We Can’t Stop. We Won’t Stop.

Today, a well-respected media outlet–the Wallstreet Journal–helped advance women’s health. It did.

bedrest

You see, there’s a mass of information swarming around new moms and moms to-be. Everyone’s talking about pregnancy, birthing techniques and breastfeeding. Strollers, carseats and cribs. Postpartum depression, baby care and returning to work. But there’s a critical piece missing.

By choosing to go ahead and run a piece called “Bigger Postpartum Challenges Than Just Baby Weight,” the Wallstreet Journal gave a mainstream nod to the fact that there are significant physical effects as a result of pregnancy and giving birth. Some of which get in the way of a good sex life–or any sex life, for that matter. Some of which are intensely painful, embarrassing or debilitating. So I thank them for running that and for allowing me to be a part of the piece. Because I’ve looked into the eyes of far too many women who are left blindsided when they learn their condition could have been easily treated–and often even prevented–if they received care postpartum. So check out the full article here, the pregnancy exercises slide show WSJ also published, and please pass along to every mother–no matter her age–and expecting mom you know. 

And. To the commenter who in response to the piece, wrote:

“What a crock!…Our mothers and grandmothers never complained about how having children affected their lives. In the 3rd world the women have it much tougher and yet aren’t complaining.”

I agree. No, they didn’t complain. They still don’t. But that’s the point. They deserve a system that educates and facilitates them through pregnancy and postpartum care–including their pelvic health. Seeing woman after woman after woman–mothers and grandmothers!–through treatment that restores their quality of life is proof that they want and very much need that. And yes, women in developing countries are faced with significantly more extreme challenges. But we all deserve the best maternal health possible. Don’t we, Jon? And I, for one, won’t stop until we’re there.

How to Get Your Sex Groove Back Postpartum

It’s pretty clear to anyone familiar with Share MayFlowers that we think new moms are an “at-risk” group when it comes to their pelvic health.  Lots is changing in their bodies, in their relationships, in their environment, and they are often left without the resources to negotiate all of these changes.  I addressed this today over at Isis Parenting’s blog in a post called “Let’s Talk About Trucks and Sex.” And tomorrow night I’ll be weighing in on a webinar hosted by Isis Parenting on postpartum sexual health, which will prove an excellent opportunity for moms connect with myself and my Isis gal pals, Chris and Nancy concerning precisely these types of issues and questions! If you’re a pelvic health provider, this is likely familiar info to you. But you also know as well as I do that it isn’t familiar across the board, so I very much appreciate your help passing along the info!  Registration can be completed in advance and the webinar will be archived and available to all registrants after the original airing.

Register Here

Get the Groove Back: Postpartum Sexual Health Webinar, Tuesday October 8, 8pm est 

sex

Cross Fit: Fit for Pregnant Women?

Hey-oohhhh, Share MayFlowers crew….it has been a while.

Mounds going on, lots to share, and we’ll start with the following posts.  First, a post from Emily Oster’s Facebook page (author of the recently-released pregnancy book, Expecting Better) regarding debate over a woman posting CrossFit pics of herself in her 3rd trimester.  Second, my “comment” to her post…which I admit was way too long for Facebook etiquette.  My bad.

~ jessica

Photo Credit: NYTimes.com Well Blog

Photo Credit: NYTimes.com Well Blog

Emily Oster On Facebook:

After approximately a million people shared this with me I have felt compelled to comment on the pregnant weight lifter (link is below in very unlikely event you have not seen).

 I should open by saying the first thing I thought when I saw the photo was that those are awesome socks. 

A lot of the discussion has revolved around the general topic of “exercise in pregnancy”. I think it’s first worth noting that we should separate the aerobic exercise issue from the lifting-heavy-things issue. I spent some time in my Slate blog (the post is here) on aerobic exercise. There, the concern is getting your blood pressure up too high. 

