Do I need to do Kegels in Pregnancy?
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Kaely Harrod 0:00
Hi. Welcome back to Kaely Daily Today's question is: Do I need to do kegels during pregnancy? And we have a very special guest answering that question for us. So stay tuned for more. This is Kaely daily, the bi weekly podcast about all things do live Tips and Tits where we answer one question about pregnancy, labor, postpartum, or lactation, in order to have your journey in this parenting world be just a little bit more informed and filled with consent. Welcome back to Kaely daily. We are joined today with a lovely PT that I adore Katie Bayer. Katie and I met a number of years ago when I was a brand new doula. And, Did you remember this when we met? So I have to tell a short story.
Katie Bayer 1:01
I'm not sure I do remind me.
Kaely Harrod 1:03
So we met at like a doula night where we were networking. And you were the first person that ever introduced me to the idea of scar mobilization for C section?
Katie Bayer 1:13
Yes. Okay.
Kaely Harrod 1:15
Do you remember that? And I was like, teach me and you're like you want me to show you right now? I'm like, where do you want me to lay down? Where can we go? Restaurant? Like, yeah, yes. So that is how Katie and I met. And I have sent dunks and PT with her myself and have loads of clients go to her and she is a wealth of knowledge. So Katie, I would like for you to introduce yourself and kind of how did you get into PT, pelvic floor pt? And then we'll dive into the question. So
Katie Bayer 1:45
okay, I'll try to keep it brief. But um, I have twins who are 11. And they were C section babies, and they were a little early. And then I have a single who was a VBAC, which is vaginal birth after C section. And after my C section with my twins, nothing was offered to me which at the time, I didn't even really honestly, even being a physical therapist, just more of a general PT, I probably should have known more than the average person, I had a somewhat challenging recovery, pain, you know, my C section scar, never told to touch it. And then I started kind of doing more research on postpartum and what should be out there. And oh, I'm supposed to be doing something with a scar. And, you know, just really feeling very alone physically, and how to return to things. And again, I had a leg up, I was already a physical therapist, and I should have known more. So that kind of just kind of served me into the whole postpartum world, and then eventually getting into the pelvic floor more specifically, as well. And then after I had my vaginal birth, you know, really got to experience kind of that whole delivery and how different it was. And just, it just gave me such an appreciation for how little people are given as far as information on what to expect people come to me with postpartum issues. And I'm like, why didn't somebody just tell me? Why don't like just the knowledge alone, we're expected to birth humans through an area we know absolutely nothing about. And then just deal with whatever happens there on our own. So I've just I got very passionate about the recovery process. And that led me into more of like, well, how can we prevent this? And that got me into more trouble on the birth prep stuff that I love doing with my pregnant patients now?
Kaely Harrod 3:23
Yeah, that's awesome. I feel like even as a doula, my understanding of the pelvic floor has grown so much in the last number of years, and gotten to the point where I'm like, we don't know, like, we have a terrible brain body connection with this whole area. Like we're just like, you do what I want you to do it, otherwise, I'm just gonna act like you don't exist.
Katie Bayer 3:44
Yeah, yeah. And that's what I talk to my patients about is just connecting to your pelvic floor. It's an area where I think innately from the very beginning, it's kind of an area of shame and area that we don't, it's dirty, we don't touch it, we don't talk about especially, you know, in our culture, just, you know, in certain areas, it's just seen as this area that we just don't talk about hush hush. And also it's internal, it's an area that we don't look at. So you know, unless you're making an active effort, which many people are like, you know, please no! we just don't know anything about it. And then again, we're expected to do this very major physical thing through it. And I mean, I think just the knowledge of what the pelvic floor is and what we're supposed to be doing with it and pregnancy and postpartum is so just you know, knowledge is power and I think you know, people going into delivery with that knowledge has such a leg up on you know, on people who just haven't been you know, educated about it, right?
