KAREN: Welcome back to the podcast, girlfriends. Today, I have the pleasure of interviewing Lizzie Kiefer, otherwise known as Doc Lizzie DPT on Instagram. She is a physical therapist specializing in pelvic floor therapy.
Therapy, so all you pregnant mamas listen up because we are going to talk today about how to stay healthy And fit and prepare your pelvic floor for a smooth and easy delivery Not only for birth, but also how to heal in the postpartum And protect your pelvic floor and all kinds of other topics. There's diastasis recti If I think I'm saying that correctly, we've got so many juicy topics that I'm going to pick her brain about.
And I'm so excited to welcome her on today and the wealth of wisdom she is sharing with us. So welcome to the pain free birth podcast, Lizzie.
LIZZIE: Thank you so much for having me. I am completely honored to be here. I love everything that you post and it was even super helpful for me through my pregnancies.
And I'm just so excited to be here and talk about this. I'm so
KAREN: happy to have you. Yeah, we were just catching up and you were telling me you found me. Something with your first pregnancy And birth which is a hospital birth and then you recently had a home birth for your second I do want you to tell our audience just a little bit about that because I think it was You have such a beautiful story in how you handled transition.
So what was what? I just like it's so fun to catch up with people who like you've been like You Following on Instagram from like a distance, and when you came on, you're like, I know. We're having a moment here. We're inviting you into our moment.
LIZZIE: Yes, completely relate. So for my first birth, I had a hospital birth And then I had thought about a home birth at the very beginning, but I was just, It was my first one. I was a little bit hesitant but looking back, I would have been completely fine, obviously. And so going into my second one, I knew in my heart that God was calling me to a home birth and it just felt so right.
So hospital birth I went through that and I still did all of the prep work that I needed to for, the pelvic floor and whatnot to prepare for pregnancy and the birth and also the mental side of things too, since, you know, going into. The hospital you're faced with just tends to be more decisions to make um, based on the interventions that they have available.
So you have a little bit more you have to think about in that sort of scenario. So mental preparation was absolutely huge for that as well. And then going into my home birth, it just was a very similar preparation experience, but the actual birth itself was very much different. Both of them were positive experiences, but They both had different transformative moments as well, but this most recent one, the home birth, there was very specific moments that even today I'm like, bring into my daily life that have just changed me as a person, as a mom, wife, friend, so much about me that was changed from that birth.
It's incredible.
KAREN: What's one moment
LIZZIE: that you can say
KAREN: changed you
LIZZIE: Yeah, so for my home birth It was one of those things with my second birth And so I had it in my mind even though I know better I had it in my mind that labor would just go a lot quicker because my first time around I labored a lot Pretty long and it was pretty intense for a lot of the labor.
So I was just thinking that this next time around, it was going to be really quick because you hear those stories. And so when I woke up at 3 AM with contractions or surges starting, I was like, okay, I guess this is happening. And that's the first transformative piece of the birth was I went into labor at 37 weeks and I had.
Things that I had planned to do with, work projects and just getting stuff ready for the baby that I had not done yet. And so it was a huge moment of surrender that, okay, this is happening. I can't, there's nothing I can change about this. The other stuff is going to have to wait because this is the moment I'm going to be in.
So there was a little bit of a mental and emotional release that I had to go through to just surrender to. What was going to be happening that day. So everything progressed rather slowly, just like light contractions throughout the morning. And as it got to around lunchtime, I was like, okay, I feel like things should be progressing.
Getting a little more intense and closer together, but they just weren't quite there. So I did multiple things to try to get things to move along. Just like walking and doing all of my asymmetrical stepping and um, I even, you know, rested and I started pumping to stimulate that part of things.
And it did pick up a little bit, but I about 7 o'clock that night. I was actually pretty frustrated because I was getting a little nervous that things weren't progressing as they should, or. Quote unquote, I thought they should. And so once I got my daughter to bed that night, I really just relaxed with my husband.
And finally, a couple hours later, I was like, you know what? I just need to go be by myself and try to get things moving. Cause they were somewhat intense, but not to the point where I was like, We're going to be having I went upstairs and I sat which is, you know, dilat we just get ourselves to floor to relax and get ev of mood and groove.
And i So frustrated with how things were going and just like this should be I should have already had my baby by now is this gonna happen? Am I gonna have to go to the hospital? What's gonna happen here? And so I was sitting there and I turned on my Christian hypnobirthing playlist and I just had this emotional breakdown I could not stop the tears.
I mean it was just everything was coming out and I just sobbed and said God I can't like I just can't Take control of this anymore. I don't know what else to do, but just to sit here and let you take over and, you know, figure out what's going to come next. And so after that emotional release, not even 10 minutes later, that had to have been transitioned because it went from zero to a hundred, my contractions were a minute apart and they were in tense.
