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 can do something about that. And, and just having those open, honest, real conversations with each other, and, you know, in front of other people in front of your kids talking about it earlier. I think that's a key piece, too, is just normalizing that. We talk about kids and babies poop all the time, like, “oh, did you see that color? Oh, that was uh…” You know? We shouldn’t stop, just keep talking about it. Right? It's normal. So, normal human body functions. Sara: Yeah, I love that normalizing. I love how you talked about all this preventative care that we do for other parts of our bodies. And that point that you made about the rehab/physical therapy, if you tore your ACL or whatever, what different kinds of training you would get, compared to if you birthed a human out of your pelvic floor. Betty: It just, it just doesn't make sense. Whether it's your C section, both of those are, you still grew a human being, it was still on your pelvic floor, and your abdominal wall is attached, fascially-speaking, to your pelvic floor. So it's all of those things. We definitely need to rehab those if not prehab them as well. Sara: Yeah, and I love your point about, “at what point are we not allowed to talk about these things anymore?” And obviously, privacy is something that we should honor. But I also just love saying, yeah, talk about this with your friends. I feel like, as I've come deeper into birth work, that's something that I'll be in a group of women and someone will be like, “Okay, I know, this is kind of TMI, but have you ever used a menstrual cup?” or whatever. And I'm like, “I love menstrual cups. Let me talk to you about it,” whatever the topic is. Betty: 100%, yes! Sara …that comes up, right? And to not be like, “Oh, that's not TMI. That's actually something really cool that I want to tell you about this one that I tried, and this one that didn't work as well,” or whatever. Betty: Mmhmm Sara: And I also thought of this story that I thought you might appreciate. So I'm going to share. Betty: Yeah, absolutely. Sara: So I'm currently taking prerequisites for nursing school so that I can go on and become a certified nurse midwife. So I was taking anatomy, I'm getting a second bachelor's degree, and I'm just in this 200 level anatomy class randomly given a partner to do homework with and he's, I don't know, somewhere in his 20s year-old man; he's a newlywed. And we're learning about, I think, the female reproductive system. And during… we watched the lecture virtually because of COVID policies being different. So we're watching the lecture virtually together. And then we're supposed to pause and teach and question each other throughout the lecture. So, to make sure that we're understanding what she has just taught us what our professor’s just taught us. And our professor had mentioned something about how after birth, often, people struggle with urinary incontinence and those sorts of things and pain, sometimes. And so, during my little chat with my randomly-assigned 20-year-old newlywed guy that I'd never actually met in person, it was like, “just so you know, if you go on to have a baby, and your wife has trouble afterwards, with urinary incontinence, or any sort of pain or dysfunction, or whatever, she doesn't have to suffer, she should reach out to a pelvic floor PT, even though it's common, it doesn't mean that should happen. There's so much that you can do.” And he was like, “Okay, thanks for the infomercial. Moving on.” Betty: I love it. I love it. I love it. Yeah, it's so good. And if you don't mind me interrupting you, Sara: No, please! Betty: I believe that is just absolutely wonderful. And I often think of that, too. Even if people aren't receptive to hear, you know, they're like, “Okay, you can get off your soapbox. It's all good, I heard ya.” Or they're just not interested. I just think of it as kind of like seed planting. You just don't know yet. You're gonna hear this, this little conversation, and maybe five years from now, 10 years from now, you'll be like, “Oh, I see.” And it just becomes more important at that part of that person's life. So the more we just talked about it and the more we’re like, “Hey, this is an option….” The more seeds that get planted, the more awareness that is out there, the more people actually know that you have a pelvic floor, right? Sara: Yeah, I feel like I can totally be a witness for that, too. Because I can look back at the times of, “oh, this conversation planted a seed.” And maybe it was kind of like, “why are we talking about this right now?” Betty: mmhmm Sara: But, planted a seed to normalize that this is something that we talk about. So… Betty: Yeah, absolutely. Sara: Then I knew who to open up those conversations with later when I realized how it was relevant. And then I knew to start talking about my pelvic floor health and just other similar, related topics. Betty: Absolutely. Sara: …to be a seed planter. So Betty, if you could design the ideal prenatal to postpartum comprehensive care program, what would it include and what role would pelvic floor PT play? You've started talking about this. So this is just, what do you want to add to what you've already said about this, and how can we work to make that dream a reality? Betty: Oh, I have so much to say on all these questions. I'll try and keep it brief. So in a nutshell, a little birdie is telling everyone a secret who's listening to this, I'm actually working on creating an online program that is, is pelvic floor PT focus, but holistic in nature, from my pelvic PT perspective. And so, included in that will be some holistic things of like nutrition, mental health, spiritual health, and then coming around with breath work and the nervous system and the fascial system, and how to do some mobility exercises, how to do a self-exam on yourself, do a self-screening. There's all sorts of things that I'm putting in this comprehensive program, if you will, that can be used at