That New Mom Life Podcast Episode 7: Your Body After Baby

Welcome to Pelvic Floor 101 with Sara Reardon, a physical therapist known as The Vagina Whisperer. Learn what to expect with your postpartum body changes.

An image of a mirror on a colorful background.
Photo: Getty Images. Art: Jillian Sellers.

After discussing changes to emotions, sleep schedules, and friendships, it's finally time to chat about all the physical changes that can happen to a new mom's body. This week on That New Mom Life, Grace Bastidas and Desiree Fortin are joined by Sara Reardon, a pelvic health physical therapist who you might know as The Vagina Whisperer on Instagram.

Reardon explains the pelvic floor, diastasis recti, power-peeing (Grace didn't even realize she was doing this!), pain in postpartum sex, and what pelvic floor physical therapy entails. Spoiler: Kegals aren't always the answer!

Reardon is a firm believer in the power of talking about your experiences. She wants moms to know that if they experience these changes, they are not alone and there are resources to really help.

"I would see mom after her mom in my clinic, and they would feel so isolated [or ask], 'Am I the only one who's experiencing this?'" says Reardon. "And I'm thinking, 'Oh my gosh, I see 30 to 40 patients a week who have this problem.'"

If The Vagina Whisperer can't convince you that you're not alone, hopefully the That New Mom Life community can. Four moms share their experiences with abdominal separation, urinary leakage, and postpartum insecurities. One mom even opens up about her "bionic butt."

As she so aptly says, "You can't make this stuff up! Motherhood!"

Listen and subscribe to That New Mom Life on Apple Podcasts, Spotify, or wherever you find your favorite podcasts. That New Mom Life will be back again next week with more postpartum insights.

Upcoming topics this season:

  • How to share the parenting load
  • Establishing routines
  • Sex and romance as new parents
  • Preparing for what's next

If you have a story to tell or want to learn more about That New Mom Life, email us at thatnewmomlife@meredith.com.

Listen to episode 7 right now:

Plus follow along here:

Grace: You know, I have to say that all the body changes did hit me that first time I looked in the mirror after having a baby. Do you remember that, looking at yourself in the mirror naked?

Desiree: Girl, I completely, completely relate. That was exactly me, both with carrying triplets and delivering three babies at one time, and then having a vaginal birth with Cambria, both times staring at myself in the mirror, naked, thinking, who is this person?

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Grace: Hi, I'm Grace Bastidas and whatever relationship you had with your body in the past, having a baby changes everything!

Desiree: Hi, I'm Desiree Fortin, and yes! Your boobs, your belly, your pelvic floor all feel very different no matter how you gave birth. And we know, from personal experience, that can be tough.

Grace: What even is a pelvic floor?! It's possibly something you haven't even thought about before—but once you hear from our guest today, you'll understand why it's so important and what you can do to heal your body.

Desiree I'm so excited to hear from Sara Reardon—aka The Vagina Whisperer. She's a physical therapist who helps women after birth. But first, let's hear from some amazing moms about how they adjusted to their postpartum bodies.

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Mom 1: When I delivered my daughter, I had an episiotomy and experienced a fourth degree tear. While I didn't find my immediate recovery to be too difficult, I also did not expect to be wearing adult diapers months after we had come home from the hospital. I can still vividly remember holding my laptop behind me as I abruptly left a client meeting to hide the fact that I had just pooped my pants and hoped that no one noticed the smell. I immediately called my OB and essentially said something is very, very wrong and I needed to be fixed.

After months of twice weekly pelvic floor therapy, she referred me to a colorectal doctor, which is how I eventually ended up having surgery over 18 months after I gave birth, to implant a small battery pack in my low back, that powers a lead that runs through my sacral spine and provides ongoing electrical pulses to my pelvic floor. That stimulates the muscles there, which for me are too weak to strengthen on my own. It's sort of like a pacemaker for my butt.

My mom friends refer to it as my "bionic butt." You can't make this stuff up! Motherhood!

Mom 2: When I was pregnant with my first child, I knew the toll that pregnancy would take on my body. However, I didn't realize the toll it would take postpartum. I'm in the military, and I had to get back into shape in order to take my physical fitness test.