And so I called my husband up and he called our doula immediately. She's okay give me a call back, when she can't really speak through her contractions. And so we hung up 20 seconds later, he calls back. Okay. She needs you here. And then he called the midwives right after that. Cause I was like, I want to get into the tub.
I want to get into the water. And both of them arrived and we were able to get into the water and things just progressed. So beautifully. And within an hour, my baby was there and it was just one of those things where looking back that emotional release and that surrender was exactly what my body needed to allow for the birth process to go.
And that is something that, it's not just for birth. Like it takes you into other parts of your life that. When you feel like you have a control like you really don't so Just give it up and that's when things start to move in the direction that they're supposed to but that was the biggest transformative piece of this last birth
KAREN: Oh, that's so beautiful and so true like when we struggle to have to stay in control and I feel like This the expectations we carry into birth that we're also trying to control like how the birth is going to go in our head And in your mind it was going to go faster because this is your second baby But that's not happening and that moment of release like that emotional release.
I have seen it time and time again With clients and women sharing their birth stories with me The moment we let those floodgates open and let go of all control, let go of our expectations, let go of our fears. Like we become like a puddle on the floor. It is it has a massive shift in our hormonal physiology and like baby comes so soon after that it's it's almost like our body's waiting for us to just give it permission to open and release and we have to open and release emotionally.
In order to let our body open and release.
LIZZIE: Yeah. And it's, during that day I was like, okay, I'm telling myself, just let it go. How it's supposed to let the trust the process. Like it's, I'm educated on birth obviously, but like when you're the one in it, sometimes you let these things get to your head.
Totally. Yes. Yeah. So I was telling myself that I was trusting the process, but. Internally, I very obviously was not. And so when I got to that point, yeah it's, I know that we need to be able to relax our pelvic floor and allow those hormones to flow. And like the feel good hormones to flow through those contractions in order to allow that process to happen.
And yeah, it was at that moment that things were like, okay, Lizzie, this is it. This is what you needed to do game on. So it's so cool to see. Yeah.
KAREN: Oh. I love that story. Thank you for sharing that with us. I'm always game for birth story. But let's get into your work with pelvic floor therapy and physical therapy.
Did you get into this before having kids or after? So I, when I got out of PT school, I originally started in just general orthopedics. And I actually did a little bit more in the neurological side of things. And it wasn't until about a little before 2020 that I was like, you know what? I want to dive into pelvic floor therapy.
LIZZIE: And the reason is because I hear so many women talk about these issues that I'm like, Hey, I know I can help people with this. Let me figure out the best avenue here. And so it was before having kids that I really dove into it all and um, made it my. Life work right now and my passion and there was no turning back at that point because one it's so Fascinating to see how all of this is connected to the body to pregnancy to postpartum even women who have never had children The pelvic floor is just A very incredible part of the body um, and kind of the gateway to so many different things.
And so once I started teaching women about this and seeing how they improved or how it actually truly transformed their lives it was just, this is it this is what I want to do and how I want to help women. And obviously once I got pregnant and went through all that myself, it added another layer to it but the whole thing, it was just, It was a passion that I took and ran with it, and I just can't look back now.
KAREN: Oh, I love hearing that. What do you feel like is the missing piece between pelvic floor health and birth? Oh man,
LIZZIE: there is so much information, I should say, out there on the wild web and There's a lot of misleading information to, and I think the biggest missing piece when it comes to pelvic floor health and pregnancy and birth, especially is understanding that your pelvic floor is very much integrated through the whole process.
And, yes, internally, our body is really just doing what it needs to do, because it is. It's smart. It knows it's physiological. That's just what the body does during labor and birth. But the pelvic floor, we can tend to hold tension there. And if we don't know how to physically relax our pelvic floor and get into that state of relaxation or that state of release and surrender.
Then we can hold that tension and that can actually prevent us from either progressing during labor or it can lead to issues like maybe needing some more intervention or Possibly excessive tearing that maybe wouldn't have happened if we understood how to let that pelvic floor get out of the way And how to allow baby to do what it needs to do and not forcefully push it out or things like that So the biggest missing piece is understanding that you can work on those things during pregnancy such as learning how to You actively relax the pelvic floor and work with your body during pushing and things like that.
That can make such a significant difference during pregnancy and birth.
KAREN: What's one thing a pregnant woman can do now during pregnancy to prepare her pelvic floor for birth?
