Postpartum PT Care, Interview with a therapist in Madison

I had the honor of interviewing a therapist in Madison, Jessica Dufault from Mindful Motion Physical Therapy to learn more about how she helps postpartum care in Madison. She specializes in pelvic floor and women’s wellness. She is an excellent resource for women in the pre/postnatal stage and also works with women that have experienced a pregnancy loss.

Julie: Hello Jessica,

Thank you so much for agreeing to speak with me. Would you start by introducing yourself?

Jessica: Hello,

I'm excited to be talking with you about pelvic health today and thanks for inviting me!


I'm a mom, partner, business owner and Pelvic PT in a small private practice. I support people throughout their lifespan (18+ years old, my wisest client was 94!)


Julie: Who can benefit from PT for the pelvic floor?


Jessica: Anyone with a pelvis! But specifically if you've gone through life transitions such as pregnancy, postpartum and perimenopause. During these times, your health and pelvis can undergo transitions that can be challenging to navigate alone and may sometimes require additional TLC.


Julie: I work with a lot of pre/postpartum moms. What are some symptoms that they may notice if they need physical therapy?

Jessica: Great question! If you are pre/postpartum, here are some things to look out for

Peeing when you don't want to

Prolapse which is a shift in position of pelvic organs (feeling of pressure, heaviness or a "falling out" feeling)

Difficulty with internal menstrual product use

Pain with penetration, including sex, exams, menstrual products

Scar tissue restrictions or pain (perineal or cesarean)

Diastasis Recti (separation of abdominal tissue) which can lead to feeling weak or even LBP

Pain in areas like the low back, sacroiliac joint, hip. As well as sciatica and pubic symphysis dysfunction

You may also be looking for guidance on exercise or fitness

You may want support for prepping your body for demands of pregnancy and birth


Julie: If someone has a cesarean birth is PT still helpful?

Jessica: Yes! I had an unplanned cesarean and I had NO idea how difficult the recovery would be and didn't have the support I needed (which is one factor that pushed me from an orthopedic PT to a pelvic PT!).

Taking care of the scar tissue, assessing the position and movement of pelvic organs and regaining abdominal strength are all very important to ensure good long term pelvic health.

Julie: I also work a lot with bereaved moms. I think a lot of times they don't always think about being postpartum because they are not given the same attention as a mom that is lucky enough to bring a baby home. Do you have experience working with bereaved moms? How might your work look different? What might be important for them to know?


Jessica: I don't have a lot of experience here but over the years I have supported a few people who've experienced loss in pregnancy, during birth or a few weeks after birth. And maybe my experience is limited because of what you've already mentioned, that they aren't given the same attention, resources and discussion on all aspects of physical postpartum support. And yet they have the right and deserve the same access to physical pregnancy/post-pregnancy care.


Because if you have experienced a miscarriage in early or mid pregnancy prior to 20 weeks, or a stillbirth (whether vaginal or cesarean) at anytime past 20 weeks, your body has been impacted by hormones and all the accompanying physical changes to the body that pregnancy and birth can bring on. Which deserves attention and support!

We can start early education and support depending on each person's readiness however we wouldn't do a full pelvic assessment until 6 weeks post birth.

All of my clients are screened for mental and emotional health and this helps me to understand where they are in the (potential) grieving process as well as what support they've been able to access and then I can fill in referral gaps as necessary.

And with all clients, I follow their lead in how we approach the plan of care and meet them where they are and with what they (and their bodies) seem ready for. This is especially important for clients with a history of trauma or loss.

Julie: This is so helpful. Thank you! It is a great to know that you are aware and sensitive to the trauma and grief that all these moms are going through and ways to support them.

Julie: What are the benefits that PT can offer?

Jessica: Navigating changes in our bodies can be a lot and accessing a pelvic PT can help people feel well supported physically, emotionally & mentally. Knowing you don't have to "go at it alone" or "suffer in silence" can have a profound impact.

Also it's not just about the pelvic floor! My training and education allow me to support people with all aspects of their health and wellness as it relates to menstruation, fertility, pregnancy, postpartum, perimenopause & menopause.


Julie: If someone is interested in working with you, how do they initiate that?

Jessica: Our website is a great place to start. Lots of info there on who we support and all the options- like using insurance, choosing our ​self-pay programs or even our online programs. We also offer online scheduling through our website.

We do have a free and private Facebook group that everyone is welcome to join if they are looking for more community, support and general pelvic health education.


Julie: Thank you so much Jessica for taking the time to meet with me today. Is there any other information that would be important to know?

Jessica: I often get feedback that our space feels very warm and inviting and that talking with me is way easier than they anticipated (and they say "I wish I had come sooner!") We work hard to make the experience feel supportive and easy. If anyone has reservations, I'm also open to chatting via email or phone call as necessary to make sure it's the right fit overall.

