Motherhood is all consuming.

Having babies, nursing, feeling the fear of loving someone that much, and there's this baby on your chest, and boom, your entire life has changed.

It's a privilege of being your child's safest.

Space and watching your heart walk around outside of your body.

The truth is, I can be having the best time being a mom one minute, and then the next, I'm questioning all my life choices.

I'm Lo Mansfield, your host of the Lo and Behold podcast, mama of four Littles, former labor and postpartum RN CLC, and your new best friend in the messy middle space of all the choices you are making in pregnancy, birth, and motherhood.

If there is one thing I know after years of delivering babies at the bedside and then having, and now raising those four of my own, it is that there is no such thing as a best way to do any of this.

And we're leaning into that truth here with the mix of real life and what the textbook says, expert Insights and practical applications.

Each week we're making our way towards stories that we participate in, stories that we are honest about, and stories that are ours.

This is the lo and behold podcast.

If you grew up in a house like I did, and this is not me throwing shade at my parents, they absolutely were always doing the best they could with the info they had at the time.

I know that of them to be true.

I know that is true of you as well, so no shade at my parents.

Okay?

But I did grow up in a home that did not talk about bodies that did not use, you know, quote unquote, the proper nouns for body parts.

We just.

This was kind of a vague gray space that wasn't really engaged with or talked about.

So maybe you're saying, Hey, that resonates with me.

Same, same.

Maybe that's not true for you.

Regardless of where you are on that spectrum, I think you only have to look around to realize that there are plenty of people on social media right now talking very openly about bodies and encouraging you to consider yours.

Not in new ways, but just in more familiar ways, right?

My guest today, Dr. Sarah Reardon, is one of those people.

She's been caring for people's pelvic floor as a bird certified pelvic floor therapist.

I. She is the founder of the V Hive, which is her online pelvic floor workout platform for pregnancy, postpartum, menopause, painful sex and pelvic floor strengthening.

And then, like I said, the Vagina Whisper is who she is on Instagram and TikTok, where she has hundreds of thousands of followers on both of those platforms.

And this is super exciting as well.

She is about to release her book called Floored, A Woman's Guide to Pelvic Floor Health at every age and stage.

So I feel really lucky that I got to.

Steal her.

If you're listening to this present day, kind of in the midst of.

Whatever it is that goes into releasing a book, since that's not something I've done.

But she has just been grinding, making these things happen, and so I'm excited that I got to steal some time from her.

I love talking to her.

She's easy to talk to, super easy to learn from, and yeah, I am grateful to be able to share this conversation with you guys.

She is a absolute wealth of information.

About your body, you know, like her book says at every age and every stage.

So let's get into that conversation.

Hello.

Hello everybody.

Okay.

I'm super excited to get my guest, Ms. Sarah in front of you today I've got Dr. Sarah Reardon here, the Vagina Whisperer, as she is better known on basically all social media platforms.

I'm gonna have her go ahead and introduce herself a little bit more, and then we're just gonna get into the combo that we're gonna have with you guys today.

Hello everyone.

I'm Dr. Sarah Rearden, a board certified pelvic floor physical therapist, and yes, is Lo mentioned.

I am on social media as a vagina whisperer and I'm often seen as a Volvo costume educating women and birthing moms about their pelvic floor.

I've been practicing for 18 years.

And I am just coming out with my new book, floored A Woman's Guide to Pelvic Floor Health at every age and stage to really help women better understand their bodies and to give them some information and exercise on how to overcome pelvic floor issues that are so common, but also really treatable.

So I'm excited to be here in chat today.

I'm so glad to have you.

Okay.

I also just wanna call out that I just called you, miss.

Sarah, because that's how my kids refer to everybody.

I'm like, why did I just call you Miss Sarah?

So sorry guys.

This is Sarah.

She's a grownup.

We do not have to call her Miss Sarah,

but also grownup like we, I, when I'm like, oh, the grownups, I'm like, okay, we're adults.

But I say grownup because that's also how I talk to my children.

So I totally get it.

Right.

Right.

Okay.

Anyway, yeah, so we're both moms in case you didn't know.

Okay.

So you said you've been doing this for 17, 18 years.

I actually am curious, I feel like pelvic floor health kind of exploded more recently.

You've obviously been in it for way longer.

You've made this shift into social media as well, but just why do you think, where did that come from, like that explosion or what made this happen and what made people like you, people, you know, that were desperate?

They're just so ready to listen to.

And it was really just for my close girlfriends and family members.

We were all kind of getting pregnant and having babies around the same time.

And I was like, I feel like women really need this information.

And I was.

Sending the same emails and text messages to my girlfriends.

I was like, I just wanna put this in one place so that everybody can find it.

And I also think that there's just a lot that women didn't know about birth and postpartum recovery and how we could actually prepare for those things.

And this is, you know, your voice is so important in this field as well.

And we were hearing so many people say like, I wish I would've known this sooner.

I wish I would've known about therapy sooner.

I'm like, well, why don't we help them learn about it?

And so.

I think as social media has grown and it's really become a platform for education and entertainment, and particularly during COVID and afterwards, I think just more people started finding that it could be a place for resourceful information.

And so we've seen so many therapists kind of start their accounts and create communities, and it's just really exciting to see pelvic floor health be a part of the conversations in the broader sense of birth and postpartum and women's health.