LIZZIE: Yeah. Oh my gosh, I feel like this is something I could talk about literally all day. It is just such a loaded question. I know, but there are a few key points that I will point out, but when it comes to pregnancy and preparing ourselves, a few things that I would say are the most important is number one, Learning how to work on your pelvic floor and deep core through strengthening.
So that means learning how to contract our pelvic floor and our core together as a unit. And then, of course, I'll get into the relaxation portion here, but understanding that. Strengthening those things during pregnancy, we absolutely can do. And it's something that is really beneficial during pregnancy.
And it's beneficial because it helps us to decrease discomfort during pregnancy, like pubic symphysis pain. It helps decrease the risk of severe diastasis. It helps with prolapse issues. It helps with so much to strengthen our body and work on the deep core and pelvic floor throughout our pregnancy.
And it also sets us up for a better postpartum experience because if you think of pregnancy and postpartum as a marathon, you don't just jump into a marathon if you've never trained for it, right? So if we train our bodies during pregnancy, it really sets us up for a better, birthing experience and that postpartum healing journey.
So you already know what you're doing when you, after you have your baby and are starting to heal your body. So that's number one. Number two is understanding how to relax your pelvic floor. And just what we talked about with surrender and understanding how to open the pelvic floor muscles.
This is such a crucial thing that we can do during pregnancy that when we practice those things, it becomes this. Toolbox of stuff that we can pull out. So when we're in labor and when we're going through, the pushing and whatnot, we can call back on those times that we practice opening the pelvic floor and relaxing the pelvic floor and getting our mental state to that point of knowing that we can go through that full range of motion of the pelvic floor.
Does that all make sense
KAREN: to totally I'm here.
two sides of the same coin because you've got the strengthening piece of strengthening your pelvic floor which is not just your pelvic floor but you're so connected to your core and I'm hearing you You know explain that in a way that i'm like, oh these are so interconnected You can't just isolate one from the other and then there's the relaxation piece and I think in the past like educators have focused on just one of those things like either relaxation only or Strengthening only like yeah all of this emphasis on doing like this 30 or 300 kegels a day, which is just tightening and strengthening, but It doesn't take into account the relaxation that and yielding of the floor that is so important And so like practically speaking How can women strengthen and also practice the relaxation part and are there different exercises?
LIZZIE: Yes. Okay. Let me jump into this. But first thing, cause you touched on that with the Kegels. That is something that's out there on the internet is do Kegels to prep for birth. But that is actually not what we want to do. And in very rare cases do we want to isolate the pelvic floor like you had mentioned.
We don't want to just be prepping for birth. Squeezing the pelvic floor. We want to integrate that with the deep core and with full body movements, because that is going to ultimately set us up for success for just our daily life and just for better function of the pelvic floor. So just touching on that piece.
And then when we talk about how can we do both of these, right? So when we talk about. Going through full range of the pelvic floor. This means that we are learning how to contract the pelvic floor, which is gently squeezing those muscles. Like you're stopping the flow of pee and gas, that gentle contraction and a lift of that pelvic floor.
And then as we inhale, our pelvic floor is relaxing and opening. So we can even just work on it through our breath. So if you're sitting there, we can even practice it right now. If you're sitting there, if you place your hands around your rib cage and you take a deep breath in, thinking of that breath going around all of your fingers and then down into your pelvic floor, that's your pelvic floor relaxing.
Okay. So we're going to take a big inhale here. And think of it going down into your pelvic floor. And then as we exhale, we're stopping that flow of pee
and gently engaging our pelvic floor and contracting our core. And so that is diaphragmatic breathing. And that's what we utilize when we're talking about like strengthening the pelvic floor and then we're relaxing the pelvic floor too. So we want to learn that full range of motion. Now it ties into.
The pelvic floor relaxation piece on its own, some more of that labor prep kind of stuff that we start around, 32, 34 weeks. We go through some mobility exercises, or maybe we just simply sit in a deep squat or something like that. And we solely work on just opening the pelvic floor. So we're inhaling and envisioning that breath, just opening those muscles.
elongating them like a flower's opening or whatever visual you want to use. We just envision that as we are doing our breath work. And then when we exhale, we're just releasing it. So we're not trying to contract anything. And that can really help when we are going through labor and birth because we have practiced it ahead of time.
So those are two kind of practical ways to practice, just engaging the pelvic floor and then also relaxing the pelvic floor.
KAREN: Yes, and that's, I think that's just goes so along so well with why breath work is so important in your labor prep and in birth, because if you've never practiced it, you haven't really engaged your pelvic floor.
Most people breathe shallow and, we're not aware of our whole body and how our breath actually impacts as deep into our core and our pelvic floor and how that impacts birth. Oh, my gosh. I just love what you're saying. And it just, it is so synonymous to what I teach in my course and using our breath.
