An Empowered Approach to Childbirth with Sophie Villeneuve, Pelvic Health PT

As part of our Expert Spotlight Series, our founder Lauren welcomed pelvic health physiotherapist and online coach Sophie Villeneuve, who specializes in prenatal and postpartum care.

With over 10 years of experience, Sophie created the Beyond Birthing Signature Program, which helps expecting parents prepare their pelvic floors for childbirth and recovery. Through her work, including her YouTube channel, she provides valuable education and support, empowering people to take proactive steps for their pelvic health. Together, Lauren and Sophie discuss the misconceptions surrounding pelvic health in pregnancy and emphasize the importance of preparing for a healthy birth experience. 

Catch the entire chat on YouTube, or check out 5 of our highlights below!

 

 

1. Shifting from Reactive to Proactive Pelvic Floor Care in Pregnancy

Sophie:

The pandemic stirred everybody's way of working, of course. I decided I would like to start a prevention program for pregnant moms who want to prevent pelvic floor issues that often arise from labor delivery and postpartum.

So I created this online coaching program that is now available to anyone in the world. And it's just been so amazing to be helping people beyond my community have the knowledge to empower them with their pelvic health before they have issues.

Because before the pandemic, I was seeing a lot of postpartum moms, but a lot of the time I was like, "I could have helped them not have that." If they had known how to stretch their pelvic floor before birth, they might not have had a third degree tear. If they had known how to push their baby properly, maybe they would not have a major prolapse. And so my interest was in how I can prevent these things from happening by giving them that information and that power in pregnancy.

Lauren:

Amazing. Not everybody lives close to a pelvic physiotherapist or resources like that. Or maybe their schedules are really challenging. Of course, there's nothing like receiving care in person, but at the same time, having those online resources, I think, can be so impactful, and they make this just even more accessible to more and more people. And you just can't get enough of that.

And I think your point about being reactive and seeking help versus being proactive is really impactful. I mean, I had a close family member who had a baby. It was her first one, and she got to the other side of it, and she was like, "I don't even think I knew how to push." Those were the kinds of things she was telling me. And you just realize that people's expectation is that it's just part of the process. You were either told those things or you might inherently know those things…

Sophie:

Or "As a woman, you were born to give birth!"

Lauren:

Exactly! And that's really hard. I felt for her so much. You realize how much advocating for yourself you have to do in education and learning that there can be to improve your possible outcomes. So I think that your program's amazing in that point about trying to be as proactive as possible. A lot of these things can be at least lessened.

And, I think the knowledge is power, too. I was connected with a pelvic health physical therapist, but I was still blindsided by my POP diagnosis. Thankfully I already had connections in place, but I think that knowledge and empowerment is also so important so that when you do experience challenges, you feel more confident to seek out people like yourself and just know that there are resources to get help.

Sophie:

A hundred percent. And I think your point that you were just mentioning, about how people don't know [about giving birth] and think that it should be this natural thing that everybody should be doing--the argument is often, "Women have been giving birth for thousands of years," and my response to that is always, "But at what cost?" We don't hear. 

If you ask a mother, "How is it going down there for you?" She may say, "Oh yeah, I'm changing my panties three times a day since I've had children," right? Yes, she's still alive. Yes, she had three children. But it's just not talked about enough, the impact of birth on pelvic health. Yes, you were able to give birth, that's one thing, but what have been the consequences on your quality of life as a woman? Maybe you've had to give up on sports that you liked or stopped having sex with your husband because it hurts too much. Do you think this is something that people talk about at their potluck dinner on a Saturday night?

Lauren:

No, it's not. For the most part, no.

 

 

2. The Four Ways Being Pregnant Impacts Your Pelvic Floor

Lauren:

How would you explain the importance of pelvic health to somebody that maybe is coming to it without a lot of knowledge? Maybe to someone who is planning to be pregnant, trying to conceive, or in early pregnancy and doesn't know a lot about it.

Sophie:

Basically, the impact of being pregnant on your pelvic floor comes down to four things. First, you've got all the hormonal changes that make your body looser because if you didn't have that, your belly would not expand to let your baby grow. So we are really thankful for these hormones to make everything looser so the baby can grow, but on the other hand, it will affect your pelvic floor and all the ligaments in your pelvis. So because of that vulnerability from the hormones, then you're more at risk of having pelvic health issues during pregnancy.

The second thing is that your posture is changing. So especially when we're talking second trimester, third trimester, our belly bump is pulling us forward. And that changes the position of your pelvis, and that can apply different weird pressure on your bladder and on your pelvic floor.

The third way is you've got a growing baby right on top of your pelvic floor. And for people who don't know what the pelvic floor is, it's a sling of muscles between your pubic bone, so the big bone at the front of your pelvis and your tailbone. It's all around your vagina and your anus. And these muscles are there to support whatever is on top, which is the pelvic organs, like the bladder, the uterus, and the rectum. But when you have a baby growing on top, then everything gets compressed. So that's a load that your pelvic floor needs to kind of counterbalance.

