The Ordinary Doula Podcast

E129: Postpartum Pelvic Floor Reset with Dr. Kasia Unes

• Angie Rosier • Episode 129

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You get nine months to prepare, one day to give birth, and then a lifetime of “wait, is this normal?” questions. We sit down with pelvic floor physical therapist Dr. Kasha Unes from Reborn in Utah to make postpartum recovery feel clearer, more practical, and a lot less isolating. If you’ve ever wondered when you can start pelvic floor PT, what’s safe before the six-week visit, or why your body feels totally different after delivery, this conversation is for you.

We dig into postpartum pelvic health basics that actually change outcomes: diaphragmatic breathing, diaphragm mobility, and pressure management for real-life movements like getting out of bed, lifting your baby, and returning to exercise. We talk candidly about urinary incontinence, why “common” is not the same as “normal,” and why coordination and technique can matter just as much as strength especially for runners and active parents. Dr. Unes also explains why a tight pelvic floor can still be weak, and how “lengthen to strengthen” helps with leaking and urgency.

Painful sex after birth comes up too, with concrete options like perineal scar mobilization, gentle stretching, dilation tools, and nervous system retraining to reduce anticipatory tension. We also shift to cesarean recovery, including C-section scar mobility, when manual work is appropriate, and why earlier support can make moving and healing easier. To close, Dr. Unes shares personal birth insights about advocacy, autonomy, and the reality of feeling surprisingly weak postpartum even with great prep.

If you want a postpartum recovery plan rooted in pelvic floor therapy, evidence-informed guidance, and compassion, listen now, then subscribe, share with a friend, and leave a review so more parents can find this support.


Learn more, here: https://rebornphw.com/our-staff/dr-kasia-unes/

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Show Credits

Host: Angie Rosier 
Music: Michael Hicks 
Photographer: Toni Walker
Episode Artwork: Nick Greenwood 
Producer: Gillian Rosier Frampton
Voiceover: Ryan Parker

Welcome And Guest Introduction

SPEAKER_00

Welcome to the Ordinary Doula Podcast with Angie Rosier, hosted by Hatched and Latched. Here, we explore the many layers of pregnancy, labor, birth, breastfeeding, and postpartum life through the lens of more than 20 years in a busy doula practice, supporting thousands of families. Whether you are preparing for birth, navigating feeding, or adjusting to life with a new baby, this podcast is designed to offer practical knowledge, thoughtful conversation, and empowering support for the real experiences of parenthood.

SPEAKER_01

Welcome to the Ordinary Doola Podcast. My name is Angie Rosier. I'm your host, and I have uh again with me today a really awesome guest, Dr. Kasha Unes, and she works with pelvic in pelvic floor PT. She works for a clinic called Reborn. I'll let her tell you a little bit about that. Um but Kasha, will you give us a little bit about your background before we dive into our topic of the day?

SPEAKER_02

Yes. So, like Angie said, my name is Kasha, and I've been doing pelvic PT for about six years now in Utah. And I've um worked at a few clinics, and right now I'm working at a clinic called Reborn, which specializes in pelvic health, and we have um you know a few different locations now, and a really great team of pelvic PTs, which is nice to have so we can you know um support each other and brainstorm and work on cases together. So yeah. Very cool.

SPEAKER_01

That is nice to collaborate, right? Have like-minded people who you can go to with questions. That's fine. I love that in the work that that all that we all do. Very cool.

Why Postpartum Pelvic PT Matters

SPEAKER_01

So um, for this episode, we've talked in other episodes about pelvic floor PT and pregnancy, um, labor prep, pushing prep, but we have all this time after we have a baby. Like we have nine months to prepare, a day or so to have a baby, and then we have months and years afterwards that we're dealing with the ramifications of what birth and pregnancy might have done to a body. And hopefully it's I mean, I I have all confidence and faith in the human, a female body, but there's some effects sometimes that are left that can follow people for longer than they they they might need to. So, Dr. Kasha, let's talk a little bit about that postpartum period. How how might pelvic floor PT come into that? Um, what can what are the benefits? What are what are some common challenges you see, and how can they be addressed?