Yeah. And talk about pushing a little bit. How can you, yeah. How do you use your pelvic floor or what, the way obviously you've experienced both hospital and home birth, as you said, and the way they teach you, I don't know if they coached you to push with your first birth in the hospital, but as it's very forceful, not intuitive at all, and not really good for
LIZZIE: your pelvic floor.
Yes. A couple of things. First of all, with the breath, like you had mentioned, this is such a vital piece in pelvic floor health and just birth and pregnancy and postpartum, and just to touch on that, not only is it good for the pelvic floor, but it stimulates By our diaper and moving it stimulates our nervous system and it stimulates the part of the nervous system.
That's rest and digest, right? So the pair that is so yeah, so it's so crucial to practice that Through pregnancy to help tap into that but then to understand that when you're in labor We can still tap into that system and that rest and digest system instead of the fight or flight response That is that sympathetic nervous system.
So yeah, the breath work is so Oh Key in not only pelvic floor, but just in our mental clarity through labor and birth and into the postpartum as well. So I know you were very very well versed on that as well, but I just wanted to make sure we've talked about that too. No, it's
KAREN: so true. It's so true.
It's you're literally hacking your body. Totally. And you need that practice. You can't go into labor thinking, oh, I'm just gonna deep breathing. If it's not in your. Muscle memory in your nervous system, like because birth is so intense. It's not going to come to you just in transition or when it gets hard, but if you've practiced it and you have tools that you know how to activate your rest and digest nervous system, and you know that when I breathe this deep, it's going to have an effect on my body.
That's how, that's the state we want to birth in. Like the whole screaming, like in the movies and hospitals is not, it's not the same. We don't need to do that. It's so unnecessary. There's a way to train your mind, your breath and your body to stay in that parasympathetic nervous system that is resting so that your body can actually move better and your pelvic floor is more.
Yielding. So it all works together. And that's what I love. You're like all the dots for us. Yeah, it's
LIZZIE: so beautiful. And to tie that into, going into like the pushing piece of it and I'll give my two experiences from a hospital birth and the home birth. Because I think it's important to understand.
And when it comes to pushing I'm sure like in so many of your podcasts, you talk about this on so many of your posts too. And me as well, how, when we push, we use our breath, right? We work with our body. And you just mentioned, holding your breath. If you do that right now, if you hold your breath and push, what do you do?
You tense up, right? You end up tensing either your jaw or like your hands and your jaw and the tension in your hands and whatnot. are so correlated with the pelvic floor. So if you're tensing and holding your breath, just feel what your pelvic floor does in that moment. It automatically tenses and shuts off, right?
It pulls up. I literally do this with my clients. I'm
KAREN: like, feel what that feels like. But we're telling women to push through that. Yes,
LIZZIE: exactly.
KAREN: Yeah, I
LIZZIE: know, you and me both girl, we're speaking the same language, we're like, yeah, I know. Okay, so we know that we need to breathe through our pushing, right? And so when we talk about prepping the pelvic floor for that, we do our pelvic floor relaxation, but then we can also even practice with something like a bowel movement, right?
So when you have a bowel movement and you use that breath, you can get Similar. It's obviously not going to be 100 percent the same, right? But you can get that similar sensation of allowing your body to do what it naturally knows how to do and use your breath to work with your body. So, um, In the hospital, when it comes to a hospital birth, I think you can absolutely have a positive experience.
I did. However, you do need to prepare yourself and understand how to advocate for yourself too. And so in the hospital I was able to move around and do all the things that I wanted to. I had a wonderful labor nurse and she was very willing to help me get into the positions I wanted to or suggested things.
And I was even able to labor in the tub for a little bit, which was great. So when it comes to the actual pushing part I was not coach, which I asked to not be coached, but. But that is not always the case, and very much usually it is not the case. Unfortunately, it is very often coached to hold your breath, for 10 seconds and pushed with all of your might.
That is one thing to be aware of and something to be really practicing ahead of time and just know that you're going to need to advocate for yourself ahead of time. Absolutely. If you're not crystal clear, That you don't wanna be pushed. They will coach you to hold your breath and push as hard as you can.
KAREN: Exactly. Know that going in. Know that you have to really be good at advocating if you're choosing a hospital birth, even with a midwife.
LIZZIE: Totally.
KAREN: Yep. Totally. They're glad you brought that. Just have
LIZZIE: standards and protocols. And also I want people to know that even if somebody does say something though you can still do what you want coaching you. You can say that doesn't feel good, or I don't want to do that or not even saying anything and just push how you want to, yeah, you could just ignore them and close your eyes. Yeah. Yeah. Obviously we want to a good environment, but just realize that you can end up doing what you want to do because it's your body and your birth.
