Episode 198 Dr. Betty DeLass with Reborn Pelvic Health & Wellness

“Being pregnant in general is the biggest musculoskeletal change of your entire life.”Having a baby changes your life in the best ways. It also takes a huge toll on your body.Pelvic Floor Physical Therapist, Dr. Betty DeLass, tells us how her treatments help women resolve issues like leaking, prolapse, movement restriction, adhesions, endometriosis, fertility, hemorrhoids, pelvic pain, and so much more. She helps clients not only get back to their previous activity level but also far surpass it!Run to your local pelvic floor PT or take advantage of Dr. Betty’s out-of-state options to get the personalized care YOU need. It may take time, but we promise that you don’t have to feel the way you’re feeling forever. Additional linksReborn Pelvic Health & Wellness WebsitePelvic Rehab Practitioner DirectoryPelvic Guru - Pelvic Health ResourceHow to VBAC: The Ultimate Prep Course for ParentsFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words. Meagan: Hello, this is Meagan with The VBAC Link and we have a wonderful episode for you today. We have a great friend. Her name is Betty. She is actually local here to Salt Lake City, Utah and she is a pelvic floor specialist. Seriously, you guys. It’s going to be a good one. Just hearing her speak, I feel like she’s reading from a book. There’s so much education in her mind. I feel like she is just reciting this book because she uses all of the right words and just makes sense. I can’t wait for you guys to hear more about the pelvic floor and all of the things that go into prepping for a VBAC, how we can help things after a VBAC, and even we are going to talk a little bit about infertility. Review of the WeekMeagan: Of course, we have a Review of the Week, so I’m going to read that, and then we are going to jump right in. This review is from jmclane04 and it’s on Apple Podcasts. The review title is, “I got my VBAC.” It says, “I am four days out from my VBAC. I told my husband today it was the greatest accomplishment of my life thus far. Thank you, Julie and Meagan, and all of the wonderful women of strength who shared their stories. I cried so many times on my daily walks while listening to this podcast including the day before my TOLAC started. It was truly inspiring and one of my main resources in preparing for a VBAC. I will continue to listen to every new episode.”Well, jmclane04, I hope that you are listening to this wonderful review of yours. Thank you so much for leaving that. If you haven’t left a review and have a moment, please press “pause”, and leave us a review on Apple Podcasts or Google Play. You can head over to Google and type in “The VBAC Link” and leave us a review there or you simply send us an email on Instagram, Facebook, or our personal email at [email protected]. Dr. Betty DeLass with Reborn Health & WellnessMeagan: Okay, Betty. Oh my gosh. Seriously, I love you so much. Betty: I love you too, Meagan. Meagan: Oh my gosh, seriously though. Actually, I have been one of Betty’s patients. She is amazing. She does pelvic work, in my opinion, in a very unique way. I just feel like you do things a little differently and I love that. I love that you do internal. I love that you do dry needling. I love that you’re talking about balancing the pelvis and all of those amazing things. So, let’s get into this. I think one of the very first questions I have for you is, what does pelvic floor therapy mean? What does it even mean when you say “pelvic floor therapy”?Definition of pelvic floor therapyBetty: Yeah, I think most people right out of the gates think, “Oh, you do your Kegels.” I just want to myth-bust that right out of the gate. It’s way, way, not Kegels and way, way more comprehensive and holistic than that. My definition might be a little bit different than some people's, but this is my definition of pelvic floor therapy. We are physical therapists, then we are orthopedic therapists, then we are pelvic floor therapists. We are kind of the nerdiest nerds of nerds and just couldn’t stop learning, so we dove down the rabbit hole of pelvic floor therapy, and then we were like, “Oh, here is the missing piece, the pelvis. It’s kind of important.” So that’s kind of what it encompasses in a nutshell. We do an evaluation. We do a full body movement analysis on you. We look at you from head to toe. We will have you bend all different directions, squat, balance, lunge, run, whatever you are coming in for, and then we will dive into each area specifically. We will look at your rib cage, your spine, your breathing patterns, your abdomen, and how your organs move. We’ll check out scar tissue, your hips, your pelvis, SI joints, pubic bone, tailbone, all the way down to your feet, and then we switch gears and do an internal exam as well. We are looking through the lens of a PT. We are