10 Women Share How Pelvic Floor Therapy Changed Their Lives

Danielle Robinson, 43, packed extra underwear to take to work each day when she was trying to finish her Ph.D. in neuroscience. After delivering her son and sustaining internal and external tearing during his birth, she needed to have backup pairs in case she pooped her pants at the lab. Aimee Antoine, 36, was a year postpartum and still couldn’t go on a run without peeing herself. Angela, 62, hiked the Camino de Santiago in Spain with her bladder and uterus prolapsed, aware of the bulging feeling. She was on a year-long waitlist to see a urogynecologist.

Pelvic floor dysfunction is incredibly common — 1 in 3 women will experience it in their lifetime — and the way it shows up varies widely. Some people deal with incontinence; others, pain during intercourse. For some, birth injuries lead to lasting pelvic issues, and then there are the women who have never even been pregnant, but whose bodies change along with their hormones or their age. What they all have in common is that they have historically been dismissed by their doctors, and through their own research or word of mouth, found their way to pelvic floor physical therapy — and finally, help.

Here, they share what prevented them from accessing the care they needed, what it was like to finally start feeling better, and their hopes for the future of women’s health care.

What held you back from getting help?

Whether it was the “welcome to the club, Mama” attitude around urinary leaks, normalized pain during sex, an inattentive OB-GYN, or a lack of adequate maternity leave to heal, these women all faced barriers in getting relief for their pelvic floor disorders.

“I was a year postpartum. I love to work out, and I just could not go on a run without peeing my pants. Friends would tell me, ‘That's just how your life's gonna be, you know?’ And my mom even said the same thing, ‘That's just how it is after you have babies, you just have a weak bladder.’ I just felt like that can't be true. Like, I cannot live the rest of my life always peeing my pants. I always had to wear black leggings because I was worried that I was going to pee on myself. I was really self-conscious about that. Or if my son wanted to run and play or jump on a trampoline, I thought, oh my gosh, I just hope I don't pee my pants. It was holding me back from doing the things that I wanted to do and being the mom that I wanted to be.” – Aimee Antoine, 36

“At 16, I tried to have sex for the first time and it didn’t work, it was like hitting a wall basically. Luckily I have a very close and open relationship with my mom, and I told her and she was like, that's not normal. [My gynecologist at the time] told me to try to just relax more, that some pain is normal and hopefully it'll get better. I was like, OK, obviously this is my problem and I need to figure out how to relax so that this doesn't hurt anymore. So from that point on, I could never actually have sex. Eventually I was able to lose my virginity, but I was super, super drunk and basically just forced myself to do it.” – Helen Bost Karel, 31

“At my six-week follow-up, it was just, ‘OK, the [C-section] incision looks good. Do you feel sad?’ ‘Yeah.’ ‘OK.’ And then you're out. There was no ‘How does your pelvic floor feel? How does the incision feel? How are your bowel movements? How is peeing? How is sex?’ There was none of that.” – Sarah Green Materne, 35

“My first OB, who delivered my son, he was like a dinosaur. I would try to talk to him about stuff and he’d say, ‘Oh, you don't need that.’ At that point, I didn't know anything about the pelvic floor. I didn't really know much about anything, and so I just went with whatever he said.” – Aimee Antoine, 36

“I didn’t have any difficulty getting a referral. But the problem was that I felt like I had no time for this. I felt like it was easier for me to just continue packing extra underpants and figure out a way to avoid pooping my pants somehow. I was spending all this time every day pumping and doing all these other things, so I felt like it wasn't OK for me to add another thing that would take time out of my workday. I went back to work [after eight weeks], spent two months in hell, and then had this day where I was like, what am I f*cking doing? I'm carrying extra underwear around because I'm very likely to poop my pants at any moment. And it had to get to the point where I thought, this is ridiculous, you can’t live like this, before I went and actually got an appointment.” – Danielle Robinson, 43

What was pelvic floor physical therapy actually like for you?

“I don't think I had any hesitations at all once I walked in, because my therapist is just so lovely and kind. Immediately I was like, this is a person I can trust with my entire body. I hadn't felt that way about gynecologists in the past, and it made for a really different experience. You don't have to settle for someone who makes you feel uncomfortable or pushes past your boundaries and thinks they're doing it for your own good.” – Jillian, early 30s

“I would say PT is not even close to how uncomfortable a pap smear is, in my opinion. I've had some really awful pelvic exams from OB-GYNs so I really get that fear, but I feel like most people seek pelvic floor PT because of pain and the anxiety around it, and these therapists know that, so they are very considerate. They talk to you before they do anything. She’ll say, ‘OK, you're gonna feel me touch your leg right here,’ so that you're not startled. A good pelvic floor PT will ask you for consent for all of those things, and you can still do pelvic floor PT without an internal exam. I do think it's an important part, but if you need to build that relationship with the therapist first, I think that's totally reasonable.” – Bailie, 29

