Our hypothesis (or idea) is that with pelvic floor physical therapy, women will experience significantly less trauma during childbirth. This includes less perineal tearing (aka tearing to their lady parts), less time spent pushing, and less Cesarean section risk. We also think that they will experience a better recovery with less pain and improved function after delivery.
At Revitalize Physical Therapy we specialize in pregnancy and postpartum pelvic floor issues. After years of treating women during pregnancy, we started to notice a trend with our patients. All of them had really good outcomes during delivery with minimal tearing, fast pushing phases and no C-sections. This was very different from what was considered “normal” and in the research. When we started looking to the research for answers to our great patient outcomes, we couldn’t find a single research study that looked at the effects of pelvic floor physical therapy. With this data, it could potentially change our standard of care for the pregnant patient and lead to less birth complications and their long-term implications!
After working with pregnant women for over 4 years, we have seen really great results. They have experienced less trauma with perineal tearing, shorter pushing phases during delivery, less C-sections and faster recoveries with less pain. In fact, most women tell us that it was their "easiest" delivery to date!
Don't take it from us! Here are some thoughts from some of our recent patients:
Most women are told to do kegels during pregnancy in order to "strengthen the pelvic floor for childbirth." However, the pelvic floor muscles must stretch 2.5 times their normal length in order to allow for the delivery of baby vaginally through the levator hiatus. It is also very common during pregnancy, in our experience, that the pelvic floor muscles become too overactive (aka too tight) due to the extra demands on those muscles during this time. If the pelvic floor muscles become overactive, these muscles aren't as pliable as normal and can’t stretch adequately in order to allow for delivery. This can hinder the delivery process as well as lead to higher likelihood of tearing and longer amount of time spent pushing. Tearing and other birth trauma can lead to a longer and more challenging recovery from childbirth with further pelvic floor issues. Our goal is to release these commonly tight areas and have data to support what we have seen in our patients.
Note: The levator hiatus is the opening within the pelvic floor muscles that allows for the passage of the baby (see photo).
In order to eliminate these "overactive" pelvic floor muscles, we perform myofascial release as part of pelvic floor physical therapy. Our study design includes participants starting in their third trimester in order to receive an adequate number of treatment sessions before delivery. All of our participants will receive standardized treatment so that we can evaluate the results afterwards. Then we will measure differences in the C-section rate, degree of tearing, length of pushing, and pain and functional limitations in the postpartum period.
Below is a timeline of the study for our participants:
Pelvic floor physical therapy often involves a comprehensive approach to treating the whole body using manual release techniques, joint mobilizations, strengthening and retraining exercises, and breathing training. For this research study, we will be focused primarily on manual release techniques called myofascial release, in order to downtrain (aka relax) the deep pelvic floor muscles. We will also be including training in breathing, pelvic floor stretching, and pelvic floor relaxation.
Internal pelvic floor assessment and treatment is very gentle and usually pain-free, in fact it’s less intrusive than intercourse which is why it’s safe to have this treatment during pregnancy. This is also MUCH different than "perineal massage" because it is targeting the deeper pelvic floor muscles rather than the superficial muscles surrounding the vaginal opening.
The following benefits are what we have experienced with our clients and what we are hypothesizing to be significant:
The results from this research could have long term implications for improving the standard of care for the pregnant woman. If our treatment does lead to less trauma for the mom, it should be included as part of prenatal care and education. It also can assist in less birth complications. With C-sections and longer pushing phases, there are more risks for medical complications for mom and baby, as well as infection risk with C-sections and perineal tearing. We also hope that this helps aid in a woman's postpartum recovery since she will have less physical and potentially emotional and psychological limitations to deal with if she is not in pain or healing from a potential surgical intervention.
As mentioned above, we have been performing these interventions for over 4 years on women and noticing results. Approximately 3 years ago, we started to develop a research study design in order to collect data for this treatment. In March 2019, we partnered with University of Wisconsin - Milwaukee for more assistance on this in order to ensure a quality research study. The proposal for this was submitted to the International Review Board (IRB) in October 2019 and is currently under review. Once we receive approval from the IRB, we plan to begin collecting data and providing this treatment to pregnant women in our local area. Currently, the research study will need to include a minimum of 100 participants so we are looking to perform a pilot study with the first 50 with money raised during this campaign. The remaining 50 will then need to be tested and funding secured. Our plan is to complete data collection within the following 2 years.
We are crowdfunding and asking for your donation as a way to financially provide these services. The treatment in this research study is performed one-on-one for an hour (each session) and is very personal and intimate. Because of this, we have overhead costs to pay staff in order to provide this treatment. Since we are a small, private practice, we do not have access to funds or grants that a large healthcare organization would. It is also a substantial time commitment that will greatly impact the revenue of our clinic and ability to treat other clients that are not part of this study. It is important to us to keep the cost as low as possible for the participant in order to be able to provide this treatment to a diverse demographic of women.
Our goal amount is to be able to fully fund the first 50 participants of our study after discounting our services to only cover overhead costs (no profit). Any amount raised will help offset the cost for our participants so our flexible goal is to be able to provide some additional funding for our participants if our goal is not met.
This stretch goal will allow us to fully fund the first 50 participants for the research study so there is no cost to them to participate. This will also allow for a greater diversity within the demographics of our participants since there will be no financial barrier to them.
Reaching stretch goal #2 would allow us to fully fund all 100 participants for the research study and complete the data collection much faster since there are less barriers to getting participants.
Any excess funds raised above our initial goal will be divided up among our participants to offset the cost as much as possible with the money raised.
When we first starting seeing these results in our patients, it made us so excited and hopeful that we may have found a way to help and empower women to have better deliveries and better recoveries! Complications and trauma during childbirth has been shown to increase a woman's risk for pelvic floor dysfunction including painful intercourse, incontinence, and pelvic organ prolapse. We thought that this type of treatment could help decrease that risk and help women have better long-term function without pelvic floor issues. As we always say, pelvic floor dysfunction is common but not normal!
By funding this research study, you could help the women in your life have less childbirth complications, a better recovery, and an improved beginning to their motherhood journey.
For the last 3 years we've been working so hard to design this study and find a way to provide better prenatal care to women and now we need your help to spread the word about it! We'd love if you shared with your friends, family, and anyone who might be interested. Thank you so much!
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