SPEAKER_02

So uh first off, starting with timing, uh, you know, I hear this all the time is when can I come back in? When should I come back in after having my baby? And you know, this can obviously be very uh variable based on the person, how much healing time they need, and um, and their you know, their own motivation, but um according to ACOG, which is the American College of Obstetrics and Garnecology. Um they state that it's safe to start right away if the pregnancy was low risk. So I usually tell people um to be safe, you can get clearance from your doctor if um it and get a referral if needed.

SPEAKER_01

You don't usually need a referral, but um but yeah, you can at least I didn't know that. That's interesting. I thought it was um my awareness was it was like six weeks or so, but I didn't know it could be done earlier.

SPEAKER_02

Cool. So yeah, I I remember like I looked into it, I did a deep dive and I was like, I see we see so much success with seeing women prior to six weeks. And I was wondering like why are we waiting? Six weeks, yeah. And and I think I think it's because you have typically have your postpartum visit at six weeks, so that's that's just the time that you get asked if right, it's just coincidental, yeah.

SPEAKER_01

Which honestly, like going down another rabbit hole, I don't want to get too far into it, like that so much goes on in six weeks on so many things. I wish we did visits much sooner than that, but anyway, yeah, so we can we can see pelvic floor PT sooner, that's lovely.

SPEAKER_02

Yeah, yeah, definitely. And we still don't do internal exams or internal works prior to six weeks, but there's still plenty to address within that time because you know, like you said, there's a lot going on, and we still have to you know take care of a baby and take care of ourselves, the house, recover. Yeah, like it it'd be great if you could, you know, had all the help in the world and could actually just like take care of yourself, take care of yourself for for that time for six weeks, but even if even just like if you had all the time in the world to recover and rest, six weeks is still a long time to like to not be mobile, like it doesn't it doesn't even feel good on your body, right?

SPEAKER_01

So um so things find a fine balance, really, right? Um recovery mobility.

SPEAKER_02

Yeah, so you know, obviously we don't want to push it, like we still want to respect the body's healing and your your energy levels and everything. But you know, if if you're going to be moving and and doing some things, might as well talk about it and do it the right way. Because

How Soon Can You Start

SPEAKER_02

usually you have some, you know, if you've never done it before, usually you have some questions like Yeah, for sure. Can I do this? Can I do this? How do I do this? Oh, I did this. Um, did I ruin this?

SPEAKER_03

You know?

SPEAKER_02

So um I usually recommend someone if they're asking me, oh, can I come in sooner? I usually say, uh I usually recommend about three weeks. So but I leave it up to them. I'll say, okay, let's schedule something three weeks out. But if you're feeling like, you know, I I just need more time, like then take that time. Yeah um and I also see a lot of women during pregnancy. So if I already saw them before, um sometimes we already start talking about what kind of things you can postpartum. You have done some prep work, yeah, like mechanics and things like that. So some of them end up being able to apply those concepts, and then maybe I do see them uh after that six weeks if they felt like, oh yeah, like I I was able to do those things. Um but a lot of times I'll have women come in that even have seen me in pregnancy, and even though they're like, Okay, I I understand what it's coming together, do yeah, but I still want you to take a look and check because things feel so different.

SPEAKER_03

Yeah.

Breathing And Pressure Management Basics

SPEAKER_02

So even like something that I think uh is overlooked is diaphragm mobility and diaphragmatic breathing, because if you think about it, your diaphragm at the base of your rib cage and your lungs is a lot more limited and has less space when you're pregnant. So um afterwards it can feel strange, like oh, it it actually has mobility space, and a lot of times we have to like retrain it and and get it to activate and engage, and um and diaphragmatic mobility is really huge in just overall pressure management and um mechanics of the pelvic floor and the core as well.

SPEAKER_01

So um which all of those things are stressed during pregnancy, right? Like suddenly a baby's born and your body's I don't know, it's a little bit like whoa, what's going on? So coming back to itself, coming back together takes some time.

SPEAKER_02

Yeah, yeah. And just also having realistic expectations. So um knowing, okay, right now we're just going to focus on like engaging, waking these things up, doing things in the right way, like correct breathing mechanics, but you don't need to be doing like you know, like 50 crunches a day. It's these squats, like that's not even where you need to be right now, you know?

