Pelvic Health • Puberty • Pregnancy • Birth • Postpartum • Motherhood • Menopause

Pelvic Health • Puberty • Pregnancy • Birth • Postpartum • Motherhood • Menopause

“Women who received OT for pelvic floor dysfunctions (PFD) experienced: empowerment to understand their bodies, a return to occupations they enjoyed, reduced PFD symptoms, and a changed journey with their pelvic health.”
— Schmitz et. al.

Pregnancy & Birth

At Moon and Stars Therapy, we empower pregnant women to stay active, comfortable, and confident, offering support for a healthy, balanced pregnancy—physically, emotionally, and mentally.

  • We offer pelvic floor therapy to address issues like incontinence, pelvic pain, and pelvic organ prolapse, along with guidance on improving intimacy and managing painful sex during pregnancy.

  • As a Maternal Mental Health Specialist, I provide stress management, mindfulness, and coping strategies to support emotional well-being and manage anxiety or depression during pregnancy.

  • At Moon and Stars Therapy, we provide personalized strategies to relieve back pain, joint discomfort, and fatigue using ergonomic adjustments, strengthening exercises, and maternity support tools.

  • Techniques to manage fatigue, including pacing, task modifications, and structuring daily routines to minimize physical strain.

  • Safe movement strategies to maintain posture and reduce the risk of falls or strain in daily activities.

  • Equipment and techniques for tasks like bending, lifting, and dressing to ensure safety and comfort.

  • We help you prepare physically and mentally for childbirth by teaching practice birthing positions, pelvic floor exercises, and developing birth preferences that align with your needs and emotional readiness.

  • Preparing for postpartum recovery with self-care and baby care strategies, along with home adjustments to ensure a smooth transition into motherhood.

Postpartum & Motherhood

As a pelvic health and maternal health OT, Brianna provides a holistic approach to childbirth and postpartum recovery, empowering women to feel strong, healthy, and confident as they transition into motherhood.

  • Targeting back pain, joint discomfort, and pelvic issues with exercises and ergonomic strategies to restore comfort.

  • Strengthening pelvic muscles through exercises to address incontinence, pelvic pain, and improve sexual health post-delivery.

  • Adapting tasks like lifting, baby care, and self-care to prevent strain and ensure safe movements during recovery.

  • Teaching pacing and structuring routines to manage fatigue and balance self-care with the demands of motherhood.

  • Offering strategies for managing postpartum anxiety, stress, and depression, supporting emotional well-being as you adjust to new motherhood.

  • Providing education on maintaining pelvic health and preventing future issues like prolapse or incontinence.

Puberty & Adolescence

Pelvic health OT supports adolescents through the physical, emotional, sensory, and developmental changes of puberty—especially when challenges arise around bladder, bowel, menstrual health, and pelvic pain. It’s holistic, empowering, and especially helpful for neurodivergent youth or those with sensory processing differences.

    • Normalizing changes in anatomy and physiology

    • Teaching about menstruation, hygiene, and bodily signals

    • Supporting healthy body image and reducing shame around pelvic-related topics

    • Addressing constipation, incontinence, urgency, bedwetting

    • Teaching toilet posture, body mechanics, and timing strategies

    • Creating personalized bathroom routines with visual supports or timers

    • Supporting teens with painful periods, endometriosis, or chronic pelvic pain

    • Teaching strategies like:

      • Heat and positioning

      • Movement/stretching routines

      • Breathwork and relaxation

      • Sensory regulation tools to reduce pain sensitivity

  • Teaching pacing and structuring routines to manage fatigue and balance self-care with the demands of adolescence during every moon phase/period.

    • Addressing anxiety, embarrassment, or trauma related to pelvic issues.

    • Creating a safe space for discussion, education and empowering adolescents to advocate for themselves.

  • We’re not “teaching sex ed” in the way a health teacher might—but we help teens build the skills, self-awareness, boundaries, and confidence they need to:

    • Understand their bodies

    • Make informed decisions

    • Express and protect their boundaries

    • Navigate relationships and environments safely

    🔹 Key Focus Areas

    1. Body Autonomy & Consent

    • Teaching that their body belongs to them

    • Practicing ways to say “no,” set boundaries, or ask for help

    • Role-playing consent scenarios (age-appropriate, respectful, non-judgmental)

    • Teaching how to read others' cues and respect others’ boundaries

    • Explaining that consent is ongoing, enthusiastic, and reversible

    2. Anatomy, Safety & Function

    • Teaching accurate, inclusive names for body parts

    • Explaining how the body functions sexually and reproductively in ways that are developmentally appropriate

    • Talking through safe and unsafe touch, private vs. public behaviors, and personal hygiene

    • Helping youth understand how medical devices, medications, or physical differences may relate to sexuality

    3. Interoception & Sensory Awareness

    • Helping teens recognize internal cues like arousal, discomfort, or pain—especially if they have sensory processing differences

    • Supporting self-regulation so they can respond appropriately to those feelings

    • Creating tools for self-expression when verbal communication is hard (e.g., emotion thermometers, scripts)

    4. Executive Function & Decision-Making

    • Supporting planning and impulse control around sexual behavior

    • Creating social stories, visual scripts, or step-by-step guides around:

      • Setting boundaries

      • Navigating peer pressure

      • Using protection or contraception

      • Getting help if something feels wrong

    • Supporting goal-setting around relationships and personal values

    5. Sexual Safety in Context

    • Teaching about online safety, sexting, social media boundaries

    • Understanding how to navigate environments like dating, parties, or relationships in ways that are safe and aligned with their values

    • Recognizing red flags in peer or adult behavior

  • Many teens—especially neurodivergent youth—have heightened or reduced sensory sensitivity, which can impact:

    • Interoception (awareness of internal body signals like the need to pee, poop, or that a period is starting)

    • Tactile sensitivity (discomfort with wiping, pads, tampons, or clothing)

    • Auditory or visual sensitivities (related to flushing toilets, public bathrooms)

    • Olfactory sensitivity (sensitivity to smells during menstruation or toileting)

    How OT Helps:

    • Interoceptive awareness training: Helping teens better recognize body signals using body mapping, tracking tools, and biofeedback.

