Dr. Rose Gonzales is a postpartum coach and physical therapist who specializes in the pelvic floor. She graduated from New York University in 2017 and has been pursuing her passion in caring for pregnant and postpartum women. She’s also a loving mother to her adorable one-year-old son, Leo, and fur baby, Ellie.
Did you know that a pregnant woman endures 88% of the maximum capacity of physical stress that a body can tolerate over a prolonged period of time? Duke University’s evolutionary anthropology professor, Herman Pontzer, worked on the research after scientists measured the body’s resting metabolic rate in elite athletes. If our society can offer endless opportunities for the physical rehab and needs of athletes, then we need to offer the equivalent supports for pregnant and postpartum women!
Dr. Gonzales is creating a space where women can feel confident in navigating their physical function from pregnancy and beyond.
Follow Rose on her Instagram profile, where she shares tips and tricks on all things prenatal and postpartum, provides a glimpse into her journey as a parent, and shares her adventures around the world.
INSTAGRAM – @drrosegonzales
EMAIL – rosemarie@anatomeofme.com
Hi, my name is Rose, and today I have the pleasure to be a village feature on the Mama-ish blog, and I want to talk about pelvic floor literacy! For context, I am a physical therapist who has dedicated much of my career to helping women resolve their pelvic floor dysfunction in the sub acute and outpatient setting. I’ve realized that a lot of my patient’s dysfunctions are associated with their birth outcome, and it has motivated me to address the topic more publicly here.
At this point, you may be wondering why a physical therapist would have an opinion regarding birth. That maybe, the topic is best left with the midwives and doulas, right? Well, I am proud to belong to a profession that has claimed ownership of helping women heal and recover function post birth, and this experience gives us perspective on how to help women manage pregnancy and prepare for birth. Consider it “prehab” to postpartum.
Pelvic floor physical therapists are trained to assess and restore impaired physical function by reducing pain and discomfort, providing education on how to push during labor and reduce postpartum complications. The roadmap of physical therapy during pregnancy and postpartum is individualized – which is why every woman should see a physical therapist at some point during their pregnancy and postpartum journey. But, it also doesn’t escape me that there are not enough physical therapists that are trained on the pelvic floor and prenatal/postpartum clientele, nor do all women have the resources in time and money to participate in multiple visits to go to a physical therapy clinic. For this reason, despite physical therapy being beneficial, I don’t think it is impossible to have the outcomes you want to have without seeing a physical therapist face to face. This means, if you have access to a pelvic floor physical therapy guided pregnancy and birth training online, those courses are not a waste of time or money – and I say this not trying to sell you one but as someone who wants all women to be empowered and have basic pelvic floor literacy going into birth and postpartum.
Okay, I’ll get off that soap box and move on to how you can improve your birth and postpartum outcomes today. If these steps sound redundant, that is because these principles depend on each other:
Five Steps to Improve Pelvic Floor Literacy And Function
1. Know how to lengthen the pelvic floor muscles (muscular relaxation)
Here is my unpopular opinion: having a coordinated pelvic floor is better than a strong pelvic floor – I said what I said.
You want to have a pelvic floor that is able to lengthen and respond appropriately to the load applied – whether that be during a run or flowing into and out of yoga positions. How you start to improve your pelvic floor flexibility starts with your ability to bring awareness and relaxation to the pelvic floor muscles. Breathing techniques will help with this, which naturally brings us to the next principle.
2. Use breath work to coordinate your overall function
Breath work is a powerful tool that has the ability to shift your central nervous system from the sympathetic to parasympathetic state, give your organs a nice massage and improve your coordination with the pelvic floor and core muscles. Breath work reveals how the body is truly all connected, and it will exponentially compound your pelvic floor function once you get this piece of the puzzle.
3. Mobility work
Pregnancy and postpartum are magical experiences. Some find beauty in the anticipation of having a baby; for others, it is in awe of how the human body orchestrates creating a human. Either way, your body is the rockstar, but compensating for the changes it goes through during pregnancy can cause real pain to various parts of your body. To manage this, you want to work on a mobility program that addresses your specific pain points – typically, that will be to the back, hips and pelvis. Being able to transition into and out of positions by using appropriate muscle tone and breath work provides the body with a better understanding of how to move and coordinate – and it can look differently person to person.
4. Include a strength program
Now, I’m not talking about pelvic floor strength. Being a mom requires more physical strength than even I was anticipating.
I wish I had the perspective I have now when I created exercise programs for my pregnant and postpartum moms prior to my pregnancy journey. Once a baby is born, a woman is still doing the majority of the work, especially if there are other kids in the family unit that she’s the primary caregiver for. Pelvic floor strength matters, but if the woman lacks strength anywhere up the kinetic chain, the pelvic floor will be the victim, and no amount of kegels will help with that.
5. Understand how posture can be the missing puzzle piece
There tend to be two different opinions in the rehab world on posture – either posture doesn’t matter or it does. I belong to the latter camp. The orientation of the ribs over the pelvis is proof that posture matters and has a global effect on the whole body. Consider how certain position changes during a single exercise can influence different muscle groups – it’s all dependent on your posture during the exercise.
If you are pregnant or recently postpartum, you’ll know how important your birth experience and outcome feels to your future health and happiness. In fact, you may be holding on to indirect trauma from stories of some women’s experiences that include pelvic floor dysfunction, abdominal separation, body dysmorphia, maybe even your own traumatic experiences. Needless to say, your ideal birth and postpartum experience is what you’ve spent 40+ weeks preparing for, and there is a lot of pressure to get it right. These feelings are legitimate, but the body is magnificent and is capable of growing and developing a human, and it is capable of birth and postpartum healing.
This brings me to my last point. What I hear the most that needs to be addressed alongside birth and postpartum prep is a person’s fear and distrust of their body. The magic of pelvic floor literacy improving birth and postpartum outcomes lies in the confidence and trust a woman builds with her body. We have the ability to dispel fear around pregnancy, birth and postpartum. Basic education and exposure to positive birth stories will help you in your journey of pelvic floor literacy and will bring you to your goal of having a good experience, even if your journey isn’t always what you’d expect it to be along the way. Trust your body is good and is capable of thriving during pregnancy, birth and postpartum, and if you need help, a physical therapist is a great person to add to your birth team.
If you have any questions or want more detailed tips, you can find me on instagram @drrosegonzales. When I’m not posting about women’s health topics, you can find me running around Laguna with my baby and husband in tow.