SPEAKER_01

Yeah. Um so I so I in my and I I do track this, and most people get a second degree tear, right? So they've had stitches. Um, it's kind of fascinating to me. Out of hospital has out of hospital birth has a lot less likelihood of tissue separation, where in hospital has a very high likelihood of tissue separation, but second degree is pretty typical, right? Um, and people report, um, and I don't know what you're seeing, but people report um sometimes like pulling or stretching, like they're curious about the stitches or they're worried about the stitches as those are healing in that immediate postpartum period. And sometimes there's pains that last a long time, right? So when we're looking at most everyone has some kind of tissue separation um with delivery, how can people be cautious of that in that healing process?

SPEAKER_02

Yeah, so that's where I think the um, you know, proper mechanics, pressure management, breathing is is huge because it's it's protective of um preventing too much stress on the tissue. So for example, if we're um like bracing and tightening too much, then that can cause more strain or even like muscle tightness around, and um, that can delay healing. Um if we're like when I when I talk about pressure management, um that refers to a lot of um like how we look at like how we're breathing during um during functional movements, so a lot of what we see is breath holding or um or like inhaling as as you're supposed to be exhaling. So if so for example, if you were to do a a crunch and say you're holding your breath and you're crunching up, you're using your abs, where's that pressure going to go? It's it's going to go down and you're straight down. Straight down, you're close, you know, you're closing your mouth, and where's the other opening is is down, so it wants to go that way. Um if if we're pushing for a baby, then then yeah, that that's what we want. But but we don't want to be doing baby pushing when we're trying to um you know reduce pressure and and stay continent. So even the just the cue of exhaling on effort can go a long way. So think, you know, now say you're doing a crunch or like you're getting out of bed. Um if you're doing it as you're exhaling, you're giving that pressure an out, you're directing it more towards your mouth, but then up, so then there's less pressure on the pelvic floor, the core. So um, so that's something that I I really like to teach is that okay, even if you can't feel like too much activation in pelvic floor core, or you know, you you're not feeling a stretch, or at least think be mindful of exhaling and don't hold your breath.

SPEAKER_01

Less less pressure on it, interesting. Less pressure, yeah.

SPEAKER_02

And even just that that that tip or reminder can can go a long

Incontinence Is Common Not Normal

SPEAKER_02

way.

SPEAKER_01

That reminds me, I have a two clients come to mind over the years who have who had um you said incontinence, and a lot of people over maybe not immediately after delivery, but at some point in their life, in their you know, adult life, after having babies, they'll have incontinence. And we we I think culturally we accept that as normal. I don't I that that's weird to me. But two two people in in particular had, and young, healthy people, both of them happen to be runners, which is interesting. One of them, like an ultramarathoner, the other one loves to run and hike, but both of them, their lifestyles immediately after delivery were incredibly limited by um incontinence. Um, and there is pain. And this had a huge impact on their mental well-being in postpartum as well, which we already got a lot going on in the postpartum period. But the physical, the constant physical pain and dysfunction, uh, and not being able to do things they just not even just basic daily activities, but things they loved. And we're talking like weeks later, like months later, we're not able to run or um you know have intercourse without pain, like that is a big toll on mental health as well, right? And so how can postpartum PT same same things, I assume, right? Like addressing the a variety of gravity, like there's different people have big situations and small situations, and this can address a lot of that.

SPEAKER_02

Yeah, that's a really good question. That's something that we see a lot. So, you know, we were just talking about the the beginning phases of postpartum, but you know, really you can deal with postpartum issues for a long rest of your life. Yeah, you're always postpartum, I guess. Yeah, yeah, you're always um, so yeah, it's it's never too late. Um even if you know you you didn't get started with pelvic PT, which a lot of women don't. A lot of women are like, I I didn't know about it, you know. Um, there's still a lot that we can do um to help in those cases, especially yeah, incontinence. We see um I see a lot of incontinence due to um the pressure management aspect I was just talking about, that even if your muscles are uh like at face value, seem seem great. Like I do an exam, like, yep, you have good strength, yeah, you can relax well, but what happens when I cough? What happens when I'm when I'm upright? It's like, oh, instead of you know, staying stable, they're actually getting pushed down. So we look at like technique, coordination, um, and and yeah, like I was saying, postpartum things might feel different, and maybe certain areas like the the core, the pelvic floor, the breathing like just didn't get activated like it should. And then that you start developing compensations that can be more difficult to break later on, though it's very possible. Um and yeah, and something that's interesting that we see really often is that pelvic floor tightness or hypertonicity is a huge variable.

