At your perineal wellness consultation, you and your physical therapist will discuss birth strategies and perineal preparation with regards to your specific history and birth preferences. The consultation is not an appointment to evaluate and treat pelvic floor symptoms such as urinary incontinence or pelvic girdle pain, but you may discuss these symptoms in relationship to birthing positions and perineal preparation.

For most women, we recommend scheduling a perineal wellness consultation for around the 34th week of pregnancy.

If you have any of these risk factors we recommend a consultation earlier in pregnancy. please contact us for specific guidance.

All clients hoping to attend perineal preparation sessions in clinic are asked to book a 45 min perineal wellness consultation first. Following that appointment, your physical therapist can advise you of the ideal number and frequency of 15 minute perineal preparation sessions.

Discussion topics may include, but are not limited to:

  • Anatomy of the pelvic floor and changes that occur during vaginal birth

  • Birthing positions to minimize orthopedic injury and perineal lacerations, supported by research and clinical experience

  • Education regarding the purpose and technique of perineal preparation, including instruction in how to perform it yourself or with a partner if desired. Hands-on partner training is not included in the initial consultation, and must be booked at a subsequent visit.

If appropriate, an internal pelvic floor muscle exam will include:

  • Evaluation of your pelvic floor motor control - your ability to voluntarily contract and relax your pelvic floor muscles, as well as the ability to push as required for vaginal birth.

  • Evaluation of your perineal flexibility and muscle tone - how easily your perineal muscles tolerate stretch in response to gentle pressure.

  • An abbreviated perineal preparation session, to begin the process of learning how to open into the sensations of vaginal birth.