's the exact opposite of what needs to happen for a baby to come on out.

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It's like you're closing the door on your baby and so you need to learn how to lengthen and let that pelvic floor muscle open so baby can come on down and through.

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So your partner will feel their fingers lengthening and pushing out towards your vaginal opening, and that's what we're looking for.

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And if you start on your back and you, you can't get it.

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It's pretty normal, because a lot of people can't figure out how to push on their backs, go figure.

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So get on your side.

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Your partner can keep their fingers in on your pelvic floor muscles, roll over onto your side and a lot of times in inside lying, people have a much better understanding of how to lengthen that muscle.

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Sometimes that doesn't even work.

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Get up on hands and knees, keep your fingers in.

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Just have your partner get up on hands and knees and keep your fingers on those muscles and have them push it out.

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And a lot of times the hands and knees position they have a much easier way of accessing that lengthening of the pelvic floor muscles.

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And then you could do it in tall kneeling as well, which is a lot more like pooping.

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So birth baby is like allowing stool to come on out.

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And what do you do?

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You can practice when you have a bowel movement.

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What do you do to help encourage that stool to come on out?

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Do you engage your belly?

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Do you push down?

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Do you lengthen, do you relax your pelvic floor muscles?

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It's pooping and birthing is the same mechanic, but a lot of people don't birth.

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They don't poop correctly.

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So that's our problem and that's really a pregnant women listening in.

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You need to practice your pelvic floor muscle lengthening and how to push correctly, and so what people need to understand is that the pelvic floor muscles are the stoplight for birth.

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So what people need to understand is that the pelvic floor muscles are the stoplight for birth, that if you have red light tone in those pelvic floor muscles and there's too much tone in the muscles, the baby is, it's like a sign to the baby don't come out this way.

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In fact, too much tension in the pelvic floor muscles will keep a baby's head high in the belly and it won't engage into the pelvis head high in the belly and it will engage into the pelvis.

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So we need to work on relaxing those pelvic floor muscles and making a more welcoming environment for the baby's head to come on down into the pelvis.

00:22:52.613 --> 00:22:57.893
So red light tone is like bricks you put your fingers in and you just there's no give to that muscle.

00:22:57.893 --> 00:23:03.523
Yellow light tone there's some give but it's still resistant.

00:23:03.523 --> 00:23:08.999
And green light tone is like pushing on a trampoline your hand goes down and it comes back up.

00:23:08.999 --> 00:23:11.777
That's what we need for birth.

00:23:11.777 --> 00:23:13.777
We need that green light tone.

00:23:14.490 --> 00:23:16.136
So I had a client who came to see me.

00:23:16.136 --> 00:23:26.243
She was a doula and she was pregnant with her second baby and she still, to this day, wins the award for the hardest pelvic floor muscles I've ever worked with in my career.

00:23:26.243 --> 00:23:29.625
Not a good thing to be known for.

00:23:29.625 --> 00:23:30.349
I know that's not good.

00:23:30.349 --> 00:23:34.069
So she told me that she was pregnant with her second one.

00:23:34.069 --> 00:23:36.615
In her first birth she was trying to do a home birth.

00:23:36.615 --> 00:23:39.741
Got to four centimeters dilation and baby stalled.

00:23:39.741 --> 00:23:40.604
Nothing happened.

00:23:40.604 --> 00:23:44.740
So she went into the hospital, got an epidural and then baby came out vaginally.

00:23:44.740 --> 00:23:45.903
Nothing happened.

00:23:45.903 --> 00:23:48.210
So she went into the hospital, got an epidural and then baby came out vaginally.

00:23:49.650 --> 00:23:54.560
The reason baby came out vaginally is because the epidural bypassed the tone in her pelvic floor muscle During her second pregnancy we worked three sessions.

00:23:54.560 --> 00:23:57.453
Usually I can get pelvic floor muscles to release in one session.

00:23:57.453 --> 00:24:12.823
So the fact that it took us three sessions to get some relaxation in those muscles tells you that there was a lot going on in those muscles and so I worked with her and we really worked on getting her to lengthen and in those muscles tells you that there was a lot going on in those muscles, and so I worked with her and we really worked on getting her to lengthen and let those muscles go and get some spring to it.