not a midwife or an OB, but it is a pelvic internal exam similar to that. We are looking at a range of motion, strength, coordination, trigger points, prolapse, pressure management, and all sorts of things like that, and then piecing all of those things together to figure out why you are leaking. Why are you having pain during sex? Why are you having tailbone pain? Why do you have low back pain? Why do you have SPD or pubic symphysis dysfunction or all sorts of hosts of things like that regarding the pelvic floor and why you are coming in because a lot of times, it’s a combination of things inside the pelvis and outside of the pelvis. We want to make sure we are addressing and getting to the root cause of why you are having symptoms because honestly, ten people could walk in with the same complaint of, “I pee my pants when I sneeze,” and it could be for ten different reasons. We want to make sure we are addressing the reason why you have the issue you are having. Meagan: That is interesting because many of us think, “Oh, I pee when I sneeze.” And then they’re like, “Oh, it’s because I pushed for five hours.” It’s maybe not. I think that is fascinating. I want to go a little bit into C-sections specifically and how maybe a C-section parent could utilize pelvic floor therapy because I think sometimes, even for me, back in the day before I had my vaginal birth, I always thought that my pelvic floor wasn’t touched and wasn’t damaged. Nothing bad happened to my pelvic floor because I was cut open, right? Betty: Sure, sure. Meagan: But I feel like the more I have learned, the more I’ve realized that I really needed, really needed you back in the day when I was preparing for both my VBACs and really, for my first one because I feel like, over time, I’ve had more issues stem because I didn’t get care earlier on. Betty: Yeah. I think a really common misconception, too, is, “Oh, I had a C-section. My pelvic floor was spared,” and really, that’s not the case. You still grow a human being on top of your pelvic floor. Your pelvic floor still changed. Your weight shifted and all that stuff like that. Being pregnant in general is the biggest musculoskeletal change of your entire life more than having surgery or anything like a knee surgery or a shoulder surgery, and then you put on top of being pregnant and then having a C-section. It’s like, “Oh man. Those people really need some pelvic floor rehab because they also had a major abdominal surgery too.”And so it’s just important to think about if you were to have just a simple knee surgery, you would do rehab for months to get back to activities, but we don’t do anything for pregnancy and postpartum as a standard of care. That’s really what I’m about is changing that narrative and empowering other people to speak up for themselves and seek out that care because it’s really necessary. We could avoid a lot of the other surgeries or low back pain or other issues and get people back to being active and wanting to do the things they want to do. Literally, the world changes one vagina at a time. That’s really important to know. If you’ve had a C-section, you most definitely need pelvic floor rehab just because it’s not solely pelvic floor dependent. We are working on the abdomen, the C-section scar, any restrictions or adhesions that have happened, turning your core back on, mom butt, and all that stuff. So it’s all included in pelvic floor rehab. We’re making sure that the whole system works. Also, we’re bringing down the rib cage after being expanded from baby, so there’s just so much that can be done. Especially getting that mobility back in the C-section scar. They cut through seven layers of fascia and that’s really important to know because if we don’t mobilize that, low back pain is super, super common post-C-section, so we want to make sure the mobility happens in the front side of the abdomen so that you don’t tork and pull through your low back as much as you do because it’s restricted from the C-section scar. So, important pieces to know there. Meagan: Yeah, absolutely. Absolutely. So, okay. That’s for parents that have had a C-section. What about first-time parents? How can we use you and your services to avoid a C-section?Betty: Totally. We love it when people come in proactively whether they have things going on or not. When they find out that they are pregnant, typically we see most people around their second trimester just simply because one, they don’t know that they are pregnant, and then two, they’re finally well enough to leave the house. They are not too tired or too sick and things like that. That’s a great time to come in. Even if you are having pain with intercourse or leaking before you even get pregnant, know that none of those things are normal. There are things that we can do to address that to even help with getting pregnant. And then