“My physical therapist was one of the first people to listen, to hear me. We did a very thorough consultation. I don't even know how much actual physical therapy took place that day because the consultation was so thorough. I did not feel rushed; I felt validated. I felt as though someone understood what I was going through and like I wasn't crazy. Like, no, this is very real pain.” – Jaime, 41

“Every practitioner has their own way, and it’s important to find somebody who is a good fit for you. Pelvic floor physical therapy necessitates that you feel completely safe, and to me there’s a certain ambiance needed for that. I discussed that with my physical therapist and she was super open to that feedback. I would venture that many women experiencing pelvic pain have experienced some kind of sexual assault; it’s a factor that contributes to the pathology. That safety piece has to be addressed. For people who are interested in this, I 100% recommend it, and suggest discussing your needs upfront. It may be uncomfortable but if you have that history of violation, or you need to feel safe, you need the lights dim, you want to meditate before, ask for that.” – Jane, 28

“I didn't even realize how much emotional and mental weight that I carried around my C-section and how much PTSD that I have around this scar. When my therapist started touching it, I just started crying. I didn't even know why. And she's like, ‘Oh my gosh, are you OK? Does it hurt?’ I was just like, ‘I dunno, I feel really sad. I'm scared.’ She's like, ‘You're gonna be fine. It's OK. Of course you feel sad and scared. That was a scary thing that happened to you.’” – Sarah Green Materne, 35

"After that first appointment, I sat in the parking lot outside her office and sobbed in my car. I also cried several times in her office during those initial sessions, coming to terms with what had happened to my body. During one particularly intense session when she was manually releasing my C-section scar, I broke down because I had still been holding onto so much shame that I couldn’t deliver my daughter vaginally. Physical therapy became a place where I started to also process the trauma of my deliveries." – Cristina Tudino, 42

How did pelvic floor therapy help you prepare to give birth again?

“I had twins my first go around via C-section and then with my second pregnancy, I was able to have a VBAC in April thanks to my therapist. The trauma from the C-section was physically and mentally extremely difficult. This second birth has been much more healing for me. With the birth prep in particular, it helped me know when I went into birth, what position I pushed strongest in. For a lot of women it’s side lying, for me it actually was on my back. Having that knowledge helped make this birth experience better and also give me a little sense of control, which I needed after my traumatic first experience. Knowing what to speak up for, what to ask for, and having a little bit more autonomy.” – Bailie, 29

“I was f*cking terrified to give birth again. I used my airline miles to fly to my PT and have her do an internal exam and teach me what pushing was, because I felt like I could not conceive of giving birth without just being knocked out. I was so terrified that something bad was going to happen again. And then of course my daughter was born in two hours. It was a totally different experience that was terrifying in its own way, but I didn't get mortally injured.” – Danielle Robinson, 43

“There's this expectation that giving birth is a very natural thing, but you don't just know what to do automatically. I think it can be particularly difficult if you have a history of vaginismus. Knowing how to activate your muscles and use them properly is helpful. She basically taught me how to push — what I was doing when I would think that I would be pushing, I was actually tightening everything, which is the opposite of what you want to do. Your partner can come with you to the childbirth preparation, so they have an idea of what you're doing and what pushing looks like. She taught my husband how to do perineal massage. And then after I gave birth, I had an appointment automatically scheduled with her for a month after.” – Helen Bost Karel, 31

Did pelvic floor PT improve your symptoms?

“The PT has made a huge difference. My muscles have gotten so much stronger, and that's of course helping push the organs back up again. I'm urinating much more easily. There’s nothing poking out of my vagina anymore. I'm not 100% perfect and I think I'll have to work at this my whole life, but it's not that hard to do the PT exercises. I read that the surgery was only around 50% effective and sometimes it causes other problems, so I really preferred to go the PT route if I could.” – Angela, 62

“It's important for me to underscore that before pelvic floor physical therapy, I didn't feel like I was gonna make a full recovery. My expectations were low. I don't know why, they just were. And I was wrong. I've made a full recovery. I was able to have another baby. I do not poop in my pants now. Put that in the article.” – Danielle Robinson, 43

“My prolapse was not horrible, but still it was really helpful to be validated and to not just be like, ‘OK, this is just what it is from now on.’ I feel a lot better about having subsequent children and not feeling like my uterus is about to fall out of my body. If I become symptomatic and start leaking, I know that there's a place that I can go or somebody that I can talk to who will give me a treatment plan and options to help that, rather than telling me that that's just how it is after you have a baby. Because I just don't think that that's acceptable.” – Helen Bost Karel, 31

“I still have a little bit of pain in some areas, but overall I would say I am 90% better. There is still a tightness when I don't see my PT or when I don't do the exercises that she wants me to do. When my life gets a little bit hectic and busy, and I'm not able to dedicate the time that I need to, to the stretches and things like that, I notice a difference.” – Jaime, 41

