I’m part of a few Facebook groups for prenatal and postpartum fitness professionals and I’ve unfortunately heard this never-ending story enough that – while it still gets me all riled up – it no longer surprises me.
A fellow prenatal and postpartum fitness coach said she approached her doctor at 9 months postpartum because she was having some stress incontinence issues and she wanted a referral to a pelvic health physiotherapist.
She knew this was a good step to take because she’d done her research – this was her area of expertise for goodness sake!
And you know what her doctor said?
There’s no cure for stress incontinence. You can do surgery, but that usually doesn’t help. You’ll just have to deal with that for the rest of your life.”
You see. I told you it frustrates the heck outta me when I hear these kinds of stories. Especially when the research and real life successes tells us a whole other story.
We aren’t living in the 1920s anymore where doctors just assumed that once you had a baby your body was wrecked and you just had to live with things like peeing yourself every time you sneezed.
There are so many amazing doctors and OBs out there being incredible resources and support systems for moms.
But unfortunately some doctors are still behind the times and aren’t up to date on the potential solutions out there.
For whatever reason this doctor felt it was the best move to deny this patient her right to options like pelvic health physio – even though the patient directly asked for it. So she left the office without that referral – even though she knew she deserved better.
So what would you do if you were in her shoes?
How do you respond to something like that?
Well I have some ideas to help you navigate this tricky situation – without burning bridges or resorting to trying some WWE head lock on your doc until they give you that referral 😉
While the obvious first step would be to get another doctor, it’s not always that easy.
Maybe you live in a rural area and that’s your only option for 50kms.
Or maybe the way your insurance is set up you can only see certain doctors and this is your assigned pro.
Or maybe no other doctors in your area are taking on new patients so you’re stuck with where you’re at.
Whatever the reason, a second opinion by another professional may be off the table.
So what now?
You keep advocating for yourself and you don’t back down.
Now I get that this might feel icky for you.
I’m an introvert. A shy introvert who’s natural tendency is to avoid the whole assertive “this is what I want” thing.
But when some little bully purposely pushes my daughter into a metal pole at the playground and gives her a big goose egg on the side of her head you better believe I’m all kinds of assertive.
And I’ve luckily learned to translate that mama bear mentality to my own health and happiness.
So let me help you tap into your own assertive side.
The good news is you can be assertive without being a jerk.
You can stand up for yourself without being rude.
You can demand the kind of support and care you deserve without having to go all mean girl on your doctor.
I’ve jotted down some common scenarios you might find yourself in and how you can respond in a respective, yet “I’m not leaving until I get answers” kind of way.
Let’s dive in.
When They Say “It’s All In Your Head.”
Try to not lose it and calmly say, “That may be so but it would make me feel a lot better – and I wouldn’t have to keep bothering you – if I knew for sure. So can I just get that referral please?”
The key phrase in there is “I won’t have to keep bothering you.”
If you make it clear that you’re not going anywhere and you’ll keep showing up until they give you what you’re asking for they’ll be more likely to write that referral slip – even if it’s only to get you off their back.
It’s sad but true that being a pest really does work.
And sometimes all you need to do is make them feel like you’re ready to “waste” a lot more of their time if they don’t simply appease you now.
When They Say “You’re a Mom. That’s Just the Way Your Life Is Now.”
Point out, “I appreciate that things are different now, but if that were the case wouldn’t all moms have this happen to them?”
Whether it’s leaking, signs of prolapse, painful sex, whatever, if they’re shunning you away with the idea that that’s just your one-way ticket into motherhood, remind them that that’s not true.
Point out the obvious – it’s not a normal part of being a mom because 100% of moms don’t experience it.
So that means that – while it may be common – it’s not just something that has to happen to every mom. Because it doesn’t.
And if they respond with, “Yes, well, those other moms may just not be talking about it.” Or “Well maybe all moms don’t have it, but it’s common enough that it’s normal and nothing to worry about.”
Say, “Okay. Fair enough. But I’d rather make sure that there’s absolutely nothing that I can do to help make it better because it’s really impacting my life and my ability to mother and honestly my happiness. I’m having a really hard time with this. It’s really stressful. I wouldn’t be coming to you if it wasn’t that bad.”
