MyMaine Birth

90. Unlocking Pelvic Health with Dr. Emily Wilson of Pelvic Wisdom in Yarmouth, Maine

• Angela Laferriere • Season 2 • Episode 90

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Unlock the secrets to better pelvic health with Dr. Emily Wilson of Pelvic Wisdom Physical Therapy.  Emily shares her compelling journey into pelvic floor therapy, starting from an unexpected discovery during her education, to becoming a passionate advocate for personalized care. Learn about the transformative power of pelvic floor therapy, especially during pregnancy, conception, and postpartum care, and how it can radically improve your well-being.

Discover why Emily emphasizes the importance of relaxation and breath work in preparing your pelvic floor for labor. She explains how stress and tension in the sacrum and pelvic floor can lead to discomfort, and how personalized assessments can make all the difference.  Emily also sheds light on postpartum healing practices, including the closing of the bones ceremony and methods to address diastasis recti.  Get practical advice and holistic support tips that can help new mothers feel balanced and comfortable in their bodies again.

Finally, explore the deep impact of birth trauma and the importance of healing for the entire family. Emily offers insightful techniques like meditative practices and scar tissue work to help mothers reclaim and rewrite their birth stories. Learn about the hands-on, patient-centered services provided by Dr. Wilson at Pelvic Wisdom Physical Therapy and find out how to connect with her for future classes focused on embodiment and pleasure as medicine. Whether in-person or virtual, her holistic approach blends energetic and somatic trauma work with physical therapy for comprehensive care.

You can connect with Dr. Emily Wilson through her website by clicking here:   https://www.pelvicwisdom.com/

Or over on Instagram by clicking here:   https://www.instagram.com/pelvic_wisdom/?hl=en

MyMaine Birth is a space where we share the real life stories of families and their unique birth experiences in the beautiful state of Maine.  From our state's biggest hospitals to Birth Center Births, and home births, every birth story deserves to be heard and celebrated.  Whether you're a soon to be mom, a seasoned mother, or simply interested in the world of birth, these episodes are for you.  

If you're interested in Doula Support or Birth Photography for your upcoming Birth, head over to my website to inquire about your due date.

https://www.mymainebirth.com

You can also message me over on instagram by clicking here:  https://www.instagram.com/mymainebirth

Birth Plan Essentials - September 21, 2024  11am- noon - Join me for a Free Workshop, hosted each month for the rest of this year at the Old Town Public Library.  

In this workshop we dive into the intricacies of creating your own personalized birth plan, and how to navigate the decision making process with confidence and clarity.  

We cover ALL of your options including - general labor options, variations of normal, induction and augmentation options, comfort measures and medical pain relief options that may be available to you, the second stage and pushing options, the third stage and immediate postpartum options, uncommon labor complications and so, so much more...  I literally cover every single thing that could come up for you, so don't miss out!

I plan to host these for free once a month until the end of this year at the Old Town Public Library.  The next one is on Saturday September 21, from 11am to noon.

As a special gift, you'll receive a complimentary template to help you craft your ideal birth plan - whether you're planning to birth in the hospital, at a birth

Angela:

I'm Angela and you're listening to my Maine Birth, a space where we share the real life stories of families and their unique birth experiences in the beautiful state of Maine, from our state's biggest hospitals to birth center births and home births. Every birth story deserves to be heard and celebrated. Birth story deserves to be heard and celebrated. Whether you're a soon-to-be mom, a seasoned mother or simply interested in the world of birth, these episodes are for you. Welcome to episode 90 of the my Main Birth podcast. I want to take a quick minute to share about a free workshop I'm hosting. It's called Birth Plan Essentials. In this workshop, we're going to be diving into the intricacies of creating your own personalized birth plan. We cover all of your options, including general labor options, variations of normal induction and augmentation options, comfort measures and the medical pain relief options that might be available to you. We get into the second stage and pushing options, the third stage and immediate postpartum options. I break down all of the newborn tests and procedures that are available. We get into cesarean options and other uncommon labor complications and so so much more. We literally cover every single thing that could come up for you. So don't miss out. I'm going to be hosting these for free each month until the end of the year at the Old Town Public Library. The next one is on Saturday, september 21st, from 11 am to noon. As a special gift, you'll receive a complimentary template to help you craft your ideal birth plan. Whether you're planning to birth in the hospital, at a birth center or even at home, having a birth plan in place will ensure that your wishes are clearly communicated to your birth team and healthcare providers. By attending this class, you'll also qualify for an exclusive discount for my in-person services and online childbirth education offerings. You can register by filling out the form on my website, mymainbirthcom, or simply sending me a DM over on Instagram at mymainbirth. You can also follow me over there for all of the updates about future dates of this workshop and other childbirth education offerings that are going to be coming up. It's called Birth Plan Essentials and I'm offering it for free each month until the end of the year, so if you're expecting, I hope to see you there. If you're not able to make it, I do offer this workshop virtually over on my website. It's just $44 and you can find all of the information over there at mymainbirthcom.

Angela:

Now for today's episode. We're going to be doing something a little different. Today I'm talking with Dr Emily Wilson of Pelvic Wisdom. She is a pelvic floor therapist based out of Yarmouth, maine, and you can learn more about her by checking out her website, pelvicwisdomcom, which is linked in the show notes. All right, hi, emily. Welcome to my Maine Birth. Hi. Thank you so much for taking the time to chat with me today. I'm really looking forward to our conversation. So, to jump right in, will you start by sharing a little bit about who you are and what you offer for services to families here in Maine?