when you are pregnant, prepping for labor and delivery, a lot of things that we will look at are just your movement patterns. We make sure your hips move off or your spine and your hip flexors are in good mobility. We can help with the round ligament pain. We can help lengthen the pelvic floor, make sure you are coordinated, and make sure you know when you are pushing, pushing correctly, and then also making sure that you’re– I’m going to get a little bit nerdy here. The deep frontal fascia line is a fascia line from your head to your toes and it incorporates the pelvic floor, the inner thighs, the adductors, and then the hip flexors. We really work a lot on the balance of that and making sure your adductors, your inner thighs, have a good length so that you can get into a deep squat to get those hips wide and pelvic floor open, and just making sure that you are in a good position from a musculoskeletal standpoint for baby to drop down in that pelvis. We make sure that you are able to open up the pelvis and get the pelvic floor out of the way so that you can have a vaginal delivery whether that’s the first time or a VBAC.  Also related, we’ve had a lot of really cool patients come in who are seeking VBACs. They are doing everything they can. They’re going to a chiropractor, acupuncture, pelvic PT, and doing all of the things. They have beautiful, beautiful outcomes. It’s just really cool to see. Meagan: Oh yeah, I love that. I would say that’s another misconception. “Oh, I haven’t had a baby yet. I don’t need pelvic floor rehab at all.” I’m just listening to you and there are so many things you can do and prepare to really have a beautiful experience and save us so much damage in the long run because not everyone has severe damage, right? But we could learn all of the tools to minimize anything. Betty: Totally, totally. Absolutely. I’m a big fan of prevention health and wellness and actually having true health care versus our sick care model that we currently live in. Meagan: Mhmm, absolutely. You mentioned a little bit about back and even ribs and stuff, what other symptoms, other than sneezing and peeing or pain during sex, would someone maybe have that would alarm them to say, “Hmm. Maybe I need to just seek out an opinion for a pelvic floor rehab person”?Betty: Yeah. Anything related to the low back, SI, and tailbone would be a great spot to start including, like you said, the leaking, and anything with the bowels. So constipation, hemorrhoids, painful periods, endometriosis, diastasis recti, prolapse or heaviness, pressure down in the pelvic floor whether it feels like your organs are falling out or your vagina is falling out– those are all things that we treat daily. Most of the time, people come in for one thing and then we dive deeper into their history and they’re like, “Oh yeah, this and this,” and then all of a sudden, they’re like, “Oh my gosh. All of these things that I thought were just part of who I am aren’t even things anymore.” So really, all of the things that we can address because we are that comprehensive PT, orthopedic PT, and pelvic PT. We treat it all and make sure that you are literally living your life to the fullest and walk out of here being like, “Wow, I never thought that I could feel this good.” That’s where we put our pride and joy in helping make that happen for people. Finding a pelvic floor PTMeagan: Oh my gosh. I love it. You have so many therapists all over Utah. How can we find even more people like you, for our listeners who are not here in Utah, that have the same qualifications? Because you have other– I’m going to talk about it in a second. I mean, it’s not other things but she does other things. She has this thing called dry needling and it’s my favorite so I have to talk about it. But anyway, how can people really find someone with qualifications like you?Betty: Yeah, absolutely. So there are a couple of websites that I’ll send people to. It’s called www.pelvicrehab.com and that’s a great resource. You can just type in your zip code and they’ll pull up a bunch of practitioners that all have a little bio and potentially a picture if they pay for a subscription and whatnot. Then also www.pelvicguru.com and the same thing. You type in your zip code and it pulls up practitioners around you. You can look at them. I would treat it similarly to seeking out a hair stylist or an OB, midwife, or doula. You want to make sure. You can have a chat with them, see if you’re a good fit, and see if they fit your philosophy of what you are wanting from your care perspective because there is definitely a dynamic shift that’s happened in pelvic rehab itself.A lot of us are being very much more holistic but there are still some people who sit there in the biofeedback and kegel world. That’s what their treatment is, so just make sure that you’re matching well with the person