Tight Pelvic Floor And Kegels Myth

SPEAKER_02

A lot of people think, well, I'm just weak, I need to um, I need to strengthen, I need to do kegels, but um you'd be surprised how often tight pelvic floors cause more of an issue. So um so when someone's, you know, maybe they're holding tight due to like stress, pain, anxiety, or they have like scar tissue that didn't get worked on, um, which is something that that we can work on, is like manually pelvic PT, you do a lot of like scar tissue stretching mobilization.

SPEAKER_03

Cool.

SPEAKER_02

Um but anyway, so pelvic floor is tight, you can develop weakness as well. So when muscles are tight, they can be tight and weak. So if muscles are stuck, they're not working like they should, then it's it's easier for them to leak.

SPEAKER_01

But they're kind of barely hanging on, right? They're barely hanging on, tight on weak.

SPEAKER_02

Yeah. So something we do a lot is use the concept of like lengthen in order to strengthen. And it can be really hard for people to conceptualize. So sometimes we spend like a few visits just like trying to get people to understand that concept because when you feel like you're going to leak, especially when you have an urgency issue, um, your brain and your body is like panic, tighten. Oh yeah. And then we learn, well, that's actually that can actually be reinforcing the issue and is what's causing you to leak. So yeah. Um, so yeah, we need the body to learn to let go in order, in order to be strong and and work through all the ranges and um, yeah. So, you know, we just see uh basically how is the pelvic floor working um outside of other other like external stimuli or or like certain tasks and and we work on that. So, okay, the muscles aren't engaging. Let's let's give you cues, let's teach them to engage, let's strengthen them. Okay, muscles aren't relaxing, let's figure out how to relax them, stretch them. Okay, coordination is off, endurance is off, we're doing it in the moment. But then we also address okay, now it's happening when when you're doing the thing. So you know, someone could look great on an exam, like on the PT, you know, on the table, and then they're like, Well, every time I um I get out of bed, I leak. It's like, okay, what's going on in that moment? Um or like with the running aspect, um, you'll get a lot of people who when they're running, they they think, okay, I need to like tighten.

SPEAKER_01

I need to um and some of this is subconscious, right?

SPEAKER_02

Yeah, it's so subconscious. And um, we actually try to teach the muscles to to relax and you know not be in like max contraction, because when they're in mid-ranges, they can actually absorb the load better when you're running and when you know when you have that that pounding effect. So um yeah, so we we do have to get creative sometimes to like recreate these scenarios, but um, but yeah, but it's yeah, but it's cool to see um you know women that have had certain issues for years see some progress and like, oh my gosh, I didn't know I could leak, you know, I could sneeze or cough without leaking, you know.

SPEAKER_01

Yeah, so again, awareness is so so huge. I know the other day you were telling me about a 90-year-old patient who like you said it's never too late. It's never too late, yeah, yeah. Great, great progress.

SPEAKER_02

She like didn't believe me at first. She's like, No way, like this can actually get better. You know, I just came here because my doctor told me to, and when she when it helped, she was like in disbelief. She was like, What? I didn't actually know this was an option.

SPEAKER_01

That that is so cool. I love that awareness is huge.

Painful Sex Scar Work And Trust

SPEAKER_01

So um okay, let's talk briefly about painful intercourse and sex. Like that is a thing I hear quite a bit with clients afterwards. Um seems too common. How how can people address that?

