Welcome to Your New Body

The moment you become pregnant, you will never again live in a body that hasn’t been pregnant.

The moment you give birth, you will become postpartum—forever. You will never again live in a body that has never given birth.

If you have a loss, you will never again live in a body that has not experienced a womb loss. Any future pregnancy will be a pregnancy after loss.

This is the way of it. There is no going back, bouncing back, to the body you lived in Before. If your OB or midwife or friend or celebrity or fitness trainer on social media tells you you’ll go back to how you were before, they were wrong. This is the truth. This is the way of it.

And—this is not bad news. No, it’s not! You have a new body—Welcome! New is not bad, change is not bad. Hard sometimes—yes. But inherently bad—no.

Postpartum is forever. We often think of it as the first few months or 40 days or Fourth Trimester. There are whole books written about it. And they are helpful, yes. But they aren’t the end. Most people I talk to who have given birth will tell you it took a year, two years, three years to feel like “themselves” again. I remember myself going for a run at 11 months postpartum and thinking, “Oh, this feels like me again. There she is.”

Every body is different. Everybody is different.

You may find that some things come back. Your strength returns, and your joy in life after sleepless nights comes back. You can still play soccer and do yoga and go to the gym, maybe slowly at first but gradually building back up.

Sex is different, but you find new positions that you didn’t used to like feel good now, or ones that were your favorite are no longer. And your vagina, if your baby was birthed via that path—it will always be different. (If no one told you that yet, I’m here to tell you that it will always be different. I’m sorry no one told you yet). Not bad—just different. Though at first it likely doesn’t feel that great.

Your belly—that may always feel different. It stretched beyond imagination, really. Maybe it’s squishier, maybe it is saggy, stretch-marked, tiger-striped. Maybe it has a scar across the lower part, just above where the belly meets the pelvis. An exit. Maybe it doesn’t feel beautiful to you (maybe yet), but know that it did an amazing job.

There will be grief. It is ok to feel the grief. Grieve the body you had before. Grieve the change. Grieve the loss. The loss of freedom, independence, tight skin, and smaller feet. Feel the grief, let it pass through you. Some of it may take up residence for a while—welcome it as a friend. It has something to teach you. But don’t let it overcome you. It is not you. It will pass, get easier, not feel so heavy.

When you’re ready, try on Gratitude. Your body did the most miraculous thing of carrying and building and nurturing a human being, then opening to the cold world outside to let that person be born. Your body is so strong, so resilient, so marvelously creative. Start there. Gratitude for your feet on the ground. The way your senses bring the outside world inside. The feel of the sun on your skin. The cool of air coming in through your nostrils, the warmth of your exhale.

As you practice gratitude, maybe you eventually come to the parts you have grieved. Can you thank your belly for stretching and holding your child? Can you thank your breasts for the way they produced nourishment for your child? (Even—perhaps especially—if you weren’t able to feed your baby the way you wanted to?)

Over time you may find feelings of neutrality toward the previously charged areas of your body. Neutral toward your belly, toward your vulva, toward your breasts. And maybe, eventually, perhaps you can try on feeling love for this body again. Or for the first time.

Ps. The theme of week 3 of MotherCircle is MotherBody, where we dive into the five universal postpartum needs to care for our bodies after birth. There is still space to join this 8-week course. Click here for more details.

The Chosen Loneliness

I have always liked being special. Growing up I only wanted to stand out. I was always good at school, always smart, always the teacher’s pet. I had weird medical issues growing up and as sick as it sounds—kind of enjoyed the attention I got. I literally had a collapsed lung the day that we had a pulmonary lab in physical therapy school, so all my classmates got to listen to my absent breath sounds with a stethoscope. And...I liked that. (I did not like the chest tube, surgeries, and hospital stay, however). (But even now as I’m telling you this story, there is still some weird satisfaction in telling it—"See, I’m special!”)