So anyways. When I was in the hospital, I was able to push how I wanted to, however, when it did it towards the end towards that really crucial point when baby is starting to crown during this time, we really want baby to, massage that perineum and it's very normal for baby to go in and out a few times to allow for that perineum to stretch and that tissue to stretch before coming all the way through because that is what it helps with.
Perineal tearing and preventing, severe perineal tears and whatnot and hemorrhoids too. So for me, I was at a point where I was laboring for quite a long time and I'd been pushing for a little while and it was a mixture of, There was a lot of people behind me. There was, I was having my baby at shift change.
So there was a nurses who were with me during the labor and the new ones that were coming in, who both wanted to be there, which I was fine with, whatever. So I was on all fours and raised pushing. And so they're all behind me cheering me on, which is great. But at the same time, I think that's a time where, you really need to allow your body to just Do what it needs to do and not necessarily forcefully push baby out at that time, right?
That's a crucial time to go inward. And so for me, I I did kind of bear down because one, they were coaching me. And two, I was just at a point where I was like, I'm just ready to get my baby out. And so I pushed pretty hard the last few pushes and it did lead to perineal Terry.
And I did have pretty significant hemorrhoids after but all in all, like it was still a positive experience. So that's something to know with hospital birth is just really it. Set ahead of time, how you want your environment to look and make that known to your nurses, to your doctor or midwife ahead of time and your birthing partners because they are going to be the ones who can help advocate for you and who already know your birth wishes.
So that's the piece on the hospital setting. So moving into more of the home birth setting, it was very much a different experience and now that I've had a home birth, I can't go back. Like it was so beautiful and amazing. And the environment was just so peaceful and so calm.
And it was at nighttime. It was about midnight. And my midwives were around me, my doula and my husband, and we have twinkling lights on and everyone was just calm and when I was pushing. I got into different positions that I felt good with and I was able to push through when it got to, when baby was right at that perineum, I was able to push, but then let it come back and just really go inward and allow myself to be in that moment and focus on.
What is inside of me? Not just like the sensations I'm feeling, but knowing that this is normal, this is supposed to happen and baby is almost here. So it was just such a calming experience. Having them speak words of encouragement during that time and say, Lizzie, you're doing the right thing and listen to your body.
And so after I had that birth, it was just like wow, this is how. It should be and I want everyone to experience birth this way because it was so incredible.
KAREN: Yeah, it's such a radically different experience and it's really hard to convey that like with words I find because it's nothing like the birthing at home is nothing like in the hospital and it's really hard.
And you do once you do it, you're just like, I can't ever put myself through.
LIZZIE: And here's the thing. Like I loved my OB. I thought she was fantastic. But it was just the experience that I knew that I needed to go through having a home birth. My midwives were phenomenal. I absolutely love them.
I'm like, I can't wait to come back, God willing someday. All the babies. Oh my gosh. It's the wildest thing because, Even immediately after I had my daughter, it was not even, right when I had her, I was like, I will do that again. Like I want to do that again. It was so weird and it was just incredible.
That is what you want for every
KAREN: woman. Absolutely. It's so true. Yeah. And I totally agree with what you're saying. The way they teach pushing in the hospital is like, Archaic, it's like practically barbaric. It's damaging. I tell them this all the time And that's why I teach in my course like that a different way to push like you said using your breath and I include techniques to Actually help get your breath as deep and low into your pelvic floor to really fully Like you're describing, expand and open your pelvic floor because so many of us, even if we're doing deep breathing, we're more so inflating our abdomen or our womb space.
And there's ways you can get that breath really deep to actually have the impact you want. And that's when the magic happens. It's when you're open that your uterus can then push really strong. And that's where you see I could feel my daughter at one point shift down and I was like, same.
Like it's mind blowing. You're like, that's a human. I can feel like my baby coming through my birth canal. Now that you've talked about that, it's that was an experience I will never forget or a sensation because I, so I personally had an anterior lip and you can, wait and Push through whatever, but I opted to have them move it out of the way for me.
LIZZIE: Cause I was just like, I know what's that's moved a little bit. We can get through here. So they were willing to help me out there. And then it was right after that. I could feel yes, in that pelvis and right in that canal and she was moving. And I was like, This is so wild.
KAREN: It's
LIZZIE: so wild. It's so
KAREN: cool.
So cool. It's intense. It's wild. You're just you have no words. You're just like, whoa. Yes, the breath is so powerful. Now, for women who've experienced diastasis recti, talk about that for a minute. What is it? How can we prevent it? How can we start to heal it?