SPEAKER_02

Yeah, that's one that I I love working with because I do think it's too common and just accepted that it's it's okay for women to have pain. Um and usually we look at the muscular aspect and scar tissue. So we see, especially postpartum, um, it's really common to have some pain with with sex after having scar tissue, but perineal scar mobilization can really go a long way. It can be super helpful. Um, and even later on, like even if it you're even if it's not addressed right away, we can still have some success there. Um, and you can also develop a lot of muscular tightness. So there are you know a lot of different reasons why the muscles can become tight, but We can do manual stretching, dilation, pelvic wand, self-stretching. Um it's something I really love to do too is involve partners. So if the partner is willing, um I'll tell them bring your partner in and I'll teach them to do some of the techniques that I'm doing. And um, it's really fun to watch the dynamics. Yeah. And um and I think it also really helps show the partner what like what the woman is going through. So it and it helps them be more mindful in the moment. So almost every time, you know, I'm I'm doing a pelvic stretch, and then I'll switch and say, okay, now now you're going to do it. I'll talk you through it. And the the partner is just like pushing super hard, and like the woman's like wincing, like, ah, too much. And oh, I didn't think I was pushing that hard. But almost not every time, almost always they push way too hard. And it's nice to show them, like, okay, even when you push a little like this, like, do you see how that's pretty sensitive for her? Like, that's that's painful. You really need to like be patient, ease into it, let her breathe through it, and then do you see how like the whole body, the whole system is the response, yeah, interesting. So, like, that's where we also get into a lot of the like the autonomic nervous system aspect, and um, you can develop a lot of anticipation of pain. So, even when the tissues and the muscles are more flexible and and working better, if you know, every time you've done this activity, uh, your body and your brain associates with pain, you know, think about the pelvic floor, it's a vulnerable area, right? So it's like, I gotta protect. So, you know, we work on a lot of um like trying to reduce those like anticipatory reactions, like diaphragmatic breathing can be super helpful. Um, and um, you know, we can do like a gradual, kind of like a gradual exposure approach. So kind of like you have to like regain the body's trust. Okay, a little bit here, okay. That's okay. I feel okay. Okay, now we're going to stretch a little further. Okay, okay, I don't need to panic. So it's a lot of like gradual work, a lot of patience. And I say, like it can seem like you're you know taking a step back, but you're really doing that in order to like move forward, you know, take be able to moving forward, yeah. So um, yeah, so that's that's a that's a fun one to treat for me.

SPEAKER_01

Oh yeah, I love that. Yeah, it's it's huge, that's important. So very cool. Cool, yeah, awesome.

C-Section Recovery And Scar Mobility

SPEAKER_01

Well, I want to shift gears a little bit. And as we're talking about postpartum and all of the things that come into postpartum recovery from delivery, which can last really the rest of your life, um, the adult, you know, lifespan. Let's talk about those who have a cesarean. So they didn't have a baby come through their pelvis, right? Like past the pelvic girdle. Um, the baby came out a different way. Not a lot of people, well, what we find in our, you know, as doula is like people usually don't want that. There's plenty of people who do prefer that mode of delivery, but typically the people we're working with want to avoid c-sections. We like to keep low C-section rates in our, you know, as we can. Um, that's a whole other episode. But how somebody recovering from a cesarean, that's different, right? Like, um, give us some tips and pointers on uh cesarean recovery.

SPEAKER_02

So I I may be biased, but I definitely think that women, all women should come into pelvic PT after a C-section. So um some people might not know that we work on that area because they just think pelvic floor, but working on C-sections is is within our scope as well. It's it's a big part of it as well. So um typically you'll get this is one that you usually do want to wait, you know, that like six to eight weeks of healing time, and um you know, you can still do some of the other stuff we talked about, like um, you know, like the functional um pressure management and all that, but when we're talking about like C-section specifically and the the healing and the scar, you want to make sure that the um incision is closed before you're doing the more um the manual mobilization. But something I usually tell people is that even before that, like while it's healing, diaphragmatic breathing can be an awesome way to start to mobilize that tissue, like a deeper, deeper mobility. So you can still get get some gentle mobilization and start to help those those fibers, those tissue fibers go in in the right direction as they're healing. Very cool. Yeah, and then I see that if you can come in sooner rather than later within that like eight to 12 weeks window, that's usually when we can make the most progress in scar tissue mobility. So when we look at tissue healing times, around that time is when the scar starts to um like solidify, get more formed, and so it it's not saying that you can't still mobilize it, but it gets harder and harder. So if you can get in within that time, you can um you can definitely see more progress. Interesting. But I have seen I have seen good success in people with old C-section scars too. So it's also never too late. It's never too late.

SPEAKER_01

I hear a theme here, it's never too late.