Kaely Harrod 4:37
Yeah. Yeah, well, and I think one of the one of the things that kind of started me down the path of thinking about pregnancy PT like pelvic floor PT during pregnancy, and not just after delivery, was the idea that like kegels are so regularly recommended just blanket right like just randomly read a blog of like, do kegels before birth and Preparation for pushing as if your pelvic floor pushes, right? And so I sort of was like, Ah, well, no. But then also after doing plenty of my own, like research and training on, on, like balancing and spinning babies and baby positioning and all that, I'm like, actually, the chance of you having a rock hard pelvic floor is very high. So maybe kegels is the opposite of what you want. So today's question is, do I need to do key goals in pregnancy? And I brought Katie here to answer that for us. Which, of course, as my questions go on question that will have follow up questions.
Katie Bayer 5:41
Yeah. And it's a very kind of a loaded question as it should be. It should not be simple. So I hate when it's just the simple like equals or the answer. So I tend to get very fired up about that. I actually stopped using the word Kegel for a while just because I was like, we're gonna call it activations I just feel like there's this Yes, connotation. When you think about cables. And I've returned back to the word, I think the word is fine. But I think so much, it's as if there's like a cure all for everything. And just like you said, with delivery, your pelvic floor does not birth your child, your uterus does, your abdominals will help. But you know, your uterus births the child, your pelvic floor, is something that just has to part waters that has to get out of the way. And so we don't want a rock hard, pelvic floor at all. But like, I think we, we need to think about balance. So that word, we use the word balance to spinning babies, which I also love and do with my pregnant patients, because I think it's again, about making the body be able to balance between being strong, but also having lengthen, the ability to lengthen, so anything, any muscle in our body, we don't want it to be too tight. We don't want to be too loose either. But very rarely do I see a pelvic floor that's just loosey goosey and not doing anything. And all we're doing is kegels. We need to have a balance. So my kind of short answer to that question is yes, but because we need strength in pregnancy, for sure. You want to have a pelvic floor that's working for you, you want to be stable, you want to be supported. But more often than not, I have women coming to me in pregnancy and in all facets of their life and time of their life with a pelvic floor that has too much tone. We're not we're working on lengthening. And we're working on opening long before we're getting to kegels. And so yes, kegels are important. Strength is important. But the vast majority of what I'm doing with my patients who are pregnant is connecting to the pelvic floor. Like I mentioned before, just learning because most people are doing even if they think they're doing kegels, they are doing them wrong, they're squeezing their butt, they're squeezing their inner thighs are holding their breath. So introducing the connection between breath and our diaphragm, to the pelvic floor. Because some people just have a hard time they're like, I don't know, am I doing anything in my pelvic floor, where's my pelvic floor. So I just tell them when in doubt, our diaphragm and pelvic floor are related. So when the pelvic floor or when the diaphragm lengthens, so does the pelvic floor, so when in doubt, always return to your breath, always return to your diaphragm, because at least we can feel that we can wrap our hands around our ribcage and really feel that movement. And then working on both the you know, kindling, so feeling what that feels like. And honestly, more often than not, I'm doing that to make sure that they have any kind of strength or want to know what their strength looks like. But also to feel the difference. So if I'm doing a kegel and I can feel what that feels like, then let go and feel what that feels like. That's what you're gonna want to access when you're delivering the baby. So what it feels like to have that release as you inhale, because that's when that muscle releases and lengthens naturally, we're using that breath and that connection to open. So that's really important and delivery. But also thinking about you know, even just ahead of you know, getting into the delivery room, we want to work on that because you want again, kind of like a stretching routine, you want to prep the muscle a little bit to be able to lengthen and I find that the more somebody connects to their pelvic floor and pregnancy, the easier it is for them to tap into it even just you know, subconsciously not even aware because when you're in the you know, delivery room, you're not exactly super attuned and focused into your body, it's painful, and you're kind of in the in the middle of it. So just having that kind of prep ahead of time, allows your body to naturally be able to go having some reminders for breath, which is why I love love doulas because there's somebody in the room who is not intimately connected, and can give them that sounding board and those reminders to connect where they need to connect. So we just need we need balance in our body. I think about pregnant women is just I try to make their bodies as efficient as possible. So the the lengthening the activation, we want to have both.