And then the fourth is not really pregnancy, but labor and delivery itself. Because if you give birth vaginally, your pelvic floor will need to allow your baby to come through because the pelvic floor is around the vagina. So the impact of that on the integrity of the pelvic floor is something to consider. And that's why postpartum, we might have more pelvic floor issues like bladder leakage, prolapse. If you don't know what a prolapse is, it's when one of the pelvic organs is "falling" in the vaginal canal.

So basically all of these things impact your pelvic health. Maybe you'll get lucky with your first child and you'll be like, "I've done no physio at all, and things were always fine down there." Good for you. I would say it's not the majority. So if you're not doing any preventative work, like looking into how you can help your pelvic floor to give birth without injuring itself, then you might end up with severe tearing, pushing for longer than you should, which can develop a prolapse. You could also have trouble pooping after birth having back pain because the pelvic floor supports the pelvis and the lower back. So all of these different issues can be linked to pelvic floor dysfunction.

That's why having a preventative approach like saying, "Okay, I'm pregnant right now. I would like to do the best I can to preserve my pelvic health" can be very powerful because this is something that you can actually learn to prevent all of these issues.

 

3. Postpartum Urinary Incontinence: It's Not Just "Normal"

Lauren:

What are one or two misconceptions that you still hear about that are really pervasive that you wish we could overcome in this conversation?

Sophie:

One big one is: "If you leak urine postpartum, it's normal" and it's often dismissed. And I don't want to put everyone in the same basket. A lot of doctors now are aware of pelvic health and the importance of pelvic floor physiotherapy and send their patients to a pelvic floor physio if they have these symptoms. But if you have an older doctor maybe, or someone who doesn't believe in pelvic floor physio and you go to them a few weeks after delivering your baby and you're like, "Hey, I'm peeing my pants every time I laugh or cough, or if I'm going for a run" and they say, "Well, you've had kids. This is going to be it right now" or "Go for a bladder surgery." It's often the only option they propose. 

And I totally disagree with that because when you think about it, would you say to an athlete who broke their ankle: "Well, you're an athlete. This is the way it is. You're going to injure yourself, so just live with your injury" ? No, you would tell them, "Go see a physio, go heal yourself."

There's a rehab process to this, right? We're talking about muscles that got injured possibly through birth, so why don't we rehab these muscles, just like we would do any other part of your body? So that's one big one.

 

 

4. A Positive Birth Experience Is Possible

Sophie:

Another misconception is that if you're a first time mom, you're going to necessarily tear and have a bad birth experience. I can't tell you how many first time moms are in our program and had no tearing at all or just a minor first degree tear for their first birth. Why? Because they have prepared properly. It's a bit like, taking the sports analogy, if you're signing up for a marathon, would you just show up to the start line without training? No, because when we do that, we injure ourselves. And that's kind of written in the sky. If you're not training for a marathon and you're still trying to run it, you're going to injure yourself. Same thing for birth. We're talking about muscles having to do a very specific job that is very demanding, probably the most demanding job they'll ever have to do in their life. And then we're expecting that they will perform like a high level athlete if we haven't trained them.

So if we do give them that opportunity to train, the result we can expect is that they're going to have less injuries. So that's one thing I want to emphasize: it's not because you're a first time mom that you're going to tear to your anus and that you're going to have a bad recovery. It is possible to have a beautiful birth experience where you feel empowered, you feel confident, and you feel like you know what you're doing, and that you have very good outcomes. And recovery after is so much easier when you don't have to recover from an injury.

Lauren:

And I feel like that's such an important message and one that I wish more people knew because I've had two kids now, and I had a medical phobia. I went into it doing a lot of research, trying to just make sure for myself, Can I navigate all this? What are my plans? And I knew for me, I wanted unmedicated and things like that if possible, just because of some of my own things I was working through. So I feel like I researched quite a bit and did a lot of preparing.

But I feel like there's two things that are really pervasive. It's people who have bad experiences and it's kind of like their badge of honor to share those stories of how bad it was. And that can be really hurtful for other people. Kind of like, "I had it bad. You're going to have it bad." And not really looking at how we can reshape that and help future generations not have these traumatic experiences.

And then in movies and TV shows, as I watch the birthing experiences in these, I just cringe! You internalize that as you become an adult and you're like, "Well, that's how pregnancy and birth is, and it's awful and scary, and the only position to birth is on your back" and things like that. And just we're overcoming all of these really big things to try to help women feel empowered and not scared and say it can be a good experience. Sure, there are things that are hard. It's a lot. It's something you've never experienced before, but it doesn't have to be this huge scary thing where you're tearing and being broken apart and all that kind of stuff. And I just feel like there's a lot to overcome to help people really understand that and feel confident in it. It's not easy.