SPEAKER_02

Yep, I saw someone the other day who um had her last c-section 10 years ago. And um, we thought, okay, yeah, let's, you know, she still felt some pulling and tightness. And we said, yeah, let's let's let's try to work on it. And um, and she was surprised. She said, Oh my gosh, I didn't realize that um that that could still be treated. I'm not feeling as much, as much tightness. So um, yeah, so that can be really helpful.

SPEAKER_01

Because the mobility, like after a c-section, just yeah, moving, rolling over in bed, sitting up, like it's hard in Postpartum anyway. And then we add abdominal surgery to that. And um, that's a lot. Okay, how about how about like people planning a cesarean? Can you do prior work like if they have a breach baby or for whatever reason they have to have a cesarean? Are there things to be done ahead of time, like prenatally that can be helpful for that? That's a good question. Um it just came to my mind. I've never thought of that. Yeah, yeah.

SPEAKER_02

Usually I I tell them more about like what to expect after care, but um sometimes I I show women how to do some fascial stretching abdominally ahead of time, especially if like, you know, like you know, belly's growing quickly, you know like that stretch is inevitable. So um if you can stay on top of it and do some stretching as you grow, that can help reduce the like uh the stretch being as as dramatic and pulling as much. Okay. Um so yeah, you could do some stretching prior and uh I think strengthening can be helpful too because you know you're not going to be able, you're going to be limited after. So if you can do strengthening and practice, you know, the the right breathing, pressure mechanics, um that I I think that can be that can be super helpful too.

SPEAKER_01

Okay, very cool. Um, and let's talk a little bit um self-care, right? Like self-care comes in a lot of different ways. Um and and I think doing some self-care, well, as someone's pregnant, as their postpartum, um, regardless of how they had a baby, as I've learned more about this, I think it's an incredibly important part of self-care. Um almost a treat to yourself, like you you deserve to get um this kind of help. I I want people to add that to their list of self-care.

SPEAKER_02

Yeah, yeah, totally. I I do too, because especially postpartum, we see a lot of uh, you know, obviously there's a lot of focus on baby, but like the more we can talk about like self-care for mom, I think the better, because that's something that's you know constantly um overlooked. So um yeah, and I think that um with yeah, when it comes to c-section or not, um just like respecting what the mom went through, I think can be helpful too. And um if you know, in the case of C-section, if like she she wanted it or not, or is an emergency or traumatic, um, you know, even just like giving that space that it's like it's it's okay to be upset about it. Like uh, you know, it's of course we want to focus on positive too, but right sometimes women kind of need that um, you know, that period to um's like mourning, like for some, yeah, like and like work through the trauma of it in a way. So absolutely um, yeah, yeah.

SPEAKER_01

Very cool, very cool.

A Pelvic PT’s Own Birth Story

SPEAKER_01

So if I may, I know that you have had a baby, right? Yeah, yeah. What and you what you were in this field when you went through that. Um, if you are okay sharing to whatever extent a little bit about your experience um and how what you know had helped, um, and what you learned having done what you you know gone through this process yourself with your own body, what you learned for your professional life after having done it personally. Yeah, this is a good question.

SPEAKER_02

Because I uh before I had my baby, I used to tell my husband that I need to have a baby for for research. And he was like, Oh my gosh, like you're crazy. Like I'm joking, obviously, but deep down I was like, ooh, yeah, I get into it and yeah, and kind of like have my own experience. And not saying that you like need to have a baby in order to like be a provider in this space, but um, but I definitely was was excited about that aspect. Um so yeah, I think during pregnancy I felt like I had um a lot of good tools and knowledge, especially when it came to like the the mechanical, like musculoskeletal aspect. I was like, okay, I need to work on my posture, I need to keep up with with my exercise. And um, and I was pretty lucky that I didn't have like a significant um like nausea and and illness and stuff. So um, but then um labor was it was just such an interesting experience because that's usually like I'm not there, you know, like I Right. You don't see that piece of it. I don't see that piece of it. So um yeah, I think for me, I was wanting to see how long I could go without getting an epidural and um and you know, tried to do some of the labor uh postures and and stuff, but um, but yeah, it got to that point that I was like, okay, yeah, I I I I I think I'm going to opt in. And um and I and I really hated the feeling of like, yeah, feeling just like a mobile, like on the on the table. And I was like, oh my gosh, this really feels like like a lack of like control and autonomy, and you know, even being in this field, I was like, I don't know, it was still like surprising to me.

