In this episode, Founder of Hearth Healing, Laura Williams, talks about postpartum care after leaving the hospital.

Today, Laura talks about the harms of finding generalized information online, setting postpartum expectations, and optimizing care to the mother and the baby. What is the difference between common and normal occurrences in the postpartum period?

Hear about virtual postpartum healing, the outcomes of Laura’s virtual consulting, and get Laura’s advice to her younger self, all on today’s episode of The Healthy, Wealthy & Smart Podcast.

 

Key Takeaways

  • “There isn’t a one-size-fits-all approach to recovery, and we need individualized information.”
  • “The key that unlocks that resilience is knowledge.”
  • “There should be an equal attention to both the baby and to the patient.”
  • “It may not be life-threatening, but it can still threaten your quality of life.”
  • “Giving people knowledge can help them move forward in a meaningful way.”
  • “Imposter syndrome is real but don’t take your knowledge for granted.”
  • “Be brave.”

 

More about Laura Williams

headshot of dr laura williams Laura Williams is a Doctor of Physical Therapy (DPT) and Board-Certified Women’s Health Clinical Specialist. She lives and practices in Salida, CO, with her husband, 3-year-old daughter, and second child on the way.

Laura founded Hearth Healing, a 100% virtual postpartum healing service, in 2022, as a pelvic health consultant. Though not a substitute for in-person healthcare, postpartum healing consultation should be viewed as a vital way to bridge the gap in maternal care. People deserve information about how to improve symptoms that impact their quality of life after childbirth, without having to wait months, or feel limited by lack of childcare or transportation.

At Hearth, Laura provides individualized answers to postpartum healing questions, early healing strategies, self-management advice, and guidance on appropriate resources, products, and providers.

 

Suggested Keywords

Healthy, Wealthy, Smart, Pelvic Health, Postpartum, Education, Knowledge, Virtual Care,

 

To learn more, follow Laura at:

Website:          www.yourhearthhealing.com.

Facebook:       Hearth Healing.

Instagram:       @yourhearthhealing.

 

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Read the Full Transcript Here:

00:00 Hey, Laura, welcome to the podcast.

00:04 I’m very excited to have you on today to kind of continue a conversation that I started

00:10 last week with Dr. Rebecca C. Graves.

00:12 We were speaking about the true need for physical therapy and occupational therapy in the hospital

00:19 for people after giving birth.

00:21 And today we’re going to talk about, well, what happens when you leave the hospital?

00:26 What happens in that postpartum period after that?

00:29 And that’s where you come in.

00:30 So thank you so much for being here.

00:33 Thank you so much for having me.

00:35 And let’s start with a question as we were speaking before we went on that we get a lot.

00:41 And that is, what is the difference between a common occurrence and a normal occurrence

00:48 in the postpartum period?

00:49 Yes, this is a hot topic.

00:54 So as pelvic PTs, we really want this higher standard for everybody after childbirth.

01:03 We don’t accept this sort of generational knowledge that’s been passed down that certain

01:08 things are just a rite of passage of having children.

01:11 It’s our burden to bear the suffering after childbirth because we know more and science

01:18 has taught us more and we know how resilient our bodies are and that we’re capable of healing.

01:22 So a big one is that it’s normal to leak every time you cough and sneeze during and after

01:29 childbirth.

01:30 So no, you do not have to pee a little bit forever.

01:33 This is like my number one soapbox.

01:36 It is really common to have some urinary leakage after just the distension of the pelvic floor

01:43 and that sort of lack of pressure management right after having a baby, particularly after

01:47 vaginal childbirth.

01:49 But it shouldn’t persist.

01:50 It shouldn’t persist beyond six weeks postpartum and it certainly shouldn’t be persisting decades

01:56 later.

01:57 And if it recurs, this is also something that isn’t just because you’ve had babies, there’s

02:01 some other like level of dysfunction going on.

02:05 The fact that intercourse will be painful forever, really common, that intercourse doesn’t

02:10 feel awesome when you have a lot of scar tissue in your pelvic floor after you ripped a baby

02:16 out of that space, right?

02:17 And you had stitching and things are in a little bit of a new organization, but sex

02:23 does not have to be painful.

02:25 And there are a lot of things we can do so that it’s not.

02:27 And God forbid it be like actually enjoyable someday or something that we look forward

02:31 to and don’t just endure.

02:35 Diastasis recti is a big one.

02:37 So a diastasis is a really, really common and normal thing that happens during most

02:42 pregnancies.

02:44 We don’t diagnose it as a diastasis unless it’s beyond two centimeters or two finger

02:48 widths.

02:49 But it’s not something that can’t heal.