that you’re finding when you do look on those directories. Otherwise, just a simple Google search too of “pelvic floor therapy near me”. Another key piece through that is to know that most of us are PTs, but there are also OTs as well that do pelvic rehab. Meagan: Okay, good to know. I don’t even know if I realized that OTs can do pelvic rehab. Betty: Yep. Dry needlingMeagan: Awesome. Okay, let’s talk a little bit about dry needling or a lot of it, whatever you decide. All I know is, okay. A little bit of storytime. So Betty rides. She cycles and so do I. We did a little, it’s not a race, but a ride across Utah essentially. She was telling us about dry needling and everyone went to bed. I should have been exhausted, but I just had to learn more about dry needling, so I started YouTubing it and Googling “dry needling”. I was like, “Oh my gosh. This looks crazy.” It kind of reminded me of acupuncture a little bit. But anyway, when we got home, I scheduled Betty, got in, and she did this dry needling. I will say it can be a little intense, but so amazing. So talk about what dry needling is, maybe how it differentiates between acupuncture, and how it can benefit people out there. Also, I know that you’ve been doing it on C-section scars now, right? Betty: Yes!Meagan: Let’s talk about that too. What does dry needling do to a C-section scar? I haven’t had that done yet but let’s talk about those things. Betty: Yeah, yeah. Okay, I’m going to start but if I get distracted because I like to talk forever, then totally redirect me. You can be like, “Don’t forget to talk about this.”Meagan: Okay.Betty: So dry needling is a tool that we use to help communicate with the nervous system and so if you think, most people know what acupuncture is. Acupuncture and dry needling use the same needle but have totally different philosophies on the treatment and intervention of what it is there for. Acupuncture is very eastern medicine, Chinese medicine, acupuncture points, Chi energy, meridian lines, all of the stuff like that. Dry needling is all about the trigger point in a muscle, so a knot. When you’re like, “Ooh, I have a knot,” that’s the trigger point. That’s what we’re after. We use that needle to do dry needling in a trigger point in a muscle. What happens when you have a trigger point in a muscle is there’s decreased blood flow which leads to decreased oxygen, which drops the pH in the muscle, which then, neuropeptide chemicals sit there and signal to the brain, “Pain, sharp, dull, stabbing,” or whatever your brain’s perception of that is. We take a dry needle into the trigger point which creates a local twitch response. Like when your eyelid twitches, it has a little twitch trigger to it. It feels like that plus some spicy spark electricity when a muscle twitches from a dry needle. Then, what happens from that twitch is blood flow comes back in, oxygen comes back in, the pH gets restored, and then those neuropeptide chemical toxins release into the bloodstream and wash up, kind of like a lactic acid burn. The post-needle soreness that you feel feels very much like a workout sore only very specifically located to where that needle twitched. That can last anywhere from a couple of hours to a couple of days. Immediately after dry needling, it’s such a cool clinical game changer both for the clinician and the patient because it’s super effective and efficient. You immediately have a better range of motion, less pain, and better activation of muscles. It just does this whole host of things chemically locally, and then also through the nervous system locally in the spinal cord, and then up into the brain from an essential system side too. It’s an amazing modality for you. So that was dry needling. What was the next part that you wanted me to answer? Meagan: I’m trying to remember now. Betty: Something about a C-section scar—Meagan: C-section scars, yeah. What I was thinking is how, and maybe even why. Betty: Yeah. Meagan: I mean, you kind of just even talked about it. My left part of my C-section scar– I think that’s where maybe my provider was stitching, my left side specifically. It seems like it’s tighter on that side. Betty: Yes, totally. Meagan: Tighter, maybe tougher. I don’t know exactly. Betty: Yeah, more restricted. Meagan: More restricted. And so, I don’t know. It sounds like maybe that would benefit. But yeah, let’s talk about dry needling a C-section scar and how that can help and why you would benefit. Betty: Absolutely. First, I want to touch on the tightness of one side of the scar versus the other. Typically, it depends on where your surgeon stood and where they tied their last knots. So if your surgeon was standing on the left, it will be tighter on the left and if they were standing on the right, it will probably be tighter on the right. So just keep that as a side note of, “Where was my surgeon