SPEAKER_01

Yeah, yeah, and even though like I think a lot of people are surprised by that. They're it's something they want, they're planning on, and they're grateful for the parts of it they want, but they're surprised about the yeah, like wow, it's some people are really weirded out by not having control of their body or being able to move as they want.

SPEAKER_02

Yeah, yeah. But um, but yeah, and I I did do a little bit of research before, and I asked my provider if it was possible to do um like a PCA, so like the patient-controlled analgesia. So um yeah, I was hooked up and I I could let it wear off, and then I could like press the button to get more if needed. So I did um kind of like let myself like feel some pain at times, like I wanted to feel a little more. So feedback, yeah, yeah. And I was a bit stubborn, like I knew like I could ask for help, but like I was sitting there like like moving my own legs to like roll over and stuff, and you are independent, yeah. So um I think you know, doing again, I'd probably try to be more okay with like asking for help, but um but then when it came to the the pushing part, I I did try to be more mobile. So even with that bedural, I let it wear off a little bit and I did ask for help this time. I see if my husband nurses, and I was like, I'm getting onto like hands and knees. So I was like still like on the back of the bed, and I um and you know, I was doing all the things like that I teach others, and and I was like, okay, I feel something, like I don't know, it's really difficult. Um and but it was like going okay, and then I was like, you know what? I'm I can do this. I'm gonna I'm gonna use use gravity. So I actually like made like my husband and the nurse helped me get into a squat position. Like I like rolled over like like my butt like onto my feet. Oh yeah. Um, even though I couldn't really feel my legs, I was like, I just know this is like right for me. Like this is this is what my body and baby needs. And I was like, in that moment, I was like, I don't care what it takes, like I'm gonna do it. Good for you. And so like the nurse was like looking at me like, Are you sure? Like I was like, just listen to me right now.

SPEAKER_01

Like, yeah, I love that.

SPEAKER_02

And um, and I think I was pretty lucky, but I uh pushed three times and came out. So like he started it started coming out fast, and the nurse said, Hold on, stop. I have to get the doctor. I was like, What do you mean? I'm not gonna hold on.

SPEAKER_01

I'm not gonna stop here.

SPEAKER_02

Like, we're we're progressing here. So um, yeah, so we were in position and he uh and he he popped out.

SPEAKER_01

So that's where and you were in the squat position, like you were squatting.

SPEAKER_02

Cool, yeah. So and so you know, I was proud of myself for like advocating for myself and being like telling them, you know, um This is what I'm gonna do. This is what I'm gonna do. Yeah. So that's where like based on my experience, like I really like love to tell my patients, like, advocate for yourself, like, or find someone that's going to help advocate for you. And um yeah, because in the moment it's there's a lot going on.

SPEAKER_01

It is, and it's hard to advocate for yourself in that moment. You've got because you're doing you're doing the work, right?

SPEAKER_02

Yeah, yeah. So yeah, so like postpartum, I feel like I also did pretty well because I um I think like doing the prep work during pregnancy helped me feel better, but I still was surprised as to like how weak I felt, even though I did like strengthening while I was pregnant. I did not expect to feel like such a noodle, like in my core. Yeah.

SPEAKER_01

And um, and like you know, I think that's a shout out to like the legit like the reality of recovery. Recovery, regardless of how well the pregnancy went or how prepared you are, you still need to take that time, honor that time to recover and see where your body, you know, realize where your body's at and what it needs.

SPEAKER_02

Yeah, totally. Even though like I feel like I did the right things, I feel like I I was lucky and how like my body body reacted and um so tell me if if you don't mind sharing tissue separate, where is it?

SPEAKER_01

First degree, second degree, none at all. What were you what'd you have to recover from there?

SPEAKER_02

Yeah, I had uh a couple of I had like first degree perineal and I had first degree like labial. Oh yeah. So it was like pretty minimal. Cool. Um and honestly, I didn't really notice too many issues with that. I think because it was first degree. Um, but even as a pelvic PT, like I I didn't I didn't want to look down there. Like I kept thinking like, oh, I'll check it out myself. I'll I'll take a look. And I was like, I don't know. I just yeah, interesting.