    • Desensitization strategies: Gradual exposure and regulation strategies for touch and smell-related challenges (e.g., adjusting period products, toileting routines).

    • Environmental adaptations: Noise-canceling headphones, bathroom visual schedules, preferred wipes, or clothing modifications.

    • Regulation tools: Weighted lap pads, fidget tools, movement breaks before toileting—integrated into sensory diets.

  • Pelvic health OT is especially valuable for teens with:

    • Autism

    • ADHD

    • Sensory processing disorder

    • Intellectual/developmental disabilities

    • Trauma backgrounds

    OT Approach:

    • Uses neurodiversity-affirming language and practices

    • Builds predictable routines and uses visual supports

    • Integrates special interests to boost engagement

    • Focuses on self-advocacy, communication supports, and emotional regulation

    • Coordinates with school teams, families, and medical providers

    Sexual Safety and Health

    • OTs often fill in gaps left by traditional sex ed that doesn’t meet their learning style

    • Use concrete language, visuals, videos, and role play

    • Provide repetition, predictable formats, and social scripts

    • Use a trauma-informed and affirming approach to discuss sensitive topics without shame

    • Collaborate with caregivers and medical teams to create unified support systems

General Women’s Pelvic Health & Menopause

Pelvic health occupational therapists (OTs) play a valuable role in supporting women through all phases of life including menopause—a transitional life phase that brings not just hormonal changes but often significant shifts in physical, emotional, and functional well-being.

  • Menopause marks the end of menstrual cycles, usually occurring between ages 45–55, but can happen younger in women with Premature ovarian failure/insufficiency (POI). It brings a natural decline in estrogen, often accompanied by symptoms that can affect quality of life, including:

    • Hot flashes

    • Sleep disturbances

    • Pelvic pain or pressure

    • Urinary incontinence or urgency

    • Vaginal dryness

    • Mood changes

    • Fatigue and joint pain

  • For those who’ve had ovaries removed (e.g., due to cancer, endometriosis, or gender-affirming care), menopause can begin suddenly. Pelvic health OTs help by:

    • Managing pelvic floor issues, post-op healing, or new symptoms like hot flashes or pain

    • Supporting return to intimacy, physical activity, and daily routines

    • Providing strategies for coping with rapid hormonal and emotional changes

    • Assessing and addressing pelvic floor muscle dysfunction, which can lead to:

      • Urinary leakage (stress or urge incontinence)

      • Prolapse symptoms (pressure or heaviness)

      • Pain with intercourse (dyspareunia)

    • Teaching strengthening or relaxation techniques for pelvic floor muscles (it’s not all about kegels)

    • Providing biofeedback or guided exercises to increase awareness and control

    • Creating personalized strategies for urgency, leakage, constipation, or frequency

    • Teaching techniques like bladder retraining, timed voiding, or proper toileting posture

    • Advising on dietary and hydration habits that support pelvic health

    • Supporting women in managing changes like vaginal dryness or painful sex

    • Offering education and strategies to improve comfort, confidence, and connection

    • Helping with positioning, use of lubricants, or pelvic relaxation

    • Supporting those with heightened body awareness or discomfort from hot flashes, sleep disruption, or mood changes

    • Using sensory-based tools (weighted items, breathing strategies, mindfulness)

    • Providing routines and strategies to improve sleep and reduce stress

    • Assisting with fatigue, joint pain, or brain fog that may affect daily activities

    • Creating energy conservation routines, ergonomic strategies, or joint protection

    • Supporting physical activity routines that are pelvic-safe (e.g., walking, yoga, Pilates)

    • Encouraging women to understand what’s happening in their bodies

    • Promoting self-care, positive identity, and confidence during this life stage

    • Promoting sexual exploration and expression whether that be alone, with a partners, with toys, and/or through literature

    • Helping navigate conversations with healthcare providers, partners, or employers

  • Pelvic health OTs don’t prescribe HRT but support clients navigating its effects:

    • Helping manage changes in pelvic tissue, dryness, or discomfort as estrogen levels shift

    • Supporting activity tolerance, mood regulation, or sleep while hormones stabilize

    • Educating on how HRT may impact bladder, bowel, or sexual function in the context of daily life

  • Focus on supporting pelvic floor function while honoring each person’s unique identity, body, and experiences. This specialized OT can help with concerns such as bladder and bowel health, sexual wellness, chronic pelvic pain, and post-surgical recovery (including gender-affirming procedures).

    Care is affirming, inclusive, and trauma-informed—addressing physical function, emotional well-being, and comfort with one’s body, while creating a safe space that respects gender identity and expression.

Citation

Johanna R. Schmitz, Hannah Schoener, Karen Atler, Christine A. Fruhauf, Delaney Pearce, Arlene Schmid, Kelsey Mathias; Women’s Experience Receiving OT for Pelvic Floor Dysfunction: A Case Series. Am J Occup Ther July/August 2023, Vol. 77(Supplement_2), 7711510310p1. doi: https://doi.org/10.5014/ajot.2023.77S2-PO310