Pregnancy and postpartum recovery can be a mystery to every woman until they go through them. Even still, the first pregnancy, delivery, and recovery can be significantly different than the last. However, when you’re not only a physical therapist but also an expert in pelvic health, you know certain things that can make your experience a little easier. Head knowledge and experience now give Mackenzie Van Loo a richer appreciation and understanding of the journey of pregnancy, birth, and recovery.
Mackenzie Van Loo is not only a physical therapist; she is a certified obstetrics physical therapist and pelvic health expert. So, you could say she knows quite a bit about preparing for labor, birth, as well as recovering physically from having a baby. At twelve weeks postpartum, the recovery process is incredibly real and very fresh to Mackenzie.
“My daughter, Holiday, didn’t come until 41 weeks and three days, and even then, I had to be induced,” said Mackenzie. “I labored very hard and intensely for 35 hours, but I failed to progress, and Holiday’s heart rate began to drop, so we decided it was time for a cesarean. Even with my knowledge of what to do, the outcome was one that I still had to mourn.”
Before her education in obstetrics physical therapy, Mackenzie’s vision of childbirth, like many others, was what she’d seen portrayed in the movies: women screaming and tremendous amounts of pain. What Mackenzie realized in her labor and birth was something different. She found that labeling the contractions as they were – pressure, stretching, cramping – and knowing that they would last no more than 90 seconds were strategies to laboring well and independently with confidence.
The Bowling Ball in a Hammock
The act of carrying a baby for nine months is still a long, low stretch that alters the structures of the pelvis and abdomen. Mackenzie likens it to a bowling ball in a hammock- that long low stretch over time changes the structure and support of the hammock, aka your pelvic floor. Additionally, during a vaginal delivery, the pelvic floor stretches three times its length. While a cesarean birth doesn’t stretch quite as much, it dramatically impacts the pelvic floor, especially the core muscles.
Despite her knowledge and insight, Mackenzie knew she still needed someone else’s professional input to ensure she was properly coordinating her pelvic floor and core muscles.
“Cutting muscles and nerves changes the way your brain moves parts of your body. Getting and keeping myself as strong as possible before delivery has helped me recover quickly but getting my core to work in a coordinated manner took longer than I expected. Having insight from a colleague was so helpful.”
The Blamed Body Part
It used to be that the pelvic floor alone was blamed for all kinds of issues, such as incontinence, painful intercourse, and prolapse. Advancements in interdisciplinary teamwork have aided medical professionals to understand that these problems often occur due to a multitude of things: deficiencies in strength in the hips and rest of the body in addition to the core, and pelvic floor, hormonal changes, birth trauma, psychological stress, sleep deficiency, nutrition, neurological disorders and the like.
According to Mackenzie, it isn’t just their pelvic floor’s fault if a woman leaks urine when running or jumping. “You need more muscles than just the pelvic floor to run or jump,” she points out. That’s why any postpartum woman would benefit from a professional assessment from a pelvic floor physical therapist as soon as their OB gives them the green light to begin exercise. A knowledgeable PT will cover their bases to screen and then strengthen all appropriate muscle groups in addition to the pelvic floor to meet an individual’s specific goals. A thorough pelvic floor assessment will ensure that the pelvic floor muscles have a roadmap to performing at the same level as the rest of the body.
“A person can work their whole body as hard as they want, but if a muscle group isn’t performing well, they won’t get the best workout and put themselves at risk for dysfunction,” said Mackenzie.
She adds that just like a soccer player would rehab an ACL injury, the pelvic floor and core muscles must also be rehabbed after pregnancy and birth. However, many women choose not to do so or do not know to seek help. Unfortunately, the problem doesn’t go away by ignoring it.
Getting help for a personal issue doesn’t have to be taboo; it is more common than most women realize. Mackenzie’s laid-back demeanor and genuine understanding quickly make most women feel at ease.
Additionally, pelvic floor physical therapy isn’t limited to only women who have recently had a baby. As Mackenzie likes to say, “once postpartum, always postpartum.”
What she means by this is that the body changes after having a baby. But the great thing about muscles is that they, too, can change. Whether five days or 50 years postpartum, change is possible to improve quality of life.
Mackenzie wants her patients and everyone to feel confident and comfortable going into their birth experience, knowing that they can influence labor, birth, and recovery. She also hopes that her patients can come out of their birth experiences knowing that they also have the power to change their incontinence, heaviness in the vagina or rectum, leakage of urine, and painful sex. There are people out there that can help. She points out that a good PT will identify early if you need a second PT opinion, if you need another medical provider consultation for your goals, or if PT is simply not the best option for your needs. No matter what, your PT is part of your medical team, there to help you meet whatever goals you have for fitness, function, and for living a full life.