It's interesting.

Right?

That COVID lockdown, we're all home.

We need each other.

We need information.

Whatever I. So it's kind of cool to hear you say, I was actually doing this before.

I know you said you had a smaller account or different, you know, people that you were talking to.

That you have been very aware of the need for this for a really long time.

The other thing I would say too is maybe this is true for some other people as well, but I kind of grew up in a home where my mom didn't talk about the body.

We didn't have the sex talks and all of that, and you can think what you want about my parents doing it that way.

Yes, I'd like to do some of it differently, but I do think it's even just like this movement away from that too.

Kind of a, Hey, we're gonna talk about our bodies.

I can wear a VUL costume on the internet, and that's okay.

It's not this horrific, embarrassing thing.

It's actually hilarious.

And let's talk more about it too.

So I feel like you were probably in there too, right?

When people are really recognizing that they really need to talk about this because we're all running around a little bit clueless, and we don't have to be that way.

Right, right.

And I think that, you know, there's always like thief is the, I mean, comparison is the thief of joy.

And I'm like, listen, it is.

One vulva at a time.

We're trying to help here, right?

Like if one, I mean, we started this, I started this because I was like, if we can help one person have a better healthcare experience, better understand their bodies, stop leaking, have less pain with sex, like have a more empowered birth, like that's the goal.

You know, I think that the follower count is really just a testament to how much people are wanting this information.

They're not getting it from elsewhere.

So I really think that the growth of social media has been, you know, there is a lot of consistency in work that goes into that, but it's also because people are looking for help and they aren't getting it from their medical providers or in their own healthcare experiences.

So, yeah, I mean, I also, I've been doing this for 18 years and I feel like it's really incredible that social media is a free tool to help us reach more people.

And that is awesome because.

I'm in New Orleans, you're in Denver.

Like if we don't have, you know, if people aren't in those two particular cities, how do they get support?

How do they get to work with us?

And I think that social media has been a really cool way to reach so many people outside of our own kind of geographical communities.

Yeah.

Yeah.

And I mean, it's helped me learn too.

I would never have had a conversation or, you know, quote unquote met you if social media weren't a thing.

Right.

And so even for, you know, providers to kind of.

Share knowledge and information across platforms and spaces.

Yeah, it's been really cool, as most of you are probably aware because you're literally listening to a podcast right now that's trying to help.

Okay, so, okay, we're talking a little bit about birth and empowerment and all of that stuff.

Where do you see, let's see, how do I frame this?

Okay.

It feels like a lot of us kind of know when it comes to the pelvic floor health, the almost the opposite.

Like we're just taught, especially specific to birth, do your Kegels.

Right?

And we have this kind of prolific thing out there that's really not maybe part of the story, I mean a little bit, but it's really not what we need to know about pelvic floor health.

Just kind of that foundational level like.

Birth on a relaxed pelvic floor.

So I guess how do you kind of approach even that at a very basic level?

What do you kind of say to that story that we have that's kind of totally off when we're just kind of towing into these pelvic floor waters a little bit.

It's a great question.

I think for most women, particularly myself, you know, I'm in my 40 early forties and growing up in the age of like cosmopolitan and you know, different magazines, it was like, do your Kegels for a tight vagina, for better sex, for stronger orgasms, for less leaks.

And it really put this one contraction, which is a closing of the urinary sphincters, tighten the vagina as like the holy grail of pelvic floor health when it's not.

It's like saying.

You have back pain, just do crunches.

And it's a real disservice, I think, to just give this blanket prescription to women when, you know, I'm a physical therapist, by training and I'm trained in how to approach the pelvic floor.

And so it's really much more nuanced in that.

Like some people have weakness, some people have, tension and Kegels are the wrong thing for them.

Some people have coordination issues.

So in the book, I really broke it down less by.

Hey, you need strengthening.

Do this.

You need weakness.

Do this.

I was like, here's a chapter on bladder health.

This is what your normal bladder.

You know, should look like how often she'd be peeing the proper way to sit.

Things you might be doing that are actually like damaging your pelvic floor.

And if you have pelvic floor issues like leakage or frequency or a hard time starting your stream, like try these exercises to help.

And so it kind of pulled us away from thinking like everybody needs to do Kegels were, it's like, that's one small piece of the puzzle, but it's everything from how you sit and how you exercise and how you breathe and how you pee, and how you poop.

Like.

All of these puzzle pieces really need to come together, but we're never educated on pelvic floor health.

We maybe get a little bit of info about our periods when we're young or if we're lucky in, depending on where we live.

Maybe a little bit about sex ed, and that's like use birth control.

This is an STI and sperm meets egg, and here's baby.

Like it's, we don't even talk about sex in a real kind of, approachable and, and and honest way, but we certainly don't get pelvic health education, you know?

And so it's really how can we educate women with the basics of their body, help them understand it better so they can advocate for care, and what can we start giving them at home that they can do right now?

And that's really what I was hoping to achieve with this book.

Yeah.

Okay.

So that actually brings me right to my next question, which is, okay, you know this, so many of my audience is pregnant, and often with a first baby.

And so I think there can be this, you know, you just named a lot of things that don't overwhelm me anymore, but I think it can be obviously incredibly overwhelming.