00:24:12.823 --> 00:24:17.740
She was successful in having a home birth her second pregnancy but I guarantee it was because of the work that we did together.

00:24:17.740 --> 00:24:26.432
If she had not, she would have gone down the same path because those muscles were not willing to open up and to give and to lengthen.

00:24:26.432 --> 00:24:36.450
So it's just so important that the pelvic floor muscles lengthen so that the baby can come on out and that really can help avoid the tearing.

00:24:37.632 --> 00:24:46.653
Because tearing happens when there's resistance and the muscles aren't lengthening and you're tightening your pelvic floor as you're trying to push a baby on out.

00:24:46.653 --> 00:24:52.612
That's what creates a lot of tearing and also pushing too fast, too soon.

00:24:52.612 --> 00:24:56.991
Right, don't blast the baby out, it's not a rocket ship, yes, yes.

00:24:56.991 --> 00:25:01.453
So people are just like, oh, I just had to get it out and they just push way too fast, too hard.

00:25:01.453 --> 00:25:03.823
That also causes a lot of tearing.

00:25:03.823 --> 00:25:21.295
So in the postpartum period, if you did tear, if you did have an episiotomy, you really need to work on that scar tissue in that area and help to soften it and get it to release so that it's not hard, so that you can now have penetrational intercourse without pain.

00:25:21.295 --> 00:25:28.976
You can get pelvic floor muscles to be stronger, because scar tissue just isn't as flexible as normal tissue.

00:25:28.976 --> 00:25:38.038
So you need to piece and get that softer so that the muscles can function better and the intercourse piece.

00:25:38.038 --> 00:25:45.289
Intercourse is actually the best mobilization for scar tissue, but if it's creating a lot of pain, don't just suffer through it.

00:25:45.391 --> 00:25:46.192
Go get help.

00:25:46.192 --> 00:25:47.836
Go find a pelvic floor PT.

00:25:47.836 --> 00:25:50.342
Work with someone who's trained with me.

00:25:50.342 --> 00:25:56.490
I have a directory on my website, so please check out and see if there's someone nearby you that has trained with me.

00:25:56.490 --> 00:25:59.558
They know the most respectful way to work with the body.

00:25:59.558 --> 00:26:05.217
They know the patterns to look for in your postpartum body and they know how to best release them without creating pain.

00:26:05.217 --> 00:26:10.152
If you've seen a pelvic floor PT and they've created a lot of pain, I'm so sorry.

00:26:10.152 --> 00:26:26.431
That should not be a thing and they just don't know any differently, and so I'm really changed the way pelvic floor PT is is delivered so that it's more respectful to our clients, because we shouldn't be creating pain in this area especially.

00:26:27.272 --> 00:26:34.951
So there's so much that goes on in the postpartum body that you need support after birth.

00:26:34.951 --> 00:26:46.002
I really really wish that every single person who's had a baby would be seen by one of my practitioners who's taken my postpartum course, so they know how to look for all the patterns in your body.

00:26:46.002 --> 00:26:56.781
They know how to help support you in your healing the quickest way possible and getting your pelvic floor muscles to be strong again to function well.

00:26:56.781 --> 00:27:28.516
Along with your lower abdomen, your belly, your lower part of your belly, below the belly button gets really more stretched out than what happens above the belly button, depending on where your baby grows and most people it grows lower than higher and that lower part of your belly can just get lazy after birth and when you right, that's kind of that postpartum pooch that develops, right, that's kind of that postpartum pooch that develops.

00:27:28.516 --> 00:27:30.904
It's a lengthened muscle and so your upper belly didn't get as lengthened.

00:27:30.904 --> 00:27:56.419
So your upper belly is trying to help give you stability in your body but when doing so it sometimes pushes out that lower belly and that actually can cause a little more pressure going down into the pelvic organs and that can create leakage during stress, incontinence when you laugh, cough, sneeze or exercise, and it can also be the potential start of prolapse or making prolapse worse.