02:53 It’s not something that should be persistent longterm.

02:56 It can absolutely close.

02:58 Our tissue is tensile for a reason.

03:00 We have the ability to close that diastasis and it does not require surgery to be managed.

03:07 So there’s a time and place for surgical repair of a diastasis.

03:11 And that’s a really particular instance of severity.

03:16 But that’s the exception to the rule.

03:18 So if you see a surgeon before you see a physical therapist and they tell you that you need

03:22 surgical closure of a diastasis, that’s jumping the gun.

03:27 And then I hear these extremes like, oh, I just want to start running at four weeks after

03:31 having a baby or I’ll never be able to run again after having a baby because I’m peeing

03:37 my pants when I run or it’s too painful.

03:39 So there’s this gray area that those things are common to feel those ways.

03:45 But it’s not, your body’s not necessarily ready at either of those times.

03:50 And we have to set a foundation or I hear like don’t activate your core for 12 weeks

03:55 after having a baby.

03:56 Right?

03:57 Well, that’s not possible either because you have to pick up your child and you have to

04:00 pick up a car seat.

04:02 So we have to engage your muscles.

04:04 Right.

04:05 So that’s just a few.

04:06 Yeah.

04:07 Yeah.

04:08 And then you’re like, wait, what?

04:10 So what, why are these sort of common myths being persisted?

04:16 So what, what information is not getting to new parents or to, you know, these new postpartum

04:25 patients, if you will, or people, what are they missing?

04:29 What are they not getting about their bodies?

04:32 What information is in getting to them that is likely persisting these myths and beliefs?

04:39 I don’t think people are really getting any information.

04:42 Most of the time.

04:45 Going back to Rebecca Seigre’s our conversation last week about, hey, let’s give some information

04:51 in the hospital.

04:53 You know?

04:54 Exactly.

04:55 Yeah.

04:56 So, you know, there’s a big disparity that’s happening.

04:59 People are being discharged from the hospital after having any form of any mode of delivery,

05:06 right?

05:07 With an abundance of information about how to take care of their infant.

05:10 I often say like, we leave the hospital knowing how to delineate every single shade of our

05:15 infants poop, but nothing about our own bodies.

05:19 And like, we’re just not told anything.

05:21 So then we go home and we’re sort of left to our own devices to sift through this, you

05:29 know, unbelievable amount of information on the internet.

05:32 Right?

05:33 Facebook groups, you know, mommy and me groups, things like that.

05:38 That might not be the most accurate information.

05:41 Exactly.

05:42 Or just straight up like scrolling Instagram and TikTok at 3am, you know, and seeing something

05:47 that resonates with you and drawing for strings and hoping that something is right.

05:55 So the problem is that there isn’t a one size fits all approach to recovery, and we need

06:01 individualized information.

06:05 There’s really, really phenomenal information at our fingertips now, which is a blessing,

06:09 but it’s not all right for everybody at every stage of healing.

06:15 So what we need to be, you know, this lack of good information is happening because people

06:23 are chatting with those their friends and those mommy groups or hearing from their mothers

06:27 and their mothers, mothers that this is the way it was for them.

06:31 And if everyone around me is peeing a little when they sneeze, then that just must be normal.

06:35 That just must be like my lot in life now, you know, so there isn’t this intersection

06:40 of really good evidence based information.

06:44 And I was going to ask the question of, well, what should people do if their experiences

06:53 the experiencing these common but not normal symptoms, shall we say, after childbirth?

07:02 Most people, like you said, they’re going to go to social media, which we know there

07:07 is a lot of research on social media, YouTube, things like that.

07:10 What is the danger, I guess, and just going to YouTube or to social media, seeing an influencer

07:19 and the influencer just do kegels.

07:24 What’s the problem?

07:25 What’s the harm in that?

07:26 What’s the problem there?

07:28 Yeah, I mean, the I don’t want to say harm necessarily, because I think finding something

07:35 that resonates with you, finding someone that’s speaking a language that speaks to you that,

07:40 oh, that person’s experiencing what I am experiencing, that makes me feel seen, right?

07:45 Anything we can do to destigmatize these issues and be vocal about them and just speak the

07:50 truth about them empowers women, right, empowers people in their postpartum time.

07:57 But the problem is that, again, like there is no one size fits all approach.

08:00 So if the message is you just need to do kegels because all of your dysfunction is coming

08:06 from a weak pelvic floor without ever having someone evaluate the strength of your pelvic

08:10 floor, you may actually be on the other end of the spectrum, which is more often than

08:15 not what we find in pelvic floor examination, which is that pelvic floors that have experienced

08:20 trauma, chronic pain, their response to that is to guard just like any other trauma that

08:27 we experience, right?