LIZZIE: Yes, so diastasis, diastasis, however you want to say it so diastasis recti is separation of the abdominal muscles, your rectus is like your six pack ab muscle that so many people know or see, and um, this naturally is going to separate some during pregnancy, and 100 percent of women who go full term or, up to even 37 weeks will have some sort of diastasis, completely normal, and if anybody says you can prevent it.
You can't, you can prevent the severity of it by doing, the deep core work we talked about, but we can't prevent it. And that's absolutely okay. We need it to expand. We need it to move. And so when we are postpartum, obviously these tissues and muscles and the connective tissue of that deep core have been stretched and weakened.
And so when we are postpartum, What we are trying to do is strengthen that connective tissue and strengthen those muscles that we can help them go back together and become strong again. Now, one thing I think it's really important for women to understand is. If you've never measured your gap prior to getting pregnant or anything like that, you may not know what like your normal is postpartum.
So if you have a small little gap or a, a slight gap age after you have quote unquote healed your diastasis, that's okay. It doesn't mean you haven't actually healed it. So that's something really important to understand. But by going through a lot of the foundational breath work, just like we do during pregnancy and reconnecting to our body and our pelvic floor and our deep core.
That is how we start by healing our diastasis recti. And for women, this can take several weeks. For others, it can take upwards of a year to heal a diastasis. And that's also very important to understand too.
KAREN: That's awesome. And I love that you have programs to really help with that and how you push ladies can really impact the severity of that as well.
So much depends on that with your recovery in your body in so many ways. Oh, totally. Are and that's actually.
LIZZIE: Yeah, that's actually been proven in studies that when we do hold our breath and push out, it can actually worsen our diastasis system because we are putting so much of that pressure outward so that pushing piece is important for not only, the pelvic floor piece of it, but just, literally everything.
KAREN: Yeah, your recovery is gonna I remember when I learned. Some of these techniques, my third, I didn't know them, some of these until my third. And this is what I teach everyone in my course with her. I literally recovered in to me, it felt like within 24 hours, I did not feel like I had given birth.
I was walking around, I was moving. I had no swelling. I only bled for a few days and my midwives were like, You're up and about really fast. I was like, yeah, I feel great.
LIZZIE: Like
KAREN: I don't I had no swelling No, terry no soreness with no pain within the next by the next day not even a full day and I was like Wow, like the power of our breath to protect our bodies when we're not forcing it and how Much is that so intuitive, right?
When, if we're talking about birth as this feminine thing, and when you shared about trying to force it and hold on to control, and when we actually just let go and surrender, not only in like our emotions of our mind, but even in pushing, even in the most intense part, when we're not trying to force our baby out, and even in that moment, we're using breath to guide her and open more and open deeper.
It protects our body. It protects our core and it changes everything. So I cannot, I could not agree with you more. And I love just in, in how it all comes together. It's so beautiful.
LIZZIE: Even going into, when you talked about the connection with that breath, it's connecting with your baby too.
And that's the big thing about birth is it's not just you, right? It's the baby and the baby is guiding as well. We can work with our body. We're actually trusting our baby to, to know what it's supposed to do. So it's so cool. But.
KAREN: Oh, so true. So true. You, I know you talked some about Swollen feet and ankles.
This seems to be a super common pregnancy symptom and it's almost oh, yeah, of course It's a given like you're gonna have I had really bad swollen feet Is this something we can prevent and how would you coach women on preventing this or what do you do? If you do find yourself in a situation with lots of swollen Oh, my
LIZZIE: gosh, there are definitely is, everyone's going to have different factors, right?
But there are some key things that are just true. That's evidence back, right? So when it comes to swelling and edema during pregnancy, especially in the feet and ankles one, we have so much increased fluid in our body, right? I forget the poundage that we get from actually just Fluid in our body, but it's 50
KAREN: percent more blood volume.
That's just your blood. Then you have however many pounds of excess fluid, amniotic fluid, water retention, all of that. Yeah. It's a lot
LIZZIE: more than baby. Yes, exactly. And so this is going to put a little more. A little more, a lot more stress on our body, right? And with that, it puts stress on our lymphedema system, our lymphatic system.
And so the lymphatic system is in charge of allowing fluid to flow through the body and our immunity as well. So it can cause some blockages on the lymph system. And so 1 thing that we can do to help with that is. Proper hydration and that's with water, obviously, but also electrolytes. That's so important during pregnancy.
And that is something that I did different in my two pregnancies. And I actually did have quite a bit of lower extremities swelling in my first pregnancy. And in my second, I had none. It was pretty wild. So proper hydration and electrolytes to balance out our body with all that increased fluid.
KAREN: Now electrolytes have salt in them.