00:27:56.419 --> 00:28:11.163
We want to after birth, you want to really focus in on getting that lower belly to draw back up and in as much as the upper belly more so than the upper belly or think of it as a zipper where you start at the pubic bone.

00:28:11.163 --> 00:28:22.635
If you actually contract your pelvic floor muscles, then your lower belly draws back, then the round, the belly button draws back and then your upper belly draws back, like you're zipping up a zipper up your belly.

00:28:22.635 --> 00:28:33.223
So that's a much better way to contract the abdomen versus a top down where your rib cage down and your lower belly usually juts out.

00:28:33.223 --> 00:28:40.181
That could be a potential cause for stress, incontinence and prolapse.

00:28:40.903 --> 00:29:09.781
So just know that you need to get that lower belly activating more and there's a ton of now online exercise programs for postpartum women and you really do need to start with that foundational movement of understanding how to activate your core correctly so that you bring it and you're not creating these patterns that could cause more problems and a lot of women are just want to jump right back into what they were doing before they got pregnant and your body's not ready for it.

00:29:09.970 --> 00:29:18.935
It really does need this foundational strengthening to help you to make sure that your core is supporting your pelvic organs.

00:29:18.935 --> 00:29:42.768
It's supporting your pelvis and your back and I just want moms to know that if you're trying to exercise and your back keeps going out or trying to get your pelvic floor muscles stronger and it's like you're hitting your head up against the wall, the open birthing pattern could be one of the reasons and someone who can help you to close up that open birthing pattern.

00:29:42.768 --> 00:29:52.936
If you're seeing a pelvic floor physical therapist and you're not getting better, please encourage them to take one of my holistic treatment of the postpartum or pregnant body courses.

00:29:52.936 --> 00:30:11.483
They'll have much better skills to help support you and getting you to heal, and it truly is my goal and my dream to have a certified birth healing practitioner in every city in the world so that moms can really get the care and the support that they need after birth.

00:30:18.557 --> 00:30:19.739
That's so amazing.

00:30:19.778 --> 00:30:34.682
Go to get pelvic floor physical therapy if it's causing more trauma or if it's causing the same sensations that the trauma caused, especially if you had a tear or a episiotomy to go back and stretch that scar tissue I'm just thinking about.

00:30:34.722 --> 00:30:38.996
When I went to pelvic floor physical therapy I was like let's not stretch the scar tissue anymore.

00:30:38.996 --> 00:30:40.219
It was just intense.

00:30:40.219 --> 00:31:18.751
I love your approach of trying to get those muscles trained and get your bones back together, because the more I learn about how to get the baby through the pelvis like with we all took spinning babies at the hospitals that I work at and just understanding how to move and how the pelvic bones articulate and all of that stuff to get the baby through the body, when we're doing it correctly, yes, we are pushing on our side, which, yes, that I mean if you are pushing in a atmosphere with gravity, you're gonna have some bones that are locked in place unless you're standing up or squatting.

00:31:18.751 --> 00:31:23.188
But if you have an epidural, that's probably not going to be possible.

00:31:23.188 --> 00:31:25.455
Even if you're on your hands and knees, you're locking something.

00:31:25.455 --> 00:31:26.700
You know there's probably not going to be possible.

00:31:26.700 --> 00:31:28.204
Even if you're on your hands and knees, you're locking something.

00:31:28.204 --> 00:31:31.934
Something's going to be locked and maybe your sacrum is going to lift or the front part of your pelvis.

00:31:32.695 --> 00:31:38.776
The hands and knees position is actually the best position for birth because the pelvis is open.

00:31:38.776 --> 00:31:42.624
There's not any pressure on any of the bones that need to open.

00:31:42.624 --> 00:31:50.260
Hands and knees is one of my favorite and one of the positions that I don't find as much issues in the pelvis.

00:31:50.260 --> 00:31:55.099
When we're talking about squatting, a supported squat is much better than an unsupported squat.

00:31:55.099 --> 00:32:04.613
So if someone is sitting with pressure on both legs and both legs are supporting them, there is a greater risk of the pelvic tearing of the pelvic floor.