08:28 We don’t open wide up, we shut down and we close off.

08:32 And so that’s what happens to those those muscles that have range and coordination,

08:36 just like any other muscles in our body.

08:39 And so we really need to know like, what is my particular circumstance?

08:44 How is my body functioning that is leading to these episodes, which may be different

08:49 than, you know, someone next to me having the same result, right, that same leakage,

08:53 but it could be coming from two different problems.

08:56 So we’re not addressing that root problem.

09:02 So what people what we’d love for people to do, right is from, you know, where Rebecca

09:06 and I stand as healthcare professionals and yours is like, we want people to be getting

09:11 better information before they leave the hospital.

09:15 We want people to be getting fundamental information about their bodies.

09:19 What is the extent of their injuries?

09:21 That is an inherent right for people to know we’re so afraid to be honest with women, right?

09:28 Be honest with postpartum people because we think they’re like fragile and they’ll break

09:33 if we tell them the truth about their bodies.

09:35 They just had a baby.

09:36 I was gonna say they just pushed a human being out.

09:39 They are not fragile.

09:43 They’re actually incredibly resilient, because now they’re going to go home after doing this

09:47 unbelievable superhuman thing and care for that infant.

09:51 And like make food with their bodies, you know, so they’re really resilient.

09:56 But the key that unlocks that resilience is knowledge, like understanding what they can

10:00 do to feel empowered and to do small take small steps toward their healing independently.

10:05 And these are really simple things like what is the extent of their injuries?

10:09 Where is their scar tissue?

10:10 How can they monitor their scar tissue?

10:12 How can they move it on their own right away?

10:15 How can they breathe when they move to manage pressure?

10:18 Well, you know, how can they use good biomechanics to roll in bed to pick up their car seat to

10:22 pick up their infant?

10:25 How can they monitor their own physical signs that they’re ready to progress exercise like

10:29 leakage and bleeding and pain?

10:31 How can they monitor their own vital signs?

10:34 Right?

10:35 How can they monitor for things like clots and cardiac events?

10:38 What are the flags, things like that?

10:41 Infections?

10:42 Yeah.

10:43 So that they do feel like they understand, okay, yeah, I could probably walk another

10:46 mile tomorrow that felt really good or oh, no, that felt like my edge.

10:50 Right?

10:51 We’re smart enough.

10:52 We have enough intrinsic wisdom to know how to do that if people just empower us with

10:56 some kind of guidelines, right?

11:00 And so what Rebecca’s fighting really hard for and what we’ve, you know, I work at a

11:05 small rural hospital in Salida, Colorado.

11:08 And so at our hospital, we deliver about 100 babies a year.

11:12 I’m sure that number is on the rise because our community is growing, but that’s very

11:16 different than having delivering 100 babies a month at a tertiary hospital.

11:20 Yeah.

11:21 Yeah.

11:22 So we lack a lot of red tape that big tertiary hospitals have.

11:25 We have been able to implement an automated immediate postpartum evaluation for every

11:30 single person that has a baby in our hospital.

11:32 Amazing.

11:33 Congratulations.

11:34 Thank you.

11:35 But, you know, we know that’s not the norm across the country, but really like much

11:42 of the information we’re disseminating to people could be disseminated in a handout

11:46 by other professionals.

11:48 You know, just to say like, we know this is more information than you can take in right

11:52 now.

11:53 We know you’ve literally just pushed a human out of your body, but in three weeks when

11:58 you start to move more and you start to wake up to your skin again and you’re like, wait

12:02 a second, is this okay?

12:03 How do I monitor this?

12:04 And you have this information that someone gave you.

12:07 That’s really powerful.

12:08 Yeah.

12:09 Um, and, and I think it’s also important because what that does is it helps to manage expectations,

12:15 you know, like I had like a very minor surgical procedure a couple of years ago and my doctor

12:22 laid out exactly what to expect day one, day two, day three, day seven, day 14, day 21,

12:29 day two.

12:30 I mean, it was like, and so when things were happening, I was like, oh, she said this was

12:35 going to happen and I’m seeing her tomorrow, so we’ll discuss it.

12:38 Or oh, she said, by the time I’m at this point, I should feel this.

12:43 And the management of those expectations allows you, like you said, to have a little more

12:49 agency over your own body to decrease fear around, um, uh, a surgical procedure.

12:57 So in this case, especially women who have had a C-section, I mean, that is major abdominal

13:03 surgery.

13:04 If someone has heart surgery or any other major abdominal surgery, they’re leaving with

13:09 the list of what things to do, things to look out for and for when it’s like, see ya.

13:15 Yes.

