Who’s on Your Pelvic Health Team? A Clear Guide to Knowing Who Does What
It all begins with an idea.
If you’ve ever found yourself Googling pelvic floor symptoms and suddenly realizing there are a lot of different providers who talk about pelvic health… you’re not alone.
OB/GYNs, urogynecologists, pelvic floor therapists, midwives, doulas, chiropractors, personal trainers — the list is long, and each profession has a completely different role.
As a pelvic floor physical therapist, one of the biggest things I hear from new patients is:
“I had no idea who I was supposed to see for this.”
So let’s clear up the confusion.
My goal with this guide is to help you understand exactly who does what, what each provider can help you with, and when it’s time to bring them onto your pelvic health team. Because when you have the right team, your healing becomes clearer, faster, and so much more empowering.
01. OB/GYN
A medical doctor specializing in reproductive, pregnancy, and gynecological health.
What they CAN do:
Diagnose and medically manage gynecologic conditions (fibroids, endometriosis, prolapse)
Order imaging and labs
Prescribe medication
Perform surgeries
Manage pregnancy and postpartum medical care
Provide routine pelvic exams
What they CANNOT do:
Provide hands-on musculoskeletal rehab
Assess movement, strength, or pelvic floor coordination
Offer exercise-based treatment for pelvic floor dysfunction
When to see them:
For medical evaluation, medication, imaging, or routine reproductive/pelvic care.
02. Urogynecologist
An OB/GYN or urologist with advanced training in pelvic floor disorders.
What they CAN do:
Diagnose and treat pelvic organ prolapse
Manage urinary and fecal incontinence
Address pelvic pain medically or surgically
Perform specialized procedures (urodynamics, cystoscopy)
What they CANNOT do:
Provide movement-based rehab
Retrain pelvic floor coordination
Offer exercise-based treatment
When to see them:
When symptoms are complex, persistent, worsening, or require more advanced testing beyond your routine OB/GYN visit.
03. Pelvic Floor Physical or Occupational Therapist
A licensed rehab professional with advanced training in pelvic floor evaluation and treatment.
What they CAN do:
Assess pelvic floor muscle strength, tension, and coordination
Evaluate your whole body to understand why symptoms are happening
Treat incontinence, prolapse, pelvic pain, constipation, diastasis recti
Provide birth prep, labor strategies, and postpartum recovery guidance
Use exercise, neuromuscular retraining, manual techniques, and education
What they CANNOT do:
Diagnose medical conditions like endometriosis or infections
Prescribe medication
Perform surgery
When to see them:
For movement-based rehab, muscle tension/weakness, postpartum changes, pain, leakage, heaviness, or when you feel “off” and don’t know why.
04. Midwife
A provider specializing in pregnancy, birth, postpartum care, and reproductive wellness using a whole-person lens.
What they CAN do:
Provide prenatal and postpartum care
Screen for pelvic floor issues
Support birth prep
Guide early postpartum healing
What they CANNOT do:
Diagnose or surgically treat pelvic floor disorders
Provide structured pelvic floor rehabilitation
When to see them:
For holistic pregnancy and postpartum care, birth support, and early guidance on pelvic health.
05. Doula
A non-medical professional offering emotional, educational, and physical support during pregnancy, labor, and postpartum.
What they CAN do:
Support your comfort and preferences during labor
Provide education on birth and postpartum healing
Offer positioning strategies and emotional support
What they CANNOT do:
Diagnose, give medical advice, or perform exams
Treat pelvic floor dysfunction
Prescribe exercises
When to see them:
For birth support, advocacy, guidance, coping strategies, and postpartum emotional support.
06. Chiropractor (Perinatal/Postpartum-Trained)
A provider specializing in alignment, biomechanics, and joint health with additional training in pregnancy/postpartum changes.
What they CAN do:
Address spinal, pelvic, ribcage, and sacral mobility
Treat low back, pelvic, and neck pain
Provide perinatal-safe adjustments to support comfort and baby positioning
What they CANNOT do:
Diagnose gynecologic conditions
Treat internal pelvic floor muscles
Provide medical or surgical care
When to see them:
For alignment issues, back or pelvic pain, or adjunct support during pregnancy and postpartum.
07. Personal Trainer
A fitness professional trained to create and coach exercise programs for strength, mobility, and overall fitness.