Perhaps the woman in the photo is also doing a lot of aerobic exercise, but weight lifting alone like this seems very unlikely to raise her heart rate to 90 percent of maximum, which is where it looks like blood flow to the baby might be compromised.

 This is actually separate, however, from the question of whether lifting heavy weights during pregnancy puts women at risk. Studies of this have mainly focused on women who do lifting for a job — which does introduce problems like that kind of women who have jobs involving heavy lifting tend to be different in other ways from women who do not — and they do seem to find some small negative impacts. 

A 2013 review (you can see the abstract here suggests that there may be some downsides, but they are small. 

And, of course, there are upsides to being in good shape for labor, recovery, etc. 

http://well.blogs.nytimes.com/2013/09/24/pregnant-weight-lifter-stirs-debate/?_r=0

My Response to her Post:

Hi Emily-  I have to admit my first thought was, “Her right lower extremity is externally rotated more than the left,” followed by “Wow, my cleavage never looked that good, “ followed by, “Man, she is strong!”  However, my first thought when looking at the thoughts of other’s on Ms. Ellison’s CrossFitting decisions was, “Why is there no concern for mama’s body in this debate?”  The concerns cited by others appear predominantly focused on the fetus, with the studies cited similarly focused (pre-term delivery, low birth weight), save for the additional factoring-in of preeclampsia.  I see a situation like this, count on evolutionary biology to protect the fetus through all manner of otherwise unfavorable circumstances, but count on only the mother’s coordination of her deep stability system – the deep abdominals, pelvic floor muscles, and respiratory diaphragm – to keep her uterus inside her body for the long run.  And lots of things – related to life in general, exercise, and pregnancy and childbirth – have the potential to muck that up.  A just-published review of the literature reports “some evidence linking strenuous physical activity with pelvic organ prolapse but this is neither consistent nor adequately powered to reach any firm conclusions,” but goes on to state that there is “a marked paucity of literature relevant to the research question (that) makes it difficult to draw firm conclusions.”  A previously published report in 2009, discusses the role of obstetric and non-obstetric factors in development of pelvic organ prolapse.  It suggests that heavy lifting is a factor and says conclusively that parity is a factor (leaving me to wonder what does risk look like when both are combined…?).  Beyond all this, CrossFit has recently come under scrutiny for accepting “exercise-induced urine leakage”, aka “stress urinary incontinence”, as proof-positive of the workhorse ethic espoused by many (after the release of this CrossFit video), but colleagues of mine have reason to believe that many CrossFitters actually want information on how to integrate pelvic floor training into global strength and conditioning.  Great news, since both stress urinary incontinence and pelvic organ prolapse share risk factors.  So time will tell (because it hopefully will lead to more research) the degree to which exercise involving impact and/or heavy lifting in life and during pregnancy brings risk to the mother in the short and long term, and how much any risk might be mitigated with good technique and integrative pelvic floor training.  For now, I am quite impressed with Ms. Ellison’s obvious capabilities, think her baby will be just fine, and hope she is exhaling and engaging her deep stability system with every heavy rep.

“All In” For Pelvic Health

jess 3Writer’s block.  I am learning that it can happen even to those of us who feel we have endless thoughts to share.  Those thoughts run around my head like bumper cars on the ocean – swirling and churning and running into each other, and it all leaves me wondering sometimes, “What am I doing?”

Will Share MayFlowers become a game-changer of a campaign, breaking down barriers that keep people from accessing care and feeling like they deserve that care in the first place?  Can it really be the pelvic and maternal health pink ribbon equivalent that I have always thought possible?  Will it make a difference?  These doubts and ponderings hit me hard over the last 48 hours, so I borrowed a bit of advice from ‘The Princess Bride”: “Go back to the beginning.”

I re-read my own essay about why I wanted to launch this whole crazy journey in the first place.  And it helped.  The beginning reminded me of why I’m in the middle now and of where I hope that we find ourselves.

Happy MayFlowers.  I’m still all in.