13:16 Good luck.

13:17 So this is called a protocol, right?

13:19 And it’s a protocol that is based on scientific evidence of the histology of our tissue healing.

13:26 Right?

13:27 These are timelines based on averages.

13:30 Caesareans are not new.

13:31 We’re not doing ACL repairs and sending people home without a protocol.

13:35 Exactly what you’re saying.

13:37 Right?

13:38 We know pretty much on average how long it’s going to take to heal and what the benchmarks

13:41 are going to be.

13:42 And there’s of course outliers on both ends of the spectrum.

13:45 So why we’re not doing that for exactly what you said, a major abdominal surgery that interferes

13:51 with our deep tissue stability system that impacts all of our, not only all of our visceral

13:59 function, our bowel and bladder function, our uterine function, but impacts, you know,

14:05 contributes to one of the biggest problems in our country, which is low back pain.

14:09 Low back pain.

14:10 I was just thinking that.

14:11 Yeah.

14:12 So, um, yeah.

14:13 So exactly what you’re saying, like why we’re doing abdominal surgeries and not treating

14:16 them the same way that we’re treating other orthopedic surgeries is baffling.

14:21 It’s a part of this bigger cultural issue of not prioritizing good support in women’s

14:27 health.

14:28 Right.

14:29 Right.

14:30 And, and just think if women knew warning signs or knew, had a better grasp of expectations,

14:38 perhaps we can reduce maternal mortality rates because, Hey, they know like, man, I’m two

14:45 days out from a baby and I’m feeling this.

14:48 And it says, you know, I spoke to my physical therapist, I thought it’s not normal.

14:52 Get yourself to the hospital.

14:54 Like this is an emergency situation.

14:56 Like you said, this is a red flag.

14:57 I need to take care of this.

14:59 Exactly.

15:00 And I think there’s a lack of, uh, agency in reaching back out to physicians or feeling

15:07 like we’re burdening our healthcare workers by reaching out to them.

15:10 You know, we think we’re being dramatic or we’re exaggerating because we do as women

15:15 have a tendency to sort of do our fuck up meditation, as I say, right?

15:19 Like more of a suck up, suck it up attitude and all the emphasis is on the infant.

15:23 And so having, having a doctor say, I want you to monitor these things.

15:28 I want you to come back to me at these things, then empowers you to feel comfortable.

15:34 Right.

15:35 Because again, if someone has a total knee replacement, a total hip replacement and ACL,

15:39 they’re given those instructions.

15:41 Yeah.

15:42 Hey, if this happens next day, yes.

15:46 And they’re seeing a physical therapist, if not that day or the next day within three

15:50 days of that surgery.

15:51 Yeah, yeah, yeah.

15:52 For sure.

15:53 For sure.

15:54 Somebody is monitoring them multiple times a week for infection, right?

15:57 Right.

15:58 Or signs of ADHD, things like that, which can happen after a major abdominal surgery.

16:05 After surgery too.

16:06 Yes.

16:07 Yeah.

16:08 So, you know, these are things that, that for whatever reason, it’s just been look glossed

16:13 over, or turn, look the other way, or like you said, it’s all about the baby, less about

16:20 the mother.

16:21 When I think there should be an equal attention to both, to the baby and to the patient.

16:29 Yeah.

16:31 If we’re not caring for the patient, right?

16:33 The patient, if we’re not caring for the mother of that baby, then we’re not optimizing the

16:39 quality of care that baby is going to receive.

16:41 And we’re not optimizing that mother’s ability to contribute to community, to contribute

16:45 not only to her family, but to her community.

16:47 Right.

16:48 Right.

16:49 It’s going to impact her work performance when she returns in way too short of a time

16:52 that we’re going to give her.

16:55 It’s going to impact her presence at work, all of those things.

16:59 And so everybody loses, right?

17:01 Yeah.

17:02 It’s a lose, lose.

17:03 Yeah.

17:04 And a lot of these things that we’re talking about, you know, I often say like, it may

17:08 not be life-threatening, but it can still threaten your quality of life.

17:13 Sure.

17:14 Which is so important.

17:16 Right.

17:17 So beyond those like big red flags, they things like DVT and major nerve palsies and you know,

17:25 other things we see that are cardiac events, things that we see that are really life-threatening.

17:30 These are things that really impact often a person’s not only ability to care for themselves

17:34 and care for their child, but their self-efficacy and their sense of self-worth and their ability

17:40 to want to put energy back into their body to feed themselves well, to exercise, to do

17:45 all these things that really then impact their long-term health.

17:48 Right.

17:49 Right.

