When most people hear the term “occupational therapy,” they picture stroke rehabilitation or helping a child grip a pencil. Few connect it to pregnancy pain, postpartum recovery, or pelvic floor dysfunction. But occupational therapy (OT) is one of the most versatile — and underutilized — tools in women’s healthcare.
In this episode of All Things Women’s Health, board-certified OB/GYN Dr. Chris Stroud sits down with licensed occupational therapists and pelvic health specialists Sarah King and Julia Baker to break down what OT really is, who it’s for, and why every woman deserves to know about it.
What Is Occupational Therapy — Really?
Occupational therapists don’t just help people return to work. In OT, an “occupation” is anything that occupies your time and carries meaning — being a mother, a gardener, an athlete, or simply someone who wants to kneel in prayer without pain. The goal of OT is to help people do the things that matter most to them.
OTs work across an enormous range of settings: pediatrics, stroke rehab, hand therapy, mental health, driving rehabilitation, school-based programs, and yes — women’s pelvic health. The profession is far broader than most people realize, and it often overlaps with physical therapy in both environment and technique, though the philosophy and approach differ meaningfully.
Pelvic Health OT: What It Treats and How It Works
Sarah and Julia specialize in pelvic health — an area of OT that addresses conditions including:
- Stress urinary incontinence (leaking with laughing, sneezing, or exercise)
- Pelvic pain and painful intercourse
- Painful periods or difficulty using tampons
- Pregnancy-related low back pain, sciatica, and pelvic girdle pain
- Postpartum core weakness and abdominal separation (diastasis recti)
- C-section scar tissue and restricted mobility
- Difficulty pushing effectively during labor
A key insight from Sarah and Julia: most women assume their pelvic floor problems stem from weakness, when in reality the more common issue is tightness. “Just because something is common doesn’t mean it’s normal,” Sarah says. Leaking, pain, and dysfunction are not inevitable — they are treatable.
How OT Supports Women During Pregnancy
Pregnancy changes the body dramatically. The pelvis widens, the rib cage expands, the center of gravity shifts — and the body compensates in ways that often cause pain. Common pregnancy complaints that OT can address include low back pain, sciatica, pubic bone pain, and general pelvic girdle discomfort.
Treatment approaches include myofascial release, dynamic cupping, biomechanical coaching (like hip hinge movement patterns), and activity modification — including something as practical as figuring out how to get in and out of a large vehicle without triggering one-legged pelvic instability.
The earlier in pregnancy a woman seeks OT, the more options are available. Seen at 18–20 weeks, a therapist can focus on strengthening and postural alignment. At 34 weeks, the focus shifts more to pain management and comfort — but there is always something that can be done.
Postpartum Recovery: Vaginal Birth and C-Section
Both vaginal birth and cesarean delivery are physically significant events — yet postpartum rehabilitation remains far from standard. Sarah and Julia make the case that every woman who gives birth could benefit from OT, just as every person who has knee or shoulder surgery receives physical therapy.
After a Vaginal Birth
Vaginal birth stretches and sometimes tears pelvic floor tissues, while pregnancy itself over-lengthens the deep abdominal muscles. After delivery, these muscles don’t automatically “come back online.” Other muscles — the glutes, low back, and pelvic floor — have compensated for months and won’t easily relinquish control. OT re-establishes the mind-muscle connection, restores rib cage and pelvic alignment, and helps the body function as an integrated unit again. Julia recommends scheduling a postpartum OT visit around six weeks after your due date.
After a C-Section
A cesarean section is a major abdominal surgery — comparable in scope to an open hysterectomy — yet recovery support is often minimal. OT addresses the scar tissue that forms across multiple tissue layers after a C-section, using scar massage and myofascial release to restore mobility and allow the abdominal muscles to function properly. There is also an emotional dimension: many women avoid touching their scar due to fear, body image concerns, or grief over a birth that didn’t go as planned. Addressing that relationship with the scar is part of the therapeutic process.
Importantly: C-sections do not protect the pelvic floor. The nine months of pregnancy stretch the pelvic floor regardless of how birth occurs. Both types of delivery carry their own recovery challenges.