Dr. Emily Wilson:

Thank you for having me. I'm Dr Emily Wilson of Pelvic Wisdom Physical Therapy. I have a practice in Yarmouth, maine, and see people one-on-one in the clinic and I also offer online services as well, and I treat all spectrums of the pelvic floor for a woman or a female body or female identifying body, throughout the lifespan. So I see as young as teenage girls up to women that are post-menopausal in their seventies, eighties, even. So it's a really broad spectrum, but I will say like, the bread and butter of my work is pregnancy, conception even, and postpartum as well.

Angela:

So what originally led you down this path?

Dr. Emily Wilson:

Yeah. So anyone who does pelvic floor work as a physical therapist at least goes to PT school, right. And so in school I had no knowing yet that I wanted to do pelvic floor work, and there was a one hour lecture within the six years of study, like that's it, like it was one hour exposure, and so it's something that's really not well talked about, which is not that surprising within our world and our healthcare system and our training system. And at that point I was not open to the possibility. I really wanted to work with children and pediatrics and special needs in particular. But it just kind of happened where I got out of school I was doing my last clinical with a pediatric rotation and my first boss was hiring me for when that was over and I was ready to start practicing. And she was like what do you think about pelvic floor therapy? And I was like I don't know, I'll go to a class. And it was it's all things that have to be learned in continuing education or outside of the typical physical therapy program.

Dr. Emily Wilson:

So I went to a class and I had happened to have pain at the same time, but it felt like SI, joint pain or sacral pain, and I had no clue it was coming from the inside muscles. So within two, three days of this training they were like there's a muscle here, if you touch it it can radiate pain. And just to let people know where that is, it's like the little dimples in the small of our back or it can be on the front of the abdomen, like where the ovaries are. That those are two places that one of the muscles of the pelvic floor can refer and it was amazing they had. We did internal work and we're exchanging and learning on each other and my classmate was able to quickly identify the muscle that was tight. And my classmate was able to quickly identify the muscle that was tight, heal it within 30 seconds. It released just like any external muscle would in the body and the pain went away.

Dr. Emily Wilson:

It like created the pain for a minute to make me know it's familiar and that's where it was coming from. And then it dissolved the pain and there was just something so pivotal about that moment. I know I was 24, without kids, like I would. Just there was no reason for my SI joint to be hurting out of the blue and none of my PT stuff was working on it or none of my colleagues could figure it out. And then this class 30 seconds of work fixed the issue and that's really where my excitement for this career path and the specification of pelvic floor therapy came in. So, yeah, I did that workout in Wyoming and opened their pelvic floor specialty like program and did that for about five years and then moved to Maine and decided it was time to do it on my own and open my practice.

Angela:

I love that you were able to figure out what was bothering you.

Dr. Emily Wilson:

Yep, and luckily it was only like a week or two of pain and then I was perfectly at the class and it just like set me up to like understand how pivotal this part in the body is and how I mean to me. It just feels really empowering to help women or individuals come back to themselves and feel in charge of that space in their body, like they have the autonomy to heal.

Angela:

So, for anyone that might not know, would you break down what even is your pelvic floor and why would someone want to go to pelvic floor therapy in preparation for birth?

Dr. Emily Wilson:

Yeah, so we all have pelvic floors men, women, children, beings which they are a group of muscles that function in the pelvis almost like a hammock or a sling holding us up our whole life, right, so there's a contraction would be, I think, of it like a trampoline, right, a contraction it would come up like a trampoline, or Kegels we call it, and then a relaxation or softening to me would look like it's coming back to a hammock, and we need that full mobility, that up and that down, to have good structure in our pelvis, to have good support of our organs, to be able to hold our pee and our poop, to be honest, and then pleasure, right, that's a part of it too, to have the ability to feel in this space. And so a lot of my patients are coming in and the muscles are, I would say, stuck more in this trampoline pose or tension, because the body's holding something in our root and that's when, I find, then the dysfunction starts to happen. So I see such a breadth of symptoms, but anything regarding the bladder and I'll list them real quick, just so like it's not going to be have to go Urinary leakage, but the opposite urinary retention, having to go to the bathroom and push your urine out. You can't urinate the way you want. Bladder pain is another big one. That's kind of the bladder symptoms. Bowels leakage there as well, constipation pain, hemorrhoids can be a sign of pelvic floor tightness.

Dr. Emily Wilson:

I also see a lot of digestive issues and like strange abdominal pain that doctors don't know what to do with. I find that there's a lot of visceral restriction or scar tissue or fascial restriction in the abdomen. So I do see a lot of. I think they're kind of fun like to puzzle, piece what's going on in the abdomen and then uterine. I see a lot of endometriosis, fibroids, cysts. I also see abnormal periods Sometimes that can change quite a bit with our work. Fertility issues prolapse, the bladder can also fall. That's called a cystic seal. The rectum can also have movement and then I think the biggest thing I see is pain with intercourse or pain with touch and I also see with that intertwined and that's where I bring in this like psychosomatic piece of the puzzle is like the trauma and what our body's holding. So that's kind of the quick breath of what I do.

Dr. Emily Wilson:

And for pregnancy and postpartum the pelvic floor can get stressed from being pregnant.

Dr. Emily Wilson:

So most people I find are holding some kind of residual tension, but it's not enough to signal a symptom or it does start to signal a symptom to you Sometimes.