Jessica

May is a month of new beginnings and blooming flowers. A day and a week are already set aside in May to honor mothers and to promote women’s health, respectively. Good stuff, to be sure. But not enough. We want the whole month. Let’s elevate conversation and action with regard to female pelvic and perinatal health all month long!

I am a woman. And I love being a woman. I love girly things, like miniskirts and painted nails. I love the challenge that childbearing and breastfeeding brought to my body and spirit. I love my “women’s intuition,” well known as a phrase only because it actually does exist. I love being part of a deep sisterhood that is without words; that lets me look in the eyes of a woman in the Democratic Republic of Congo, hold hands with her, share a smile and know that we share a connection as women that doesn’t need me to speak Swahili or her to speak English (or ask for help from our male interpreter!).

Women are beautiful and complex and strong, and profoundly amazing. I am fortunate enough to be surrounded by many people who share that sentiment and strong enough not to be brought down by those who don’t. Women can be sensual, tough as nails, tender and resilient all at the same time. And yet woman, upon woman, upon woman embodies resiliency to a fault by putting the needs of others before her own—to the detriment of her own health. Despite pelvic pain that renders sex un-enjoyable for her she is “tough as nails” and continues for the sake of her partner “because it’s not fair to him to not have sex, so I just bite my lip, suck it up, and get through it.” Ponder what something like this, or ongoing urine leakage, does to a woman’s connectedness to her inherent sensuality. So what is Share MayFlowers?  Hang with me…I promise I’ll bring it around.

I love women that are strong. One example is the recently departed and deeply missed Lyn Lusi, who together with her husband Jo Lusi, a Congolese orthopedic surgeon, founded Heal Africa in Goma, DR Congo. She committed her adult life to her family and the development of an amazing place that is more than just a hospital. It is hope and help and stability for people in DR Congo, where war and insecurity and violence have been a way of life for far too long. For women in particular, it meets unique and sometimes devastating needs for physical, social, emotional and spiritual healing.

In an entirely different way, strong is also Brittany Howard of the band Alabama Shakes, whose authentic and visceral stage presence positively killed it at the Paradise Rock Club in Boston last month. I don’t have many conventional hobbies, but good music—particularly good live music—is a part of what keeps me in balance (or some semblance of it!) with life as a mother, healthcare provider, wife, etc. Given my love affair with both women and music, seeing Brittany own her rock star status was monumental. Don’t just take my word for it. My 61-year-old mother went as my last minute date to the show and raved about how captivating and empowering it was to see a strong woman bringing everything she has and “rocking out” (Mom’s words!). I can’t sing OR play guitar, but when I grow up I still want to be Brittany—or Susan Tedeschi, another female inspiration, true to her passions of motherhood, marriage and downright BRINGING IT with her soulful vocals and guitar, all while in a fabulous dress!

So Share MayFlowers is for women who are strong and who are looking for strength, for women who are inspirational and looking for inspiration, women who can rock out and those who still want to be rock stars when they grow up! Because despite the advances in women’s health in our country (kudos to pink ribbons!) and TV and radio segments about painful sex on WBUR and pelvic organ prolapse on Dr. Oz (on which I have to completely agree with my colleague, Julie Wiebe, PT) too many people still squirm at the mention of female genitalia and too many women wait too many years before seeking care for pelvic health issues such as urinary incontinence and pelvic pain. There is no reason for us not to move toward open, engaging and meaningful discussions about female pelvic and perinatal health (perinatal = preconception, pregnancy, childbirth, postpartum). We may need to first collectively learn how to have these conversations—yes Virginia, you do have muscles down there. And it’s not un-ladylike to talk about them or want to know how they work! Share MayFlowers is here to help us all find our voices and to be a platform for advocacy, education, and connecting the general public, the media, and healthcare providers to each other and to the many organizations that have tirelessly been working in one meaningful way after another to promote issues related to female pelvic and perinatal health.