So.

My head goes, okay, so they follow Sarah and she's going to tell them, you know, think about all these things and then they're gonna follow me.

And I'm going to say, also, don't forget to think about all these things.

So what do you say to that pregnant mom who comes to you feeling like what I just described and is saying, Hey, I wanna care about this.

It's clear to me that this matters.

Where do I even start knowing that I also, you know, wanna have a good birth and I, I want breastfeeding to go well, like, how do you get to, or how do you speak to those moms who wanna do this and they wanna care about this, but also, you know, they kind of care about the other things, which yes, are also very connected.

But yeah, I.

I mean, it can feel really overwhelming.

I mean, I feel it as a mom now, and I'm like, okay, wait, how do I like learn how to communicate with my kids and take care of my perimenopausal body and do my pelvic floor exercises and my skincare routine?

I'm like, okay, the list is long.

Right.

But I think, you know, the goal is to kind of give you really small bite-sized.

Things to work on.

It's like one thing I'm like, pick one thing, like stop pushing when you pee, or exhale when you're lifting a stroller or your baby, or pull in your pelvic floor before a cough or a sneeze.

It's like these like really small changes that I'm kind of encouraging you to make and you don't have to do it right all the time, but I at least you want to be.

I want you to be aware of what your options are.

I think the biggest challenge for me is that we've never even given women the option to be like, Hey, this information's out there.

Do you wanna consume it?

Do you wanna try it?

Do you wanna work on it during birth or after?

We've just kind of been like, oh, they don't need it.

These things are gonna happen to them anyway.

So just like let it be.

And I'm like, that's gaslighting us.

And I would say more often than not.

Every single patient who's come into my clinic after giving birth, they've never been like, oh, I'm so glad I didn't know this before.

'cause it felt, it would've felt too overwhelming.

They were like, I wish I would've known this sooner.

Why didn't anybody tell me?

So I think it's really just giving women the option of like, Hey, take this information and if you wanna implement it, great.

If you don't, or it's not the right time.

Like, well, at least you know, and you can make the choice about what you do wanna change or what path you wanna follow.

I love that concept of small bites, right?

Pick the one thing you're going to do.

You know, like you said, not push when you pee.

Because I think I, I talk about that a lot in birth education too, because everyone comes at me and they're overwhelmed about, you know, I don't wanna tear and I also wanna breastfeed, and you know, what about this?

And it's kind of like, I want you to pick one thing today or this week, I. Literally one thing that you're going to dig into, learn about, like narrow it down to this one thing.

And I think, you know, we think we have to get everything done all at once too.

And obviously pregnancy can go really quickly.

You know, if you have ever kids at home, if you're postpartum, like there is a lot going on in our lives, including my own.

But I think we, you know, social media, going back to that, it has given us so many inputs that it's hard to say.

Okay.

I would like to think about my pelvic floor.

I am going to focus on this one thing, and when I feel like, okay, that's so cool.

I actually never push when I pee anymore, you know?

Then we choose the next thing, but it doesn't have to, you know, we don't have to be doing all the things right all at once.

We don't have to learn about, you know, the entirety of the labor process in one day.

But I think, I think that it can feel like we do where, you know, we just think there is so much that I'm just, I'm just throwing my hands up and I'm not gonna do anything at all.

It is, I mean, it's a fire hose, you know, and it's a fire hose of information and, and I felt that way during pregnancy.

I'm prepared for my birth.

So much, but I did zero preparation for breastfeeding and looking back I was like, huh, I wish I would've done more her breastfeeding.

But I'm like, I was a new mom, I just didn't know, like, you're not gonna get it right all of the time.

And I think we are trying to do things so perfectly, but I'm like, again, it's like I at least like I wanna make the choice about what information I consume or what information I implement versus not being given that choice at all.

And the other thing I really encourage moms to do, and this is from my own experience, is that I'm like, you lean into what makes sense to you.

Like if what I'm delivering doesn't feel right for you, then I'm like, go in another direction.

Because I think our intuition is really what makes us think like, oh, this feels like something I kind of wanna focus on.

Versus being like, I've gotta do all these things and like think about the material of my baby blanket and like what breast pump I'm using.

Like, it's like, I think you gotta just like take a breath.

Everything's gonna be okay.

I. But for me, I knew like, okay, if I can have a particular kind of birth, I know my postpartum recovery is gonna be a lot easier for me.

And then when I did have an easier postpartum recovery, I was like, okay, then I know that I can be able to do blank.

You know?

So it was kind of like, I was just thinking about like, what is the, what am I really focused on?

It wasn't about like being this hero or having this unmedicated birth.

It was really just like.

I wanna have a good recovery.

Like let me dive into like what are the best ways for me to kind of get there?

And that was the guiding light for me.

Well, part of me thinks that that's why pelvic floor health as well is maybe on this, you know, not rise because we've been in it for a while, but why it's prevalent and important and why people care now too.

It's because I think we're acknowledging that.

Specific to birth and postpartum seasons, like it's not just about the birth anymore.

And when your recovery goes better, when your postpartum goes better, often breastfeeding will better go better.

And it, it's not because that's, you know, your pelvic floor is not connected to your boobs, but just this idea, I feel better mentally.

I feel better.