Dr. Emily Wilson:

That signaling starts to happen in pregnancy because the body's under extra pressure and stress. Your bones are softening and getting ready for labor and delivery, your belly's growing it's the biggest expansion and surrender and I find that the pelvic floor can be a little bit upset during that process so we can have increased back pain, can be from your pelvic floor, the leakage can start. The bowels can be a little bit funny. I mean there's a baby taking up space in there right and so a lot of the work I do in pregnancy is getting ready for labor and delivery and helping the muscles and the tissues be as supportive without being held in that trampoline as that like stiff tension. So I love that we can do both. We can make people more comfortable during pregnancy and all of it's getting ready for pregnancy or labor and delivery. So it's kind of fun that both are happening at the same time for that big expansive event.

Angela:

Yeah, so how does pelvic floor therapy really help as our bodies are changing throughout pregnancy and as we prepare for birth? I feel like there's a lot of mixed information out there on this topic.

Dr. Emily Wilson:

Right. So as the body's changing, I mean we first get that huge hit, that huge surge of relaxin, which is that hormone that's starting to help loosen and soften the pelvis. That's happening in the first trimester, that surge of it, and then it's sitting in the bones and the tissues and allowing the ligaments of the pelvis to be able to soften and relax throughout the rest of pregnancy so that we're ready for that when birth happens. So even that change, people can start to feel shifts and changes in the sacrum and the pelvic floor. And as the bones are shifting, that's when the pelvic floor can become stressed, maybe because of an imbalance or a way you're kind of a movement pattern you've adopted, especially with like walking in a funny, like like that waddle right that can like make changes in the pelvic floor. And so usually what I'm seeing is the pelvic floor gets a bit stressed and either it's been in their history or it's new. That either way Right. But if it's been in their history of pelvic floor dysfunction, they're going to probably have more symptoms show up during pregnancy. So I'm really not finding to talk about like the myths or the things we're seeing online that we're not sure if they're right or not.

Dr. Emily Wilson:

I'm really not seeing people have like weak pelvic floors postpartum or during pregnancy, and I think the common misconception is that we should Kegel all the way through our pregnancy and after and like. That's like the saving grace. That was a male doctor named Kegel thought that was like the solution for the world Right. I'm finding that most of my patients are stuck in tension and they actually need to down-regulate or do like a reverse Kegel is what it's called and so, learning to attune to the nervous system, can we relax and soften these muscles so that they're not as tight and stiff? Because that could, like I said, cause pain, discomfort during pregnancy, but then also for the big event for labor and delivery, the muscles of the pelvic floor aren't pushing your baby out.

Dr. Emily Wilson:

The uterus is doing that job. The muscles have to just open the doors and get out of the way Right. But if you can't soften and relax into that reverse Kegel let's call it, then it's going to be really hard for that baby to kind of continue downward and that's where that hardest part of like relaxing through the contraction comes in. It's like feels like impossible to do, but that's where that's coming in. It's like how can we soften and open the pelvic floor? And I find that patients that are getting the work done in pregnancy are having an easier time with that and having less tears or no tears, which has like been a really fun trend lately in the clinic.

Angela:

That's awesome. So you have a lot of different exercises that you recommend to people, different tricks that you try.

Dr. Emily Wilson:

Yes, there are many tricks and it's so individual to the person.

Dr. Emily Wilson:

And then I just want to add that most people also think that too loose and weak happens postpartum, and I think it's just important to note like most of what I'm seeing is the body having a reaction and a tension pattern.

Dr. Emily Wilson:

So let's say you had a, someone had a shoulder surgery, right, they're usually not walking around unless it's dislocated with it, just like hanging and floppy and weak, right. Usually they're like holding their shoulder in a sling, their shoulders to their ear, everything's protected and guarded and they come in and they're like now my neck hurts and now my head, my headaches are happening, now my shoulder blade, and so it's like the spreading cascade of tension. Well, the same thing can happen postpartum. Even with a quote, unquote non-traumatic birth, right, the body can still be like what just happened and suck everything into that kind of Kegel or tension pattern and hold that stress in that area. So it's really I would go to a PT to decide if you need to do Kegels or if you need to down train. And it's hard to get that answer unless someone like looks at your tissues and tells you what's happening.

Angela:

Wow, that's really interesting. So what kind of role does breath work play in pregnancy and as you're preparing for and during labor and birth?

Dr. Emily Wilson:

Yeah, so the diaphragm is like your breathing muscle under your rib cage, right, so under the sternum, following the ribs, and it goes all the way around 360. The diaphragm matches the pelvic floor, which is also considered a diaphragm, so they move together. So every time we inhale our lungs get bigger and spread. The diaphragm has to descend downwards towards the belly button to let and make space for air to come in. The pelvic floor should copy and do the same thing where it's coming down and softening into that hammock or that relaxed position. And then every exhale there's a slight movement upwards. So the diaphragm comes up and the pelvic floor comes up, almost like a Kegel, you could say, or that trampoline pose. So we want that, we want that like some pump action and that mirroring to happen to me. Just let's talk outside of pregnancy for a minute. That's just helping, and during pregnancy, but it's helping move fluid, lymph, blood circulation is happening with that and then the muscles are getting that chance to like, contract and relax. And it's a small level, smaller than if you were to voluntarily squeeze like a Kegel, but that's just helping the system stay healthy. When the diaphragm is tight, you can usually see that the pelvic floor is matching that with tension. So it can even be left-sided right, where it's like the left side of the diaphragm, let's say, is tight because your baby hung out more on that left side right. Every mom knows like, yes, my baby kicked me and they can usually remember for me what side they kicked on. Like, oh yeah, that baby always hung out under that left rib and kicked me right there, right and so, and even if you don't remember, I can feel it. But that imprint creates the diaphragm to go up and almost get stuck in an up position.