00:32:04.653 --> 00:32:17.923
You will unweight your legs so you maybe are hanging over your partner's legs and so that your lower body is dangling or you're on the bed so that your legs are unweighted.

00:32:17.923 --> 00:32:26.298
That's going to push off the pelvic floor muscles and there's less chance of them tearing, which is hard with an epidural.

00:32:28.613 --> 00:32:33.262
Oh yeah, we have squat bars and we can lower the bed and we can do all sorts of stuff, but I don't.

00:32:33.262 --> 00:32:37.539
I think we would still, for the most part, have some weight on the legs.

00:32:37.539 --> 00:32:39.912
We really don't push that way very often.

00:32:39.912 --> 00:32:51.690
I think the only time in my career that I can remember actually delivering a baby in the squat position, it was a mom that came in without an epidural and just basically dropped her baby.

00:32:51.690 --> 00:32:53.798
She was like I have to do it this way and I was like okay.

00:32:56.872 --> 00:33:01.622
So, yeah right, her body chose a way to do it, and that's really what, what?

00:33:01.622 --> 00:33:07.453
Should be happening to do it, and that's really what, what should be, happening.

00:33:07.534 --> 00:33:09.618
I think in in our society we're afraid of pain as a realization.

00:33:09.618 --> 00:33:11.000
Right, and we have pain in the body.

00:33:11.000 --> 00:33:15.280
Our first instinct is let's get rid of it, and and and.

00:33:15.280 --> 00:33:16.104
Birth is intense.

00:33:16.104 --> 00:33:29.817
There's there's a lot of intent to what is happening in birth and I think the intense pain, contraction, expansion, whatever you want to call it is so intense.

00:33:29.817 --> 00:33:35.681
But yet people pathologize that and think that pain equals bad.

00:33:35.681 --> 00:33:40.743
But in birth, pain just means that things are opening that have never opened in that way before.

00:33:40.743 --> 00:33:46.688
If you can understand that this yes, this is painful, but it's an okay pain.

00:33:46.688 --> 00:33:49.335
It's not a detrimental pain.

00:33:49.335 --> 00:33:51.479
It doesn't mean that something's wrong.

00:33:51.479 --> 00:34:05.601
If we can embrace that and work through that, then I tend to see in my practice that women who get epidurals don't have as many traumatic responses in the body than women who don't ever.

00:34:06.102 --> 00:34:16.898
I do feel that it's a different pathway for a baby when a mom gets an epidural, and so I would just recommend I tell my mamas, all my pregnant mamas, like your, main goal is not to suffer.

00:34:16.898 --> 00:34:19.070
Suffering is not the goal here.

00:34:19.070 --> 00:34:25.389
So if you are suffering, you need to get whatever you need to to not suffer anymore suffering.

00:34:25.389 --> 00:34:26.853
You need to get whatever you need to to not suffer anymore.

00:34:26.853 --> 00:34:27.815
It's an epidural, that's an epidural.

00:34:27.815 --> 00:34:28.516
You give into that it's okay.

00:34:28.516 --> 00:34:43.101
But no matter what you do, whatever's happening in labor, talk to your baby and let your baby know what's going on, because that baby is a very conscious being and it is taking everything that is happening during that birth process.

00:34:43.101 --> 00:34:45.393
And so when you get an epidural, the baby feels like you go away.

00:34:45.393 --> 00:34:45.460
You do oh, during that birth process.

00:34:45.460 --> 00:34:46.791
And so when you get an epidural, the baby feels like you go away.

00:34:46.791 --> 00:34:49.579
You do oh, that's interesting.

00:34:49.579 --> 00:34:54.222
You disconnect, he's no longer connected to your body because you're not connected to your body.

00:34:54.630 --> 00:34:56.998
Yeah, you're not moving in response to anything anymore.

00:34:56.998 --> 00:34:59.936
Ah, wow, that's like my mind has just flown.

00:34:59.936 --> 00:35:00.960
I hadn't thought of that ever.

00:35:02.391 --> 00:35:03.534
And a lot of people don't.