17:50 And also, I think looking at their social life, their, you know, if you think, I can’t,

17:57 you know, I can’t run or I can’t do this, I’m leaking and oh, I had a baby, this is

18:01 normal.

18:02 But then, well, what happens?

18:04 Well, maybe they stop going to the gym, right?

18:06 Because they don’t want to be embarrassed.

18:08 They don’t want to be in that situation.

18:10 Right.

18:11 So then what can happen?

18:12 A whole cascade of events.

18:14 Like, what if that’s, what if you love going to the gym or you loved running, you’re part

18:17 of a running group, it was your social circle, your support team, everything starts to fall

18:21 away, which then affects you from emotionally, physically, mentally, and of course, is going

18:30 to affect the way you’re parenting that child.

18:34 Yeah.

18:35 Yeah.

18:36 And that’s to say, like, you know, there are all these barriers to even getting to that

18:39 six week follow up visit with your OB or your, you know, doctor, which already is too late.

18:45 It’s just too late.

18:46 Right.

18:47 Right.

18:48 But there are so many barriers to that visit, especially for, depending on your, you know,

18:55 SES and where you live, and there’s a lot of racial intricacies into that and beliefs

19:00 about the healthcare system, trust in the healthcare system, not to mention, you know,

19:05 childcare, transportation, time away from work, not everybody gets any maternity leave.

19:10 That’s right.

19:11 So you know, you miss that six week visit.

19:14 The one time that someone’s going to screen you for certain, you know, levels of vitality,

19:21 that’s a huge problem.

19:23 And then if you do go to that visit, you know, your doctor may or may not screen for all

19:27 the things that we as PTs look for, right, or other sorts of childcare providers or maternal

19:32 care providers look for.

19:34 So if those questions aren’t asked of you, you may never know to ask them.

19:40 And then you just don’t get linked to those resources that where we can really nip a mild

19:47 problem in the bud early on.

19:49 Right.

19:50 So then say they do go back to running and they’re always leaking, but they have a prolapse

19:53 that was never diagnosed and that worsens over time.

19:56 And then the long term is like, somebody’s going to tell them there’s a surgery that

19:59 can fix that.

20:00 And then they have this slaying procedure that failed in eight to 10 years and they’re

20:05 back in our office and you know, and then they go through menopause and no one talked

20:09 to them about how perimenopausal hormonal shifts impact their tensile forces of their

20:14 tissue.

20:15 So there’s all these layers and it does stick with people lifelong.

20:17 So when I asked my, you know, 70 year old patients about their childbirth history, they

20:22 often scoff at me, but these things leave signatures in our bodies that stay with us

20:27 forever.

20:28 Yeah.

20:29 Um, you know,

20:30 Yeah, I remember speaking to someone, they said, well, once you’re postpartum, you’re

20:34 always postpartum.

20:35 You’re always postpartum.

20:36 It doesn’t matter what age you are, you are always postpartum.

20:40 Yeah.

20:41 And, and that’s a really important thing to keep in mind.

20:45 Yeah.

20:46 And so, cause I asked patients the same thing.

20:48 I asked about their childbirth history and they’re like, I’m in my fifties.

20:54 My kids are like in college, what does this matter?

20:58 And I’m like, well,

20:59 Yeah.

21:00 Then you start to get in there and peel back some layers and you know,

21:05 Oh yeah, I’ve sex has just been painful forever.

21:07 I don’t remember the time it wasn’t, it’s fine.

21:09 I’ve just endured it.

21:10 Right.

21:11 And you’re like, well, that’s sad.

21:14 That’s not right.

21:15 And you know, I’m, I’m want to pick up on something that you said earlier, um, about

21:20 people who maybe are in more rural areas.

21:24 You’re in a rural area or have transportation issue, childcare issues.

21:28 They can’t get to their doctor after six weeks, let alone to a physical therapist once a week

21:35 or twice a week or something like that.

21:38 So what is there a way to work with these people online?

21:45 Yeah.

21:46 So how does that work?

21:47 Cause I know that’s what you’ve started.

21:50 So can you talk a little bit about like, Hey, how does this, cause people will be like,

21:54 what do you mean?

21:55 How can someone work with me online with my pelvic floor?

21:59 How does that work?

22:00 Yeah.

22:01 Um, so, you know, coming from, so just a little bit about my background, I know you’ve discussed

22:07 it a little bit.

22:08 Um, you know, I’ve been a pelvic health PT for about five and a half years.

22:12 I’m super passionate about perinatal care.

22:15 That’s really my heart and soul.

22:17 And um, I’ve seen it go really, really well.

22:20 Like I think that the service that we’re providing in our hospital is phenomenal and people do

22:24 get this really beautiful through line of care across four trimesters.