Dr. Emily Wilson:

So it's really common that women are losing that full breath pattern during pregnancy, right, we all talk about, you know, third trimester. It starts to get hard to breathe and that kind of that impacted feeling right, like baby's taking up so much room, which is so cool, and I would love for you both to have space. You'd be able to breathe and baby have space to move so we can go in. And during pregnancy we could start to soften that diaphragm and open things up so that it has more room. Mom feels like she can breathe and then pelvic floor feels like it can move and relax.

Dr. Emily Wilson:

So I'm looking at a lot of that during pregnancy. The other thing to note is if the back of your body so let's say like the spine where the diaphragm connects to the posterior diaphragm, if that's tight, it's now very well researched and seen that usually your pelvic floor in the posterior part so we're talking about like towards the rectum, but it can be vaginal or anally that those muscles would be tight and protective. And so, yeah, matching and understanding where the tension is and where the body's substituting or compensating and then opening up those patterns so then people can breathe, because if you can breathe then you can help breathe your baby out for labor and delivery.

Angela:

Right, so you do a lot of preparing moms for birth through all different ways. Yeah, how often should do you recommend like that someone should see a pelvic floor therapist throughout their pregnancy or even postpartum?

Dr. Emily Wilson:

Yeah, I really make it patient dependent, and so I have some people that work with me in preconception and have a history of pelvic floor issues and so they get pregnant and some of them it's like I think you're doing great, your body's responding well, let's just check in once a month and they really like that spaciousness to kind of grow and expand, that spaciousness to kind of grow and expand but also to be like held in that timeframe. I've also had patients where they get pregnant and they're still healing from, let's say, a revision surgery with between, like the of the perineum, like a pretty big scar, and, yeah, reconstruction surgery. I like to kind of see them a little more frequently in the first trimester to do as much scar work and opening of the tissue as possible so that we're preparing for, if it's a possible, possible vaginal birth. We're preparing for that to be as easy as possible. But for the most part, if people are doing pretty well, I say call me when you have pain or when you whichever comes first or when you're like right on the brink of that third trimester is a great time to start coming in If you haven't needed the services yet. And then I like once a week at that point, if I, especially if I haven't seen them in the beginning of pregnancy. So we're understanding how their body's working. We're making sure the pelvic bones are ready to open and expand because just as much reorganizing and movement a baby does with their skull and their bones, mom does just as much opening and expansion of the pelvis. So we can make sure that, one, you're more comfortable, like I said before, but then two, the bones are ready to expand and that the muscles of the pelvic floor are ready to do that. So I usually do that till about 34 weeks, at 36 weeks. I love this is Tammy Kent's work that I do. She has multiple books that are wonderful and I've learned hands-on from her. She opens the birth portal and so I also do that in my work. It's something that can be done at 36 weeks. We try not to do it before then because we want baby to stay put and grow and stay in the womb as long as possible, right Till it's time. So what this birth portal does it's an energetic preparation for a baby. So I always believe our bodies innately know what to do. There's wisdom there.

Dr. Emily Wilson:

I do sense a lot of moms have fear and reservations and things come up Right, and so what we can do first is look at the pelvic bowl or the pelvis in their mind's eye. This is a meditative practice coming up. Are they holding fears? Usually that's in the front of the pelvis. Is there feeling scared or a lack of support around, or lack of support around the birth and around the transition into motherhood or multiples? Is there any issues with mom or with females in their life? What about males or masculine, dad or husband or partner? What are we holding and we can start to like wash away and let baby know like these aren't about you. I'm very excited to meet you and we're ready for that when you are. But don't interpret my fear about me as a mother, about you, your arrival, right, so we can really be clear with baby that this is my healing and my work and I'm so excited to greet you. So you almost create like a blank slate and clear some of these energies which I found really helpful for moms going into labor and delivery.

Dr. Emily Wilson:

The muscles themselves. Even though this is all external, this meditation, the muscles will soften at the same time because if we're, the muscles of the pelvic floor tell a story somatically of what your body's holding trauma, limiting beliefs, feelings, unprocessed emotions right. So as the body finds safety, you name it, you tell the body I'm listening, I'm here. It will soften and open, yeah, and then, after we clear and make that blank slate and get ready energetically, then we can check in with baby. And if baby wants clear and make that blank slate and get ready energetically, then we can check in with baby. And if baby wants and is excited, we can practice what a birth would look like.

Dr. Emily Wilson:

Right, so we can feel baby's energy, we can feel the birth portal open. I'm sure you've probably felt this, but anyone who's given birth or been to a birth, to me it feels like this liminal space kind of opens up this like stopping of time, and then we meditate on baby's energy traveling down through the waves all the way to the cervix the cervix opening, softening, moving your pelvic floor, getting out of the way and baby's energy coming through your body and then landing. We get to imagine baby landing on your chest for the first time, meeting that baby and looking into their eyes and feeling the support of a partner, if they're there, or supporting birth partner yeah, it's just, usually it's full of tears and people feeling into their strength as as being as a woman, as a mother, and that feeling then gets to be transferred over to the birth Right, and so it's just a nice way to open up that space and call in baby, but then also meet your power, meet your like inner lioness is kind of how I think about it.