00:35:03.534 --> 00:35:09.556
There's pros and cons to everything and we need to just understand.

00:35:09.556 --> 00:35:10.719
What are we choosing here?

00:35:10.719 --> 00:35:12.990
And if it's an epidural, that's fine.

00:35:12.990 --> 00:35:14.175
Just let the baby know.

00:35:14.175 --> 00:35:18.673
Hey, baby, it's going to feel like I'm going away, but I'm not right here.

00:35:18.713 --> 00:35:39.521
I'm going to be talking you through it, but it's going to feel like I'm gone, Just know, that we're doing this process together and then if you end up having to need a C-section, then you're just like, okay, babe, you know we got to do this now, this is what's going to happen, we're going into surgery and we got to get you out now, and so just talk to baby, let baby know.

00:35:39.521 --> 00:35:46.590
And it's the same thing especially in cesareans.

00:35:46.590 --> 00:35:51.342
I was able to witness a cesarean birth and you know, they immediately took baby off to the warmer and baby was just so upset, upset, upset.

00:35:51.342 --> 00:35:55.159
And I just went to dad like, dad, go put your hand on and go talk to your baby.

00:35:55.159 --> 00:36:05.771
And as soon as he did that, baby just calmed down because it it's like what the hell just happened to me, and so, and it's like where am I, who are these people and what's going on?

00:36:06.454 --> 00:36:07.175
Think about that.

00:36:07.175 --> 00:36:14.378
Your baby is a very conscious being and that's why babies can be so fussy afterwards, because it was a hell of a process for them.

00:36:14.378 --> 00:36:30.300
Right, they're trying to talk about it, they are, they are, and so if you can just listen and let them just cry and let them express, just understand that that's what they're doing, it can help them settle more after the birth as well.

00:36:30.300 --> 00:36:34.231
So everybody's involved in that birth process.

00:36:34.231 --> 00:36:35.273
Who's ever in that room?

00:36:35.273 --> 00:36:42.858
Your partner can be traumatized just as much as you are, even more because, they can do and you're in pain.

00:36:43.197 --> 00:36:55.036
There's the worst thing in the world for a man to feel, especially a man, because men try to fix things, save things, help you and for you to be in that much pain and there's nothing for them to do, that's a traumatic experience for them.

00:36:55.829 --> 00:36:58.155
Yeah especially if they're the ones that caused that pain.

00:37:01.382 --> 00:37:05.440
Right, it's a big event.

00:37:05.440 --> 00:37:10.157
It's a big event and it does take it on the body and I just want people to understand that.

00:37:10.157 --> 00:37:14.434
Another issue I find is this one isn't as common but it is.

00:37:14.434 --> 00:37:18.304
It's a huge issue and that is difficulty taking a deep breath.

00:37:18.304 --> 00:37:44.398
And what happens is that, as the when you're pregnant, that baby is taking up so much space and depending on what that baby chose to push against as it was growing, if it's pushing, your liver is on the right side of your rib cage, of your body, and stomach's on the other side, and baby can use that liver kind of as a punching bag or kicking thing and it can push up into you know, and it can really bruise your ribs.

00:37:44.518 --> 00:37:49.603
Or that liver is intimately connected to your diaphragm.

00:37:49.603 --> 00:37:57.141
Especially for our shorter waisted mamas, they will arch their rib cage up in the front to make more room for baby.

00:37:57.141 --> 00:38:11.260
Well, that tightens the rib cage in the back, and so now rib cage in the back can't expand out like it needs to Put your hands on either side of your rib cage, so your thumbs are in the back and your fingers are in the front.

00:38:11.260 --> 00:38:20.655
You want to take a deep breath in and allow your rib cage to expand out to the side and your thumb should move just as much as your fingers do.

00:38:20.655 --> 00:38:29.900
If you find that your fingers are the only thing moving, you need to make sure that you can start trying to breathe more into the back part of your rib cage.

00:38:29.900 --> 00:38:44.961
If you just fold yourself over onto an exercise ball or put a pillow on your lap and just fold over on top of it and then just breathe into the back part of your rib cage and just get that moving more, that can help.