What they CAN do:
Design strengthening programs
Modify workouts for pregnancy/postpartum
Teach breathing and lifting mechanics
Provide external cueing for safe form
Support return-to-fitness after medical clearance
What they CANNOT do:
Diagnose pelvic floor dysfunction
Treat pain, incontinence, or prolapse
Prescribe pelvic floor-specific rehab exercises
Perform internal or external pelvic floor assessment
When to see them:
When you're ready to build overall strength, progress exercise, and integrate pelvic-safe fitness into your routine - ideally in collaboration with a pelvic floor therapist.
So… who should you see first?
If your symptoms involve leakage, heaviness, pelvic pressure, pain, constipation, or postpartum recovery, a pelvic floor therapist is almost always the most helpful starting point.
If you need medical testing, imaging, medication, or surgical evaluation, an OB/GYN or urogynecologist is essential.
And if you want support during birth, better pregnancy/postpartum care, or guidance returning to fitness once medically cleared, your midwife, doula, chiropractor, and trainer all play valuable roles.
No one profession replaces another - they strengthen each other.
And you deserve a team that works together to support your whole-body wellness.
Looking for a pelvic floor therapist in New Jersey?
At Catalyst Physical Therapy & Wellness, I help women navigate pelvic health challenges with clarity, compassion, and evidence-based care - so you don’t have to piece everything together alone.
If you’re ready to feel supported, understood, and empowered in your pelvic health journey, you can book a discovery call right on my website.
Whenever you’re ready - let’s get you feeling like you again.
Dilators Shouldn’t Come With a “Good Luck” Packet: What You Really Need for Pelvic Pain
It all begins with an idea.
If you’ve ever been handed a set of dilators, a quick verbal rundown, and told to “try these at home”… you are not alone.
And you deserve so much better.
I hear it far too often:
A patient works up the courage to tell her provider about pain with sex, tampon insertion, or pelvic exams — and the solution she’s given is a set of dilators with little to no guidance.
But here’s the truth:
Dilators are a tool. They are not a treatment plan.
And without proper assessment and support, they can leave you feeling confused, overwhelmed, or even more discouraged.
Let’s break down why this happens — and what you actually need instead.
The Problem: Dilators Are Being Prescribed Without the Support You Deserve
Women regularly share the same story with me:
🚩 No pelvic floor muscle assessment
Before using dilators, you should know why you’re having pain.
Is it muscle tension?
Muscle guarding?
Coordination issues?
Nervous system sensitivity?
Scar tissue?
Hormonal dryness?
Without an exam, no one actually knows — and dilators may not even be the right starting point.
🚩 No real education beyond a handout
A pamphlet or a 60-second explanation is not enough.
Dilator training involves:
Understanding the pelvic floor muscles
Learning how to relax, breathe, and release tension
Knowing how to insert, angle, and progress safely
Understanding pacing (slow, steady, not forced)
Making sure pain does not increase
Incorporating nervous system work and full-body strategies
This cannot be taught in a rushed appointment.
🚩 No follow-up to track progress
You deserve someone checking in on:
Your comfort
Your form
Your symptoms
Your emotional responses
Your progress
Whether the size or technique needs adjustment
Whether dilators are still the right tool
Pelvic pain is not linear — guidance matters.
🚩 No referral to pelvic floor therapy
This is the biggest red flag.
Dilators alone do not address:
Muscle tension
Overactivity
Trigger points
Breathing mechanics
Core/pelvic coordination
Posture or movement patterns
Nervous system dysregulation
Hormonal factors
Pelvic floor therapy is the piece that ties everything together.
Why This Matters: Pain Is Complex (and Treatable)
Pelvic pain is never “just in your head.”
It’s also never something you should be told to push through.
You deserve:
✨ A full pelvic floor muscle assessment
✨ A plan tailored to your symptoms, body, and comfort level
✨ Someone to teach you techniques step by step
✨ A safe space to ask questions
✨ Guidance for nervous system down-training
✨ Support for pain with sex, tampon use, pelvic exams, or daily life
✨ Follow-up so you never feel lost or alone
You deserve pain-free intimacy, comfort with tampons, and pelvic exams that don’t make you tense up in fear.
Dilators Can Be Amazing Tools — When Used Correctly
With proper support, dilators can help retrain the pelvic floor, reduce muscle guarding, and build confidence.