Angela:

Yeah, I love that the mind and body are so connected. So for a couple of postpartum things that might come up, I know a question that I get asked a lot is what do I do to get my pelvis to go back to the way it was pre-pregnancy?

Dr. Emily Wilson:

Yeah, the bones can feel different postpartum right, because they've expanded and they're trying to find their way back. Sometimes they need help to find that compression. So bands can work like belly bands. It's a sucked in feeling, it's a compression feeling which can feel really helpful. I would say my caveat with that is to not wear it all the time. I also want, even with like a belly binder, I want your abdominal muscles figuring it out too. But let's say you're going for a walk for the first time, or maybe it's a walk like that's a little hilly or a trail and you're bringing baby Like why not, if it feels good to have that compression, create a little bit of a hug for the nervous system and the body to kind of feel supported. That could also be copied with a scarf. Kind of feel supported. That could also be copied with a scarf Like honestly, you could take a scarf around your low pelvis and tie it around and see how that feels to have that hug.

Dr. Emily Wilson:

The other thing that I hear of and you know this is famous in many cultures but closing of the bones ceremony, and there are quite a few women performing these in Maine and they can come to you, to your house and use ties and scarves all throughout the body, but especially the pelvis, to help close those bones and close the birth portal A few weeks to a few months postpartum, like when you're ready to kind of ground your energy back in. A few months postpartum, like when you're ready to kind of ground your energy back in, and that's I don't do that exact ceremony but I do that same work of like rebalancing the pelvis and bringing the bones back to themselves, cause yeah, we have to somewhat close that portal after and sometimes to recognize if it's still open, you can feel really open and almost raw and vulnerable in the real world. So I've I've heard this quite a few times with moms that are like anxious to get out and about in society and they take their baby out and baby's fussy and mom feels overwhelmed, right, and it's like maybe only two or three weeks postpartum like that probably means you're still so energetically open from literally bringing a soul into the world. So I like to do that work like eight weeks postpart, and also the ribs to heal and kind of come in and create that stability and that new breath pattern or return of a good breath pattern. So it's all possible.

Dr. Emily Wilson:

Most people need a little bit of help. I think of it as like reorganizing or refung shwaying the place, like even the organs. Like I said, the diaphragm can be pushed up, the stomach can be pushed up, we can have some organ memory of when baby was in utero, and so it can be really helpful to have someone who knows visceral work or organ work. Is what that means? To help the nervous system exhale, to help mom feel like she's herself in her body, like that's my biggest goal. Postpartum is like let's hold the mom, not just the baby, and let's make you feel safe and comfortable in your body again.

Angela:

Yeah, that's amazing. So to get into one other postpartum issue that I feel like comes up a lot, the diastasis diastasis recti. I get asked about this from moms that have even had the closing of the bone ceremony and are a year or more postpartum and are still having some of these issues. Would you be able to share your thoughts about this?

Dr. Emily Wilson:

Yeah. So diastasis, diastasis, dra, however you want to say is perfect, I don't think there's a right way. We actually have had a poll and PTs are like want to say is perfect, I don't think there's a right way. We actually have like had a poll and like PTs are, like I say it, different. You know it's like it's however you want to say it, but essentially what it is is it's the rectus muscles of the abdomen. This is like our six pack muscle. There's a lot there.

Dr. Emily Wilson:

When someone has a six pack, there is a line in between it, your linea alba, and as the pregnancy happens, that can stretch apart. Especially if someone has like a joint laxity or ether stand loss kind of diagnosis, there can be more stretching to the tissue. So it's pretty common that women are going to get some kind of stretching or separation during pregnancy. Things you can see this happening is you would lift your head up and you maybe see a coning or a divot in the belly. Usually it's a coning when pregnant, like it's like someone's kind of punching up through it and you know it's not the baby punching you at that moment and that's the muscles and the tissues trying to gain strength and trying to course it.

Dr. Emily Wilson:

But having an issue with that, so things to avoid it during pregnancy or avoid severity of it, is sitting straight up out of bed, I would. I would tell people to roll on their side and then sit up they call that log rolling Um and to not do sit-ups, not do crunches. After you know, after into the second trimester, I would stop um, anything that's really tugging those abs open essentially.

Dr. Emily Wilson:

So and there's some taping and some things we can do to prevent it during pregnancy. But I say it's pretty normal If you have it postpartum, most women naturally heal it on their own, just from life and the way the body knows how to mend it and heal itself. Some women, like you said, get stuck with that symptom where they still lift their head and they usually it's not coning as much anymore, usually more it's a divot or a separation that you can feel. So when we're testing in the clinic it's how deep is that hole or how deep is that gap? And it can happen above the belly button towards the sternum and it can happen below the belly button. It's a little more common above the belly button. So I see it heal pretty well, even years postpartum, when someone finally gets some work and some fascial rearranging is how I think about it.

Dr. Emily Wilson:

So when you're pregnant you're in that lumbar lordosis. The back gets really arched right, belly's forward, belly's stretching in the front and the back gets kind of tight and the tissue kind of crunches there I don't know if crunches is the right word, I don't know. You get the picture. Yeah, it like, yeah, it stays there and so that stays postpartum unless we start to work on it.