00:38:45.362 --> 00:38:53.903
But sometimes that liver needs help coming back down and and finding its happy home again versus being jammed up.

00:38:53.903 --> 00:39:03.614
When it's jammed up, that diaphragm can't have its full excursion and it can really cause people not to be able to feel like they can take a deep breath.

00:39:03.614 --> 00:39:08.463
And I've had with a client from several different states with this issue.

00:39:08.463 --> 00:39:19.039
Because they go to a doctor and the MRI is clear, the CAT scan is clear, the doctors are like, yeah, I don't know why you can't find it's a restriction in mobility of the diaphragm.

00:39:19.570 --> 00:39:20.996
They don't know how to work with that.

00:39:21.431 --> 00:39:34.260
And sometimes restriction is coming from the organs itself, so the liver and the stomach need to find their way back down into the abdomen to take the pressure off of the diaphragm for it to be able to function well.

00:39:34.260 --> 00:39:49.077
I had a mom who carried twins and one twin was horizontal across her upper rib cage, so the baby just kind of like stuck right underneath her rib cage there and for two years she could not take a deep breath.

00:39:49.077 --> 00:39:54.775
And she came to see me and in one session she was able to take a deep breath again.

00:39:54.775 --> 00:40:03.996
And I ran into her the next day and she goes oh my gosh, I cannot believe I'm not hyperventilating, because I can finally breathe normally in the first time in two years.

00:40:04.356 --> 00:40:09.789
I mean, if you think about it, like, here's what I love about love being sarcastic about allopathic medicine.

00:40:09.789 --> 00:40:33.795
Like me as a nurse in the allopathic medical field, coming from a family of a surgeon and nurses, if there were a patient that had a tumor taking up their whole body, right, their whole abdomen, pushing up on their liver and on their organs and everything, and that tumor was removed and that patient still had problems breathing, I am 100% sure that any doctor would say, oh yeah, it was a stupid tumor.

00:40:33.795 --> 00:40:38.297
Yeah, you got to let your body like reshift, but pregnancy, no, that's a normal condition.

00:40:38.297 --> 00:40:39.661
It can't cause the same thing.

00:40:40.931 --> 00:40:44.079
Right, you're spot on, kelly, spot on.

00:40:44.079 --> 00:40:55.498
Yeah, and that's not the same, right, and I just this idea of like even scar tissue, like what's super crazy, and you see this all the time in the hospital.

00:40:55.657 --> 00:41:14.242
If someone has a total knee replacement or a total hip replacement, they get physical therapy twice a day for however long they're in the hospital and then they get home health while they continue to heal and they go to outpatient therapy and even if they get gallbladder surgery, they have physical therapy to come to help them to recover.

00:41:14.750 --> 00:41:23.630
Very rarely in a lot of hospitals across the country do they have any physical therapy or occupational therapy support for anyone who's had a C-section.

00:41:23.630 --> 00:41:28.190
Physical therapy or occupational therapy support for anyone who's had a C-section.

00:41:28.190 --> 00:41:48.378
A C-section is major abdominal surgery, and here's the problem is that you are in this electric bed with guardrails handrails on each side and so you can put the bed up and and you sit in a bed at a 45 degree angle all day long while that scar tissue is healing.

00:41:48.378 --> 00:42:00.581
You maybe only lay it down flat to go to bed at night, but then when you go to roll over, you use the handrails and you've got that to help push you up and then they discharge you and you have to go figure out how to do that all on your own at home.

00:42:00.581 --> 00:42:08.864
Good luck, handrails with a baby a baby and learn to breastfeed.

00:42:09.769 --> 00:42:19.152
Yeah, it's absolutely asinine that there is zero care for the pregnant and postpartum person in a hospital after giving birth.

00:42:19.974 --> 00:42:22.902
Yeah Well, I mean even now they're making do pre-physical therapy.

00:42:22.902 --> 00:42:27.117
They're making people go in before their surgeries to get physical therapy.

00:42:27.117 --> 00:42:33.336
We don't do that with pregnant people and that's the biggest change that your body can have Absolutely 200%.