Make it clear that this isn’t a minor ache. Paint a picture of what it’s really like.
“Every time I laugh I’m worried I might leak. It’s embarrassing and incredibly stressful. I don’t want to live like this.”
“I can feel a weird pressure-y bulge every time I go to pick up my daughter and it’s so uncomfortable.”
“I wish I could enjoy sex. I used to love it. But something feels horribly wrong now. It’s painful. It’s making me feel like a horrible partner. I don’t want to keep having to say “not tonight” and feel so sad and guilty.”
Tap into their empathetic side and hopefully they’ll see the value in actually helping you.
When They Say “Your Pelvic Floor Is Fine. You Don’t Need Physio.”
Whether you had a C-section and they think only moms who have vaginal births can benefit from pelvic floor physio (which absolutely isn’t true – you still carried a baby for 9-ish months which takes a toll on your pelvic floor, even without a vaginal birth).
Or they do a quick check and things look “fine”.
Or you don’t have any symptoms or issues, you’re just being proactive and want to make sure everything looks good before you dive back into more intense workouts.
All these reasons (and more) are fantastic reasons to see a physiotherapist.
I had zero issues when I went for my 6 week postpartum physio check-up after my second daughter was born.
But I still went because I wanted to know for sure that things were recovering well, my pelvic floor was responding well, my diastasis was healing well…
We live in a society where the emphasis is put on reactive care – instead of preventative medicine many doctors simply react after an issue becomes an issue.
But being proactive can save everyone time, money, energy, sanity.
So make it clear that you understand you’re probably okay, you just want to make sure.
“I feel pretty good, I just want to make sure that everything is healing well and my muscles are recovering properly before I dive into more intense workouts. I’d rather catch something now before it becomes a bigger headache or issue.”
If they’re pushing back and still saying “But you don’t need it.”
Say, “That may be the case but I’d rather make sure I don’t have to come back here in 3 months to get a referral for something that could have been prevented in the first place.”
When They Say “Just Do Some Kegels.”
Kegels seem to be the cure-all postpartum, don’t they?
But the truth is that – while kegels can be great for some women – they aren’t great for a handful of moms (like moms with a too tight or hypertonic pelvic floor).
And we want to make sure that if you’re doing kegels, you’ve got the right strategy down pat.
And then on top of that, pelvic floor physiotherapy and rehabbing your core and pelvic floor goes way, way beyond kegels.
So if your doc checks you and says “You’re fine. Just do some kegels and that’ll be enough.”
Say, “I appreciate you checking and I value your opinion, I would simply love to make sure that there isn’t anything else I could be doing to help my body heal.
My friend told me that her physio gave her some exercises specifically for her body and what she needs to work on so I’d love that more customized approach.”
Now I’m not trying to demonize doctors.
There are some truly amazing humans out there who are super supportive of moms and understand our unique needs.
My doctor actually checked my pelvic floor function post-birth with my first and she’s the reason I went to pelvic floor physio in the first place. Without her I would have no idea that it even existed. I’m so grateful for her.
So I would like to believe that most doctors really do have our best interest at heart.
There are just a few who don’t appreciate the kind of support we need – and deserve.
Or they simply aren’t educated enough about postpartum care to see that there are very valid reasons for referring out.
The point of this post isn’t to bash doctors.
The point is to empower you to advocate for yourself and insist that they pay attention to your plea for help.
Doctors take a Hippocratic oath for a reason.
They’re supposed to protect and care for us in a way that’s ethical and fair.
Gently remind them of that and – especially if something doesn’t feel or function right – keep advocating for yourself.
Don’t leave that office (or keep coming back) until you get the help and resources you need.
You aren’t a “drain on the system”.
You aren’t “wasting their time”.
You deserve the best care possible.
Go get it.
P.S. Please share this with your mom friends on social media (using the links above and below) or shoot them a quick “you gotta see this!” email.
More women need to know that it’s okay to advocate for themselves and be armed with the tools they need to make it happen.
Thank you for spreading the love!