Dr. Emily Wilson:

So I do a lot of opening of the fascia and the low back and the lumbar region and helping bring the tissue around. Helping to open the obliques on the side of the abs and then bring closure to the front. Tape can help with this but manual work, helping to teach those tissues to rejoin. But typically it's just a rearrangement, like we need to just get the tight tissue that has excess in the back to come around and close on the front. So I see quite good results with the work I do on that. Some people it's rare but some people, especially with like multiples, sometimes they have to get a surgery for it. But that's not my first suggestion. I would suggest doing anything you can therapeutic-wise in the abdomen before a surgery.

Angela:

Now I'm also wondering about prolapse. Is this something you're seeing often and, if so, what is the most common type that you're seeing?

Dr. Emily Wilson:

So a classic prolapse, or when they say the word prolapse it's used sometimes it's used a little more generally so only the uterus can prolapse through its own canal right, so the uterus will come lower.

Dr. Emily Wilson:

Call it uterine prolapse. The rectum can also prolapse through its own canal, so that's when, like, the rectal tissue would start to come out of the anus. When we have a bladder issue, a lot of people just refer to it as a bladder prolapse. It's a cystic seal is what it's called. So it means the bladder is pushing into the vaginal canal right, it's moving like from front to back and it's falling down. So some people talk about getting slings for that or having a surgery. The rectum can have what's called a rectal seal, so same seal as the ending. It means a movement of the rectum into the vaginal canal, so it's like ballooning or bubbling into the rectum. So those are the three types or four types I guess I named. That can happen. I do see uterine prolapse and cystic seals and rectal seals quite often in the clinic. If you're postpartum, newly postpartum, there's a great chance that with a few months and some therapeutic work and managing your pressure well and what I mean by that is picking up your baby in like a squat or a deadlift with an exhale when you go to pick them up. So learning how to brace and control your abdominal canister so that you're not forcing pressure out of the weak spot AKA the pelvic floor, so that would just mimic and create that downward movement which can create a prolapse when you're immediately postpartum. Or, let's say, pushing might've caused something like that right, so it can happen during labor and delivery. When you're postpartum, the uterus is shrinking so much and it takes months right Like a good solid three months to see like uterus come back to size, but I really think it's like a whole year. Postpartum is how the tissues are kind of condensing and strengthening and coming back into their space and their homes. So if you're newly postpartum and you're feeling it, there's a great chance that it can be healed pretty well. But I would definitely seek someone out when you're feeling symptoms Like I feel like something's falling out of me. I feel like, especially when I wear a baby or when I pick something up heavy, I feel a lot of pressure down there. And I also want to say that I have had patients feel that exact way and I do an exam and their midwife does an exam or their gyno or OB and it's not a prolapse, it's just your pelvic floor muscles are tight. They can cause an achy falling out sensation. If you're touching tissue right, if you're like vaginally in the shower and you like touch the tissue and it's coming out of you, I would say that might be likely a pelvic floor or a prolapse bladder or uterine. So it's possible but it's really healable in those early stages. I've definitely seen people with prolapses without babies that have never been pregnant or given birth, and I've also seen them years down the road from the pregnancy postpartum timeline. Essentially, what's happening is it's not just the uterus dipping down because of laxity of the ligaments, it's like the uterus kind of turns itself inside out and the cervix grows longer. So the assessment is me, vaginally people feel open to that feeling the length of the cervix. To be able to tell, like, how much the tissue is falling in on itself, I guess, is a good way to put it. So I've.

Dr. Emily Wilson:

I just studied under one of my new favorite mentors. His name is Martin Badeau and Badeau Bodywork is the name of his work. He taught a method for healing prolapse. I mean in the eight years of extensive pelvic floor study, studying under pelvic floor therapists, I had not had training like this that got to the root and healed a prolapse. So with his work you release the abdomen, you release the pelvic floor muscles and then you create a suction technique to help pull the uterus back into place and it, like, brings her back into position.

Dr. Emily Wilson:

I think sorry, I think of the uterus as a she, but think of gender, however you want, or non-gendered, that's just my, my connection with me.

Dr. Emily Wilson:

So I've seen the uterus fully resolve even a grade three prolapse, which is pretty low, which is fabulous. I think there's a tendency, especially in America, when women are having a grade three or four prolapse, to send them to surgery, and I'm seeing this method fully reduce a key like not all the time, but it can fully reduce the prolapse. And the big thing to think about with prolapse, or the big thing I think about, is what's happening above. Sometimes the liver is low on the right side of the body and then the organs are repositioning and creating a cascading event that puts pressure on the bladder or the uterus. So it's really like piecing and puzzling the whole body and getting the story and then helping to bring that uterus back into place tightening ligaments with some like cross fiber work if needed, it's healable. Yeah, other people wear like pessaries. But I think if you can, if you're close to someone who practices under Martin's work, I would go see see them for some pretty revolutionary prolapse work.

Angela:

Wow, I think that's so good for moms to hear about, because when you have, especially, a hospital birth and you're not, you know, getting the home birth like midwifery birth and you're not, you know, getting the home birth like midwifery care, you're really not getting a lot of postpartum support. You're going back in six weeks and you know it's not always a long appointment and getting into all of the issues. So if moms are having some of these things to go and find, you or someone like you to yeah, really really can help some of these things. And it doesn't necessarily mean that things are actually coming out. It can just be things are lower inside of your body too.