“My progress was slow, but after six months of regular PT, my pelvic floor muscles became strong enough to begin to restore my rectum to its place. I also began to notice certain meaningful changes: learning how to breathe in a way that engaged my core and pelvic floor made a big difference when I was doing everyday activities like carrying grocery bags. I had to take it easy for a while with yoga, but over time I was able to start lifting weights again without throwing my back out. Generally, I became more aware of my pelvic floor and whether it was tense — I even started experiencing more sensitivity during sex.” – Cristina Tudino, 42

“Once I was doing the stretches every day as she prescribed, it felt like progress was happening. I wasn't always in pain. I was more relieved as time went on. It's been two years, and I feel a lot better. I don't have to leave class for my back pain. When I'm on my period, I can use tampons as big as I want and it doesn't hurt. Like sometimes there will be a little discomfort, but it's manageable rather than it being completely life-ending pain. I didn't think that it would be able to be fixed. I have had my period since I was 12 and now I'm 21. And it hurt for years, but it finally got figured out.” – Gretchen Dwyer, 21

“With a cesarean, the pelvic floor is so important for all of those muscles that are in and or around your lower abdomen. It’s all connected. Pelvic PT has helped me be able to rehab all of that, including the stress the pregnancy puts on your abdominal wall.” – Sarah Green Materne, 35

What would you say to someone who’s considering going to pelvic floor PT?

"If your doctor's telling you you don't need pelvic floor physical therapy [but you know something is wrong], do your research. Find someone who will work with you and see if you can start a regimen. Because it really is life-changing. Honestly, I don't know where I would be without it. And sometimes you have to take your health into your own hands, because not all doctors are informed on it, unfortunately.” – Jaime, 41

“Everybody can benefit from pelvic PT. You don’t have to be a person who has grown or delivered a baby. Everybody has a pelvic floor. It's part of your body that goes through some trauma and then you're going to try to make it better, just like if you were in a car accident and you had some kind of arm or neck injury, you're going to rehab that. You're gonna say, this feels bad, it doesn't feel like it used to, and I wanna fix it. It’s the same thing.” – Sarah Green Materne, 35

“If there is someone who is going through this and feels like they don't have time or energy to pay attention to this because they're also not sleeping, caring for a newborn, and trying to go back to work, I just want to say it is possible for you to get all of your function back even if it feels really, really impossible. It was really hard for me to believe when I was going through it that I would get all of my function back and I wouldn't be somehow faulty or carry this with me for the rest of my life.” – Danielle Robinson, 43

“Even if you feel embarrassed about it — because it can be an embarrassing topic, it can be a hard-to-talk-about topic — it was worth it times a million. It literally changed my life.” – Helen Bost Karel, 31

“At the price of my own discomfort (socially and emotionally, that is), I tell every mom I know who has mentioned ‘peeing while they run’ about pelvic floor rehab. One of the biggest roadblocks to getting the care so many women need is our shame around discussing certain bodily dysfunctions after birth. I spent years suffering, and I wish someone had told me that I did not need to.” – Cristina Tudino, 42

Pelvic floor dysfunction is common, but not normal.

“It’s not exaggerating to say that this kind of care saves lives. It would be hard to imagine how I would be going about my life 10 years later if I had not been able to get that care and resolve those issues. My activities of daily living would be very challenging if I was still managing pain, unable to have sex without pain, having all kinds of scar tissue unaddressed in an area of the body that's critical for things like standing and walking — critical for things beyond sex.” – Danielle Robinson, 43

“How many people just leave after their six-week appointment feeling like, this is just my life? This is how I am now because I've had a baby. It doesn't have to be that way. It takes a lot to be vulnerable and raise your hand and say something doesn't feel right or something feels different than before. That can be scary and embarrassing. But the more that we talk about it and have some validation and compassion around all of these like very hush-hush topics, it is exactly what we need.” – Sarah Green Materne, 35

“It's empowering to understand and take control of your own body. That's the best thing that physical therapy has done for me. I feel like I understand what's happening at every point. My vagina isn't something mysterious and inscrutable that I don't understand, and I can have an effect on the way I experience my own body.” – Jillian, early 30s

“The lack of awareness around women's health is disheartening. So many women don't know the resources that are out there to help them. Any way that we can continue to promote women not ignoring some of those pains or those symptoms that they're having that can be easily treated by going to physical therapy, that's life-changing.” – Jaime, 41

“I thought pelvic floor therapy was just for women who have had babies, but it's so much more than that. It could be painful intercourse. It could be constipation, a number of things. It's not just for women, it can be for men also. I just wish that there was more knowledge out there about it and people knew more about it. It should be a part of your yearly physical.” – Aimee Antoine, 36

“I truly believe it should be standard care, especially for women giving birth.” – Bailie, 29