SPEAKER_01

I'm not ready to see it.

SPEAKER_02

Yeah. So that's where I like I appreciated like my my other providers that that would help out because I was too tired and I didn't have the energy. And um, yeah, so so yeah, I think I was pretty lucky with my with my tear there. And um the my um ob even said she thinks that the tearing came from how quickly he came out because he just kind of like shot out.

SPEAKER_01

Three pushes, that's remarkable for a first baby.

SPEAKER_02

Yeah, and I think um part of that could also be due to um I have a hypermobility disorder called EDS. So um, you know, maybe like as I got in that position, as things pretty, you know, maybe that had something to do with my my hypermobility. So it's not something that I'm like, oh, like you like other people, like you should be able to do this translate as well. Everyone's so different, you know, and I think that's just that's just how how my body is, and like that's how my mom was in her labors. Um, so yeah.

SPEAKER_01

Wow, very cool, very cool. Well, thanks for sharing that with us. Wow, cool, cool, cool. Well, Dr. Kasha, thanks for being with us today. Uh well, do you have anything, any other um last words of wisdom to wrap up as we we complete our session? We've again today been talking about the benefits of pelvic floor PT in postpartum for recovery after vaginal delivery, after cesarean, um and and it it can be years after, honestly. I I think a theme is it's never too late.

SPEAKER_02

Yes, yes, totally.

Bring The Baby And Final Takeaways

SPEAKER_02

Um, yeah, I think we've gone through a lot and um yeah, there's there's just so much to it, but um but one thing that I will say is that when you're coming into pelvic PT, if you have to bring your baby or your child, don't feel bad. I know some clinics have different policies, but we'd rather have you still come in and take care of yourself than like have to cancel the visit because we're so used to working with like babies crying.

SPEAKER_01

Okay, cool.

SPEAKER_02

A lot of women are self-conscious about that. Like, I'm so sorry, I had to bring them, or oh, I should I cancel my visit? And we're like, no, just just bring them in, we'll figure it out, or maybe we'll use them as part of your treatment.

SPEAKER_01

Oh yeah, because you're gonna be working with that baby, right? They lift that baby, twist with that baby, carry the baby.

SPEAKER_02

Yep. So the other day I had a mom and we did exercises with her baby and involved the baby, you know, and um, or I did um once I was doing like internal work, like pelvic floor work to help the pelvic floor to relax. And we noticed like every time her baby was like fussy and crying, her like pelvic floor would catch up. So we were like, no, this is just the moment. So we're like, okay, let's work through this while your baby's crying. And interesting. And um, so it's yeah, so it's just kind of funny, but but yeah, that's that's powerful. That's cool. Yeah, so that's just a tip. And sometimes it is valuable to um not bring babies so you can have an excuse to do something yourself, and so yeah, that's it. Lots lots of different ways to go about it.

SPEAKER_01

So yeah, cool, cool, awesome. Well, thanks for being with us today. Um, and like we said, Dr. Kasha works for Reborn in Utah. They have several different locations, but we would encourage you wherever you live in the world to look at your local resources and see what public floor PT might be available to you. I've been surprised in the different places that I'm aware of and have worked and lived how this is a growing field. And I absolutely love that. So yeah, well, thank you so much for having me. Pleasure to have you. So as we wrap up this episode of the Ordinary Deal Podcast, just want to, as always, encourage you to make a human connection with someone else, whether digitally, electronically, virtually, in person, um, eye contact, handshake, a hug, please make a connection with someone else. We are important to each other. Hope you have a great day, and we'll see you next time.

SPEAKER_00

Thank you for listening to the Ordinary Doula Podcast with Angie Rosier, hosted by Hatchedonlatched. You can find episode credits in the show notes and more information by visiting hatched and latched.com. If this podcast has been helpful to you, please leave a rating wherever you listen to your podcasts. Your support helps us continue having thoughtful conversations about birth, breastfeeding, and postpartum life. Be sure to tune in next time as we continue exploring the many experiences, questions, and realities surrounding the journey into parenthood.