You know, maybe something like I didn't tear horribly.

I'm not peeing my pants.

And then when you, you know, you postpartum mom feel better, it can maybe then support that breastfeeding part too.

So I think that's, you know, these are super interconnected even though it's not like, you know, system A is connected to system B, but when it's about how you feel.

Then it does then change how we're able to navigate that postpartum period.

And then just, yeah, like the challenges of adding babies to our families and our lives.

So I think that people recognize that too.

I'm doing this, you know, I'm doing these postpartum or pregnancy practices Yes.

To help my birth.

Also because I'm going to feel better and that is going to serve me and everyone around me.

Right.

You know, all the kids that may be in your family.

So yeah, I just think that this is also tied together, together, even though there's not these, you know, direct ties every time between body systems or whatever.

Yeah.

And I think that, again, making it bite-sized and accessible to people where it doesn't feel like you need to completely overhaul your life.

Like when my husband's like, we need to stop using Classic and go to All Glass.

I'm like, oh my God, that feels so overwhelming.

You know?

Right.

But it's like, okay, you just kind of like chip away one plate at a time, or one Tupperware at a time, you know?

So.

Yep.

Yeah, so I think that, you know, the goal is to not make it feel overwhelming and.

I think the hard part is, is we put so much on moms.

Like part of this is that our healthcare system is not set up to completely support us.

Where you were proactively sent to therapy during pregnancy to help you prepare or to navigate aches and pains, or you're not proactively seeing a pelvic PT postpartum in the hospital like you would if you had a knee replacement or a back surgery like.

The system is putting a lot of the onus on us because we don't have the infrastructure to support parents and moms in the us.

Like we just don't.

And so it's not your fault, it's just the systems aren't there, and so a lot of it is like.

I'm hoping that demand for some of these services, like now you can get lactation support in the hospital, but it didn't used to be that way.

And so my hope is that there's a point where pelvic floor healthcare is integrated into postpartum recovery and it's automatic versus women having to like experience an issue or like knock down a doctor's door to get it, you know?

And so I think I just want PE women to know like, hey, this is not on you all the time.

It's because we're trying to make changes in our systems that better support you.

But again, my thing is like options.

Like I want women to have options.

And it's interesting 'cause I was thinking about this in the shower the other day because, you know, I really support women in any type of birth experience they wanna have or they end up having like, I'm like, whatever direction this goes.

Like that's what I'm here to support you with, prepare you for, and support you with postpartum.

But I think what our medical system does is like, we don't look at the people who had a particular outcome like.

What helps someone have less tearing?

What helps someone have less prolapse?

What helps someone have a non-traumatic birth?

Like those are the studies I wanna be done, because I'm like, what can we do to make more of that happen instead of other things?

Like, I think we're just like, oh, well, you know, 93% of moms didn't, you know, tear during birth.

So like that's just the step.

But I'm like, well, what did the 7% do?

That led to less tearing or no tearing.

Like that's the group I wanna study.

And that's where I'm like, okay, these are the tools that are supported in the research that say like, Hey, if you do these four things, you have a less likely risk.

So let's share more of that information instead of just saying, oh, well almost a hundred percent of women habits.

So like, this is just the case.

I'm like, ah, it's not really how I like think about how we can best support people.

Right.

Well, and I think it makes me, it makes me think of just that kind of overriding kind of way our, our healthcare system is, it, it's, a lot of times we are responsive, right?

But we're not preventative.

And so even pelvic floor lactation support, you know, I'm so glad we have lactation support postpartum now in a lot of hospitals.

You can come back a couple of times or your insurance covers it.

That's wonderful.

But you know what, if our insureds covered that first prenatal, lactation appointment too, where, you know, you go and you set up a plan, you know, but most insurances don't cover those.

And I'm sure, you know, maybe lots of IB CERs are like, yes, they do come talk to me.

You know, but, but do you know what I mean?

Like, I'm so glad we're doing those things, but so often, you know, we're, we're just responsive, like you're saying.

Whereas, you know, if, if we knew the 7% who don't tear and we put that in prenatally, where that was some sort of, you know, covered included thing, but we just don't do that.

So, you know, in my, in my head, I see someday maybe post far postpartum pelvic floor therapy will be covered or.

Or whatever, but can we sneak in before, like you're saying, so obviously, you know, we will, we'll take whatever we can get, right?

If you start covering my postpartum pelvic floor appointments, then I would be on cloud nine.

Like all of us should be getting that and taking advantage of it.

It would be so great too though, if we can get to that point where we're doing the pre stuff.

Then we, we wouldn't even need it after.

Right.

Totally.

I totally agree

with that.

And that's so Hello?

Yeah.

We don't have to talk about our

healthcare system.

I know.

But you know, when you talk about, so the, one of the reasons, like I really started my account talking my social media account, talking more about pregnancy and birth, and now I talk about a lot about perimenopause and menopause as well, is because pre being pregnant, giving birth.

And going through menopause, which a hundred percent of women, if we live long enough, will go through menopause.

Those are the three biggest risk factors for developing a pelvic floor issue.

You can have them before if you've never given birth or you know, whenever.

But I think that when you, I hear that, that's when like we do so much education on diabetes, osteoporosis, high blood pressure or breast cancer.