But without that support?
They often end up sitting in a drawer because no one taught you how to use them safely.
Your body needs more than a “good luck” packet — it needs care, context, and compassion.
If You’re Feeling Frustrated, Confused, or Discouraged… Let’s Talk.
You are not supposed to figure this out alone.
Pelvic pain is highly treatable with the right approach, and you deserve someone who listens, evaluates, guides, and celebrates your progress every step of the way.
If your current plan feels unclear or incomplete, I’m here to help.
You (and your pelvic floor!) deserve real guidance, real support, and a plan that actually works.
👉 Book a discovery call with me at Catalyst Physical Therapy & Wellness
Let’s get you feeling comfortable, confident, and pain-free again — without the guesswork.
Why Your Pelvic Floor Needs More Than Kegels
It all begins with an idea.
If you’ve ever mentioned pelvic floor symptoms to your doctor and were immediately told to “just do kegels”… you’re definitely not alone.
I hear this nearly every day from new patients:
“My doctor prescribed me kegels to fix XYZ.”
But here’s the issue: kegels are often recommended without:
a pelvic floor muscle assessment
an evaluation of core function
any understanding of what your pelvic floor is actually doing
or a referral to a pelvic floor therapist who specializes in this exact area
And while kegels can be helpful for the right person, they are absolutely not a one-size-fits-all solution.
Let’s break down why.
01. Many people don’t have a “weak” pelvic floor — they have a tense pelvic floor
One of the biggest myths in pelvic health is that leaking, pain, or pressure automatically means your pelvic floor is weak.
In reality?
A large percentage of people have pelvic floor muscles that are too tight or overactive, not weak.
When the muscles are holding tension at rest, they are already in a shortened, contracted position.
Adding more contractions (kegels) to a muscle that is already clenched?
👉 It usually doesn’t work.
👉 It can actually make symptoms worse.
This is why a pelvic floor assessment is essential.
You need to know whether your muscles need strengthening… or relaxation, release work, and coordination training.
02. Your pelvic floor doesn’t work in isolation
Your pelvic floor is only one part of your core system — and that system includes:
your diaphragm
your abdominal muscles
your low back
and your pelvic floor
Everything works together. Everything influences everything else.
If your breathing patterns, rib mobility, abdominal coordination, or spinal mechanics aren’t functioning well, your pelvic floor won’t function well either.
This is why kegels alone rarely solve pelvic floor symptoms.
A whole-body approach is what creates long-lasting change.
03. Are you sure you even know how to kegel?
This is not your fault — but most people who think they are doing a kegel… aren’t.
A pelvic floor contraction is subtle and coordinated.
Without guidance, many people:
bear down instead of lifting
tighten their glutes or inner thighs instead of the pelvic floor
clench their abs
or create extra pressure downward
If the “kegel” you’re doing is actually pushing down, you may be unknowingly worsening leakage, prolapse symptoms, or pain.
This is why understanding your own anatomy, body mechanics, and activation patterns matters.
So when are kegels appropriate?
Kegels can be effective — when prescribed with intention, precision, and clinical understanding.
But they should never be the starting point without assessment.
If you’re experiencing symptoms like:
💧 Leaking or urgency/frequency
💥 Pain with sex, tampon insertion, or pelvic exams
😮💨 Pelvic pressure or heaviness
Then you need a proper pelvic floor evaluation to determine:
whether your muscles are tight or weak
whether there is a coordination issue
whether your core is contributing
how your breath, posture, and movement play a role
which tissues are involved
and what your body actually needs
Because kegels may help.
They may also hurt.
The key is knowing what’s right for your body.
It’s time for a proper assessment — not a blanket prescription
You deserve more than a generic “do kegels and let me know if it helps.”
You deserve someone who can:
✨ Assess your pelvic floor
✨ Identify your root causes
✨ Create a plan tailored to your actual symptoms
✨ Guide you with clarity and confidence
Your pelvic floor is complex — and your care should be, too.
Ready to finally get answers?
At Catalyst Physical Therapy & Wellness, pelvic floor therapy is not an afterthought — it’s what I specialize in.
If your current plan feels incomplete, confusing, or ineffective… let’s talk.
👉 Book a discovery call or evaluation today
Your body deserves a treatment plan built for you, not a one-size-fits-all exercise.