Optimizing your pregnancy and postpartum journey
Dr. Maddie’s Philosophy
At my core, I believe in empowering individuals to navigate their journey through pregnancy and postpartum with confidence and positivity. My commitment is unwavering: to provide comprehensive support and care that prioritizes the physical and emotional well-being of every expectant and new parent. Drawing from a wealth of knowledge and personal insight, I strive to minimize discomfort and promote optimal movement patterns throughout this transformative period. My philosophy is rooted in compassion, expertise, and a dedication to enhancing the body’s ability to maintain activities throughout pregnancy and support the body during the postpartum rehab phase.
Physical Therapy Services
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Pregnancy
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Postpartum
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Pelvic Organ Prolapse
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Diastasis Recti
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Sexual Dysfunction
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Cesarean Recovery
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Thank you so much for the amazing care you provided over this past year. I would not have been able to go back to work and be a present mom if it wasn't for you. I am so thankful to you! You are amazing and I hope you know what an important part of our recovery (postpartum moms) you are. Thank you again!
S
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Maddie is such a wonderful clinician. She is so professional and is a wealth of knowledge. Throughout the course of my pregnancy, she helped me avoid leakage, safely remain active, prepare for a natural birth, recover for a c-section, educate me on baby wearing posture and magically unclogged ducts. Every encounter was pleasant, helpful and I always left in better shape. Go to her for any of your pelvic floor needs. You won’t regret it!
Kimberly
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Maddie is incredible! After seeing multiple pelvic floor physical therapists in Sacramento, I can confidently say that Maddie is hands down the best. She is calm, focused, sweet, and incredibly knowledgeable. She always takes the time to listen to my concerns and is flexible on how best to support me based on my needs at any given time. She welcomes feedback and is always on her game, putting me first in every session. I will be so sad when I am no longer able to be Maddie’s patient, but am confident the day will come because she is THAT good, and all of my pelvic issues will undoubtedly resolve because of her and her thoughtful approach to supporting my body. Run don’t walk to Maddie. You won’t regret it.
Rachel
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I’ve been seeing Dr Maddie Irby throughout my perinatal period and she’s been an incredible support. She’s so passionate about the work she does and has taught me so much about anatomy while helping me to heal and strengthen. She’s the epitome of professionalism and has a great bedside manner. I’ve received pelvic floor support elsewhere and have not felt so at ease as I have under Dr. Maddie’s care.
Katie
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Pain with seggs after having a baby is very common regardless of type of delivery. And if you are breastfeeding there is an additional hormone component.
The following tips can help with reducing pain with initial insertion:
✨Support: Your legs are attached to your pelvis. If your legs are working really hard to keep themselves up, they may pull tension into the pelvic floor. Try using pillows or you partner to support your legs so those legs can relax.
✨Lube: Lube can help reduce friction with initial insertion. There are many different types on the market and you may have to try a few to find the brand you like. However avoid: flavored lube, heating/cooling lube, parabens, glycerine, and propylene glycol. If you are breastfeeding a hybrid lube with hyaluronic acid can really help moisturize the tissue.
✨Scar massage: Did you have a tear during your delivery? Gently work the tissue all around the scar, without putting your fingers on it. If you are greater than 6 weeks postpartum, you can get on the scar and move it in circles, up/down, side to side. It’s important that it isn’t painful. Plus this also includes cesarean scars!
✨Vaginal estrogen cream. Are you breastfeeding? (This includes exclusive pumpers). Your estrogen levels stay low until you decide to stop breastfeeding. Decreased estrogen can also contribute to pain with initial insertion as well as vaginal dryness. You can talk to your MD about a prescription. OR get over the counter vaginal hyaluronic acid which mimics vaginal estrogen without the estrogen.
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Your jaw and pelvic floor are connected. If you are clenching and grinding your teeth during labor, that can also contract your pelvic floor. And that pelvic floor needs to relax and GET OUT OF THE WAY!
Instead try slow breathing, in through the nose and out through the mouth. You can even add a “moo” or a “HUM” to really help calm the nervous system. Those deep, vibrating sounds can help bring your parasympathetic nervous system (AKA your rest/digest/baby making nervous system) on!
By decreasing the tension in your jaw, you can promote relaxation of the pelvic floor and maybe even shorten your labor.
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I love a child’s pose after delivery.
During pregnancy your whole back and side body can become very shortened/tight and we tend to breathe more into our front body. This can have a profound impact on your diaphragm, ribcage movement, ability to manage pressure and pelvic floor.
In a child’s pose you are closing down the front of your body so you can focus on moving the sides and back of your ribs. With your arms over your head you’ll get a little lat stretch to start to release some of the tension in your low back.
I find placing a pillow or two between your hips and calves can help support your body, allowing you to relax more into the pose.
Once you’ve found a comfortable position, practice breathing into the sides of your ribs and into the back of your ribs, without letting your shoulders rise towards your ears. You can picture your diaphragm is going down into the abdomen on your inhale.
The more you can get your breath out of your shoulders and into a more 360 degree ribcage breath, the easier it will be to engage your core.