any point in time of life, whether you're, you know, before kids, during pregnancy, after pregnancy, later on in life, when your kids are all older and grown out of the house. It doesn't really matter. It's never too early. And it's never too late. In my view, the sooner the better, great, but you can…  the oldest person I've helped was 92 years old. So it's totally possible to do it later, too. So, kind of bringing all those things that I have acquired knowledge-wise, throughout my clinical practice, and then also just personal experience to kind of blend it in there as well. I've had two kids myself. And so I'm super, super excited to have that be out in the world and available so that everyone can have access to it. Because honestly, I can only treat so many people in a day or a week. And there's so many people who do that. And there's there is not enough pelvic PTS to go around for the needs. I mean, literally every person walking on the planet has a pelvic floor, including men. Right? Sara: Right. Betty: So that's kind of what I'm working towards. And then, making that a reality is just letting you guys know that it's going to be coming. And stay tuned for more details of when it's out and ready to be purchased. So I don't have a date on that yet. But you can spread the word a little bit that it's a work in progress. So Sara: Yes, I'm so glad I asked, so I know. It was a hypothetical, “if you could…” and you're like, “well, actually, I’m currently doing that.” I love that. How do we make sure that we're updated when this happens? How can we follow you? Betty: Yeah, you can follow me on social media is probably the best way. Instagram is my primary mode of social media. So you can find me @drbettydelassdpt, and that's Dr. B, E T T Y D E L A S S D P T. [***UPDATE: Dr. Betty’s new handle is @rebornpelvichealthandwellness.***]  And then you can also find me on Facebook at Reborn Pelvic Health and Wellness. I do have a website, which is also www.rebornphw.com. And that is currently almost ready to be published. So it'll be announced on all three of those platforms once I get there. I don't know, I don't even have an estimated timeframe frame. But my goal is before the end of the year to have that out into the world. So I'll put that out there in the universe. And we'll see. I'll hold myself to it. Sara: And I love that because you're based in Utah like I am. But my listeners are all over. And so I love that they can follow you find out some of the awesome goodness that you're sharing with the world without being local, since they can't actually benefit from receiving care from you. So that's awesome. Betty: Yep, so I also have people from all over. So, we've moved all over, through the years, throughout the United States. And so that's important to me to be able to reach other people. I also do offer other options too, for people to work with me, not only locally, I do a concierge service. So I go to people's houses. And then I also offer remote online consultations where we can help work on making a plan of how do we get to the right providers and get you started on a couple of things in the right direction to optimize and know what questions to ask your provider so that you're getting to the right provider at the right time and not jumping from one person to the next person, the next person searching and searching and searching and not getting answers. So I do offer that to people who are outside of the Salt Lake City, Utah area. And then I also do offer an intensive, out-of-town program. So if someone were to really, really want to work with me from outside of Utah, they can travel here, and then I can come to their hotel room or if they are staying with a friend or whatever. And that, I do two hours a day of treatment for a week long. Sara: Wow. Betty: Yeah. And so I can do that as well. If people are like, “Oh, I really want to work with you.” So you have to be pretty committed for that one. But it's totally doable. And I do have a couple of people that do a little bit longer sessions that are even three hours away from Salt Lake City. They'll drive in here and we'll do a two-hour session. And then they'll come back in a few weeks, and we'll do another two-hour session. So we can mix and match a little bit of whatever works for you and what's going on. So there is opportunity to work with me, even if you're outside of Salt Lake City area. Sara: That's awesome. I love that you're being really creative and thoughtful about how you can reach beyond where you can physically reach. That's awesome. Betty: Absolutely. Okay, I just have one last question for you. I know this is kind of a whirlwind. And we all want to hear more. So I'll have to have you back on once you launch your comprehensive care plan, and you can give us all the details once it's ready. Betty: Sure, I’d love that! Sara: But for today, last question, if you could choose just one word to describe pelvic floor health and your feelings about it, what would it be and why? Betty: This is such a hard question. This is so hard. It's so hard to pick one word. Let's see. Let's just go with “necessary.” Sara: Oooh Betty: It's just totally necessary. Yeah, I think that sums it up pretty well. Sara: Awesome. I love it. And that is what the name of your episode will be with a subtitle to give more information about what we talked about during this episode. But they'll know just from looking at the first word that pelvic floor health is necessary. And that is what we've been talking about today. Thank you so much for taking a little bit of your time and talking about this necessary work. Betty: Thank you so much, Sara, I enjoyed this so much. Outro: If you're interested in sharing your ideas or experiences on the podcast, go to birthwords.com. If you're liking what you hear, please leave a review on your podcast app. For more resources about language for a better birth. Subscribe to the monthly newsletter at birthwords.com and follow Birth Words on Instagram and Facebook.