Any tips on asking your OB for a referral to pelvic floor PT after giving birth? Coming up to my 6 week appointment this week and I’d like to ask, but my doctor has been a little dismissive in the past

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Tell your OB, lie if you need to, that you’re having bladder leaking frequently (and any other symptoms you’re having) and ask if they can refer you to a PT to treat it. If they still say no, tell them to please put it in their post visit notes that they refused to refer you for treatment of provide floor disfunction.

helpfullike

This is frankly the way to go !

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“I want to go to a PT who can help with my pelvic floor. Who can you refer me to?”

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Do you need a referral? All 50 US states allow for self-referral to some amount of PT, let alone that most good pelvic PTs don’t take insurance anyway 😬

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I’m at an HMO (Kaiser), and my insurance covers pelvic floor PT (and doulas I’ve spoken to said they’re actually pretty good and recommended I try to go) but my understanding is I need a referral. The same doulas recommended trying to get PT to prepare for childbirth, but my OB said no but to check back at my 6 week appointment.

Completely reasonable for you to ask. And rude for her to be dismissive. Maybe look for another OB. that’s major red flag to me

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Or him* sounds like a male OB if I’m being presumptuous

I needed it as well and my OB flat out refused to do it and said pelvic floor PT didn’t do anything. I went to my regular primary doctor and she wrote me the referral that same day. Hopefully you don’t have that experience but know there’s other options out there 😀

helpful

What??! You need a new OB…

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Where I am (LA) you get what you pay for with PFPTs. Most of the good PFPTs don’t take insurance but will provide a superbill. You don’t need a referral to see them. PTs that insurance covers see you for 15 min and then hand you off to a trainer. If you are going just to be safe that’s probably fine but if you are experiencing actual pelvic floor issues it just isn’t enough time. If you’re experiencing heaviness or incontinence just pay and go to a good PT who will spend a solid hour or more with you.

It is disgraceful that OBs gatekeep PFPT and really have no clue how to diagnose birth injuries.

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Hope you get he healing you deserve. Pelvic floor injuries can be so disorienting and isolating.

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Also curious about this. I’ve heard pelvic floor therapy pre birth (if you’re delivering without a c section) can also be very beneficial.

I could be misremembering the timeline, but I’m pretty sure my PFPT would not start treatment until the 12 week mark unless you had been receiving treatment from her pre-pregnancy. Before 12 weeks required a release from your OB (I understood different than a referral and potentially more liability for the OB). So I’d clarify with your OB if she’s resisting for you to go at all pre-birth or just this early in the pregnancy. I think most studies about benefits of PFPT pre birth are looking at treatment in second and third trimesters, predominantly third.

The 6w rule is so outdated. I can’t believe doctors and even some PTs follow it. There’s so much that can be done by a PT other than internal work. I subluxed my pubic symphysis and waited until 6 weeks to see a PT. She could not believe my doctor did not catch it. It was centimeters out of place and I was in tremendous pain when I walked. She put it back in place and I immediately walked with little pain. I can’t imagine how much smoother my healing journey would have been if I had had seen her earlier. The gatekeeping around PT really needs to stop. With any other injury no one would tell you to wait 6 weeks.

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Trigger: rare illness post birth

Just sharing that I was diagnosed with postpartum preeclampsia 3 days after giving birth despite not having risk factors or preeclampsia in my pregnancy. Sharing as I had absolutely no idea about this illness.

Main things to do are check your BP everyday at least the first ten days after you give birth, and go to hospital if it's very high (over 160/110). If you get severe headache or stomach ache then also be vigilant.

Happy to answer any questions!

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