22:28 But I’ve also recognized that that is not the norm.

22:31 And seeing, I’m just seeing, I started seeing all these deficits in the healthcare system.

22:34 So people were really slipping through the cracks in that postpartum period because of

22:38 all the things we’ve already talked about all these barriers to getting to in-person

22:42 services.

22:43 Um, we also know that, you know, our healthcare system is just extremely taxed and asking

22:51 our physicians to do more is a really difficult ask.

22:54 Like we’re all at the real edges of what we can, of our capacity in a week of how many

23:00 clients we can take, how many people we can see, what we can do for them.

23:03 So um, when I have someone who’s like, I can’t get to that six week postpartum follow up

23:08 with you, right.

23:09 With pelvic PT, um, because I don’t have childcare and like bring the children, get here, I will

23:16 call you.

23:17 We can talk on the phone.

23:18 Right.

23:19 Um, because we, as PTs are always like trying to do the most for people and go above and

23:23 beyond, but there are limits still to how many hours are in a day, how much we can stretch

23:29 and what we can provide to people.

23:30 So in seeing all these barriers to care, um, I decided to navigate my way into more of

23:39 a consulting space.

23:42 So this is the, this is my answer, right?

23:45 This is my answer to like, okay, traditional healthcare is not working for everyone in

23:50 every circumstance.

23:51 Sometimes it is beautifully.

23:52 Um, and there’s a time and place for everything, but when people are unable to get to a pelvic

23:58 PT, right, say they see their provider at six weeks, they get that referral, then they

24:03 have to wait another 12 weeks because the pelvic PT is in their area are so taxed and

24:08 so backed up.

24:09 If there is a pelvic PT in their area.

24:11 Um, then what, right?

24:16 Then we missed the entire fourth trimester, right?

24:20 This entire really vital period where people are in these early stages of healing, laying

24:25 scar tissue, laying, having the opportunity to lay a strong foundation again, after all

24:30 their supportive tissues have been stretched.

24:32 So then what, so coming at this as a consultant, um, as a way of people being able to schedule

24:39 a time online with me, meet me virtually a hundred percent virtually, I’m not meeting

24:44 with anyone in person, have a one hour session that is 100% individualized and then get really

24:52 fundamental information that they deserve to have.

24:55 So you know what I’m not doing is I’m not evaluating them.

24:59 I can’t evaluate their pelvic floor.

25:01 I can’t diagnose them.

25:02 I’m not going to tell them like, sounds like you have a prolapse, right?

25:06 That’s not what I’m here for.

25:07 I have immense respect for the professional physical therapy and there is no substitute

25:12 for in-person healthcare period.

25:14 But there’s a lot of patient education that I feel like I can disseminate in good faith,

25:20 like that I could put in a book tomorrow, you know?

25:23 Um, but the reason I’m not doing that is because I want it to be individualized because it

25:27 needs to be individualized.

25:30 And so this is a way for people to have a safe space to ask their burning questions

25:36 from home without childcare, without transportation, naked nursing, drinking their wine.

25:43 I do not care.

25:44 Um, but have access to someone who is a professional with a lot of knowledge, um, and who can really

25:51 help them get where they need to go.

25:53 So then my job as a consultant is here are the best programs, providers, resources, um,

26:01 products for you right now.

26:04 Um, and here are some really simple instructional videos on how to do the things that we talked

26:09 about in the beginning of this talk, right?

26:11 How to safely roll in bed, how to monitor your scar tissue, how to breathe when you

26:15 move if they’re higher level and they’re starting to progress to exercise.

26:19 And now things are starting to come up how to kind of build back into an exercise program

26:25 or get with the trainer who can help them do that safely.

26:27 Right, right.

26:28 So kind of being that central point and then if necessary, you could say, Hey, I know someone

26:34 here who you can work with or here’s this like system that I’ve developed because this

26:40 is something I’m so passionate about and I just want to make sure you’re in the best

26:44 hands.

26:45 Yep.

26:46 Yeah.

26:47 And so still doing that, you know, I’m still working in a HIPAA compliant EMR system.

26:50 Everything goes, everything honors patient privacy, even though I’m not working under

26:53 my license and not working as a healthcare professional.

26:57 Um, so their privacy is completely honored, but it’s just a, it’s a sheer product of feeling

27:05 like people shouldn’t have to wait in pain and suffering and discomfort for this information.

27:10 They should have access to it as soon as they need it.

27:13 Um, until they can get to that next provider or to that next step, but not be in a position

27:20 where they’re able to make things much worse than they need it to be.

27:24 Right.

27:25 So what have you seen with this consulting practice?