at?”Meagan: He was on the left. That’s what I was thinking. He was on the left. Betty: Yeah, most people are on the right because the surgeon is right-handed so they will stand on the right, but if you had a left-handed surgeon, they would stand on the left so that should make sense. And then as far as dry needling scars, it can be done on any scar, really. It doesn’t have to be a C-section scar, but that’s the one we most commonly see. We are pelvic floor PTs, so we see a lot of C-sections. We take a dry needle into that tissue where the scar is superficially and then once it’s in there, instead of the trigger point twitching that I just described, we spin the needle and wind up the fascia around the needle. So fascia, if you don’t know what that is, is the spider webbing material all over you. It basically holds you all together. You’d be a blob on the floor without it. If you think about chicken, if you peel chicken apart, you can see the fascial spider-webby stuff. You basically stick the needle in the tissue and twist it up. It usually doesn’t hurt at all when we are twisting it up. It sounds gnarly but it’s not that bad. It’s all superficial. Once it’s twisted up, we really can’t even pull the needle out because all of the fasciae wraps around it. And then we sit there and breathe a little bit, talk about something else, and then once that tissue has relaxed and the nervous system has decided, “Oh, okay. I can let go of this holding pattern here,” then we can pull that needle out. We can always untwist it too and pull it out, but it’s really great. We’ve had tons of really great success with that with people who say like, “Oh my gosh, that burning symptom is gone,” or “I can touch my C-section scar now.” Pretty immediately, big, big changes can happen with that. That just brings up mobility and movement. Another thing that we commonly do with that is often times if that C-section is tapped down, we’ll also needle the rectus abdominis which is the six-pack muscles both above and below that and then where it attaches into the pubic bone too. That can release a lot of things. A lot of times, people might have urinary urgency frequency and burning, almost UTI-like symptoms after a C-section just because that fascia is pulled tight and that fascia from that abdominal wall goes into your pelvic floor. That can cause issues in the pelvic floor too if that C-section scar doesn’t move well in creating those UTI-like symptoms even though you maybe test negative on all of those. That’s another good sign of, “Hmm, I should go to pelvic PT because I have negative cultures when I test for a UTI.” Meagan: Yeah, that is interesting because I had that. They kept saying, “No, you don’t have a UTI.” That was after my second C-section. I was like, “I’ve got to.” I grew up with UTIs so I just figured, “Oh, I had a catheter in. I probably do because I’m more susceptible to it since I have a history of them.” They kept saying, “No, no, no, no, no you don’t.” I was like, “Okay.” But now it makes me wonder. It just makes me wonder if that had anything to do with it. It honestly happened for weeks, though. Like, weeks after birth. Betty: Yeah, yeah. So definitely something to do with pelvic PT for sure. We might need to get you back in to needle that C-section scar. AdhesionsMeagan: I know. I definitely don’t have that UTI feeling anymore, but I know that I have tightness on that left side. I know that I have adhesions in there. That’s another thing I wanted to talk about with having two C-sections myself. Having a C-section or just a scar in general, anytime our body is cut open, our body creates adhesions and scar tissue, right? So two questions. One, can it affect the outcome of a vaginal versus Cesarean birth if we have dense adhesions and scar tissue in there, and can you as a pelvic PT rehab provider help with that? Can you do that? Betty: Yeah. Well, so we can definitely help with scar tissue, mobility, things like that. Now, true adhesions. You can’t really break adhesions up from endometriosis or really heavy scar tissue, but we can definitely move the tissue around it and we can get that scar as mobile as possible. Sometimes, there are the extremes where it’s like, “You do need surgical intervention to remove adhesions depending on the severity of it.” I just want to put that out there. Not all things can be managed with conservative care, but most things can. And so just figuring out where is your sealing on that and figuring that out. As far as tears, whether it’s vaginal tears or C-section tears, having the mobility through that just allows your body to function the way it’s supposed to so your pelvic floor can move out of the way. Baby may be able to better drop in the pelvis if all of that is mobile the way it should be. When you have restrictions and things like that, things tighten and bind