Julie: Jessica you are a valuable resource to the community. Thank you so much for talking with me today and all that you do for the postpartum moms. One of the reasons I asked Jessica to speak today is because of all the great content I see her putting on instagram for free. If you haven’t found her on there yet she is

that_ pelvic _lady.

For more resources on pregnancy or postpartum mental health contact julie@kullcounselingmadison.com.


Anxiety therapist Madison: Still coping with Covid-19 and anxiety


This is an article that was modified from another article that I wrote in 2020 about anxiety during covid.

It is 2022. We are still dealing with Covid-19. If you are noticing the weight of it hitting you again you are not alone. We are at the two year mark, going on year 3. Your anxiety may be on the rise again as we head into another year. Here are some coping tips I offered in 2020 which are still applicable now. I have added in a few additional ones.

  1. Exercise- exercise is important for physical and mental health. If you have an anxiety disorder exercise plays an essential role in managing anxiety. Exercise not only releases serotonin and endorphins to improve your mood but also can reduce activation in the amygdala which is the area of the brain that sends a distress signal to activate our fight, flight, freeze response. https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response

  2. Get outside- Time in the outdoors can be restorative. Having deficient levels of vitamin D can also be linked to depression and anxiety. https://www.unitypoint.org/livewell/article.aspx?id=ca7f4766-8ba8-43a2-bbe7-0ef9efab5c6d

  3. Meditate- Meditation can improve focus, decrease anxiety, and help with emotion regulation among other benefits.

  4. Keep a routine- our bodies thrive on routines. Routines can improve productivity, setting expectations and having some control.

  5. Sleep- REM sleep can also play a role in decreasing activation in the amygdala. Setting up a sleep routine can signal to our body when it is time to go to sleep.

  6. Social Support- these are hard times. While you many be social distancing from friends you do not need to isolate. Reaching out to friends can provide a sense of normalcy and a sense of belonging.

  7. Manage your screen time- Between work, school and socializing online many of your are getting more screen time than you ever have before. Screen time can impact anxiety, sleep and overall well-being.

  8. Focus on what you have control of- unfortunately with Covid-19 it may feel like there are many things that are out of your control. Focusing on these can lead to increased anxiety. Instead try focusing on what things are within your control. Make a plan for the things that are in your control, and let go of the things that are out of your control.

  9. Stay present- Ask yourself what do I know in this moment instead of the what ifs.

  10. Attitude of Gratitude- in the midst of all this chaos there is a lot to be grateful for. What do you feel grateful for? Write it down, say it out loud. Surround yourself with positive messages.

  11. Be mindful when reading the news. Is it serving you? Are you finding out anything new? What does knowing this information do for you? How are you feeling when you read the news? Do you need a break?

  12. It is okay if your comfort level changes- again, and again and again. Listen to your needs.

  13. Get dressed for your day. Even if you are working from home. Even if you don’t have any meetings.

  14. Weigh your risks. Everything has a risk when it comes to your physical and mental health. Calculate your risks versus what is important to you and then make your decision on what you are comfortable with.

  15. Acceptance- you are living in a global pandemic. If you are having anxiety right now- accept that it is there. Acknowledge it, name it, allow yourself to notice how it feels- notice what sensations go with that feeling and allow them to be there.

    For more information on coping with anxiety during the pandemic or to set up a free 15-minute consultation email julie@kullcounselingmadison.com or 608.239.4807 to work with a therapist Madison.

Coping with Anxiety and Covid-19

anxiety woman

In the last few weeks it may feel that your world has been turned upside down. Many of you may be quarantined, social distancing, staying at home or safer at home. In this time of uncertainty, Covid-19, many of you may be feeling an increase of anxiety. Here are some tips for managing anxiety during the pandemic.

  1. Exercise- exercise is important for physical and mental health. If you have an anxiety disorder exercise plays an essential role in managing anxiety. Exercise not only releases serotonin and endorphins to improve your mood but also can reduce activation in the amygdala which is the area of the brain that sends a distress signal to activate our fight, flight, freeze response. https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response

  2. Get outside- Time in the outdoors can be restorative. Having deficient levels of vitamin D can also be linked to depression and anxiety. https://www.unitypoint.org/livewell/article.aspx?id=ca7f4766-8ba8-43a2-bbe7-0ef9efab5c6d

  3. Meditate- Meditation can improve focus, decrease anxiety, and help with emotion regulation among other benefits.

  4. Keep a routine- our bodies thrive on routines. Routines can improve productivity, setting expectations and having some control.

  5. Sleep- REM sleep can also play a role in decreasing activation in the amygdala. Setting up a sleep routine can signal to our body when it is time to go to sleep.

  6. Social Support- these are hard times. While you many be social distancing from friends you do not need to isolate. Reaching out to friends can provide a sense of normalcy and a sense of belonging.

  7. Manage your screen time- Between work, school and socializing online many of your are getting more screen time than you ever have before. Screen time can impact anxiety, sleep and overall well-being.