It takes a lot of self-assurance for a celebrity to admit to having urinary incontinence and be willing to be the face for protective garments. Why should it end there? Can we get a celebrity to talk about perineal trauma during childbirth? Or dealing with painful sex? Or how they had urinary incontinence and sought treatment to eliminate the leakage, not just a palliative measure to keep their clothes dry? Or instead, can we give all the credit and praise afforded to celebrities in our country to the “everyday” women who are pursuing this level of openness and striving for better care for themselves? These are the women who inspired me to add this new adventure to my already teeming aspirations and schedule. The women who come into our clinics wondering where this information was when they had their injury/symptoms/baby—wondering what can be done to change things for their friends, their daughters, for every other woman. Wondering why they spent months or years (decades) thinking it was their fault, that it was a normal consequence of aging or childbirth, or that there was nothing to help them.

Why do we feel so passionately that female pelvic and perinatal health—yes the “down there” kind of health—deserves at least a month of focused attention annually? Consider these statistics:

  • Nearly 80% of women in the US have at least one pregnancy resulting in childbirth in their lifetime.
  • Pregnancy/childbirth is the single greatest factor in lifetime risk of developing urinary incontinence, and developing urinary incontinence for the first time while pregnant is the single greatest predictor in ongoing postpartum urinary incontinence.  (For the record, ANY amount of urine leakage counts with any activity—from a trickle to a few drops to a gush!)
  • Urinary incontinence affects 13 million Americans, 85% of whom are women and it is estimated that 50% of women will have urinary incontinence at some point in their lifetime.
  • Chronic pelvic pain disproportionately affects women 4:1 with research indicating that its prevalence is on par with that of chronic lower back pain and asthma.

I’m not just a hammer wearing my nail-goggles. These are real statistics. And real statistics come from real people—women just like you and the people you love. Please consider them as you take in my explanation of why this cause is so significant for all of us.

Lastly, consider why women are expected to travel through the natural, wondrous, but monumentally physical experience of pregnancy and childbirth without really getting guidance on how to get their bodies put back together and on the right track postpartum. And yet someone sprains an ankle and often without question heads straight for physical therapy. I’m just sayin’…

So are you ready to start wearing and sharing some flowers?

 

“Gotta go, gotta go right now?” Yeah, there’s an app for that.

RosenblattpeterThe following guest blog comes from urogynecologist, Peter Rosenblatt, MD, creator of a new app for bladder retraining, a proven conservative technique to address overactive bladder.  There are hosts of ways that overactive bladder (and related symptoms) can be addressed by many types of healthcare providers and we’re happy for all efforts to make that easier!  Add this tool to the all important and ever-growing toolbox!

Multidimensional + multidisciplinary lessens ‘multi’ trips to the bathroom.

Jessica

Chances are, you’ve probably heard of pelvic muscle exercises that are recommended for women that suffer from urinary incontinence.  These can include “Kegel” or squeezing exercises, as well as exercises for better pelvic muscle relaxation and coordination and they are just one of several non-surgical treatments for common conditions, such as stress incontinence (leakage with activities like coughing, sneezing and exercising) or overactive bladder (urinary frequency, urgency, and leakage associated with these sudden urges) that affect literally millions of women in the U.S. Another treatment for these conditions that you may not have heard about is something called “bladder retraining”, which is a simple behavioral modification technique that can be quite effective in managing these conditions, especially when they are combined with other treatments, like the right pelvic muscle exercises.

Bladder retraining is a method where you void (urinate) at specific times during the day, and then slowly increase the time between voiding.  That’s the basic idea behind this technique, and it will likely make even more sense as we get into the details below and for those of you who are familiar with “apps” from iTunes, there is a free app that I recently developed with the American Urogynecologic Society (AUGS) that can make this process even easier.

The best way to begin is to keep a diary of your voiding habits for a 24 hour period. Write down on a piece of paper every time you go to the bathroom, both during the day and when you wake up at night to urinate. Also keep track of any episodes of urine leakage, and what you were doing at the time (for example, coughing, sneezing, washing dishes). Click here for a printable voiding diary.

