106: Pelvic Floor Function after Childbirth – Kathe Wallace

My guest is the author of Reviving Your Sex Life After Childbirth, a pioneer for diagnosing and treating pelvic floor dysfunction, and also a practicing physical therapist who specializes in the pelvic floor, specifically. Overall, she is one of the leading authorities on the PF and has a wealth of knowledge to share in this episode.  

She talks about treatment, what to expect during the “4th trimester”, and common ways of regaining sex drive after birth through pelvic floor physical intervention. Listen along!

Postpartum Considerations
Kathe says that what sparked her interest and important work with post-childbirth mothers was that no one was really helping mothers regain their sex drive. Additionally, she drew from her own experience as a mother to drive the work she would do with other mothers. More specifically, Kathe specializes in the all-important pelvic floor muscles.  

She says that obstetricians often don’t address the pelvic floor muscles and the importance of strengthening them after childbirth.  

The Most Common Impacts of Childbirth on the Pelvic Floor
Kathe says that pain is the biggest reason why mothers come to her for physical therapy. She says that providing information and treatment for the pain not only alleviates the symptoms but provides a huge relief to mothers who might have uncertainties and stresses about regaining their sex drive.  

Other common reasons are simply a lack of sexual desire and incontinence due to weakened pelvic floors. Laxity and looseness is another common byproduct of childbirth on the pelvic floor, which can certainly contribute to mothers feeling uncomfortable about sex, making them more likely to avoid it.  

Kathe spends some time talking about the connecting fascia and tissue that comprise the pelvic floor and how childbirth can stretch out the tissue. It can take a lot of attention to strengthen the muscles back to form, so Kathe says it’s an important step to seek physical therapy.

The Benefits of Kegels for Arousal and Lubrication
Kathe says that a lot of mother struggle with getting adequately lubricated for sex after childbirth. This is a completely normal phenomenon, so she dispels the myth that only menopausal women struggle with it. Kegels and other physical interventions can really help with lubrication.

Arousal is another closely related facet of sexuality that kegels can improve. During the “4th trimester” it’s hard for mothers to get aroused. Strengthening the pelvic floor can help immensely.

For strengthening the first layer of muscles, she suggests the technique called the “wink and nod”. She says that if you squeeze and think about moving the clitoris, closing the vaginal lips, and winking the anus you can strengthen the first layer of muscles. For the deeper layer of muscles, you would seek to bring your anus to your pubic bone, so to speak.

For much more on that, listen along!

How to Release a Tight Pelvic Floor
Kathe says that there are cases where the pelvic floor actually is too tight and could benefit from a regular release of tension. For those who perhaps are too tight, she has a wide variety of diaphragmatic breathing exercises that can help. She goes into much more detail on how to know if you can benefit from tightening or loosening exercises. Definitely, don’t miss that!



Resources for Kathe:  

Her website: https://kathewallace.com/

Her book: Reviving Your Sex Life After Childbirth

Free Pelvic Floor Handout: https://kathewallace.com/resources/free-handout/

Questionnaire for Females About PFD: https://kathewallace.com/physical-therapy/patient-forms/

Find a PT Sites: https://ptl.womenshealthapta.org/#s=1 || https://pelvicrehab.com/ || https://pelvicguru.com/

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