EPISODE #49

Healing After Childbirth

In the first episode of our Sex & Parenthood series, Dan Savage and Jane Marie agreed that any parent who isn’t ready to have sex within the first year of parenthood should get a pass. But what if that year comes and goes, and you’re still in pain from a childbirth injury? (Psst! if this is you, we hope you’ll send us a question for our Google Hangout next week! Details below.)

LST listener Sadie gave birth 10 months ago and had a severe tear.

Sadie's family one minute postpartum

Sadie’s family one minute postpartum

Sadie's family now

Sadie’s family now

Sadie’s gotten mostly better but sex is still painful enough that she has to talk herself into it every time. In this episode, she describes the physical and mental impact of her injury, and her reluctance to look for help because she’s afraid of being told that this is a good as it gets.

Dr. Hollis Herman

Dr. Hollis Herman

Sadie actually has a lot of options—there are many different kinds of specialists who treat childbirth injuries. One possibility: pelvic floor physical therapy. Yep, physical therapy for your pelvis. And just like a sports physical therapist can help get a basketball player back on the court, a pelvic floor physical therapist can help get a mom back in the sack. We talked to Holly Herman (left), one of the field’s pioneers, to find out how.

Tune in to get the nitty gritty on why your body can feel so beat up after childbirth, how it can be fixed, and Holly’s surprising tip on what to pack in your go-bag for the hospital or birth center. (I promise, nobody else has told you this one!)

How to find a pelvic floor PT
If you want to try out pelvic floor physical therapy, you can find a certified therapist through the Herman & Wallace Pelvic Rehabilitation Institute, which Holly founded, along with her colleague Kathe Wallace. You can also go to the American Physical Therapy Association.

Books on healing your pelvis
Holly’s favorite books for understanding childbirth injuries are Heal Pelvic Pain by Amy Stein, Healing Painful Sex by Deborah Coady, and Sex Without Pain by Heather Jeffcoat. She also likes Penny Simkin’s When Survivors Give Birth for moms who have survived sexual abuse and other vaginal traumas.

GOOGLE HANGOUT: Streaming live right here on Tuesday, February 10 at 2pm ET
We know that lots of you are just grinning and bearing it through the pain. Or maybe not even grinning. That’s why we’re doing a Google Hangout with pelvic floor physical therapist Debra Goldman, who studied with Holly Herman. If you’ve got a weird pain that won’t go away—from a tear, an episiotomy, or a C-section—or you can’t stop peeing your pants, or it hurts every time you poop, tell us. Really, there’s nothing that will faze Debra. Just leave us a detailed comment about how you got your injury and what the problem is now. Anonymous is fine. We’ll pick our favorite comments, and Debra will explain what might be going on, and how typical injuries can be healed. If you miss the live stream, the video will be archived here, too.

We thought you might want to get to know Debra a little bit before the Hangout, so we asked her to put together a list of her favorite home remedies for pelvic pain. Think of it as your starter kit to a pain-free sex life.

Seriously, tell us what’s up with your pelvis.
Have you gotten help? Been too overwhelmed or scared to even try? If so, what’s hanging you up? Let’s talk, people. There are too many hurtin’ pelvises out there, and they’re not gonna get any better unless we start talking about this stuff. Go.

Top illustration: The Open University

96 thoughts on “EPISODE #49: Healing After Childbirth

  1. I recently discovered this podcast and am so thankful for it. I am 9 months pp and have not had sexual relations with my husband for over a year. I have a long history of endometriosis with numerous surgeries. I had an extremely tough time becoming pregnant to the point that we purchased donor eggs. As sometimes happens I found out I was pregnant naturally a week after our big purchase. Needless to say my pregnancy was very difficult. I had to have a c-section due to medical reasons and although it has been 9 months I still feel so uncomfortable most days. I feel as if my insides are going to fall out, my back is painful and I am incontinent at times. I wish I had known of all of this before hand, not that it would have stopped me from having a child but at the very least to mentally prepare myself. Why are these things never mentioned? It is such a life altering experience and can at times bring about anxiety and depression. I just want to be normal again…my kind of normal. Back to what I wanted to say, thank you for these podcasts. They are so informative and helps me realize I am not the only one in what sometimes feels like and isolated situation.

    1. I had that same feeling that my organs were “falling out” almost like when a tampon is too low. I think you would definitely benefit from the pelvic floor PT!

  2. I wish I had seen this when it aired originally. I had a daughter June 2014 and waited patiently to be able to have sex comfortable for several months. Then more months, then it was well past a year and I still had terribly pain. Everyone says your vagina stretches out, but mine was incredibly tight and no amount of lube, relaxation or wine was gonna make sex enjoyable. I finally decided this can’t be normal and talked to a general practitioner who didn’t know what it could be. She sent me to an OB who couldnt find anything wrong during an exam. He referred me to a pelvic floor PT and it has helped tremendously. She said I was suffering from muscle spasms on part of my vagina which made it unable to stretch open for penetrative sex. In CA it was even covered by my insurance and I have generally resisted going to doctors because where I’m originally from everything costs extra and I usually can’t afford it. It felt so good to talk to a practitioner who understood what I was experiencing and had a plan to treat it. It takes time for everyone to heal, but if it’s going on and on with no end in sight, it may be time to seek help. I don’t think anything can really prepare you for the wide spectrum of “normal” when it comes to pregnancy, childbirth, and babies. I had a pretty narrow picture of what was the average experience and it was such a struggle to understand everything I experienced was just a different kind of normal.

  3. This episode was so helpful! When I was pregnant, I read “Bringing Up Bebe,” which was the first time I heard of pelvic floor physical therapy. I think had I not heard about it, I wouldn’t have even mentioned my postpartum vaginal issues to the midwife at my 6 week check. I only had a small labial tear, but sometimes I still started peeing without meaning to at that point. I had no clue if that was normal or not! Luckily, I started seeing a great pelvic floor physical therapist right after my appointment. Not only did the exercises she helped me with make a big difference, but she also helped me know what was a realistic pace for my body to heal. For example, she said I could expect to leak urine when running for at least a year (which was true, and now 19 months postpartum I suddenly don’t have the issue). It was also really nice to have a scheduled hour away from my baby every week, and my physical therapist was a really kind more experienced mom. I also wish I had seen the pelvic floor physical therapist WHILE I was pregnant for the pubic symphysis pain that I assumed I just had to suffer through. Now, I tell all my pregnant friends about pelvic floor PT!

  4. I love that you recommend Penny Simkin’s When Survivors Give Birth, but I noticed you spelled the author’s last name incorrectly in your post.

  5. I had pelvic floor PT a couple years back after spending a summer convinced I had a UTI. I bounced from doctor to doctor and by total chance I had happened upon a blog article discussing pelvic floor PT. I finally was diagnosed (and mostly because I pushed the theory), went to PT, and “recovered”! I had flare-ups of pain from time to time but now, they are very rare. Luckily, after giving birth to my daughter this past January, I had very little soreness down there. However, I did have some ongoing GI issues, so I can definitely relate to the frustration and anxiety around health issues after baby. Pregnancy is absolutely GRUELING

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