Thirty-eight years ago, in 1988, I gave birth to my first son.

I was 24 years old and had been a practicing physical therapist for about three years. Like many young clinicians, I thought I understood the human body fairly well. Then I went through childbirth myself.

After 23 hours of labor and four hours of pushing, my son was delivered by cesarean section at 4:33 a.m. He weighed 9 pounds, 15 ounces and measured 23¾ inches long. A very large baby for a young mother.

The labor had been long and exhausting. A spinal anesthesia attempt was unsuccessful, so general anesthesia was ultimately used. Years later, I would discover I had a spondylolisthesis at L4-5, finally giving context to why the spinal could not be completed.

After delivery, I became profoundly swollen. My legs, feet, ankles, really my entire body, retained fluid. The clothes I had packed to wear home from the hospital no longer fit, even though they had fit me at about four months pregnant. The swelling was so severe that when I stood, my toes barely touched the floor.

What confused me most was the scale.

I had just delivered a nearly 10-pound baby after a prolonged labor and major surgery, yet I had only lost 10 pounds total.

As a physical therapist, I remember thinking: What do I do to help myself?

But there were no answers.

I had learned how to rehabilitate orthopedic injuries and neurological conditions. I understood anatomy and movement. Yet education regarding postpartum recovery was not available. There had been endless discussion about caring for the newborn, but almost none about caring for the mother.

No one talked about pelvic floor recovery, abdominal healing, swelling, scar mobility, bladder function, prolapse, breathing mechanics, or the physical and emotional recovery after birth.

At that time, women were largely expected to recover quietly and independently.

That experience stayed with me.

My second birth experience became another turning point in my life. I had a VBAC (Vaginal Birth After Cesarean), and that experience deepened my passion for childbirth and women’s health even further. I became increasingly interested not only in rehabilitation after birth, but in empowering women during pregnancy and labor as well.

In 1993, I became a Lamaze Certified Childbirth Educator (LCCE). I wanted women to feel more informed, supported, and confident than I had felt during my own first birth experience. Teaching childbirth classes allowed me to connect with women in a completely different way, not just as a clinician, but as a mother who understood the uncertainty, fear, excitement, and physical demands of pregnancy and birth.

As the years went on, I continued searching for answers that traditional physical therapy education had never provided. I joined the OB/GYN Section of the American Physical Therapy Association, founded by Elizabeth Noble, one of the true pioneers in women’s health physical therapy. Through that community, I found mentors, colleagues, and a growing specialty that finally gave language to what so many women were experiencing.

I studied with Elizabeth Noble herself and later learned from Holly Herman and Kathe Wallace, whose teaching helped shape the future of pelvic rehabilitation in the United States. At the time, pelvic health physical therapy was still a very small world. Many of us were learning piece by piece, course by course, often driven by our own experiences as women and clinicians.

One of my earliest urinary incontinence courses was with Dr. Jo Laycock, a physiotherapist from England who was internationally recognized for her work in pelvic floor rehabilitation. I remember many nurses attending alongside physical therapists, which reflected how new and interdisciplinary this field still was.

Over the years, my education continued to evolve alongside my patients’ needs and my own life experiences.

As women came to me with pelvic pain, incontinence, pregnancy-related issues, chronic pain, and later perimenopause and menopause concerns, I kept learning so I could better support them.

I pursued advanced training in pelvic health physical therapy, therapeutic pain management, yoga therapy, women’s health coaching, and eventually earned my transitional Doctorate in Physical Therapy. More recently, I completed certification programs focused on perimenopause and menopause care, areas that are finally receiving the attention they deserve.

None of this happened because I had a perfectly planned career path.

It happened because women kept showing up with questions that deserved better answers.

And because I understood, personally and professionally, what it felt like to navigate recovery and womanhood without enough support.

Along the way, I also became involved in teaching. I served as a teaching assistant for Herman & Wallace pelvic rehabilitation courses for many years, mentoring clinicians entering the field of pelvic health. In 2023, I became a Lead Teaching Assistant, something that felt especially meaningful considering how much this specialty has grown since I first entered it.

Looking back now, I realize I was not only searching for answers for my patients. I was also searching for answers for my younger self.

The specialty of pelvic health physical therapy barely existed when I gave birth in 1988. There were few mentors, limited research, and almost no standard postpartum rehabilitation education for physical therapists or physicians. Much of what we now consider essential postpartum care simply was not discussed.

Over the decades, I have had the privilege of participating in the growth of this specialty.

I witnessed pelvic health physical therapy evolve from a marginalized area of practice into a recognized and evidence-based field. I saw conversations about urinary incontinence, pelvic pain, prolapse, sexual health, pregnancy, postpartum recovery, and now perimenopause and menopause slowly move from whispered concerns into legitimate healthcare discussions.

Most importantly, I saw women finally begin to receive care that acknowledged their own recovery mattered too.

For me, pelvic health physical therapy has never been just a professional specialty.

It has always been deeply personal.