Next, figure out a comfortable average interval based on your diary results – a time between voiding that you think you could manage on a regular basis. Typically, this may be 2 hours, although some women with overactive bladder may need a much shorter interval in the beginning, such as every hour, or even shorter than that. Let’s say the interval you choose is 1 hour. For the next 5 days, during waking hours, make a point of voiding every hour on the hour – and here’s the key to success – go whether you feel you need to urinate or not! In other words, even if you feel you could hold it a little longer…don’t! The idea behind bladder retraining is to “tell” your bladder that you are in charge, and that your bladder is not in charge of you. You’ve heard of “mind over matter”? Well, this is similar…let’s call it “mind over bladder”!

So, when you wake up in the morning, go to the bathroom. Let’s say it’s 7 am. You’ll then void again at 8 am, 9 am, etc. You may need to spread out your drinking over the day, but don’t compromise on your fluid intake – drink what is normal for you on a daily basis. Then, after 5 days, increase the interval by 15 minutes, so now you will be voiding every 1:15. For example, you would void at 7 am, 8:15 am, 9:30 am, 10:45, etc. Again, 5 days later, increase the interval to 1:30 and so on, until you get to a more normal interval. The average person voids between 5-8 times during the day, so that’s somewhere between 2:30 and 3:30 hours between voiding for most people. You may or may not get to an interval of 3:30, but I promise that if you are currently voiding every 45 min, and you can slowly build up to 2:30, this will be an enormous improvement for you. I don’t recommend to my patients that they do any of this bladder retraining at night (ie. after they go to sleep). The general consensus is that if you can take care of this during the day, the night time issues should take care of themselves.

Sure, you may be thinking (and I hear this from my patients all the time), “This sounds fine, but I have a lot of things to do during the day, and I can’t keep staring at my watch, figuring out when I need to urinate the next time.”  I agree – you have a lot more important things to think about than your bladder. That’s why I developed an app called the “BladderTrackHer” with the help of the American Urogynecologic Society and a group called The France Foundation. You can download the app for free from the iTunes store.

We developed this app to assist you with bladder retraining and it actually does a lot more than that!  It can keep an electronic diary for you of your voiding habits and you can e-mail this diary directly to your doctor, if you choose. It not only reminds you when to void as part of the bladder retraining program, but you can set it up to remind you when to do Kegel or other important pelvic exercises and when to take your bladder medication (if your doctor prescribes such medications). It will also provide helpful tips to improve your overactive bladder condition, such as diet and fluid intake modifications.

Remember – bladder retraining is just one of several non-surgical methods that can be used to effectively manage urinary incontinence and overactive bladder. This is certainly something you could start with before seeing a healthcare provider, but it is not a substitute for seeing a physician or other provider with expertise in bladder and pelvic health. If your symptoms do not improve with pelvic muscle exercises, diet modification and bladder retraining, then make an appointment with your doctor or get a referral to a specialist (either a urogynecologist or a urologist that specializes in urinary incontinence) to make sure there is nothing more serious going on, or to consider medications or other treatments that are often used to treat these conditions.  You can also see a pelvic floor physical therapist for additional non-pharmacological and non-surgical care and it can often be helpful to see them in conjunction with a physician specialist.

Finally, there is a lot of great information available through the American Urogynecologic Society (AUGS) on a patient website called OAB (overactive bladder) Central, including a survey, a brief quiz on bladder control, tips on how to make lifestyle changes, and much more.

Peter L. Rosenblatt, MD

Dr. Rosenblatt specializes in Female Pelvic Medicine and Reconstructive Surgery, including robotic and minimally invasive surgery for incontinence and prolapse, at Mount Auburn Hospital (Cambridge, MA). He completed his residency at the University of Massachusetts Medical School in Worcester, MA and his fellowship at Women and Infant’s Hospital in Providence, RI. He is an Assistant Clinical Professor at Harvard Medical School. Dr. Rosenblatt is Board Certified in Obstetrics & Gynecology by the American Board of Obstetrics & Gynecology.