So you're saying to decrease now because here's the thing ladies like yeah What do they tell you're that when you go to the doctor or your OBGYN and you have the swelling they say oh Reduce your salt intake. It's actually the opposite. You want salt you want electrolytes and that's gonna reduce swelling
LIZZIE: Right exactly and you want obviously like The good salt, right?
Not table salt. We do want to watch our table. Sun probably just not even use it, but like using good mineral salt, that is what we need for our body. And it's yes, I get that question all the time. When I talk about electrolytes, they're like, Oh, but that's so much sodium. That's because, we've been told that salt is bad, but add this to the list
KAREN: of things we've been conditioned to believe that are not true.
LIZZIE: Yeah. Yeah. Having the proper electrolytes, potassium, magnesium, all very important during pregnancy and especially for swelling and then the other thing is, We can do very simple lymph drainage and lymph drainage is I have some posts on this actually on my profile that people can always look up or you can even like youtube these things too but lymph drainage allows us to open up those centers of where like those lymph nodes are we have a lot in our pelvic region and that's where the center of them are so you Working through opening those with very gentle touch.
We often think we need to massage the heck out of things, but lymphedema and like lymph drainage, we want to use light touch so we can work on just gently opening those up and then gentle strokes up our leg to help with that fluid drainage and then even laying up against a wall and putting our feet up and doing gentle like calf pumps or leg shakes, all of that can help with getting that fluid to drain from our ankles and from our feet.
So very simple techniques. But not, so many people do not know about these.
KAREN: Wow, my mind is being blown right now, and I'm thinking of all the implications of what you just said, because you mentioned the lymph nodes are concentrated in the pelvic region. Then what happens I'm thinking, my brain goes to inductions, being hooked up to IV fluids for 24 hours.
48, sometimes 72 hours in labor in an induction that may very well take several days, constantly having this flood of excess water from IV fluids in their body. And where is that concentrating the most in their pelvic floor region? And then we wonder why baby can't get through, why baby gets stuck, why pushing baby can't ascend.
Why pushing. Like all these complications Many of them can be traced back to these interventions like this something as simple as oh that makes sense. You've been hooked up to fluids and your body is now carrying excess of 20 pounds or whatever
LIZZIE: and and of course we have you know lymph nodes in different areas like our armpits like up in our by our ears and whatnot, but The, yeah, the majority is by that pelvic region, or there's just a lot there.
And so it's just so crucial to have these tools to be able to refer back to, to help yourself through these different stages. Yeah,
KAREN: this is so valuable information. I feel like So people what's important for women to know for postpartum recovery? Especially you know, you hear these horror stories of I was just looking at a real the other day.
I was like in my content creation. Like I want to do like a remix with this. I don't know if you've seen this comedian, but it's Allie Wong. And she tells the story of her friend who is this dainty, kind hearted sweet lady goes through a childbirth. Yeah. And this long, arduous 72 hour kind of birth, and she's pushing for hours, five hours, let's say.
It was crazy. And then she, Halle goes to visit her, and there's, her friend opens the door, and she has this prolapse. And she's look at what birth did to me! And it's like this dangling horror story, like it just, and her friend turned into this Ratchet woman Birth like destroying her body.
Yeah, and tell us of like you hear these stories and it's not that they're untrue It's unfortunately reality for women who have experienced prolapse or other more severe tearing Or conditions that arise after childbirth after a birth, especially where they're pushing for several hours. Yeah, what can be done?
Can pelvic floor dysfunction like this be healed? What do you recommend for women? Yes, so oh my gosh, this is such a big topic because obviously, you know those Maybe more negative experiences. They're so valid and they went through that and it's very true for them, but it doesn't have to be that way.
LIZZIE: And we can prevent so many of these dysfunctions and these things that happen during birth. If we just educate ourselves and get the right education and, work on our bodies ahead of time. So when it comes to postpartum. And, say you did have something like my first birth, I had a perineal tear, which is totally fine.
And it's very common for your first birth. It's not even if you do everything right, sometimes it just happens. So even if you have things like perineal tearing, there's so much we can do to heal it instead of just wait and see, or instead of waiting until your six week visit with your provider, because a lot of times, unfortunately, that six week visit is five minutes or less. And a lot of times they don't even check your perineum. They don't even check what's going on down there. Even so many of my c section moms are like, they didn't even check my incision and it blows my mind. It's what are you
KAREN: doing? Like you're
LIZZIE: talking about
KAREN: birth control. That's all you're
LIZZIE: doing.