Kaely Harrod 9:55
Yeah. Yeah. Well, I think one of the things I go into with client So you can, I would love your feedback on this. IsRelaxing, like taking some time to learn to relax and lengthen your pelvic floor. And I do recommend pelvic floor PT. But not everyone follows that recommendation in pregnancy. But lengthening on like a birth ball or like a surface where you can feel some feedback when you do that. Because I think we, we, again, are kind of just stuck it connected. Yeah, that part of the body. But also the idea of relaxing, like, when we sit on the toilet, we take for granted that our pelvic floor relaxes there, you know it?
Katie Bayer 10:36
Well, it should! Some have a hard time with it, too. But yes, you're right. If you're not having issues with constipation, then yes, that is something that happens. And we don't think about it, like you said, especially like when we're kids before all this like life and you know, injuries kind of stacked up on top of us, which lead to pelvic floor stuff, that stuff kind of just happens. And then we kind of screw up screw up our bodies. But um, but yeah, I love the idea of sitting on a ball or a little towel roll, you can sit on something underneath kind of your perineum, or underneath, you know, kind of just just under where you're sitting and feeling it lengthening into that. And then once you have that connection, I love having them taken into different positions. So where do you think you want to be delivering? If you're getting an epidural, you do not have to be on your back, as you know, you can be in you know, multiple positions. If you have a position that feels like you can connect to your pelvic floor best or feels good to your body, I tell people well, that's a great idea to start, you know, start there, who knows when you're, when you're in the delivery room, everything can completely go crazy. So who knows. But that's good to have information of how your body responds with that connection to your pelvic floor, when you're standing if you don't plan to have epidural what you know what positions feel good to you moving around as much as you can, and prepping and practicing, not when they're pregnant, to really get to get that feedback, and that that connection in different positions.
Kaely Harrod 11:58
Yeah, yeah. So I have an unrelated Well, kind of related follow up question, I suppose. One of the things that I sometimes think about when I'm sending folks or referring folks for PT in pregnancy, is that there's a benefit of seeing the same person pre and post nataly, would you say that's the case? Or does it really make a difference?
Katie Bayer 12:22
I think it Oh, and I think that helps them everything, whether it's your mental therapist, or whether it you know, whoever it is, you have a connection and especially with something like pelvic floor, which is intimate I do internal work, vaginal work on pregnant in during pregnancy and postpartum, you know, as long as it's appropriate with the patient, and as long as they consent. So, you know, it's a very intimate thing. And I think to have that relationship, benefits, the recovery, and then just the connection you have during your treatments. That being said, if you know, it happens that you have to change and go to another PT, I don't think you're at like a huge disadvantage. Okay, getting pte anywhere is worth it. As long as you feel like they're giving you good care. Yeah, but I certainly and I just love seeing, you know, what's what's happening over the course of pregnancy have hearing their birth story? Yeah. And then, you know, knowing what their body was doing a little bit beforehand, and then I can kind of feel what's happened afterwards. And as a PT, I think most PTS would say, yes, it's awesome to see that whole progression, you know, from being recognized into being, you know, a new parent. But, um, but ultimately, get PT, period, whether or not is with the right person or with the same person.
Kaely Harrod 13:33
Yeah, that makes sense. That's a good question. So I know you primarily work local to DC well, to the Virginia area, you have any virtual offerings. At the moment? I should, I should have asked you this before.
Katie Bayer 13:48
So yeah, I do virtual, for sure. And I think it actually works really well. For somebody who just wants to kind of discuss and talk about the birth, you know, what happens in birth, I do a lot of discussions about breath work. And again, positions, we talk a lot about how to, you know, take advantage of the way our body moves, our hips and our back, and different things like that to you know, help during the various stages of labor. So I think it does work well. I love getting my hands on people, but that's not always an option. And it's not, you know, people may not have the time or whatever it is, you know, we understand, not everybody can do it. So virtual, especially for birth prep, I think could can really work well and even for postpartum, especially the early postpartum, kind of just like oh my gosh, I just gave birth to a baby. And is this normal? What's going on? What should I be doing? So people also don't have to wait for that like magic six week checkup to get in virtual or personal so we can start with PT does not have to be internal. You know, if you have any kind of tearing or you had a C section, we wouldn't be doing any direct work there. But we certainly can work on many, many other things that can help with your recovery. And I think people feel like they have Can Wait, you know, for some magic window and virtually that certainly doesn't have to happen and even in person it doesn't.