Sophie:

Totally. And I think also, we live in an era where it's so easy to get these stories. You go on Instagram and sometimes it's thrown at you even though you didn't really want to hear it. Or just like you said, I think as soon as you're pregnant, people feel like somehow it's okay to throw their story at you, even though you haven't asked for it or give unsolicited advice. So yeah, it's a hard time to live in. And I understand the women who, when they're pregnant, are shutting out all social media because it's very overwhelming and it affects your mindset.

Lauren:

I was very careful with what I would watch. And even in my birthing classes, sometimes they'd want to show you a video of how a nice birth could look. I was like, "I don't know if I want to see any of those things because I'm in a good head space right now and I don't want to mess with that."

Sophie:

Exactly.

 

 

5. Caitlyn’s Second Pregnancy Story: Knowledge is Power

Lauren:

Can you share a success story or two about just some wins that you've had in this space and working with people?

Sophie:

Of course. I think one story that I would really like to share is the one of Caitlyn, a client of ours in the program. And the reason why I can share her story is because it's on my YouTube channel, and we've done a testimonial interview, so it's public and it's out there.

Caitlyn was a second time mom when she reached out to me. She was pregnant with her second baby, and she had a very traumatic first birth that ended up with episiotomy and forceps. And she had such a long recovery. It took months for her to basically get back to normal because of pelvic floor issues. And so the second time around, when we actually met to see if we wanted to work together in the program, she said, "You know what, Sophie? I'm even considering scheduling a C-section because I don't want to add more trauma to my pelvic floor."

And it's fine. I feel like there's no "bad" or "right" way to give birth. And I was supporting her in that choice. I was like, "If you want to prepare for a scheduled C-section, we have support for this in the program as well." It's not a program where it's only for women who want to give birth vaginally.

And another myth, actually, is if you give birth through a C-section, you won't have pelvic floor issues. People are very surprised sometimes postpartum. They're like, "I had a C-section and I'm leaking urine. What is the deal?" So that's a whole other topic on that side. But that's kind of the spirit she was in when we first started working together. And she was like, "I want to do the program to the T anyway in case I get into labor before my scheduled C-section, so I have the knowledge to navigate labor more comfortably than last time and be more confident."

So she was not sure where she was headed. She did the program to the T, and she wrote to me three or four days before her scheduled C-section. And she was like, "You know what? I canceled it!" because she felt so confident in giving birth vaginally, and she ended up having the most beautiful birth experience. 

People share their wins in our community, and I still remember getting her message. And when I read her post, I started crying because she was like, "I had no tear at all. I'm three days postpartum. I don't even need medication for my pain because I don't have pain." And she said that basically her second birth healed her from her first. How empowering is that? You have trauma from a first birth and your second birth actually healed you from that. So this is just another example of how knowledge is power. She had all the tools, she did all the work, she put the effort in and she got the results, and that allowed her to take care of a toddler as well.

And that's a thing with second time moms, it's another layer. If you do have a C-section, you can't lift a lot. The recovery is much harder. And if you have another little one who's weighing 35 or 40 pounds, it can be really challenging. And it's the same thing if you have a vaginal birth that doesn't end up being super good and you're in a lot of pain or symptoms after, it can be really hard to take care of your family. So I think the motivation for second time moms is even higher to have a good recovery because they know how much more they have to do after the birth.

Lauren:

That's amazing. Thank you for sharing that. I think it's really helpful to hear those stories. I know just seeing stuff on social media, a lot of people who have experienced traumatic birth experiences, pelvic organ prolapse, things like that, they wonder if they can even have another pregnancy and birth. With all of those things, your foundation is so rocked, you don't even feel confident that you can pursue that if it was something you're interested in. So I think hearing these stories of how other people are able to face something that can seem really scary and truly traumatic and come out on the other side and feel empowered and healed and all those things is really impactful.

Is there something that you would like to leave us with? One thing you wish folks knew, or just some last parting thought?

Sophie:

One thing is if someone is expecting right now and they're like, yes, I want to do this. I want to take care of my pelvic floor so I can have the best birth experience and the best recovery, I am offering free consultations online to chat with whoever is interested, and then we can see what your needs are, what your situation is, and we can see if we're fit to work together.

I've also got my YouTube channel, Beyond Birthing, where you can find a lot of free resources to prepare for birth, but also the basics of what is the pelvic floor and what we do with it when we're pregnant. So I think that's another great resource to consult if you're interested.

 

 

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**Medical Disclaimer: This post is intended to provide information and resources only. This post or any of the information contained within should not be used as a substitute for professional diagnosis, treatment, or advice. Always seek the guidance of your qualified healthcare provider with any questions you may have regarding your healthcare, conditions, and recommended treatment.