27:29 What are some outcomes that you have seen with the people that you’re working with?

27:34 Yeah.

27:35 So I’ve found that it’s helped people avoid a lot of unnecessary intervention.

27:41 So, um, you know, acute pain after childbirth with urination and being able to give somebody

27:49 some really simple strategies to mobilize their tissue to breathe differently when they

27:54 sit down on the toilet, right.

27:56 Recognizing that’s probably a hypertonic response to that pain that’s then furthering their

28:00 inability to have a bladder to avoid their bladder.

28:05 Um, helping people understand like this is probably the mechanism.

28:09 It’s amazing how much people calm down when they understand why something is happening.

28:13 Absolutely.

28:14 Right.

28:15 Yes.

28:16 A hundred percent.

28:17 Like when we do labor and delivery training, we explain that the ring of fire, um, during,

28:23 you know, push phase is just the podendal nerve on stretch, just the podendal nerve

28:27 on stretch, you know, and that’s a, that’s something that people can kind of have as

28:30 a mantra.

28:31 Um, so in that same way, just empowering someone like in that position with these are the things

28:35 you’re going to try.

28:36 You’re going to try these breathing techniques.

28:38 You’re going to try to do this manually for yourself.

28:41 This is what you do when you’re going to pee.

28:43 You’re going to stay super hydrated.

28:44 These are the foods you’re going to shy away from for the next 48 hours.

28:48 Right.

28:49 And something, a conversation like that prevented like a trip to the ED.

28:52 Right.

28:53 Um, or, you know, see, I’ve seen some people later in their postpartum, um, around like

29:00 18 months or so who are in that one to two year period where they’re really back to all

29:06 their regular activities and, and they’re still having some leakage, but only at really

29:10 high level things, but never really went to physical therapy on a regular basis.

29:15 Right.

29:16 So that, because they couldn’t with their jobs and their kids and the realities of their

29:20 lives.

29:21 Um, and so they didn’t really rebuild the strength of their pelvic floor and their transverse

29:26 abdominis and the, that in coordination with their breath and under load and sort of the

29:31 load that the pelvic floor could tolerate.

29:32 So kind of going back to the foundation and saying, here’s where I want you to start again.

29:37 And then I want you to integrate this slowly back into those activities.

29:40 And at the point where that pressure overrides too much demand on the pelvic floor, then

29:44 that’s where you’re going to hang out for a little while.

29:46 Right.

29:47 And then your way back up.

29:48 Um, so kind of everything on that spectrum from sort of people calling me with like the

29:54 shock of afterbirth, you know, those early few weeks, um, to people that are much, much

30:01 later on and are realizing that maybe regular PT isn’t something that fits into their day

30:05 to day life.

30:06 And I feel like I can consult with people until a point where I’m the first to advocate

30:13 for the profession and advocate for healthcare and say like, no, this is time to go see someone

30:16 in person.

30:17 Right.

30:18 And you know, that, that saying knowledge is power.

30:21 It’s it’s an old adage for a reason.

30:25 Yeah.

30:26 Because so often just giving people knowledge doesn’t have to be the hands-on care, but

30:31 just giving people knowledge can help them move forward in such a meaningful way.

30:37 Yeah.

30:38 And I think I felt confident starting this business and, you know, taking this little

30:44 tangent in my life and taking a risk on this avenue because I started to realize that the

30:50 most valuable information people were getting from me was on that first visit.

30:54 Yeah.

30:55 Makes sense.

30:56 You know, the amount that we share with people in that day one that they have never heard

31:00 from anyone else, the fact that we simply sit and talk to them for an hour at the evaluation,

31:08 and they feel heard, right.

31:09 And they feel validated and they feel like a lot of that fear is dispelled.

31:14 They gain more confidence.

31:16 Yes.

31:17 They gain so much confidence.

31:19 Yeah.

31:20 And oftentimes I’m like, I wish you hadn’t had to wait eight weeks for us to have this

31:25 chat, you know?

31:26 Right, right, right, right.

31:27 Or, you know, or you start speaking as you’re having these conversations, the patient’s

31:31 just looking at you like, what, wait, what?

31:35 Yeah.

31:36 Wait, I, I could have done X, Y, Z, but no one ever told me?

31:41 Or I could have, oh, okay.

31:44 Oh, wait a second.

31:45 So I think you get a lot of like light bulbs going off in, in the mind of the patient or

31:52 the person sitting in front of you as listening intently, asking better questions.

32:01 And like you said, then individualizing the information given to that person.

32:06 Yeah.

32:07 Often just questions that they didn’t know they were allowed to be asked.

32:10 Right.

32:11 Right.