I know exactly. It just irritates me to no end. And yeah that could be a whole, but when it comes to, so you did have some issues like the prolapse issue. There's so much we can do to improve this. Now, there are certain areas with a prolapse. If it is a very severe. We can do all the things in the world, but there are other things that we can utilize, such as a pessary, which is like a device that helps with the symptoms that we may have if all the conservative stuff is not working.
And then very last resort is surgery, but surgery should never be the first option because there's so much we can do through exercise and rehab to improve this. And for my first birth in the hospital, I did have a grade two prolapse. And so that means that, some of my uterine tissue was just falling through very slightly.
And this was due to me pushing pretty intensely in the past. The last few contractions, right?
KAREN: And isn't that amazing that even like you said, only a few pushes that just a few pushes at that intensity can damage your pelvic floor and cause
LIZZIE: prolapse.
KAREN: Yeah. And again,
LIZZIE: I knew all these things, but just being in that setting and just like that specific scenario.
Anyways, so I was able to go through my rehab and I utilized, the programming that I have, and I was completely symptom free from that prolapse. And then the second go around, I had no prolapse issues. And I attribute so much of that to one, everything I did during pregnancy and then to how I utilized the program.
My pushing techniques and working with my breath and my body and all of that. When it comes to postpartum and say, you are working through some of those issues, there are steps we take. And the very first step is that breath work, magical breath work that we talk about, right? But it truly is the foundation to healing our core and our pelvic floor.
And this is because if we can't connect to our core and our pelvic floor, especially after it's been weakened through pregnancy, naturally, and through birth, Then it can be more difficult for us to strengthen on top of that and to improve those issues because we've never learned to connect to them. When I see women who they don't do anything for 6 weeks, and then they jump back into exercise, and they may have these incontinence issues or painful intercourse or things like that.
And they're told, just wear a pad or have a glass of wine before intercourse. That's just how it is. And they just get. Size and never address the foundational components. That's when I see these long term things. And that's where these things come from of pregnancy ruins your body or your body.
And it just does not have to be that way when we actually work on the foundational components of.
KAREN: Yeah. Oh, so good. Oh my gosh. I love it. I feel like we covered so much. What else, is there anything else that you feel like, what is one takeaway women need to know for if they're preparing for birth and postpartum?
Cause we forget, we got to prepare for postpartum too.
LIZZIE: I would say that no matter your circumstance or what maybe your provider is telling you, what other people around you are telling you about your individual experience, you are the one who can change those thoughts and you're in control of your thoughts and how you take action. So my biggest advice and biggest takeaway is to invest in yourself.
During that pregnancy by working on your body because that's setting you up for that birth experience and that postpartum journey. So learn to connect to your body, learn the breathwork techniques and learn the mental preparation and how to stay strong mentally through not only pregnancy, not only the birth experience, but all the demands that are going to come with postpartum and healing your body and taking care of a new baby.
So those would be the top things I would say as a takeaway. Awesome. And Lizzie, where can women find you? What programs, can you tell us what programs you offer to help support women on this journey with caring for their pelvic floor health and healing if they have one of these core dysfunctions from a previous birth or trauma or what have you?
Absolutely. I have a couple of different programs and one of them is the postpartum program. And this is a 12 week progressive program that we start with a very foundational work and work all the way up through advanced techniques in rehab. And the biggest reason I created this was because not everyone has access to a pelvic floor PT, right?
And not everyone can get to a pelvic floor PT. So I want you to have pelvic floor therapy in your home. So I'm literally walking you through step by step. Follow along videos of how to heal your core and your pelvic floor from the ground up so that you can be strong and confident and not only take care of yourself and your family, but be able to do the things that you want to do.
So I have the postpartum program, and then I also have a prenatal program that is a strength training program, or just like a core and pelvic floor mobility program. And this is a. Full comprehensive program that helps you to understand how to connect your body through all the different phases of pregnancy and how to strengthen your body so that you can be strong during the process because it is so physically demanding, right?
To be able to birth. So setting yourself up through pregnancy and it even has extra programs in it that are for like back pain or prolapse or incontinence or things you may experience here and there during pregnancy. So you have. All that touch your fingers again, just a pelvic floor PT in your pocket to set you up for a good birth experience and postpartum recovery.
KAREN: Oh, that's awesome. That's so helpful and resourceful like I truly wish I've learned so much as a doula and an educator and just Yeah, you know i've been online and some of these resources. I was like Yeah, I wish I had some of these when I was pregnant like I totally I was like that would have been awesome So I hope you guys take advantage of that and and yeah, thank you so much for coming on the show, Lindsay, and just sharing your wisdom with us.
LIZZIE: Yeah, thank you. This was such a joy. And like I said, I could talk about this all day, but this was so fun to chat with you about.
KAREN: Thank you. Have a great day, you guys, and we'll see you next week.
