I just finished reading the book Ending Female Pain by Isa Herrera, MSPT, CSCS. The book covers a taboo motherhood topic — pelvic and sexual pain after childbirth.
Ms. Herrera embarked on her journey towards helping women with pelvic and sexual pain after hearing many women’s experiences, as well as her own. After finding no resources that were available to women dealing with this, she finished her Masters in Physical Therapy and eventually opened Renew Physical Therapy in New York City. There she specifically designed a program containing excercises and stretching techniques which she calls “The Renew Program For Women”.
Then came this book.
Ending Female Pain is filled with photos and highly detailed illustrations that show your female anatomy fully labeled and explained away, as well as clear and simple images that show you how to perform the specifically selected exercises and stretching techniques. The book also contains visualization excercises, homeopathic treatments and other wonderful self-care tips.
The book was fascinating as well as informative. I learned so much about my body — even after years of feeling empowered from using the Fertility Awarness Method — this book made me feel even more aware and in tune with my own body, as well as the 3 year old cesarean scar that I often disassociate myself from.
This book is aimed at both cesarean and vaginal birth mothers, and even though I also had a vaginal birth just 9 months ago, I focused mostly on the scar care section, as this is what bothers me. I don’t like anyone touching the scar, not even myself, as it seems hypersenstive. I slowly and reluctantly worked through the simple scar care techniques, and little by little, it became easier to touch my scar and feel connected to it again. The hypersensitivity has waned, and I hope as I continue the daily scar care techniques that it will continue to improve.
Ending Female Pain covers a topic many women are afraid to talk about, and when they do, they are often told it’s “in their head” or there is no way to fix it. Ms. Herrera brings a real problem to light, addresses it, and gives you the knowledge and the tools you need to correct it and start on your path to living pain free.
Q & A
Isa Herrera, MSPT, CSCS
1. Why do you think pelvic/sexual pain is such a taboo subject?
Americans in general do not talk about sex as openly as individuals in other countries. So I would say it’s cultural and behavioral. And many times as women we think it’s part of the deal and MD’s think that’s the way it is after having a baby. Many times we hear that the MD has told the women welcome to motherhood. Also MD’s are ignorant on this topic. It is not taught in medical schools so really we can’t blame them. Their educational systems need to change for there to be a real change in this field.
2. In your book you talk about women in other countries, such as
France, having pelvic care available to them after birth, why do you
think the US doesn’t do this? —
This is a loaded question. It has a lot to do with our medical community and women’s health in general and that c sections and post-partum care are just ignored. Many think if it’s ignored it will go away. Also there is a common thread of thinking among doctors that pain is part of being a new mother —
How detrimental do you think this is to
women? What should we be doing for women after childbirth?
In other countries pelvic rehab and post-partum care are part of the care every women receives.
I think it is extremely detrimental for women not to get this case routinely. Women who don’t get the care end up having problems for years and then getting surgeries that might have been avoided with conservative therapy first.
Physical therapy for the pelvic floor is a growing specialty in the United States. All women should receive education on how to restore pelvic floor muscle function after childbirth. Every woman would also benefit from instruction on proper posture and body mechanics while breastfeeding and caring for their infant. We are working hard to bring this issue into the public spotlight.
3. Women aren’t told by their care providers about post c/s scar care
or the effects of scar tissue even years down the road. What do you
think about this?
The main objective of the surgeon is to deliver a healthy baby and assure the survival of the mother. This is a great task, no matter how routine c-sections seem to be. MD’s are very good at achieving this objective. They may not see the lasting effects of the scar tissue years down the road. Because if the scar is not oozing or infected they’re like my job is done.
4. After their cesareans, some women complain about scar
hypersensitivity, even years later. How often do you see this? What do
you think causes this and how can it be helped?
We commonly see women with scar pain and hypersensitivity, even years after their C-sections. During a C-section, approximately 8 layers of fascia and connective tissue are cut. These fascial layers connect to the pelvic floor muscles, pelvic organs and abdominal origins. Pain, burning, itching and numbness at the scar site are all common findings. Massage and mobilization of the scar tissue can help free these adhesions.
5. Some think having a cesareans makes sex better, but personally, as
well as many other women I have spoken to, find just the opposite. How
often do you find women who have had c/s complain about sexual pain?
Many rimes women think that their pelvic floor are being saved b/c of the c-section but it’s important to remember that 8 layers of connective tissue are cut and some of those layers are related to the pelvic floor muscles and viscera. So they negative self-talk among the tissues where one tissue is compromised and then the other tissues also become compromised.
6. Leigh writes:
How long should pain last after an episiotomy? Specifically referring
to intercourse… A friend of mine is really battling 3 months on –
OBGYN says it’s psychological – apparently she’s jealous of all the
attention baby’s getting.
Episiotomy pain can last a long time if not treated correctly. Your friend needs to see a pelvic floor specialist who can help her. Clinical nursing recently reported that 1 in 3 women still has pain one year after child birth. The jealousy part is just plain nonsense.
7. Leslie writes:
Will she be exploring alternative therapies like CranioSacral Therapy,
Visceral Manipulation, Cranial Osteopathy, Acupuncture and Chinese
medicine in the treatment of C-section scar adhesions? Or episiotomy
I think in conjunction with physiotherapy and the manual work on the scar that physical therapist do Acupuncture to get the first and second chakra realigned is critical for their care. I believe that women should try as many alternatives as possible.
8. Hattie writes:
I would like to know some good tips for getting an OB to not be
dismissive when discussing post partum pain (17 mo and counting). My
pain is just under my incision site and because of my size my OB will
not accept that it is anything other than dietary issues. I have
Kaiser insurance and it does no good to go to other docs, they are all
interlinked and tend to follow each others lead. Any good ideas? I’ve
basically had to deal with it though a Naturopath has helped immensely
in clearing infection out of my blood- significantly reducing the
Find another MD who is more knowledgable on the topic of scar tissue. I like that fact that you are working with a naturopath. Keep working with this individual and also ask for a referral to a physical therapist who specializes in women’s health and scar therapy.
9. Kimberly writes:
I’m 5.5 months post-partum from my CBAC (twin, double footling breech presentation). Since the Herrera webinar, I have been doing more abdominal massage to work on the scar and the adhesions that I feel on my left side. I’ve started to have some spotting – I don’t know if it’s from the massage or from the strength/yoga training I’m doing, but I do find it odd that I’m having this intermittent bleeding/spotting. It’s not AF. Is this something I should talk to my OB about? It’s also possible that exercise and/or massage is “disturbing” my IUD and that’s why I’m bleeding?
The scar massage has to be gentle and superficial and not deep, especially if you have an IUD. I clearly stated in the book on page 189 that if you have bleeding from the vagina you should immediately stop the scar massage techniques. It’s possible that she is massaging the scar too deeply and disturbing the IUD. As far as IUD’s are concerned and more importantly ANY scar massage, first check with your MD before starting the scar massage techniques in Ending Female Pain. Please have her bring the book to her doctor so he/she can okay the ones they think are appropriate for her. Five months post-partum might be too early in her case to do the massages. I would also recommend she see her OB soon to make sure there are no complications with the IUD. Any bleeding is a sign to stop the massage techniques immediately and to get a check-up from the MD. I would also recommend she stop all exercising and yoga until she gets checked out by her OB. Maybe the combination of the exercises and scar massage is too much for her right now since she is only five months post-partum.