00:42:56.400 --> 00:42:58.840
It's 100% total transformation of your body.

00:42:58.840 --> 00:43:01.641
But no, you don't need physical therapy for that.

00:43:01.641 --> 00:43:07.583
It's ridiculous and I'm really really which means the wound opens up again after you have surgery.

00:43:07.583 --> 00:43:25.579
We can reduce all of that by having a PT and OTC all postpartum cesarean births in the hospital before you go home, because you need to learn, you need to figure out how the heck, do I get out of bed without a bed rail and an elevating bed head?

00:43:25.599 --> 00:43:29.534
Because I administrator, because I can hear the administrators in my head saying, oh, the nurses could teach that, because they tell us to teach people how to do that.

00:43:29.534 --> 00:43:31.900
First of all, we aren't physical therapists.

00:43:31.900 --> 00:43:35.199
We cannot evaluate, we cannot diagnose, we cannot treat.

00:43:35.199 --> 00:43:40.253
We can only do what was put in the orders for nursing care.

00:43:40.253 --> 00:43:51.889
Second of all, having worked postpartum nursing care, second of all, having worked postpartum, five couplets is what we usually have.

00:43:51.889 --> 00:43:54.572
So how am I supposed to do that?

00:43:54.572 --> 00:43:59.811
I mean, I'm basically like getting people up to go to the bathroom and then getting them back, and that's the extent of the physical therapy care that I'm able to do with a patient.

00:44:00.172 --> 00:44:01.054
Like, can you stand?

00:44:01.054 --> 00:44:02.217
Can you take a step?

00:44:02.217 --> 00:44:03.740
If not, please sit down.

00:44:03.740 --> 00:44:05.143
Let's try again in an hour.

00:44:05.143 --> 00:44:06.735
You know that's about all I can do.

00:44:06.735 --> 00:44:07.672
Grab your side rails.

00:44:07.672 --> 00:44:09.615
You know, hold the thing over your belly to cough.

00:44:09.615 --> 00:44:10.217
That's it.

00:44:10.217 --> 00:44:10.978
That's all we do.

00:44:10.978 --> 00:44:12.983
It's not feasible.

00:44:12.983 --> 00:44:18.032
I mean, any other place in the hospital if there was a physical therapy concern, they're going to call a physical therapist.

00:44:18.032 --> 00:44:21.757
So please don't think that you're nurses to start doing physical therapy.

00:44:21.818 --> 00:44:33.094
Like, let's add physical therapy to the normal postpartum care even for a vaginal delivery, I would say as well, yep.

00:44:33.094 --> 00:44:34.396
I remember when I worked in the hospital years ago.

00:44:34.396 --> 00:44:40.012
I would only get called in if there was significant syphilis, pubis function and pain, and mom couldn't stand up to get out of bed.

00:44:40.552 --> 00:44:42.153
It's hard to get them there for that.

00:44:42.153 --> 00:44:46.038
I'm challenged to get the physical therapist.

00:44:46.038 --> 00:45:12.251
I mean not with any fault of the physical therapist, it's just the sheer magnitude of workload that they have in the hospital, and not just workload, but like the scope hospitals that come see patients that are specifically trained in just you know, like we should have lactation consultants and we should have pelvic floor physical therapists.

00:45:12.251 --> 00:45:17.032
That needs to happen and therapists, just like emotional health therapists in the hospital.

00:45:17.032 --> 00:45:19.340
I know right that all needs to be on the postpartum floor.

00:45:19.481 --> 00:45:25.126
All of it Absolutely To help deal with the trauma that just occurred in that room from the birth.

00:45:25.126 --> 00:45:26.998
I totally agree.

00:45:26.998 --> 00:45:28.481
Just occurred in that room from the birth, I totally agree.

00:45:28.481 --> 00:45:38.117
And until we take this seriously, it really does take champions in each hospital and those champions.

00:45:38.117 --> 00:45:53.141
So if you have to find the PTs and OTs that are willing to start a program to see these mamas, to know what to do with these mamas, and then you need to find the OBs, a champion in the OB realm, to start that process and, like I said, I'm super grateful.