 

“The Worst Place to Be a Woman”

Photo by Loran Hollander in Democratic Republic of Congo

Photo by PT Loran Hollander in Democratic Republic of Congo

The following post comes from my dear friend and colleague, Laura Keyser.  Along with another colleague, Loran Hollander, Laura and I connected in 2009 when the two of them needed a willing physical therapist with a heart for global health and knowledge in female pelvic health and obstetric physical therapy.  They were working at HEAL Africa Hospital in Goma, Democratic Republic of Congo for nearly two years and I did everything I could to support them in developing rehabilitation services for women with fistula.  The three of us have continued to grow as collaborators and in friendship, advancing our work in this field, recognizing this program in name as FORI, the Fistula and Obstetric Rehabilitation Initiative, and bringing it under the auspices of The Women’s Action Initiative, parent non-profit of this other little project…Share MayFlowers.  Last Thursday marked 10 years in the United Nations declaration to bring an end to obstetric fistula worldwide and will henceforward be known as The International Day to End Obstetric Fistula.  Laura, Loran and I; WAI, FORI, and Share MayFlowers all are committed to this cause and to the awareness building, education, and action it requires.  Our history bears this out and our future is unfolding, most presently with a follow up trip Laura is planning to Congo in a few short weeks, a work trip she is making to join me in Boston (starting tomorrow!), and Loran’s photos included in a CNN Online story that ran on Thursday.  Feeling curious, ask.  Feeling generous, donate.  Feeling moved, share.  Feeling floral, you can share mayflowers (donate specifically to send MayFlowers with Laura as a gift for women who ‘graduate’ from their fistula care! Donate online or email Jessica@sharemayflowers.org for more info).

I listened yesterday to a podcast of Melinda Gates speaking at Stanford about the work of the Bill and Melinda Gates Foundation.  She called particular emphasis to what she learned and gained by listening and talking to the women she has encountered in her worldwide travels on behalf of the foundation.

An important lesson for us all.

Jessica

When Jessica asked me to write a blog post about my experiences and perspective on women’s health in a global context, I thought, ‘Sure, this will be easy, I have plenty of international experience and scads of opinions about what works and what doesn’t in terms of providing health care to women.” Then I sat down to write something…and was struck by an exhausting mental fog. You see, I just returned from a three-month stint at a rural, community hospital in the jungles of India. And in the last ten days or so since I’ve been back, I’ve been in a flurry trying to plan my next endeavor to eastern Congo in a few short weeks. Sitting at my laptop for hours yesterday, contemplating the best ways I could contribute to improving women’s health around the world, my thoughts ran in circles as I wrote and deleted, wrote and deleted, wrote and…well, it went on like this for some time. (I managed to scrape together a few paragraphs about why the health of women remains subpar across the globe and how it is tied to poverty, legal rights and socio-cultural beliefs—and how women only seem to be cared about while they’re pregnant.  We rarely acknowledge the health concerns women and girls face across their lifespan.)

And then I thought …you’d much rather hear stories than statistics. The evening fell, and putting my computer aside (in favor of a glass of wine), I sat with my best girlfriend – a teacher, mother, wife, and sister – and started the conversation about women’s health. We talked about her experience giving birth in America, how much or how little her doctor told her about the physical changes her body would go through during pregnancy. We talked about stress incontinence, and how our moms joke about how they can’t run or cough or sneeze without leaking a little. And then she said, “Women just do what needs doing.” They don’t make time to complain or to challenge what has been accepted as normal because they don’t have time between getting out the door to work, picking the kids up from school, fixing dinner, washing the dishes, and everything else that “needs doing”. We see Poise pads advertised on TV, and we think, “there’s the solution!”…we can put one on and keep “doing.” And no one tells us anything different. Not our doctors, not our mothers, not our friends and colleagues. We just do. Until the conversation changes, we will keep on ‘doing.’