As a bonus you also are gently moving your pelvic floor with your breath and taking some gravity off of it, making your pelvic floor a little happier 😊
You can do this after a vaginal and a Cesarean delivery. Practice daily for 3-5 minutes to get those ribs moving!
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If you were to go to the hospital for any major surgery whether it is orthopedic, spine, and/or cardiac (to name a few). Your surgeon likely has a rehab protocol in place.
This rehab protocol details out exactly what are the precautions (i.e. can you lift anything, bend, rotate, weight bear, etc.). They usually give a guidance of exercises they would like you to perform week by week and the expectation of when you will start rehab.
With a Cesarean, you are lucky if a physical therapist comes to see you, because that is not the standard. No one talks to you about how you should get in and out of bed, how to lift your baby, what positions will optimize your incision healing, and what are safe movements you can do.
It’s time to make rehab services the standard of care for post cesarean section.
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I am honored that many of my patients, family and even friends feel so comfortable sharing everything with me.
Truly every detail matters when it comes to your health!
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Hi everyone! It’s been a minute since I’ve introduced myself.
I’m Dr. Maddie a pelvic floor physical therapist and recently started doing some volunteer birth doula support.
I truly enjoy empowering women to have a positive birth experience and feel supported throughout pregnancy, delivery and postpartum recovery.
Now that I’ve been present in a few delivery rooms, it has really opened my eyes up to the importance of advocating for patients. There can be so much pressure in a delivery suite and if it’s your first time, sometimes it’s easier just to give in to what you’re being asked. I will preface that with as long as you and baby are doing ok! Because trust me, if something is going wrong, I am the last person you want in that room.
It is so important to me to reach as many birthing people as possible! I want them to know the difference between common and normal. I want them to know the importance of rehabbing after having a baby and how long that truly takes. And I want them to go into their delivery without fear and feel confident with the decisions they are making for themselves and baby.
If you know someone who is thinking about getting pregnant, already pregnant, or early postpartum, please share with them ❤️
There are many different options when it comes to non-pharmacological comfort measures in labor. They work well at any point in your labor.
✨Heat: Can reduce muscle spasms and raise the pain threshold. Examples: heating pad or hot water bottle, warm shower, warm blanket.
✨Hydrotherapy: reduces muscle tension, pain, and anxiety. Examples: sitting or laying in the bath.
✨Touch and Massage: This can be very dependent on the person’s comfort as well as the support person. Examples: kneading of the shoulders, criss-cross back massage, hand massage, feet massage, or wherever the laboring person requests.
✨Counterpressure: honestly we aren’t quite sure how or why it helps. BUT it is very popular especially with back pain. Examples: double hip squeeze, knee press, sacral area, or wherever the laboring person requests.
✨Cold: Works longer than heat to reduce muscle spasms and reduces sensation in the area which slows the transmission of pain. It can slo reduce swelling. Examples: cold pack, cool wash cloth, frozen water bottle that you roll on your back.
✨Movement: Can reduce labor pain by allowing the laboring person to find more comfortable positions. Also helps her to feel like she is actively participating which can reduce emotional distress. Examples: pelvic rocks, swaying side to side, walking.
✨Birth Ball: Helps aid movement and relaxation. Similar examples are the peanut or the CUB. However they can be a little less versatile.
✨TENS: The gate control theory of pain. Basically it stimulates tactile nerve endings which have a lower threshold than the pain receptors.
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A Cesarean is a MAJOR abdominal surgery.
After any type of surgery there is going to be an inflammatory response which means SWELLING. The problem with swelling is that it can inhibit the muscle’s ability to activate.
But unlike every other surgery, a Cesarean doesn’t necessarily mean that you get to rest and recover. Instead you may be spending lots of time standing, sitting, and moving about your house.
Any thing that isn’t you laying down is a gravity dependent position. And we all know what gravity does…it holds us down. Meaning it is going to pull swelling down towards the pelvis, which will hinder your recovery.
So in those first few days of getting home from the hospital, please take some time throughout your day to lay down. As an extra bonus stick a pillow or two under your hips to assist with reabsorbing that swelling.
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How many of you experienced pubic symphysis pain during pregnancy? 🙋♀️
How many of you were just given a brace and told to wait until baby comes?
How many of you were sent to pelvic floor therapy?
This is your reminder that a one size fits all doesn’t work for everyone. There are so many reasons you may be experiencing pain on the front of your pelvis.
Treatments may have similarities, but every BODY is different.
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This labor warm up can be performed during pregnancy and in early labor to help with optimizing baby’s position and reducing back pain.
The puppy pose helps back baby out of the pelvis giving them extra space to move.
The exaggerated side-lying position helps to open up your flank, pelvic floor, and pelvis to create more lateral space. In this position you can even recruit your partner or a friend to massage your glutes or give your hips an extra stretch. If you are nervous falling off your surface, just have your partner stand in front of your belly to give you some sense of security.
Start with 10 minutes in each pose. You can always hold longer, like up to 20-30 minutes. Whatever feels good for you.
Remember to breathe throughout and do your visualizations to relax your body into the pose.
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