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Written by

Gina Conley, MS

So, You Want a Pelvic Floor PT Referral?

  • Pelvic Floor Rehab
If you are pregnant or have given birth, we recommend seeing a pelvic floor physical therapist, even if you aren’t having any noticeable issues. You spent 10 months pregnant, increasing the demand on the pelvic floor and forcing your core stabilization system to adapt in its function; you should be seeking some rehab from pregnancy! Or, better yet, you gave birth!! Whether you had a vaginal birth or a c-section, both require some serious healing. Why wouldn’t you see physical therapy? You would get a referral after most surgeries or injuries. What makes postpartum, a time of healing, any different?
If you are pregnant or have given birth, we recommend seeing a pelvic floor physical therapist, even if you aren’t having any noticeable issues. You spent 10 months pregnant, increasing the demand on the pelvic floor and forcing your core stabilization system to adapt in its function; you should be seeking some rehab from pregnancy! Or, better yet, you gave birth!! Whether you had a vaginal birth or a c-section, both require some serious healing. Why wouldn’t you see physical therapy? You would get a referral after most surgeries or injuries. What makes postpartum, a time of healing, any different?

You Want A Pelvic

But my provider said no or never offered a referral! What do I do??

So, what can you do if you asked your provider for a pelvic floor physical therapy referral, and they said no or asked why?

The less beneficial communication method would be to do a massive eye roll and say “because I said so” (explicates may be included, depending on your personality).

Rather, we can approach this in a way that helps both educate our providers to better understand the benefits of pelvic floor physical therapy, and also get our referral we are seeking.

1. Ask your provider to explain how they plan to support your recovery/treat your condition if they do not plan to refer you to physical therapy; what support can they offer instead that would replace that specialty? They may have some incredible insight or services available in their own office!

2. Explain what your symptoms are that would benefit from pelvic floor PT. For example, explain pain you are feeling; loss or diminished function.

3. If you had a c-section birth, explain that you want individualized treatment on scar mobilization and recovery after surgery.

4. If you had a vaginal birth, explain that you had a [vaginal tear/episiotomy/forceps or vacuum assisted delivery] and delivered a baby out of your vagina.

5. If pregnant, explain that you want to prepare your pelvic floor for birth to improve your birth outcomes and decrease the risk of tearing to enhance your healing postpartum. That you feel unsure how to properly push, or do perineal massage, and would like the guidance from a pelvic floor physical therapist. Do you have any signs of pelvic floor dysfunction, such as pain, leaking; or maybe you’re unsure how to properly move your pelvic floor, or unsure if it can actually relax?

6. Explain what pelvic floor physical therapy is. Pelvic floor physical therapist is focused on the pelvic floor and its integration with the rest of the system to support overall function. The pelvic floor plays a huge role during birth, and supports our body’s ability to stabilize, so seeing a specialist can be incredibly beneficial.

When approaching the conversation, explain your symptoms without diminishing your pain or loss of function. How will seeing pelvic floor physical therapy improve your birth outcomes (what happens during your birth) or enhance your healing postpartum?

What if you don’t want to have the conversation with your provider, or they continually refuse to support your decision to seek physical therapy?

1. Tell them to annotate in your record that you requested a referral to pelvic floor physical therapy for [insert reason, highlight it as pain, or loss of function], and they are refusing to provide a referral.

2. Learn if your state even requires a referral. Some states are direct access states, and you can seek out a physical therapist without any referrals from your PCM.

3. Seek out a cash based physical therapist. They may not be able to take insurance, or you can apply for reimbursement after your care, but cash-based physical therapists tend to not have the same restrictions or requirements of PTs that take insurance. They can spend longer with you and provide the care that makes the most sense for you, as opposed to what insurance may want them to do.

What if you can’t afford or it is not accessible for you to seek care with a pelvic floor physical therapist?

1. There are so many pelvic floor physical therapists that are on social media that offer free educational resources on their pages. Some even offer lower priced e-book or online courses that may be incredibly helpful.

2. Here are a few of my favorites: @ladybirdpt @the.belly.whisperer @hayleykavapt @womeninmotion_wellness @mypelvicfloormuscles

3. Note that social media is not the place to necessarily receive a diagnosis, but sometimes being more educated on our symptoms and what they may be related with can help us communicate better with our provider on what we think may support our care. They may actually have other recommendations based on their own expertise!

Hope these tips help you facilitate communication with your provider on how to enhance your care during pregnancy and postpartum!