32:12 To ask somebody about peeing and pooping and sex without making it with, with there be

32:17 absolutely being no judgment or stigma attached to that.

32:21 That’s a really rare, unusual space to be in.

32:23 And there’s a lot of power behind that.

32:25 Right.

32:26 Because again, those are the things that really matter.

32:27 Like we take those things for granted until they’re going, until they’re not going well.

32:32 Right.

32:33 And then they’re really defeating.

32:35 So it’s really, really important.

32:38 And it’s not to say that I ever want people, you know, I feel very strongly that I never

32:43 want people to feel like what happened to them was wrong or other people didn’t make

32:50 the right decisions for them.

32:52 Like I really want to be an advocate that healthcare providers are doing absolutely

32:58 their best.

32:59 We all have a really unique scope that is to be respected and honored.

33:04 Everyone’s doing the best with the information they have at the time.

33:07 Right.

33:08 And making the best clinical decisions they have at the time.

33:11 I do think sometimes as healthcare providers, we take for granted the normalcy of what we

33:15 do, the unremarkableness of sort of the every day.

33:20 And we forget to tell people why we’re making the decisions we’re making, you know?

33:24 So I do think that we, as a healthcare community need to be doing a better job of informing

33:29 people so that people can then make informed, give us informed consent.

33:37 But my job is not to say like, Ooh, that really, that’s too bad.

33:40 You had that baby on your back.

33:42 You know, my job is to say, okay, here we are, you know, here we are.

33:46 You have a healthy baby.

33:48 Let’s move forward.

33:49 What can we do now?

33:50 Right.

33:51 What can we learn from this?

33:52 How can you grieve that and be where you are and do what’s best for your body?

33:59 And so I definitely think there are things that need to be remediated in the way that

34:03 we, in our birth practices in this country and the way that we treat birthing people

34:07 and the way that we educate them and the way that we prepare them for labor and delivery

34:11 and the choices that we give them.

34:14 But medicine serves its purpose and every situation is unique.

34:19 And I just want to be there to help people out on the other side, no matter how it goes.

34:24 Yeah, absolutely.

34:26 Well, thank you so much.

34:28 Now where can people find more information on you and on the consultant practice that

34:35 the, your online consultancy practice?

34:38 Yes.

34:39 So the best place to get all this information is on my website, which is your hearth healing.com

34:45 hearth like a fire.

34:47 Okay.

34:48 And I’m also on social, I’m at your hearth healing on Instagram and hearth healing on

34:54 Facebook.

34:56 Those are the best places to go.

34:58 If you go to my website and you want to book a session, there’s just a box in the top right

35:01 corner that says book now.

35:03 And that takes you right to simple practice, which is my EMR.

35:06 It’s super easy to just pick your time.

35:09 I confirm it.

35:10 And then there’s a really, really simple intake so that I’m just trying to make it a streamline

35:15 for people as possible for tired new parents.

35:20 And again, you know, it’s just really readily available for anybody at any time.

35:25 Postpartum, I love that you said you’re always postpartum because I do think there’s a void

35:30 to be filled with this business for that more early postpartum time.

35:34 But I don’t want to dissuade anyone who feels like they need these services at any time

35:38 postpartum to come my way.

35:41 Perfect.

35:42 And before we wrap things up, I have one more question and it’s one that I ask everyone.

35:46 It’s knowing where you are now in your life and career.

35:49 What advice would you give to let’s say your 20 year old self?

35:55 I would say imposter syndrome is real, but don’t take your knowledge for granted.

36:01 So don’t assume that people around you that have been doing this much longer than you

36:06 know more than you because you have a unique voice, a unique perspective and unique gifts

36:11 that deserve to be shared.

36:14 And often that fresh perspective can really be the thing that leads to innovation.

36:19 So be brave.

36:21 I love it.

36:22 I love that.

36:23 Thank you so much.

36:24 And again, everyone, if you want to learn more about Laura or you want to consult with

36:31 her, check out her website at your hearth.

36:35 That’s H E A R T H healing with another H. So there’s two H’s in there.

36:41 So your heart healing dot com.

36:44 And of course, you can always go to the website for this podcast at podcast dot healthy, wealthy,

36:49 smart dot com.

36:50 One click will take you to all of her social media and to the website.

36:54 So Laura, thank you so much again for coming on.

36:57 I really appreciate you continuing our talk on the postpartum period.

37:03 So thank you so much.

37:04 Thank you.

37:05 It’s been an honor.

37:06 Yes.

37:07 And everyone, thanks so much for listening.

37:08 Have a great couple of days and stay healthy, wealthy and smart.

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©2019 Karen Litzy Physical Therapy PLLC.
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