in. It’s hard to even– like having a breech baby and having them flipped. If things are really tight, you can’t even move them no matter what you do unless things are loosened up. If the scar tissue is really tense and not moving, you might tear again on a vaginal delivery if you don’t have that mobile and moving. So just making sure that all aspects, I mean, that’s our job too, is to evaluate you and make sure, “Okay. What’s moving? What’s not moving? What do you have good activation on? What do you not have good activation on?” and then fine-tune those things so that you can be symptom-free and be able to move your body the way it needs to move. Meagan: Oh my gosh, yeah. That makes sense. That makes a lot of sense. How would a provider even be able to diagnose those really dense adhesions that are causing big problems? Could a provider say, “Your baby could be breech due to this? Maybe you could go do this.” Do you know what I mean? Does that happen? Are providers in the know?Betty: Yeah, I think that’s just a hard topic. I can speak for us as pelvic PTs. We’re like, “Well, that just makes sense. Let’s balance out the pelvis. Let’s get the adductors moving. Let’s get scar tissue moving. Let’s get the hip flexors out of the way and the round ligaments,” all of those things. Those are the day-to-day things of what we are doing. I think that the rest of the world and most providers, not all, there are some amazing other providers that are great advocates for pelvic rehab, but a lot of them don’t even know what we do or how we can help people. They still think we do Kegels and biofeedback. It’s like, “Oh, just go if you have issues later.” There’s still a lot of, “Oh, you have pain with sex? Just have a glass of wine. Don’t worry about it. You’ll be fine. Just give it some more time.” It’s like, “No, no, no, no. You don’t understand. It shouldn’t be painful at all and you don’t have to live with that kind of stuff.” So I think it just depends on the provider that you talk to, what their scope is, and what they do. I’ve even had good relationships with OBs and midwives and stuff like that. They’re fabulous clinicians and they’re really good at what they do. I’ll even ask them a question about something related to pelvic PT and they’re like, “I don’t know what you’re talking about. You can do something for that?” That’s, unfortunately, more common than not, but that’s really where my passion is too. That’s why I’m so thankful you invited me on the podcast here to share the knowledge of what pelvic floor therapy is, what we can do, what we do help with, and know it’s not something you just have to live with or have surgery or medication. There are better ways. Meagan: Yeah. Yeah. Awesome. Oh my gosh. There are so many other better ways. I am just so grateful that you are here. Is there anything else that you would like to touch on or anything that you think our listeners could really find valuable? I mean, obviously, all of the things you have said are valuable, but is there anything else that maybe I’m not asking because I don’t know the question? It’s like when you go to a provider and the provider is like, “Do you have any questions for me?” And you’re like, “Umm, should I? Maybe?” I have questions, but I don’t know what questions to ask.Betty: Sure. Returning to activitiesMeagan: It’s not even that I don’t know. It’s just like, there is so much that you do that I probably don’t even know that you do still. But yeah, especially for our VBAC parents, anything else that you would like to cover?Betty: I would just say in general, be an advocate for yourself. I know that you can echo that a lot. “This isn’t normal. I know that this isn’t normal. I should be able to do something about this.” Listen to your gut on that because most likely you can. And then, just finding those providers that are a safe space, are going to listen to your story, and be able to guide you in the steps that you need to be able to take is just an overall, general good thing to know. Something else that we do too is a lot of return to activity whether that’s walking around the block pushing a stroller, being an ultra trail runner, doing a marathon, or CrossFit. We get people back to those activities after baby whether that’s C-section or vaginal and make sure that they are fundamentally loading their body correctly and have those foundations laid so that they know they are activating their core correctly and they are using their glutes correctly. We have a lot of people who, when they do work with us, go above and beyond what they were even pre-pregnancy because they have that foundation laid. I’m a big fan of the idea that postpartum is such an opportunity to really find out some of those things that were there that you didn’t know were there because you basically get stripped down to nothing, right? I can say that from