I was about 18 weeks postpartum when I decided it was time to finally do crunches. I laid on my back and as I crunched up, I saw my stomach sink. It was scary. I was confused. "What is going on with my body?"

I ended up going to medical and found out that I had major ab separation and an umbilical hernia.

Mom 3: My experience was that I just felt sad because my old clothes didn't fit anymore, and I just wasn't feeling like myself, or feeling pretty at all. And sometimes when I sit down or I bend down, I'm very conscious of my new belly. And it just makes me feel like I miss my old body a lot.

Mom 4: A week after having my baby girl, I was watching a comedy show on TV and laughed really hard to a joke. I then froze because I literally peed myself and not just a little pee, more pee than I actually could even believe, and I couldn't stop it. I was in total shock.

I couldn't believe that my mommy did not mention this in the list of things I needed to be prepared for. So I immediately thought to myself something was wrong with me. After doing some research and speaking with my doctor, I realized it's actually very common, but many women are too embarrassed to talk about it.

After a few weeks, I stopped being a leaky mess, but I wish I could have opened up more about all I discovered about my body.

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Desiree: Alright, now it's time to meet today's guest—Sara Reardon. She helps women get in-tune with their postpartum bodies.

Grace: Hi, Sara. Thanks for joining us today on That New Mom Life. I have a very important question to ask you, The Vagina Whisperer. How did you earn that nickname?

Sara: I wish I could take credit for it.

However, I went to undergraduate and then graduate school in physical therapy and jumped right into doing pelvic floor physical therapy. All of my friends from college, when we would get together over summers, they would just kind of jokingly refer to me as "The Vagina Whisperer" once I started doing pelvic floor therapy. So they are really to credit for the name.

Grace: I love that it was your college buddies. What is our pelvic floor and what happens to it during a vaginal birth?

Sara: So your pelvic floor is really a basket of muscles and tissues and nerves that sit at the base of your pelvis. So we're likely all familiar with what a pelvis looks like, the bony skeleton of the pubic bone in the front, and the tailbone in the back, and kind of your hip bones on the side.

And at the very base of that is a basket. Muscles which are referred to as your pelvic floor muscles. And they support your pelvic organs like your bladder, which holds urine, your rectum, which holds poop, and your uterus, which holds a growing baby during pregnancy.

So this hammock of muscles gets lengthened and stretched out over the course of pregnancy as the baby grows. And then in a vaginal birth, these muscles kind of have to soften and relax and get out of the way in order for the baby to come down the birth canal.

Grace: Do C-sections have an impact on our pelvic floor?

Sara: Absolutely. So, you know, all women who are going to give birth, whether it's vaginal or cesarean, their muscles are affected during pregnancy itself. So just there are so many changes, hormonally and physically, that occur during the pregnancy.

So regardless of the birth method, you'll have changes to your pelvic floor. But even during a cesarean birth, you know, typically the abdominal wall, the fascial tissues will be cut during the operation, the surgery, and those tissues are connected with your pelvic floor.

So often after a cesarean birth, we see women who have painful intercourse who have pelvic floor muscle tension that even without a vaginal birth, they still have changes from the cesarean section.

Grace: Okay so you mentioned painful intercourse, what are some other signs that something is wrong with our pelvic floor?

Sara: So if you start experiencing urinary leakage or difficulty emptying your bladder. If you are experiencing a difficult time holding in gas or straining during bowel movements and constipation.

But particularly with intercourse, if you're experiencing painful intercourse, with either initial insertion or deeper insertion, if you're experiencing pain after intercourse or even difficulty achieving an orgasm, all of those are signs that your muscles could be affected, where you would want to get an assessment from your physician, midwife, and/or a pelvic floor physical therapist.

Grace: How common are complications? Like does this happen to most women?

Sara: It varies, but we do know that there's a large percentage of women who experienced urinary leakage and this will only increase with aging if it goes unaddressed.

One in four women will experience painful intercourse or pelvic pain at some point in their lifetime, whether they've given birth or not.

So, I mean, that's a large percentage of people and these are just reported statistics. So this is such an intimate part of our body, one that we don't often talk about. And so I think that there are likely a lot of people who are experiencing these issues and we're just not talking about them.