I'm like, one in two women can experience urinary leakage at some point in their life.

Yeah.

I'm like, why aren't we?

And that affects your self-esteem, your exercise, your, you know, relationships like your work.

Like if when I was having a pelvic floor issue, I was like, I couldn't think about anything else.

Like, I was just like constantly consuming, are my pants wet?

Can people see this?

Does it smell like it's so consuming?

And so I'm like, we don't really experience what, understand what people are experiencing or women because we can't see this problem.

So it's easy to ignore and.

What I always wanna say, I wanna normalize conversations about her pelvic floor.

I don't wanna normalize problems, and I think we've normalized problems for a very long time instead of just normalized conversations and then we can start, you know, handing out solutions.

Right.

I like that.

That problem conversations thing.

That's good.

Okay, so I wanna zero in on just this, you know, the person who is pregnant right now who's probably listening and say, right, yeah, this is all true.

So what do I do?

Especially that, I have no insurance, I'm not covered, but I wanna care about this and let's say I can't afford, the out-of-pocket cost of seeing someone like you.

So what do you say for those people, you know, where do they kind of start?

I know, I know you've mentioned a few, a few ways to kind of just start with small things, but Yeah, maybe a little more on that.

So what I

really encourage, pregnant women to do is that the first two trimesters, first and second trimester, I think really learning how to engage your pelvic floor, how to engage your core, where I have like videos on my website about this.

You can Google it.

You can read blogs, you can go on social media, it's in the book.

But really understand like what is a pelvic floor contraction that's gonna proactively support your pelvic floor and engage your abs.

And what is pelvic floor relaxation, which is what we do when we urinate or have a bowel movement or push during a vaginal birth.

So kind of connecting with that part of your body during pregnancy.

So I like to encourage more strengthening proactively of your pelvic floor.

I. During pregnancy, the first and second trimester, and then the third trimester, focusing more on that relaxation.

Learning how to push properly, peroneal massage, releasing the hips, like things that are gonna open up your pelvis and support mobility and relaxation because you know, one of my patients in New Orleans, she showed me this video of.

The childbirth education class at the local hospital, and it was nursing.

You do your KE goals through all of pregnancy so you can push your baby out with a really strong pelvic floor.

And I was like, okay, that is not the physiology of birth.

Your uterus pushes your baby out, not your pelvic floor.

Your pelvic floor needs to open up and get out of the way, like relax and lengthen.

So when I tell women that, they're like, oh, well that actually like makes a ton of sense, right?

And then I can coach them on how to push and bulge.

And it's the same thing you do while you're pooping, like you're opening up those canals.

And so using that third trimester to kind of push and relax and lengthen the muscles is where I like to focus.

And then doing some postpartum planning as well.

So I think that that's just kind of explaining it to people and educating them in that way of like, Hey, this is, you know, what you kind of wanna think about.

And also knowing that you have options so you don't have to give birth lying on your back if you have an epidural, you can be in your side, you can be in hands and knees, but like talk to your medical providers in advance so they know what your desires are and you also know that you're gonna get that support in the labor and delivery room.

And now with healthcare you have a menu of options.

You can do an in-person session, you can do a virtual session.

I have an online like birth prep program.

You can read a book, like there are so many different things you can do to kind of absorb information.

That doesn't mean you have to also go see someone in person and add another appointment to your list.

Right?

I wanna zoom in on one thing you talked about really quick, because I saw someone post about this the other day.

Hit pre.

Peroneal prenatal massage.

I fumble over those two words all the time.

Okay.

So I have heard that it is valuable.

Yes.

And you know, more valuable for first time mothers per the research.

And that less is often more, like a lot of people are, you know, you don't need to be getting in there and massaging yourself seven days a week.

That it's more like a, one to three times a week is like some of the research that I've read and kind of looked into even more.

That's what it's saying.

So can you give me the lowdown on that really quick?

'cause I feel like everyone's, you know, you need to massage your perineum and prenatally.

Okay.

And then if you're like me, or you know, maybe you grew up with parents who never talked about the body, you're saying, I'm sorry, how often, wait, what?

And so I feel like, you know, that one is where there are so many people who are saying, okay, yeah.

Right.

So to even pull back more like the perineum, the perineal body is the area between the vaginal opening and the anal opening.

So it's often called the taint or the grundle, or the Gooch, like in urban dictionary terms.

And the very base of the vaginal opening, the bottom is kind of where those muscles start.

And when you experience a perineal tear, it's at the base of the vagina.

Straight down, like at six o'clock or towards the side.

And then tearing kind of spontaneously is a better option than an app episiotomy, unless there's like a medical emergency.

And so there are, it is supported in the research that are a handful of things you can do to minimize the risk of tearing severely.

So perineal massages, I coach people to this in my clinic.

I've actually got a picture of it in the book is like inserting a thumb, a finger, a device into the base of the vaginal opening where.

Your pelvic floor muscles lie, and you press and hold for 30 seconds, 60 seconds, five or six deep breaths, and as you press and hold, it'll feel a little bit burny, but it's like a muscle stretching.

Imagine if you had a tight neck muscle and you kind of press on it and you're like, oh, that kind of feels like so good.

It hurts.

That's what you're doing to the base of your vaginal opening where your muscles lie, and then you just kind of, between three to six o'clock, the very bottom.