experience. “Oh my gosh. What happened to my body? How am I going to get back to running a marathon?” As an opportunity, you can really work on those fundamental skill sets and build a really solid foundation of movement patterns, and then just go crush it. So we really enjoy that too of getting people back to the activity they want to be doing, and then high-level activity too.Meagan: Yeah. Get back to normal life. I have had doula clients who were like, “Yeah, back in the day when I could lift” or “Back in the day when I could run” and it’s not even like they’re always leaking. It’s causing pain or they feel a lot of pelvic pressure and things like that. I just want to say that you can still do that. You can. You can get there again. If you enjoy those things and you want to, you can do it again. So know that you don’t have to feel the way you are feeling forever. Betty: Totally. Meagan: There’s help out there. It might take time. It might take time and it might take effort and patience. Give your body grace and allow it to recover, but it can happen. It really can. Dr. Betty’s virtual and out-of-state resources Betty: Awesome, yeah. If anyone is interested too, we also have some free resources on our website as PDF downloads to help with just a couple of the things we touched on. Online programs and in-person sessions are available for you guys. That’s why we are here. Meagan: Yeah. I was just going to ask you to share all of that. I know you have a course. You have freebies. Are you guys doing virtual? Is it possible to do virtual or is it super recommended for people to find providers in their area? Betty: Yeah. We definitely do virtual. We call that a remote consultation. We don’t classify it as pelvic floor therapy because we honestly can’t evaluate you over the internet, but we can be kind of like a coach navigator and play an educational role through that. So that’s definitely an option from an online standpoint. And then from there, we definitely encourage people to find someone local to them. But if they are unable to find a provider that is really resonating with them and getting them the care that they need, we do offer an out-of-town program. People fly in for a week. They come and see us in the clinic for anywhere from an hour and a half to two hours a day. We see them five days a week or for however long they are here. It is a very intensive program, then send them on their way with things to work on once they leave, then follow up with them remotely as well. We have done a few of those as well which is really fun for me when people fly in to see us. I’m like, “That’s pretty cool.” Meagan: That’s awesome. So awesome. Such a good feeling, I’m sure. Betty: Yeah, but obviously no online program, and I have online programs and they are there for education, but no online program, no “get fit after six weeks postpartum”, any of that stuff is actually going to truly get to the root of things. I firmly believe that in-person, one on one, hands-on, manual therapy with a skilled practitioner is the gold standard. I always say that if that’s what your options are, choose that first but there are other options from an access standpoint to make sure that you are getting the care that you need and helping get you in the direction that you need to go. Like I said, you can always fly to Utah and see us. Meagan: Absolutely. That is such a cool option. So if you are looking to check out Betty and her amazing team, can you tell them where they can find you? Obviously, you are in Utah, but you’re all over. Betty: Yeah. Our website is called www.rebornphw.com for pelvic health and wellness. We are on Instagram, Facebook, TikTok, all of the things @rebornpelvichealthandwellness. That’s where you can find us all over the place. Meagan: Absolutely. We are going to be listing all of those things in the show notes. We will make sure to be tagging you on social media. So if you are not on our Instagram or didn’t know we had an Instagram, head over to Instagram @thevbaclink and see today’s post. We’ll have her post right there. You can click on it and go like her page. There is so much that you post that so many people from out of state really can still benefit from. It’s definitely one of those pages that I would suggest following. Well, thank you so much for being with us.Betty: Thanks, Meagan. Meagan: Seriously, you are awesome. I just think you are incredible and I know all of the people out there do as well because I see them. I see the comments all over our Utah birth forums. So keep it up and thank you so much for sharing today all of your wealth and knowledge. Betty: Awesome. Thanks for having me, Meagan. I really appreciate it.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan’s bios, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link. Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands