Necessary: Talking About Pelvic Floor Health with Dr. Betty DeLass, DPT
In this episode, Sara interviews pelvic floor PT Betty DeLass. Betty discusses the importance of normalizing pelvic health through talking about it! She also makes an exciting announcement about how she's working to improve the perinatal experience for *everyone*! TRANSCRIPT: Welcome to episode number 77 of the Birth Words podcast. Today, I am thrilled to introduce you to Dr. Betty DeLass, a pelvic floor physical therapist who has so much good stuff to say. Intro: Welcome to Birth Words. Words are powerful. What are you doing with yours? In this podcast, birth doula and applied linguistics scholar Sara Pixton invites you to be intentional, reflective and empowering with your language as we come together to honor those who give birth. The work of birth words is to elevate the language surrounding pregnancy, birth and the postpartum period. Nothing in this podcast should be taken as medical advice. Sara: Dr. Betty DeLass is a concierge physical therapist in the Salt Lake City, Utah area. She comes to your house for each session. Her passion is to serve, educate and empower all of her patients to live life to the fullest. She is super passionate about everyone's journey along pelvic health and wellness. She treats women of all ages. She specializes in pelvic floor treatment of bowel, bladder, sexual and abdominal dysfunction, including incontinence, constipation, diastasis recti, preconception, pregnancy, postpartum pelvic organ prolapse, frequent urination, pelvic pain, painful intercourse or sexual activity, urinary urgency, urinary retention, and perineal tears. She uses a combination of an orthopedic physical therapy skill set with her pelvic health skill set to individualize your care. She provides local one-on-one concierge mobile pelvic floor PT, remote consultations, and out-of-town programs. You can find her on Instagram @drbettydelassdpt and on Facebook at Reborn Pelvic Health and Wellness. Her website is www.rebornphw.com. Welcome, Betty, to the Birth Words podcast. I'm just so thrilled that I get to talk with you about pelvic floor health tonight. I'm going to jump into some questions. And the very first one is, “Why do people, why do so many people, suffer needlessly with pelvic health issues?” Betty: All right, well, thanks, Sara, for having me on here. And I'm just as excited too, so I guess we'll just dive right into those questions. And so I think there's a variety of reasons why people suffer needlessly. I think the biggest thing is just awareness that there is pelvic floor therapy and other therapies that can help with all different sorts of things regarding birth and the pelvic floor. So, I often classify this into five phases of pelvic floor health and wellness. And so, there's five different stages of pelvic floor awareness that you can be in. So one would be people who are like, “what is the pelvic floor? I don't even know what you're talking about.” They have no clue. So it's more of that awareness part. Second group of people would be, “I've heard of it, I know what the pelvic floor is. You do kegels, right?” And so that's kind of another class of people. And then the third class would be, “I've been, I've been dealing with some stuff down there, I've Googled some things. I don't know why these kegels aren't working. Maybe I need some help in this area. No one's really addressing this leaking. I still have pain with intercourse, I've got some nagging, low back pain. And sometimes, you know, I just don't think this is normal, maybe there's something I should do.” And they've heard maybe from a friend or a neighbor, or a parent or something, “oh, you should maybe look into some pelvic PT.” So that's another classification of people. And then after that, there's the people who have done pelvic PT, and they're like, “oh, my gosh, this has changed my life.” And they just want everyone else to know about that. And then the fifth category of people that I would classify in that pelvic health and wellness journey is kind of just continuing with their optimal health and wellness and doing things in life without leaking without pain and enjoying and challenging their body in many different ways that maybe they didn't even think were possible. So those are the stages: the five phases of pelvic floor health and wellness, if you will. And I think so many people are in those one through three phases, and they just don't know, they just don't know. And so, that's kind of my life mission is to just spread that word of hey, we're here. We're here to help, and we're here to help you experience all of the goodness of life that you can do without leaking without pain without, you know, dysfunction and all that stuff. Sara: Yeah, that… I mean, it was a little bit of a leading question, because I think that absolutely… many people just don't know. And why do they not know about pelvic floor muscles, pelvic health? It’s because we don't really talk about it that much. I mean, you talk about it all day long. Betty: Yeah. Sara: Outside of people who are actively seeing and seeking help from pelvic PTS, it's often not talked about. So clearly, though, there's a need if there are so many people that have issues that could be resolved… you told me stories when we were talking before about, clients that you worked with, who after four visits totally changed their urinary incontinence, right? Betty: Mmmhmm, mmhmm, yep. Sara: Things can happen if you just know where to turn for help and what questions to ask, but you have to open the doors to conversation. And that's… Betty: Yep, absolutely Sara: …why I wanted to talk to you on this podcast, where we talk about the importance, the power of language and words, and just having conversations about these things is huge. Betty: Mmmhmm Sara: But… Betty: Absolutely Sara: …it's maybe not something that everybody's ready to just start talking about. So how do you introduce this topic of pelvic health and how important it is? To people who don't feel comfortable talking about it? Betty: Great question. So I I love, love, love this question. So I there's many different things here too. So oftentimes, I'll say, “Okay, we go to the dentist a couple times a year for preventative health, right? We go to the doctor, we go see a massage therapist, we go to the chiropractor, we do all these other things. And we should also do the same thing for our musculoskeletal system? Why wouldn't we go and get just a full body examination of how are we moving, how is our strength, how's our coordination, how's our range of motion, and kind of address those things from a preventative wellness standpoint.” So that's one area to kind of just think about. Another area too, is we should be doing self breast exams, we should be doing, you know, getting regular pap smears every three years, I think that's the current recommendation. And then shouldn't we also probably do, you know, an internal pelvic floor muscle exam as well, just to make sure things are working optimally? And then another point on that, too, is, oftentimes, if we have… tear our ACL, or we tear a rotator cuff, and we go and have surgery on those things, what do we do after that? We do rehab. But we grow human beings, and we give birth, and we're just thrown to the wolves. “Six weeks, you're good, go back to doing everything, you're clear.” And it's like, “whoa, whoa, whoa, wait a second.” We do so much more for so many other body parts of our area, or areas of our body, that it's like why, why aren't we doing this? And it's really sad, especially in America. I think the tide is shifting a little bit and the pendulum swinging the other way. But in Canada, in Europe, the standard of care is 12 pelvic PT visits postpartum, off the bat, that’s what you get. And so I would love, love, love to see that here in the United States. And I think that’s shifting too. The people who are a little bit more proactive about it, are actually doing, you know, pelvic PT in preconception pregnancy and postpartum, because on another note that I want to make too is, we know with research that if you were to go have a total knee, or total hip replacement, and you're prepping for something, and you do what's quote, unquote, called “prehab.” So you rehab before you had the surgery, you actually have better outcomes, post-surgical. So why wouldn't we apply that to our pelvic floor? Let's do it. Right? So I very much like to focus on that of the upstream side of things of, “Let's do preconception appointments, let's do pregnancy appointments.” And then we have a better understanding going into birth. And then also, can we work on a couple things so that our birth outcomes are better? Because I've also seen people too, that have had, you know, C-sections that weren't quite planning on it. But then after the fact, it's like, wow, your pelvic floor was super, super tight and elevated, and you had no idea and so that might have, you know, had we worked on that ahead of time, could it have prevented a C section? Possibly, right? I can't guarantee anything, but the conception of… the concept of that is, is valid, right? So I think at all those points, it's just, we have, we have, we should just treat that like any other part of our body, right? There's muscles down there. But it's just like you said, it's not talked about or it's a kind of taboo. We poop and pee every day. We also brush our teeth every day. So if we're taking care of one end of our body, we should probably take care of the other end, too. Right? And so it's just normalizing that conversation and having, you know, having conversations about it and talking to your friends about it. And if someone says, “oh, yeah, I just, you know, cough and sneeze and pee my pants. It's okay. It's just normal.” It's like, “wait, wait, wait, no, it's not normal. It's common, but not normal, let's… you