You just press and hold, press and hold, and then you just do that for.

Two to five minutes, like it's not a ton.

You can do it every other day.

And then as it starts to get less and less burn, you don't have to do it as often.

So it's like maybe you go to once or twice a week, maybe you have a partner do it for you.

But I think what it does is it kind of just helps soften the opening and just kind of help you relax a little bit more.

And then when you are going into birth, you don't need to have a ton of perineal massage done during the birthing process.

It actually.

The research shows that that's not as effective.

But knowing how to push properly, putting a warm compress over the area, those can be really effective.

But I always clarify, it doesn't minimize the risk of tearing.

It minimizes the risk of more severe tearing and severe tearings when it goes into what's called the grade three or four when it goes into the rectum or the rectal mucosa.

So, and that can put you at a higher risk for incontinence of stool, things like that.

So I think it's just.

Helping women understand like, Hey, you might still tear if this happens.

We're just looking for less tearing, better healing, less pain.

Okay.

I'm so

glad you just said that because I say this a lot.

And then earlier you said something where I thought, oh, I wonder if Sarah would disagree with me.

So I think, you know, you talked about, you know, if we say, oh, you know, 93% tear almost, you know, sometimes it can be like, don't worry about it.

Right?

Like that's normal and we don't want to normalize what is not normal.

I talk a lot about how, you know, like less severe tears, like a first degree tear can be a physiological normal as your body stretches and allows your baby through.

You know, we are designed to have these babies and that design includes these really stretchy, perineal tissues that sometimes make a little bit of space.

And so the research, you know, often on a lot of this stuff does, it does include the idea of tearing less severely.

It's not about, you know, you're going to have a 0% chance of tearing, or this means no tearing.

And so I guess I, I guess maybe I should be like, do you disagree with the way I talk about this?

But, but I do like to teach.

It can actually be really normal.

You do all the great beautiful prep and then you have a first degree or a mild second degree, and actually your body did beautifully and you did beautifully, and everything worked.

You know, I'm, I'm air quoting right now, but that, but that doesn't indicate you did something wrong as you, prepared your perineum for birth.

You know, obviously lots of things can increase your risk of tearing.

We can talk about that another time.

Of course.

But it, it can be normal to not tear severely because the body is designed to make space for our babies in this way.

So, you know, what

do you think to that?

Yeah.

And we don't you, I think that that's a great explanation.

I also think like if you have a baby and they're.

Hand is next to their head or they're in a certain position.

Like we, we cannot control all the variables.

Like you just can't.

And this is also what I tell women who, they're like, I want an unmedicated birth.

And they ended up getting epidural.

They're like, I feel like I didn't make it.

I wasn't strong enough.

I'm like, oh no girl.

Like you made it to seven centimeters and then you got that epidural and then you rested.

You felt had you had more strength going into birth, you had a vaginal birth, which was ultimately your goal.

Like the reason you didn't want to have an epidural was 'cause you wanted a vaginal birth.

But like.

That's ultimately, like, that was a great experience for you, you know?

And so I think that I encourage, like have a preference, but also like don't attach, you know, and you can kind of physiologically it's like a, if something is too big or we don't have enough space for it, people have different levels of collagen and elasticity in their tissues.

Like it's so variable how our bodies gonna respond that like.

To say a hundred percent of women aren't gonna tear is just not possible.

It's just not.

But what I do say is like, okay, if you do tear, like one a less severe tear is optimal.

Two, how are we caring for you?

Are we giving ice?

Are we doing some pelvic floor contractions to help, you know, increase blood flow and healing to the area?

Do you know, can you kind of sit properly so that you can feed and there's no tenderness or discomfort there?

Like how do we also give you the tools to.

Heal and recover so that this doesn't become a traumatic event for you because most women do tear one to two, first to second degree, and it's not uncommon, but it's a whole kind of holistic view of like, okay, since we know this is gonna happen, let's also prep you for postpartum recovery and give you the tools for like optimal healing.

Right.

Right.

And I think that's so crucial.

You know?

You know, let's say a lot of us are going to have first degree tear, and that's quote unquote normal, and that's okay.

And we do beautifully, whatever.

But also we still need to care for those people, like you said, like they still need you.

Don't go, it's just a second degree.

Those are normal.

It's not severe.

Yay.

Good job.

You can be glad you didn't have a more severe tear.

But also, I still need care.

I just tore my perineum and like you said, that that little stuff about, you know, being able to sit and breastfeed or whatever, we, we still need to follow up.

I. We still, you know, have this injury, I guess to tissues in our body and it still needs to care.

Totally.

Yeah.

So I like that adding that on.

Like even if you have a very, you know, normal appropriate tear, whatever word you wanna put in front of it, like you also, then what comes next?

'cause there's still is a next for that.

So,

yeah.

Correct.

And I think that that's where a lot of us feel very left behind.

You know, like after birth it feels very much like forgotten.

Like, we're forgotten because nobody did tell us how to care for our C-section scars or, how to care for our pelvic floors or per perineal tear.

So I think it's, you know, I really think that.

Some of these things, like c-sections are still gonna happen even if we put in all the, the measures to kind of decrease the risk of them.

They're still gonna happen.

But again, like what kind of care are we offering to that mom afterwards?