Grace: Alright, you brought up a really great point that most women don't want to talk about it. Why is that? And why do we need to talk about it?

Sara: Well, you're asking The Vagina Whisperer, so I think this should be dinner table conversation as it is in my home! We don't talk about these issues when we're young women, or if we have young daughters.

You know, no fault of my mother's, but when I started my menstrual cycle at the early age of 10, she gave me a book and a box of tampons and was like, let me know if you have questions. And that was it.

And then even during sexual health education in high school, we talk about how babies are made and options for birth control, but we don't even talk about like, the anatomy and what's going on down there when we know even in high school, there are female athletes that can have urinary leakage.

And so I think it just kind of compounds over time. When we don't talk about these issues, it almost makes it seem like we shouldn't or if there's something to be embarrassed about. And just the fact of the matter is they're intimate parts of our lives.

Like, it's embarrassing sometimes to pee your pants or to, you know, not be able to hold in gas and, and it affects intimate parts of our lives if we can't have sexual intercourse with our partner.

So I think it's important to talk about them so that people know they're not alone. And then I think if we start to talk about them, people know where to get help as well.

Grace: You also mentioned urinary leakage, which gets worse as we age, unfortunately. So is that something we just have to accept after having a baby?

Sara: No, it's not. So, there are studies that show that if you start pelvic floor physical therapy and retraining your pelvic floor after birth, that you're less likely to experience urinary incontinence after having babies.

The reason it changes and kind of increases over time is because our estrogen levels in our body decrease when we near menopause and lower estrogen levels can cause some pelvic floor muscle weakness and tissue thinning.

But no, I mean, I refuse to believe that diapers is part of my destiny. I think that there is so much that we can do. And really empower women to, you know, have resources to take control of this part of their body and know what options are out there for them. So, you know, leakage is not something we just have to learn to deal with, although that's been the messaging for a long time for moms.

Grace: I am right there with you. So tell us what is pelvic floor physical therapy?

Sara: So when we think of physical therapists, you know, we think of PTs who work with muscles and injuries and, you know, sports maybe, but a pelvic floor physical therapist really works with muscles in the pelvic region of your body.

So just as I mentioned earlier, that basket of muscles, if those muscles are weak and not supporting your organs or not keeping in pee and poop appropriately. If they're tense and they're causing pain or painful intercourse or constipation, or if they are uncoordinated and they're not turning on or turning off when we need them to, typically that will lead to some problems where a pelvic floor, physical therapists can look at the outside muscles of the abdominals and the buttocks and low back, and then also do an intra-vaginal or inter-rectal assessment to determine if those pelvic floor muscles need some, you know, physical therapy, whether it's strengthening or relaxation.

I think the tricky part is we've all read about kegels, but if you have tension, kegels are the wrong exercise for you and most women don't even know how to do a kegel properly. So there's just so much more to it than just doing kegels.

Grace: Oh, I'm so glad you said that because kegels are sort of touted as the cure-all.

Sara: Right, and they're not. It's kind of like saying if you have back pain, just do crunches. And we know that that's not the case.

I think especially in today's day and age, a lot of people have tension in their bodies, whether it's in their neck and shoulders that's causing headaches, or if it's in their pelvic floor muscles that you know, they have tension and that's impairing their ability to have enjoyable intercourse or they can't contract their muscles well to prevent leakage or something like that.

So I actually see a lot of women with tension and kegels would be the opposite of what they need to be doing.

Grace: So how soon can we start physical therapy for our pelvic floor? And is it ever too late to start?

Sara: It's never too late. Recently I was in my clinic and I had a young woman who was in her mid-twenties leave my office for some pelvic floor issues. And then I had another woman walk in after her who was in her seventies coming in for pelvic floor issues.

So it was just such a beautiful moment where I thought, "Wow, at all seasons of life, we can help women, because we all have pelvic floors and you can experience issues, whether even you've had babies or not." But I focus a lot on pregnancy and postpartum because I think that we just go through such a huge transformation physically, and there's just such little follow-up care.

So I usually recommend that if we're able to see someone during pregnancy that's ideal. If not, then I love having a checkup at about six weeks postpartum. Usually they check in with their midwife or obstetrician. And then they come in to see us to check their abdominals and-and pelvic floor after they returned to sex or exercise.

But even years later, decades later, it is absolutely recommended to come in for pelvic floor therapy if you see changes, or if you start experiencing symptoms, or just even want to know, "Hey, are things working down there the way they should be?"

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Grace: Alright Sara, what can moms do to strengthen their pelvic floor at home?

Sara: So, you know, some of the things I actually recommend to start with is just learning how these muscles work. So learning to contract those muscles before coughing or sneezing, or when picking up your baby, learning how to relax these muscles during bowel movements so you don't have to strain, and avoid pushing when you pee.

When you pee, you really should just relax your muscles, you don't have to push. I used to be a chronic power pee-er. I strain to push the pee out. Cause we're all in a rush and we're hurrying and doing a thousand things, so just teaching the basics of how to relax and then how to contract.

And then if you do have weakness, then you can do kegel exercises. There are a lot of physical therapists, including myself and other members of my team, who do online sessions.

So if someone can't come in to pelvic floor therapy in person, we can coach them through, how do you check to make sure you're doing a kegel properly and what other exercises can you be doing besides kegels and kind of really incorporate them into your day to day.

So it's not just doing kegels, but it's bringing that into picking up your baby, and carrying your stroller, and lifting groceries, and all the things we do all day.

Grace: I think I may have had a revelation. I think I'm a power pee-er.

Sara: You are not alone, Grace, you are not alone! So, I was too, but again, this is kind of the 101 of pelvic floor health that we're just never really taught. To just sit and chill when you're peeing or if your need to poop, I always recommend putting a little stool under your feet to help relax your pelvic floor muscles, and then not holding your breath when you are you know, pushing to poop.

And just little things that I even teach my little kids, just so that they kind of know what the normal is, because we don't, we don't even know what normal is if we're never taught.

Grace: Oh, and for so many moms, that's the only time we're alone, on the toilet. So sit and chill. Taking that with me, Sara.

What about tears and cuts? How can we help those heal?

Sara: To start, a lot of, most women actually who give birth vaginally and are first time moms will experience some sort of perineal tear during childbirth. So, it can range from something as small as a paper cut to a more significant tear that goes from the vaginal opening to the anal opening.

And that's really a small percentage of women who have a more significant tear. The first thing I really recommend is healing. So again, don't rush back too soon. I think after my first birth, I was trying to like, run at two weeks, and I was holding my baby, and loading laundry, and cooking lunch, and I just really should've given myself more time to heal.

And that initial recovery phase is so important. We see moms and we teach them how to do perineal massage after birth. So we hear a lot about perineal massage for going into childbirth, but not about really massaging that scar tissue afterwards and getting it to soften and relax so that intercourse or tampon insertion or pelvic exams are less painful.

Grace: Seeing as we're moving all over the body, let's talk about bellies. What is abdominal separation? I'm going to try to say this "diasta-see" recti? Did I say that right?

Sara: Yeah so uh there's, you know, it's tomato, tomato, but I say "dia-stay-see" recti. Some people say "di-ah-stisis" recti.

Diastasis recti is really a separation of the midline of the abdominal. So we are familiar with those six pack muscles that we have in the front. I've never seen mine, but I hear that they're there, but those six pack muscles stretch and lengthen over the course of pregnancy. Which of course, your abdominal muscles are expanding to support the baby.

Now in the midline, there's a little line of tissue that can get really stretched out and thin. And as that happens, that's what's considered a diastasis recti. It's kind of a wider, deeper separation of that midline that occurs during pregnancy and can persist postpartum.

Now, not everybody gets it, but a lot of women will. And it's really about pressure management. So it's more common in moms of multiples. It's more common if you are breastfeeding for a long time postpartum and then you get pregnant again, those tissues don't always have time to kind of recover and heal quickly. And also if you're a strainer with heavy weightlifting or chronic constipation, those things can contribute to it.

So, it kind of looks like a little football in the midline of your belly, and you can see it when you do a little crunch. So, and again, that can happen postpartum as well. And moms often feel like I still look pregnant, even though I'm not pregnant anymore.

Grace: So what, what can we do about that? And does that go along with pelvic floor complications?

Sara: There's a lot of research to show that a lot of women who do have diastasis recti will also experience pelvic floor dysfunction. And it's not like if you have one it's going to lead to the other, but you know, again, if we think about the core, the core is really your abdominal muscles in the front, your low back in the back, your pelvic floor at the bottom. And your diaphragm, which is your breathing muscle at the top.

So it's kind of like a Coke can. And if the front of that Coke can or the front of the core is impaired, then it's going to affect the whole system, which includes the pelvic floor. And this is kind of a nerdy technical term, but it's really what we call "pressure management."

So pressure management is learning how to kind of manage the pressure on the inside of that Coke can so that your muscles don't get too far distended in the front or too far weak at the bottom of the pelvic floor.

So, they definitely go together. And during pregnancy, we teach moms some simple tips about how to get out of bed without using their abdominals and kind of rolling to the side, or how to get out of a chair using their arms instead of using their abdominals, how to pick up their babies without holding their breath and straining.

And then also had to modify exercise so that they're not doing all of these things to their abdominals and core that could potentially be leading to that.

Grace: So we're going to talk about sex on a later episode, but seeing that I have The Vagina Whisperer here, from a physical point of view, when is it safe to have sex again after birth?

Sara: So, you're going to hear a lot, and what's recommended is six weeks, which I find to be a totally arbitrary number. I'm not sure historically how that happened. But I would say that most people see their physicians around the six-week mark. And then they're given the thumbs up to go back to sex or intercourse.

If you've had a perineal tear or episiotomy, you may not be fully healed, and the tissue can be very tender, so you may want to wait longer. If you're breastfeeding or nursing or lactating, you may have some vaginal dryness due to low estrogen levels. So you want to be really mindful about using a water-soluble lubricant and just kind of making sure those tissues aren't too tender or that they're fully healed.

But for me, I mean, even just physically, I was like, don't even think about it for three months. I mean, I was exhausted. We were sleeping in separate bedrooms after our second kid for the first three months. It was just total survival mode. And that was the last thing I was thinking about.

And so I also think it's okay to, you know, give ourselves a little bit of grace that, "Hey, this is going to be there eventually, but if I need more time to heal physically, emotionally, that that's okay."

So most people end up trying between the six-to-12-week mark, but if it is painful, I recommend checking in with a pelvic floor PT.

Grace: So it should never be painful.

Sara: No, it really shouldn't. And you know, it's not unusual to have discomfort the first one or two times, but that should really get better.

And I always say sex should be pleasurable and enjoyable to both parties and not painful at all. It's not something we should feel like we just have to tolerate or kind of get through. It really should be enjoyable.

And I've worked with a woman who for 11 months, she was having pain with sex and she was just told, "Give it more time, give it more time."

And she came in for two sessions and was so much better after just two sessions. And she's just like, "I wish I would've known about this sooner. Why did I just deal with this for so long?"

So I don't think it should ever be painful.

Grace: So we've talked about a number of issues that crop up after you have a baby. And we know that your body just changes so quickly after you give birth. How do you recommend we can connect with our bodies again?

Sara: I always say if something doesn't feel right to you, it's not right. A couple of leaks here and there for somebody may not be an issue, but if it's a problem for you, then it's a problem. So I think first of just thinking about are you experiencing changes after birth that are different than what you were experiencing prior to birth?

Are you having pain? Urinary leakage, pooping problems or hemorrhoids? Painful sex? All of those should make you pause and think like, "Hey, this, this doesn't feel normal to me. This doesn't feel right. I want to just go ahead and get it checked out."

So I think that that's step one, and you know, exactly what we're doing here. I think just starting to talk about it, starting to bring some awareness of, "Hey, you can have these issues, not everyone will, but if you do, there are resources out there for you."

Grace: And don't be embarrassed because you're not the only one.

Sara: You're not the only one. And, you know, that's really what sparked the Instagram account, The Vagina Whisperer.

I would see mom after her mom in my clinic, and they would feel so isolated or they would ask like, "Am I the only one who's experiencing this?"

And I'm thinking, "Oh my gosh, I see 30 to 40 patients a week who have this problem."