  8. Focus on what you have control of- unfortunately with Covid-19 it may feel like there are many things that are out of your control. Focusing on these can lead to increased anxiety. Instead try focusing on what things are within your control. Make a plan for the things that are in your control, and let go of the things that are out of your control.

  9. Stay present- Ask yourself what do I know in this moment instead of the what ifs.

  10. Attitude of Gratitude- in the midst of all this chaos there is a lot to be grateful for. What do you feel grateful for? Write it down, say it out loud. Surround yourself with positive messages.

    For more information on coping with anxiety during the pandemic or to set up a free 15-minute consultation email julie@kullcounselingmadison.com or 608.239.4807.

The guilt of miscarriage

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It is estimated that 1 in 4 women will experience a miscarriage.  For many, having a miscarriage is a devastating loss that leads to a roller coaster of emotions. One common emotion many women hesitate to talk about is guilt. When you have a miscarriage there is a large amount of guilt associated with it because you feel like you did something wrong.  

 

Different types of guilt with a miscarriage:

1. The Guilt of It was my job. You may feel that that having a baby is part of your role as a woman and a wife. You might feel guilty that this is your job and since this is your job and you did not give birth to a healthy baby you have failed your job. You might have been taught that pregnancy and motherhood come naturally (and easily might I add) so when you are not able to maintain a healthy pregnancy there are strong feelings of guilt.

2. The Guilt of I did something wrong. If you believe #1, that it was your job to get pregnant and have a baby, than this is usually where the second layer of guilt sets in. If you could not do "your job" than you must have done something wrong. Did I drink too much caffeine? Was I exercising too much or not enough? Was it that glass of wine I had before I knew I was pregnant? You probably have come up with a dozen things that might have caused your miscarriage and concluded that is was your fault. 

3. The Guilt of what if I can't get pregnant again. If it was your job and you did something wrong than you might be feeling it is quite possible that you cannot get pregnant again. You may fear that you have already lost a baby and now you feel the guilt of what if I already lost one baby and I will never be able to have another. You might feel that this was your only chance and you did something wrong to cause this. You might feel that this is punishment for something else that happened in your life.

Guilt is an intense emotion and a very real part of the healing process of losing a baby in early pregnancy. There is help working to challenge these negative thoughts and normalize these feelings. If you have experienced early pregnancy loss it is not your fault, and  you are not alone. To learn more about guilt and other common feelings after a miscarriage or more information about the free monthly miscarriage support group please contact Julie at 608.239.4807 or julie@kullcounselingmadison.com

Honoring your due date

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Your "due date". 

If you have experienced an early pregnancy loss, you might be overwhelmed with emotions when thinking about these two words.  It might feel like a deadline for you or a last hurdle you are waiting for to move from depression to acceptance. You might even feel that your due date will be the time that you start letting yourself grieve. If you have experienced an early pregnancy loss an upcoming due date might be weighing heavily on your mind. According to clinical psychologist Kirstin Bouse, via www.essentialbaby.com, "Commemorating your baby's due date isn't just a way to reflect on how important your baby was to you, it's also a vital step in the grieving process."

While everyone must find the best way to grieve and honor their baby on their due date, here are some ideas that have helped others:

1. Find something that memorializes your baby.  You may find that it is healing to have something that memorializes your baby. You may find that a piece of jewelry that you can wear is meaningful- an initial, name, date or symbol can be printed on necklaces, rings or bracelets to help you remember your baby. You might find that getting a tattoo would help you to honor your baby. Other ideas include a statue, stuffed animal, plaque, or plant are ways that you might honor your baby. You might find it to be healing to create a memory box adding any pictures, poems, toys, outfits, or other momentos that help you to remember your baby.

2. Donate. Whether this is your time or money, you may find comfort in making a donation to a charity in honor of your baby on his/her due date. Donating can be a wonderful way to not only memorialize your baby but to also help others.

3. Surround yourself with family and loved ones. You may fine it helpful to surround yourself with loved ones on this day. Those who know and will help you to honor your baby. It may be helpful for you to talk about it with others, to have a celebration in your baby's honor or simply to just be surrounded by love.

4. Spend time alone. You may find it comforting to be alone.  You may want time to process what this day means to you by yourself. You may not want to talk about the day. You may find it comforting to write about your baby or use art to process your feelings about the day.

5. Take a vacation or a staycation.  You and your partner may enjoy taking time off from work to go out of town or to have a mini vacation in town. It might help you to celebrate the day by making some happy memories or it just might be a good distraction to get through the day.

These are a few suggestions that have helped others. Everyone grieves differently and you have to find what is right for you. If you are having a hard time processing your grief or are feeling stuck there is help.

For more information about grieving after a pregnancy loss please contact Kull Counseling, LLC at 608.239.4807 or julie@kullcounselingmadison.com