Dr. Emily Wilson:

Or the pelvic floor muscles are tight right, or I even have people that just come in and get like a checkup. How's my body doing? Help with a few things, an appointment or two, and I find that that if we spend more time treating women, postpartum and moms, that makes a world of difference. These are little things that accumulate into big things over time. They kind of snowball on each other.

Angela:

Yeah, so now to get into some of the birth trauma work that you do. Can you share a little bit about that?

Dr. Emily Wilson:

Yes, so I think there's not a lot of therapists that like outly say they do birth trauma work In my field. I think we all have to be somewhat prepared. I have found a passion in it, so I have dove into that world and explored and created and flourished in that world. So and I always think, like you don't really pick trauma, like trauma picks you. So I've found that including that in my work I mean just even hearing a birth parent talk about their story you can start to pick up threads.

Dr. Emily Wilson:

If there were trauma and I will say it can be a standard birth that there was quote, unquote, no issues and you can still have trauma if you didn't feel in control, if you didn't feel like you could use your voice, if you felt like your body wasn't your own in that moment.

Dr. Emily Wilson:

That can all feel disassociating and traumatic. I will also say there can be something that's happened in the birth and that can feel traumatic. It could be as simple as one of the providers didn't feel good for you in the room, right, and so I find women a lot, they feel like their baby, their baby's, okay, they're okay. It's almost like they dis right or right off the trauma that happened Right, cause we hear that a lot and I don't think women are being nurtured in this way, typically where. But you're okay, right, even hear that a lot and I don't think women are being nurtured in this way, typically where. But you're OK, right, even even people answer that way via text, like I had the baby. This was really hard, but you're OK, like I can just writing it off is not working, yeah.

Angela:

I so agree.

Dr. Emily Wilson:

So I just want to like really see people and hear them and let listeners know, like if you felt like it was traumatic, it probably was and that's okay. That's okay to like admit and create space for healing, personally or with a professional. So it's a range of birth trauma that I see and it's a range of when I see people right. So some people come in and they want that healing pretty immediately in the postpartum Typically I'm seeing it People want to wait and process a bit and do some of their own work and get through that like acute postpartum phase with trying to figure out how to take care of a baby, and then they want to come in before the next baby they want to have, or they want to come in after, when they're feeling just a little less charged about it. So it's really when and how you want to do it Right. So it looks so different on every person, but we can. We can like replay and redo any of the scenarios in a meditative or kind of a meditative practice so you can reclaim your birth and let your body know and your brain know, and even baby will feel it in their nervous system that it can go differently right. So you. So I do a lot of work where it's bringing the baby through that like birth portal, like we talked about in a very similar way, and baby coming through without the getting stuck or the person in the room and the woman or the birth person standing up and voicing their opinion. If they needed to, or if they were in fight or flight or freeze or fawning, they can like take charge or have someone in the room that takes charge for them. So we can start to rewrite any of these patterns that this person is feeling were traumatic and and recreate that like that euphoric feeling of birth or that like that beauty of birth. And sometimes it's not just the birth, sometimes it's the postpartum. So I've had patients where baby gets taken away immediately for a diagnosis or an issue and that abandonment happens and we didn't get that connection, that that closeness and that can feel, that that could feel awful, that's trauma, right. So we can replay and reprocess that golden hour. And, and to take it further, I will say that I've seen that stored in scars, so scar tissue from like C-sections, so a mom being separated, baby putting immediate baby being put into immediate surgery, that energy got stored and held in the scar tissue and she came in eight years later and it was debilitating back pain at that point, right, and we go in to do the scar tissue work which I do.

Dr. Emily Wilson:

A caveat, or side note I think a lot of people are doing superficial scar tissue. Well, I'm not hearing many professionals talk about the deep, intricate, like intricate organ mobility with scar tissue work, right, and so I think of scar tissue like tendrils or, yeah, tendrils is a good way to put it. The body creates these anchors and that can attach. So that can attach back to the rectum, to the intestinal system, the digestive system, the low back, the sacrum, the diaphragm, anywhere it can connect to. And I'm finding that that's holding a story. So if we go in and we do that deep, deep work to unwind the scar, yeah, usually some tears and some processing comes up, but finally the body is unwind the scar yeah, usually some tears and some processing comes up, but finally the body is in a safe place and the body can unwind and move through that trauma and then the patient's scar starts moving better and they get off my table and they don't have back pain anymore. Like you connect the two and that's where, like, the magic of my work happens.

Dr. Emily Wilson:

To me it feels like magic to help women reclaim and get those moments back or rewrite them.

Dr. Emily Wilson:

You can rewrite your story and then I'll add real quick that it can you change your nervous system. When you do that, you go home and your baby or kid at this age right, however old, they feel that shift in your nervous system and they mirror back the change. So you healing your birth trauma will heal the whole family and it will help the baby process their own birth trauma. There's medicine for that too for to do with your kids and help them process and talk through your birth with them. And help them process and talk through your birth with them. But even just you doing your work and showing up, I've seen moms that their kids totally change from cautious and shy and won't play in the playground and jump off things to like we replayed their birth, healed the trauma. The kid is adventurous, almost outruly, and she's like great. I love that. He's like talking back for the first time. He's never done that. So it's so neat to watch the whole family dynamic shift as you reclaim your birth story for yourself.

Angela:

Yeah, that's amazing. So now to wrap things up, I'd love to have you share an overview of the different types of support that you offer to families here in Maine, or even virtually. I know we've talked about some of the things, but, yeah, that you offer to families here in Maine, or even virtually. I know we've talked about some of the things, but, yeah, if you could just give an overview of, maybe, the different packages that you have and specific ways that we can work with you.