When it came to standing out with my unexplained infertility on a path to IVF, the sheen of that specialness faded quite quickly. When my son arrived in an emergency cesarean at 33 weeks, I did not want to stand out. When we found out at 4 months that he is blind—I was done being special.

And yet—I find myself using these stories to feel special too. Look what I’ve been through—try to top that! It feels gross. And sometimes, I find myself secluding myself within my story. There is a strange othering that I continue to choose, sometimes to commiserate with other Others, or to prove that I’m still special.

When I joined MotherCircle, it was an online circle with hundreds of women from across the globe. I began to take in all the other women’s introductions on a Facebook page. Most of them (in my selective memory, which I’m confident is flawed in this particular story) shared about magical home births, had multiple children with whom they easily got pregnant, and maybe even had an orgasmic birth. Those were the ones I remembered. A handful told of miscarriage, very few of infertility; none told of having a child with a disability.

I felt other.

I felt like I didn’t belong.

I entered the Circle with loneliness.

I can see now that I chose that loneliness.

I resisted being fully present in the Circle because it felt safer to be guarded in my specialness than to be vulnerable in my full presence.

And something I didn’t expect happened. Over the course of the eight weeks, as we sat together in breakout rooms of 2 or 3 or 4 people, I heard more stories. A mom of twins who felt like she didn’t belong. A woman who was not yet a mother but desperately wants to be, and just went through a breakup with her partner. Single mothers. Pandemic mothers. And they all felt lonely too.

When I actually got to know the other participants—not just what they said in their introductions—I realized that I did belong. That I was other—because we are all Other.

No one has my story. I have no one else’s story. And what we see on the surface is an iceberg—I knew nothing of these women’s journeys, nothing of their own heartache and loss and yearning and Hard.

This is the gift of a space like MotherCircle. A space where we are called to join together with other women in a container of love and visibility. Where we can see that your story and my story are really not so different. Really not so special. When we can see that we are all Other, we can gather together with one an-Other.

If you feel called to join our Circle but aren’t sure if you will fit in, send me a message. Let’s get on a call and explore your resistance, your fears, your Otherness. Because I’m confident you do fit in. And if it’s the right time and place for you, you will belong.

The Grass is Greener Where You Water It. And the roses are redder.

I didn’t water my roses most of the summer.

I was great at watering the garden because it’s got a drip hose and all I have to do is turn it on and set a timer. Easy peasy.

Is it hard to fill a water can and shower the roses? No. 

But we live in the PNW, and for the most part, they stayed looking pretty. Until July. When it got hot. Then they all wilted and fell. 

They did not thrive when I was not nourishing them.

A funny thing happened when I came home from New Zealand though – there were a few blooms. Just one or two, but it was enough to remind me of their beauty. And so, I started watering them. Lo and behold, there are more and more blooms each day.

This feels so apt for some of the projects in my life and work right now. I tend to be an idea person – I come up with a brilliant idea and then I start it and then I come up with another and I start that and pretty soon I have seventeen projects going on and – not surprisingly – not all of them are thriving. 

I had a great conversation with my project manager (she runs all the behind-the-scenes action here at HQ and is amazing) yesterday and she nodded as I told her about all of this and said, “Yep, the grass is greener where you water it.” How true.

And so, we put together a plan (ie. she put together a plan with deadlines for me to follow through with…). And we’ll be watering more areas, so you’ll see some new stuff rolling out in the upcoming months. Stay tuned.

P.S. As I re-read what I just wrote, I can’t help but notice the cyclical nature of it. Fall is coming, when we harvest what we planted in the spring. I’m not beating myself up over these habits, just reflecting – and maybe it’s all happening just exactly as it is intended to. 

P.P.S. If cyclical living is something you’re intrigued by, I’d love to see you at the next Blue Moon Circle on August 30.

A Big Yes!

When I was 16, the US hosted the Women’s World Cup. I made a deal with my mom–I’ll buy us match tickets if you buy the plane tickets. And to my surprise, she went for it. 