And that's where I think we need, it's like, let's look at the before and the prevention.

Let's look at the during, but we also need to look at the after.

But if you've had a C-section, I mean you cut through seven layers of muscle and tissue.

To get and, and your uterus.

And then you're like, okay, you're home within 24 to 48 hours.

I'm like, wait, we keep people in the hospital longer for a knee replacement, you know?

And like, let's just like take a step back here.

So I think it's just really like creating a more holistic care system for pregnant and postpartum moms is really like, we're looking for all of that.

Y'all trust me.

Yeah.

Yeah.

Okay.

That brings me to one last question I wanna ask, and then we can wrap it up.

So if you're listening, present day, I was gonna say recently had my fourth baby, but she just turned a year.

But I had my fourth baby and I remember sitting at my prenatal appointments with my mid midwife, and I'm saying like, after I have this baby, I'm going to get all of my nutrition panels done.

I wanna know where my vitamins, you know, my mineral levels are, and I'm gonna go see pelvic floor PT and just, make sure that.

I'm good moving forward into this next stage of my life, all of that, and I told my midwife, if we're being honest, I'll be honest with all of you guys, I have not been good about any of this type of stuff.

I have never seen a pelvic floor pt. I have definitely been the person who has been like, I think I'm fine.

Actually, between babies, I've never had any issues that I think, maybe you could be like, yeah, yeah you do 'cause your back hurts or whatever.

But I've never had issues in my head that indicate, you've got some pelvic floor issues, you know, I've recovered well, you know, had another kid recovered well, however you wanna say that.

Okay.

So I feel like maybe I'm a good example of a person out there where you're like, Hey, you know, you probably.

Yeah, I'm not even what I teach you to be if we're being honest.

You know, I teach people to do and care more, and I haven't even given my own body that time and space.

So I'm talking to my midwife, I'm saying I'm gonna do it this time because this is.

Moving forward.

And, and she told me this story of one of her best friends who had had four kids as well.

Beautiful birth, whatever.

Things went, really well, whatever that means.

And then like five years later, so this was recently, they went skiing together and her friend had a, a prolapse in the middle of skiing, you know, was in all this pain, like, I don't know what's going on.

This is years after her last baby.

And so she, she was with my midwife and , I don't know if the midwife actually helped her right in this moment figure this out, but it turns out her pelvic floor needed more TLC moving into her next stage of life.

And, she felt fine or whatever.

But then here we are years later with all of this stuff going on, you know, which to me, I'm like, whoa, that's such a cautionary tale for yourself.

Our pelvic floors have to support us for the rest of our lives.

It's not always just about how we feel today.

And so I guess there's not a great question in that, but just kind of your thoughts on that.

Or obviously, like I'm going to get in front of someone being done having babies.

But I just, I love that story because it's such a good picture of this.

This really has lifelong implications and that's not meant to scare us, but it is meant to encourage us to care about it, right.

I. So I think that it's a really interesting and great story and that that mom is not alone and you're not alone.

Like I didn't, I'm like embarrassed to tell

you that, but two whatever months

after my second baby that I was like, I think I could use some therapy.

So one, I think we don't know what we don't know.

So a lot of folks are like, oh, I don't have pelvic floor issues, but like, oh, a certain time of the month sex hurts.

Or I can't, run more than five miles without leaking.

Or every time I get sick and I cough a lot, like I do have a little bit of leakage, but it goes away.

Or my hip hurts, my back hurts, or my tailbone hurts.

So I think we don't know what we don't know.

And so I think that's one thing that I'm like, it's like going to a dental hygiene checkup.

Like you go, you get checked out.

And if I'm like, Hey, things are great.

Come back and see me if you need me, then you're like, awesome.

Or if it's like, oh, actually I'm finding that this is like, there's a little bit of weakness here and this is something we could work on and integrate it into your strengthening workouts.

And so you're like, okay.

It's just kind of like, again, being on the proactive side of it because we know that birth.

And pregnancy are risk factors for pelvic floor.

It doesn't mean it's gonna happen to everyone, but it means you're at a higher risk of developing those issues of pelvic floor issues.

So I think it's one.

Two, our pelvic floor requires different things at different stages of life.

So I had two births and had no tearing and had amazing postpartum recoveries.

And I would say I didn't have any pelvic floor problems, like same.

And I'm like, yes, my vagina is showing up.

Go and.

I like did a quick sidestep and I was like, oh my God, I feel like I just leaked.

And it was like my hormones were changing, right?

So you, my hormones are changing what I'm doing, an activity that I'm asking something different of my body than what's usual.

I have less estrogen, testosterone, collagen, and less muscle strength.

Like I've had to work to build muscle in my body more now than ever.

So my body is changing and it's giving me information, and those leaks were like, huh?

We're not, we can't control, like we're not able to support you in that movement or during this time of your cycle.

So I was like, oh, I need to start like stepping it up like the vagina whisper can't like peak your pants, you know?

Yeah.

You can't.

You really can't.

I know.

And so then I started doing more consistent strength training work.

I was like, everything I've been telling everybody to do for two decades, and I started doing it myself, and I'm like, I can feel a stronger contraction.

You know, like I feel more confident playing tennis.

I'm taking proactive steps because.

I'm 42.