Dr. Emily Wilson:

Yeah, so mostly I'm doing hands-on, one-on-one sessions in the clinic. There's something about having my hands and feeling the energy and intuiting and using that kind of somatic trauma piece that feels really just yeah, magical. So that's kind of the bread and butter. The most of what I do is hands-on work in the clinic in Yarmouth. I also am open to doing online work with women and again it's like full spectrum of ages for a woman or a female identifying person.

Dr. Emily Wilson:

But it's a lot of hands-on body work. So a lot of unwinding tissue, listening to the body, really trying to help women come home to themselves. Typically there's I see women as not feeling safe in their bodies from multiple experiences right Birth being one of them, that can happen and so finding that safety to really be embodied like feet on the ground in their body, feeling their body when women feel disconnected, that's kind of one of the symptoms. That kind of lights a pings to me. We need to do some work to come back home. So it's a lot of energetic, somatic trauma work mixed with the hands on body work, and it's really created for how, for how you need it and what you needed.

Angela:

So what would a first appointment with you look like typically?

Dr. Emily Wilson:

Yeah, so first appointments can be one hour or two hours. I'm kind of switching my practice to longer two hour appointments that are a little more spread out and I think that's helpful for the nervous system. So sometimes I get to the end of an hour and it's like like your body was just opening and letting me in and you were like just landing from, like whatever you were going through 10 minutes before you walked in my appointment and it's like now we got to do it next week, you know. So I'm just finding the slower paces better. So it could be two hours, it could be one hour.

Dr. Emily Wilson:

Essentially, what happens is you do an intake beforehand. I look it over, you come in the office and it's talking. I want to hear your story again. I want to be able to take notes on the energies that I feel and what's happening physically and emotionally. And then we do education of the pelvic floor. I wish it was taught in all sex eds Like why are we not taught this in high school about the uterus and the pelvic floor and the body and what's going to happen during pregnancy and birth and what we'll be working on? So people really get to see with a model like here's what I'm working on.

Dr. Emily Wilson:

I like that visual, like I can see what's happening, the trampoline and the hammock, and we're going to, we're going to figure it out together and I explain an exam. We go through what feels comfortable. You get to choose right. You're never forced to do internal vaginal work but it can be a really nice addition to the work. And then it's an exam.

Dr. Emily Wilson:

So the sensei, I want to look at organ mobility, fascia, breathing bones, pelvic floor, if you feel open and we're ready, and then just kind of I'm getting a sense of the body, of what it needs energetically as well, and then usually then it's exercises. If it's an hour and people go home and I see them next week, but if it's two hours, then we get like a whole other hour to like really dive into the treatment and see some changes in the body and feel the difference in the body. But I always say one hour is great too If you're like postpartum and you're breastfeeding. That's a good timeline for getting back to baby or you can bring baby and I have a lot of moms who nurse while we're, while we're working.

Angela:

That sounds amazing. So what are the best ways for people to get ahold of you?

Dr. Emily Wilson:

Yeah, so again, my name is Dr Emily Wilson. I am located in Yarmouth and my business is Pelvic Wisdom Physical Therapy. So my website is pelvicwisdomcom. That is a great way. And what else? Instagram? I sometimes post on there it's pelvic underscore wisdom.

Dr. Emily Wilson:

Yeah, I took a little time to kind of redefine to myself that my life doesn't revolve around Instagram. I'll get back to some educational things and then, yeah, those are the best ways. I do have Facebook to pelvic wisdom, so those are all places to tune in. And then, yeah, I do want to like start creating more classes. I have ideas in my head.

Dr. Emily Wilson:

I'm just recovering from a rough start of the summer, so eventually I want to teach a class on pleasure and pleasure points in the body and really teach women like the medicine is within us, stimulate the body to help heal cysts and to help heal other things in the body. And like create more feeling right. A lot of people feel numb or disconnected. So pleasure as medicine is something I want to do soon, probably in person start, maybe online. And then I have some more coursework I want to bring out into the world when it feels right, but all about that embodiment and kind of connecting with self in a group of women. So if that sounds interesting at all, follow my Instagram or you can enter my newsletter on my website, and that'd be a great way to stay in touch.

Angela:

Awesome. Yeah, that sounds amazing. Well, thank you so much, dr Emily Wilson, for taking the time to chat with me today. It's been such a pleasure hearing about all of your wisdom.

Dr. Emily Wilson:

Oh well, thanks for having me, I appreciate it.

Angela:

And that's the end of another episode of the my Main Birth podcast. Thank you for joining me and listening. If you're looking to document your birth story or if you're interested in doula support for your upcoming birth, head over to my website, mymainbirthcom and check out my packages. I'm a certified professional birth photographer and an experienced doula, and I offer in-person services to families throughout the state of Maine, as well as virtual birth coaching worldwide. I want to invite you to grab my top free resource for newly pregnant moms. It's called 37 questions to ask your care provider, whether you've already established care or if you're in the process of interviewing new providers. This is for you. Not only are you going to get the questions to ask, but I also share how to assess their answers and the major red flags that you should be looking for. So go grab that. It's at mymainbirthcom slash download. Thank you again for tuning in and I look forward to bringing you more amazing birth stories. Don't forget to subscribe and leave me a review, and I'll see you back here again next week.