00:45:53.202 --> 00:45:56.918
Rebecca Seagraves is doing a great job trying to get the word out.

00:45:56.918 --> 00:46:04.157
But until we find those champions in each hospital, that level of care is not happening.

00:46:04.157 --> 00:46:14.697
And so, moms, you need to do the best job you can in trying to educate yourself and, please, a lot of moms go well, I'm not going to have a C-section, so I don't need to worry about that.

00:46:14.697 --> 00:46:19.750
But I have to tell you if that's one of your greatest fears.

00:46:19.750 --> 00:46:29.074
What I know in my clinic and what I hear all the time from my clients is that their biggest fear, that they did not address, is what ends up happening in the birth, exactly.

00:46:29.657 --> 00:46:37.360
I have this post that I occasionally put up that says I can tell the kind of birth that you're going to have based on your mindset.

00:46:37.360 --> 00:46:40.918
And if your mindset is I'm not even going to entertain this idea.

00:46:42.302 --> 00:46:54.978
That's where you're going Right, one Right, 200%, yeah, yeah, so, so true.

00:46:54.978 --> 00:46:57.427
And I tell my mamas you know, have a, have a good plan and throw it away.

00:46:57.427 --> 00:47:01.398
Exactly, have a good plan, but throw it away and be in the moment and do what your body needs to do.

00:47:01.398 --> 00:47:03.523
And it's a dance between you and your baby.

00:47:03.523 --> 00:47:18.358
Just recognize that when you get an epidural, your dance partner, you get put in the sideline because your body can't participate in doing the movements that need to happen in order to get the baby out.

00:47:18.478 --> 00:47:19.503
So now the baby's kind of-.

00:47:19.503 --> 00:47:22.336
Well, the nurse becomes the dance partner with the baby Right.

00:47:22.336 --> 00:47:24.503
Well, trying to manipulate your body, right.

00:47:25.054 --> 00:47:29.586
Yeah, right, and then the baby is basically doing the solo after every position change.

00:47:29.586 --> 00:47:31.378
See what the baby can do.

00:47:32.199 --> 00:47:39.143
Yeah, I mean, it's doable, it is doable and also, yeah, and I don't want to shame anybody for anything that I've said.

00:47:39.143 --> 00:47:42.335
These comments are not made to shame anyone.

00:47:42.335 --> 00:47:50.389
I just want you to see the reality of what happened and informed decisions with what happened.

00:47:50.389 --> 00:47:53.003
Like I said, you're not meant to suffer, so don't suffer.

00:47:53.003 --> 00:48:00.106
There are options, though, and I think that a lot of times, we go into birth a little naive.

00:48:00.126 --> 00:48:02.048
Well, how can we not?

00:48:02.329 --> 00:48:08.967
Yeah, that first experience is there's nothing else like it, because you've never done it before, exactly.

00:48:09.668 --> 00:48:13.706
Yeah, and so you really are at the hands of your birth team.

00:48:13.706 --> 00:48:16.224
So get a doula in with you.

00:48:16.224 --> 00:48:21.806
That's my biggest thing that I promote in my practice is do you have a doula?

00:48:21.806 --> 00:48:37.259
Because they've been there, they will be with you the whole time and they know the labor process, they know how to support you in it and then that labor nurse hopefully can come on and you know you guys all work together to make your wishes happen.

00:48:37.259 --> 00:48:43.759
So it's so important to I always tell my mamas listen to your body, what does your body want to do?

00:48:43.759 --> 00:48:58.786
Because that's what needs to happen in birth, and so the more you can practice that in pregnancy it's like, oh okay, I've been sitting for a while, so my body needs to stand up right now and doing the stretches that your body feels like it needs to do.

00:48:58.786 --> 00:49:03.864
That's all listening to your body and helping to know what it needs in the moment.

00:49:03.864 --> 00:49:05.768
First of all, doulas love them.

00:49:06.715 --> 00:49:16.422

Lynn Schulte: Mastering Postpartum Recovery with Pelvic Health Techniques

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