I'm entering the second phase of my life where.

, I'm not gonna have any more babies, but I'm also like, my body's changing.

So I think it's important for women to know, like, one, it's fine to be proactive.

Two, you don't know what you don't know.

So getting a checkup is always helpful.

Or at least reading the book and being like, oh, maybe I do have this, or, or I wanna know more.

And three, as we age, or depending on how many kids you have or what type of birth you have, or if you're entering to perimenopause or menopause, or even recovering from surgery.

Your pelvic floor requires different care during different life stages, and you wanna be proactive about that.

Yeah.

Yeah.

Okay.

Well, tell us a teeny bit more about the book.

Just, you know, like what are they going to get if they pick this book up and start reading?

Oh my gosh.

So I, this book is called floored , a Woman's Guide to Pelvic Floor Health at Every Asian stage.

And so I really address everything from like periods to pregnancy and birth to postpartum recovery and menopause.

But also there's a chapter in Bladder health pooping.

Sexual pain and, pelvic pain.

So I wanted the first chapter and the last chapter are my favorite.

So I just read the audio book for this.

So I was like, oh, those are two really good chapters.

So I'm like, start there.

And then if you're pregnant, you're like, I wanna read the pregnancy chapter and the birth chapter, right?

So kind of go to where you need, but you have this guide for everything that you'll need at a different stage.

Or if you have daughters who are.

Gonna be menstruating.

I'm like read the period chapters.

You can help educate them and yourself about how the pelvic floor is changing and being affected.

So I think that it's really a guide for you for whatever stage you're in.

And I just want to demystify this part of our body.

I feel like we can't see it, so it's really kind of hard to like know what to do.

I even go as far as to like tell women to like take a mirror and look at your vulva.

Like more people have seen your vulva than you've seen it sometimes.

And so I'm like.

Connect with it and then do a contraction, relax, like kind of start knowing how to work with it so that when you're exercising or giving birth or having sex, like you can just understand your body better and know what to look out for so that if you do need pelvic floor care, you've got some of the resources in the book or you go see someone in person.

Yeah.

Perfect.

I am still waiting for my pre-order copy, but I am, yeah, I'm excited to get into it.

And I just wanna reiterate that it is really for, full stage of all stages of life.

So if you're pregnant and you're thinking, well, I don't really care about my bladder, whatever, right now, , you can zero in on the chapters and the stuff that you do want.

And if you're done having babies, it doesn't mean, you know, don't get Sarah's book, but it.

It's written kind of for all of us in all the stages that we're into.

So I'm super excited for you.

It is something yeah.

That the world needs.

Thank you.

And I dunno that there's, there's just really not that many books out there, as I'm sure you figured out.

Well, you decided to write yours.

So Yeah, I'm really excited.

Yeah, thank you.

And I'm really excited for everybody to, to, to read it and share it.

And, thank you for sharing this with your community.

I always love chatting with you and, being able to kind of chat more about how the pelvic floor changes during pregnancy and birth.

So thank you.

Absolutely.

It's a privilege to talk to the woman in the Vva costume.

Okay.

Tell people where they can find you, Sarah.

And then I want you to answer just one quick question.

I just like asking people this.

So what's one thing that's just, you know, sparking joy and bringing you life in your life right now?

So where can they find you?

And then that question.

You can find my website is the vagina whisper.com and there's a page on there to pre-order the book and everyone gets 30 days of free pelvic floor workouts.

If you pre-order before, June 17th, the book comes out on June 10th though, so check it out.

And I'm on the.

Instagram as the vagina whisper and TikTok as the VA whisper.

'cause TikTok doesn't like the word vagina.

And the thing that is really sparking joy in my life right now is spending time with my kids.

Like we, you and I are having this conversation the day after Mother's Day, and normally I'm trying to like hide for my kids and take a break on Mother's Day.

But I've been working and traveling so much the past six months and even two years writing.

Just being around them is so awesome, and I'm just really like soaking in that time because one, I realize how quickly it goes, but two, when I'm not with them, I miss 'em.

And so just like hanging out with them and swimming and playing tennis or just eating with them at the table, like those small everyday moments, I'm really enjoying right now.

I love it.

I love your videos.

Your baseball mom videos on Instagram.

They make me happy.

Like for you, I mean you're like, oh, so I love part the field again, that lady.

Yeah.

It's so sweet.

I love it.

Well, Sarah, thank you so much for your time.

I know you are busy.

You guys, this episode, it should be airing the day before Floored releases on June 10th.

So I would love for you guys to get a copy, not just to support Sarah, but honestly to support yourself.

So I'm really excited for you.

Thank you so much for listening to The Low and Behold Podcast.

I hope there was something for you in today's episode that made you think, made you laugh or made you feel seen.

For show notes and links to the resources, freebies, or discount codes mentioned in this episode, please head over to low and behold podcast.com.

If you aren't following along yet, make sure to tap, subscribe, or follow in your podcast app so we can keep hanging out together.

And if you haven't heard it yet today, you're doing a really good job.

A little reminder, opinions shared by guests of the show or their own, and do not always reflect those of myself in the Labor Mama platform.

Additionally, the information you hear on this podcast or that you receive via any linked resources should not be considered medical advice.

Please see our full disclaimer at the link in the show notes.