So it's really, I think just letting people know that they're not alone, and that even though we know a lot of issues are common, that there can still be treatment to help with them.

But definitely you're not alone.

Grace: Sara, that was super helpful, so much great advice, thanks for chatting with us today.

Sara: Thank you for having me.

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Desiree: Well, that was an amazing, amazing interview with The Vagina Whisperer, Ms. Sara. I felt like I could relate to so much and I learned so much. Grace, how did you feel after giving birth? How did you feel about your body?

Grace: I felt like my body did not belong to me. You know, I had this big floppy belly. And the area around my C-section was completely numb, so definitely I couldn't feel my body, so that's why it didn't belong to me.

But you know, a C-section is major abdominal surgery and I remember my dad, love him to pieces, telling me, I should really strap myself into a faja. A faja is the Spanish word for a girdle, commonly used to get you that pre-baby body back, because that's exactly what I wanted to do! Squeeze myself into some shapewear!

I know some people love their belly wraps, but getting my body back was the last thing on my mind. I needed help just to get up from the couch!

Desiree: Oh gosh, I think that all moms can attest to the same experience when we're looking in the mirror and we're thinking what has happened? Who is this woman?

And that was me as well, both after my C-section with the triplets and my vaginal birth with Cambria. Especially with the triplets, my body changed dramatically, both on the outside physically, and with my pelvic floor.

I feel like I went through a little bit of insecurity for a while because I've had people tell me, you know, "You need to fix your body, something's wrong with the way you look." And, and it really makes you feel like, "Is this how it's supposed to be?" and, "I don't look good."

It required me to be intentional as well about loving myself and giving myself a new perspective about the changes in my body. And so, physically I started calling my stretch marks, I called them my "hope wounds" because I called my triplets my hope babies. And so I felt like having a new perspective helped me love myself a little bit more because they weren't going to change and they weren't going to go away.

Grace: I felt the same way, but I will give it up to moms like you Desiree, on social media, sharing, honest, raw photos about their postpartum bodies and just like putting it out there. I think that really helped me. I read somewhere a mom recently called her C-section scar "the smile on her belly," and I thought that was so sweet.

And when my daughters come and touch my belly and like, "Hey, what's this?" I just tell them, "Isn't it amazing? Can you believe you came outta here? I created you!"

So I think you definitely have to, you know, flip that around and start seeing it as a positive thing. And I think I saw you on social media this weekend in a bikini, so, good for you, Desiree.

Desiree: Yesssssss! I was actually really proud of myself because it was the first time that I was like stepping out in my postpartum body with all my saggy skin and all, I was like, "I'm going to rock this. This is my time! Wear the suit mama's, wear the suit!"

Get the suit on and go out and wear it and just make those memories with your kids, because that's what it's all about. And I feel like it does birth a little bit of confidence in you, you know? But it is really hard.

Grace: No, you looked great, Desiree! But switching topics, The Vagina Whisper gave us some really good tips about properly peeing and pooping. I discovered I'm a power pee-er, which I thought made me really strong and efficient, but not really.

And we talked so much about the pelvic floor, which I have to admit I did not know existed until I gave birth. I knew something was wrong when I would cross my legs before sneezing or even coughing. And for so long, I just thought, "Hmm it's just a little pee, what is a little pee in the big scheme?"

But it's a big deal. And it affects so many women, and I think we can all agree, and we can all say together, "Diapers are not my destiny." Right?

Desiree: They are not, they are not! Many of us just think like, "This is normal, let's just be okay with this."

And, you know, it's not normal, and…

Grace: And it's not okay. Let's keep being honest about it because the more women talk about it, the more we'll feel empowered to go get the help we need.

Desiree: Absolutely.

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Desiree: That's all for another episode of That New Mom Life, a podcast from Parent's magazine. To find out more, head to Parents.com/newmompodcast.

Grace: Thanks for tuning in, we'd love to hear from you and of course tell all your mom friends.

Desiree: Thanks so much to Sara Reardon, The Vagina Whisperer for talking to us, to all the moms who shared their stories, and to our production team, Pod People: Rachael King, Matt Sav, and Sam Walker. I'm Desiree Fortin,

Grace: And I'm Grace Bastidas, hang in there mom, you're doing great!

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