For context–I didn’t grow up in a globe-trotting family. We took road trips and went camping for vacations. At that point, I had been on 2 planes in my life. So this wasn’t a small ask.

It was a Big Ask.

And I got a Big Yes.

I don’t know if I can convey how much it meant to me that she said yes. Maybe you know the feeling–something you wanted so bad at that age that things are so important but this One Thing really was that Important. It meant a lot.

I tried to dig up some photos from the game but came up empty. I got to meet my heroes, watch some excellent soccer, and have a really special trip with my mom. 

Earlier this year, a dear friend texted me to say she was planning to “sneak off” to New Zealand for some world cup soccer this summer, and would I like to come with her? It was immediately a Big Yes–literally sent chills throughout my body. (Still does as I type this!). And still–it didn’t make the most sense. I have a 2-year-old and a partner and the clinic and yes–I did already take an international trip with a girlfriend this year. This wasn’t a small ask (and no sneaking, to boot). And yet–I said yes. It was–and is–a Big Yes.

So, I’m off to New Zealand this week to watch some amazing women play The Beautiful Game. They aren’t necessarily my heroes anymore, since I’ve found my calling and have no interest in playing soccer professionally anymore (though isn’t there a local adult league…?). But I’ll get to be in the stands alongside girls just like I was 24 years ago, cheering along as they watch their heroes, with their parents who said a Big Yes to them, too.

Sticky Note Reflections

Grab a napkin or journal or sticky note or receipt and jot down some reflections on these questions:

1. What was the last Big Yes you experienced? 

2. How did it feel in your body–how did you know it was the Right Answer, despite all the reasons your head said it might not have been?

3. Do you make your decisions more from your head or your body?

Menopause Resource List

Now here’s a book club everyone is looking for! (I say that sarcastically, but I’m guessing that it would actually be a hit with the right friends…)

This has absolutely been a theme over the past couple of weeks. Whenever a patient or friend or colleague mentions a book or podcast or influencer, I open a new tab on my browser and search for them. Then inevitably I forget about it and have eleventy billion tabs open. This drives my husband crazy, BUT today it came in so handy!

This afternoon someone came in and started her question: Do you have any books to recommend about…(I finished her sentence in my mind before she even finished)...menopause?

Why yes, I do. Let me click through my open tabs…

What Fresh Hell is This by Heather Corrina

You Are Not Broken by Dr. Kelly Caperson

The Menopause Manifesto by Dr. Jen Gunter

Looking for a provider who is clued into all things Menopause? The North American Menopause Society (NAMS) has some great information on their site, as well as a provider search. Find your new favorite provider here. 

And if you’re into podcasts, here are some recs:

The Daily - Sunday Read: ‘Women have been misled about menopause.’

We Can Do Hard Things - Menopause: What We Deserve to Know with Dr. Jen Gunter

I will keep adding to this list as I come across more resources. If you know of one that has been helpful for you, please send it along! The more we share, the more we all know, and the more power we hold. xo

On Menopause

My schedule is typically booked full of people who are pregnant, postpartum, or trying to conceive. It feels like a unique time to be working with folks in this season, being in the same season myself.

However, recently I’ve realized that I have had full days of treating women over 50. And with that, have been having a lot more conversations about estrogen, hot flashes, and all the feelings that come with The Change: Menopause.

The experiences these particular women are having around this topic range about as widely as the symptoms associated with perimenopause itself. (Note: I have a list of OVER 100 SYMPTOMS associated with the decade-long season of perimenopause—so if you’re feeling something that a friend is not, you’re not crazy!) Some of them are discouraged, distraught, and frustrated. Some are feeling it’s been easy-peasy.

But all of them are uncomfortable.