Kaely Harrod 15:07
Okay. Now, a follow up question to that is, are you able to see people all over the country or do you...How does PT work in terms of licensing? It is.
Katie Bayer 15:18
So there's this gray area in there, but no, if it's P specific P T, okay, if I was truly doing simple birth prep, yeah. Which is something that many different you know, doulas do, and other people do you know, like, it's, I would say I would feel comfortable. Yes. Doing seeing somebody from somewhere else. If you're getting nitty gritty, pelvic floor, you know, there's gray area in there, but technically no, as a PT,
Kaely Harrod 15:43
no mechanics,
Katie Bayer 15:44
just Virginia. Yep.
Kaely Harrod 15:45
Yeah, yep. Yeah. As I was asking, I was like, Wait a second. Licensing is different for physical therapy. Yeah. But there's, there's, you know, there's
Katie Bayer 15:53
different avenues that we're diving into. So you can see certain
Kaely Harrod 15:57
areas. That's one of my frustrations with pelvic floor PT is like here in DC, we have many options. And still, I think we need more, right, like we still don't have no, but there are whole areas of the country that have like nobody, you know, yeah, no, I
Katie Bayer 16:13
know people who are like the lone pt. And they're like, basically not even just our town but like surrounding area. And it's it's, I can't imagine I mean, of course, we bought seeking care because they needed if they tried, they couldn't get in by the Oh, access. Yeah, yeah. No, it's there needs to be more of us. I say that all the time. Yes. Yeah.
Kaely Harrod 16:33
Awesome. Well, I really appreciate you taking the time to talk to us today. I will make sure all of your contact info is in the show notes so people can get in touch with you. Katie has some amazing reels very informative info on her Instagram so I were fun.
Katie Bayer 16:51
Well, I really appreciate this. This was so fun. I could talk about this stuff all day. So this right
Kaely Harrod 16:55
this is great. And I appreciate often bring you back for postpartum something. Yeah, anytime. I'd love it. All right, well enjoy the rest of your day. Thanks, you too. We'll see everyone at the next episode. Edited and produced by Kaely. Her rod as I'm sure you can probably tell, and our amazing music is credited in the shownotes as well. So we look forward to seeing you and the next episode. And in the meantime, have a wonderful in consent filled
Unknown Speaker 17:30
birth.
Transcribed by https://otter.ai
Do I or do I not need to do kegels a million times a day? That is the question! While you don’t need to do them a million times a day, they are beneficial for some people, but not everyone. There is nuance! Which is true for so many things in life. This episode features Pelvic Floor Physical Therapist Katie Bayer to answer this question for us!
KEY TAKEAWAYS
Yes, kegels benefit many, but not everyone
It’s better to see a pelvic floor PT who can assess your pelvic floor tone
Lengthening or relaxing is actually what your pelvic floor does during pushing!
Using breath work is a great way to begin to reconnect with your pelvic floor
BIO ON OUR GUEST:
Katie Bayer, PT, DPT is a Pelvic floor physical therapist and owner of Transition Physical Therapy, LLC in Vienna, VA. Sheoves to help people prepare for birth, and recover in postpartum.
RESOURCES
Connect with Katie on Instagram:
https://www.instagram.com/transitionpelvicpt/
FREE OXYTOCIN GUIDE:
6 Ways to Increase Oxytocin for Labor Progression
https://www.harroddoulaservices.com/free-guide-6-oxytocin-tips
Previous Pushing Episode:
https://www.harroddoulaservices.com/kaely-daily-podcast/episode-33
CONNECT with Kaely on Instagram
https://www.instagram.com/Harroddoula/
This podcast is hosted by the Birth Prep Blueprint - comprehensive Childbirth Education for expectant parents to feel calm, prepared and confident about labor and birth. Podcast listeners (that’s YOU!) get 10% off! Use the link below to get that great deal!
https://thebirthprepblueprint.com/offers/884d5a56-9089-4482-a944-6bb7c26c9b04
If you like this episode, don't forget to share it to your Instagram stories and tag me @harroddoula
Kaely Daily is produced by Kaely Harrod of Harrod Doula Services
It is sponsored by The Birth Prep Blueprint Childbirth Class
Music by Madirfan: Hidden Place on Pixabay