And then I thought back to the precious time I’ve spent with the women of the Democratic Republic of Congo, each with her own experience of being a woman in war-torn Congo. Some were colleagues – doctors, nurses, physical therapists, counselors. Some were patients. Some were friends. With them, I started the conversation about women’s health. We talked about rape and domestic violence, and the struggle to earn enough money to feed their children. We talked about our bodies, the changes they undergo during and after pregnancy. We talked in detail about how and why obstetric fistula happens, because it happens a lot in the Congo. We talked about survival in a society that has tragically been dubbed “the worst place to be a woman.” And then we laughed over a shared meal, finding joy in each other’s company, searching for ways to make life a bit easier. And the conversation continued…leading many of my friends, colleagues and patients to find ways to empower themselves, whether through pelvic floor exercises to prevent incontinence, sharing their stories of recovery from sexual violence, or caring for other women and children in their communities. So like many women in the US, the women of the Congo keep on “doing.” They fetch water, they cook and clean, they work, they survive. And they talk, and they share.

And then, I thought about my time in India, where I also worked with women, as colleagues, patients, friends. There, I started the conversation about women’s health. We talked about back pain, pelvic pain and stress incontinence and how physical therapy and exercise can help with these conditions. We talked about marriage and how often, young girls, 15 or 16 years old, are married, sent to live with their husband’s family, and bear children without knowing anything about sexual health or pregnancy (aside from what their mother-in-law might tell them on their wedding night). We giggled and exchanged awkward glances, as we opened up a conversation that, for many, had never been on the table. We shared experiences, we educated each other, we reached out to the impoverished and malnourished young mothers who simply go on doing what needs doing, until someone tells them that the conversation has changed. And we also laughed, shared a meal and found joy in each other’s company, and we searched for ways to make life a little bit easier.

And so, you see, a common thread weaves us all together as women living in the world we live in, doers of what needs doing in our lives. And we raise each other up simply by starting the conversation, by sharing our experiences, by teaching each other about our own bodies, our own sexual and reproductive health, by no longer keeping quiet and hidden, by refusing to accept pain, incontinence, and disability as normal, by working to change the status quo. While women will go on doing, I hope they will also go on sharing. And we can all be a part of that conversation. So, let’s weigh in. Let’s talk about our experiences, our problems, our solutions. Let’s share mayflowers.

-Laura Keyser

Laura Keyser is a physical therapist with U.S.-based experience in pediatrics, neurological and post-trauma rehabilitation and background as a ballet and modern dancer and over 2 years’ experience as clinical faculty at HEAL Africa hospital in the Democratic Republic of Congo.  Through her current work in The U.S., Africa and Southeast Asia with the non-profit organizations Women’s Action Initiative and Global Strategies, Laura aims to prevent disability among mothers and infants and to promote full community participation and optimal quality of life for both.

Gotta go? Another Important Pelvic Health Issue

Urgency

Do you ever “gotta go?”  If not, you probably at least have at least a vague idea of what I’m talking about – a common cluster of bladder symptoms characterized by sudden urges to go to the bathroom that may be accompanied by urine leakage and frequent trips to the bathroom (more than every 2 1/2-3 hours and more than once at night).  The terms urinary urgency, frequency and urge incontinence, as well as over active bladder (OAB) can all be useful and accurate descriptors of this collective of bladder symptoms.

The following two videos are excellent insights to OAB, et al. The first is by Sarah Haag, PT of Entropy Physiotherapy and is a fantastically simple explanation of a complex phenomenon: http://t.co/ttFbFyTgQe

The second is by pelvic and yoga physical therapist, Dustienne Miller, of Your Pace Yoga. I love her description of the importance of calming the system when such inappropriate urges hit. http://vimeo.com/66604854

Thanks to both of them for their great work in pelvic health!!

Jessica