• The most common symptoms I see folks for within my practice are:

• Vaginal dryness

• Painful intercourse (typically attributed to the aforementioned dryness)

• Urinary incontinence

• Urinary urgency

• Grief & disorientation

I have the honor of working through some less medical/traditional PT topics, like grief and disorientation. I get to sit with them in the in-between, holding space as they process this change, the transformation from Mother to Wise Woman. To hold space for the unknowns that are in part due to a medical system that hasn’t done much research in this area, despite the fact that half the population goes through it. And even what knowledge is out there, it is still such a taboo topic that it’s often not brought up by individuals, or by their providers.

Thankfully there are more and more resources out there. This particular bunch of women I’m working with have each brought up a book or resource they’ve come across recently, as well as their own desire that everyone should know this! I couldn’t agree more, so I’m sharing those resources here.

I would be remiss if I didn’t let you know what role we as physical therapists play in walking through this season with you (whether you’re post-menopausal, peri-menopausal, or just looking ahead at what’s inevitably to come). Here are 7 things to know:

1. Topical estrogen (which you would get prescribed through your PCP) can help with vaginal dryness, incontinence, and urinary urgency. Estrogen has a bad reputation due to a study called the Women’s Health Initiative, which reported adverse effects that were later disproven. Talk with your PCP for more information and to know if it’s right for you—it is very much an individual decision to make, but you should have all the information you can get.

2. Vaginal moisturizers (without scents or herbs, please!) can help with dryness, or simply coconut oil from the kitchen! (Make sure it’s a new jar and not one that’s been up there for a decade or so...)

3. Coconut oil suppositories: Get yourself a mini-round ice cube tray and clean it real good. Melt down some organic coconut oil (without any additives) and fill the tray. Pop it in the freezer or fridge, then when they are solid, pop them out and put them in a bag or jar. You can use as a suppository (yes, put it into your vagina) for moisturizing, or before intercourse to mimic your own natural lubrication.

4. Use lube for sex! With less estrogen, the tissue around the vagina becomes more dry and irritable. It’s common to have increased sensitivity and discomfort with penetration, so take your time and don’t be afraid to use lube. If lubrication and/or estrogen aren’t helping, see a PT.

5. What a PT does for painful sex: When sex becomes painful, our bodies do what is natural—they defend themselves from the perceived danger. Your head knows that your partner is not dangerous, but your body isn’t getting the memo when it hurts. The defense they mount is tightening the pelvic floor, which in turn actually makes sex more painful, and we’re in a cycle. In PT we work on connecting with the pelvic floor to realize when we’re clenching, teach you to release the tension through yoga postures, stretches, and awareness, and can provide hands-on treatment through vaginal massage to help the muscles relax.

6. Urinary symptoms: Estrogen provides a “plumpness” to the vulva, around both the vaginal opening and the urethra. In menopause, estrogen is decreased, leading to less plumpness and more stiffness of the tissues. This can contribute to stress incontinence (ie. leaking with coughing, sneezing, exercise, etc) as well as urgency and urge incontinence (ie. the strong urge to pee and sometimes not making it in time). A pelvic floor PT can teach you about optimal bladder habits, normalize your pelvic floor tone (it can be both weak and too tight, and both contribute to urinary symptoms), and help you have more control over your bladder.

7. Energy shifts: You probably started bleeding around age 10, so aside from birth control, pregnancy, or a hysterectomy, you’ve spent most of your life with some regularity of a bleed. Menopause can be a disorienting time when you lose those cycles, especially if you have come to rely on them for some grounding. A lot of my work with people during this shift is acknowledging the grief that may accompany this change, as well as reorienting to shifting energy elsewhere and looking to things like the cycle of the moon to anchor to for orientation. Some of this work is more energy focused, and I use the modality of Holistic Pelvic Care along with traditional PT to address this facet of the change.

If you are curious if physical therapy is right for you during this shift, reach out to me or someone in your area. You don’t have to suffer, and there are providers to walk through it with you.

Presence, Courage, and Pleasure

Be present.

Have courage.

Seek pleasure.

These were the intentions I set before embarking on a recent trip to Costa Rica with my best friend from childhood. It was my first time so far away from my nearly-two-year-old, and actually my first time going on more than a road trip with a girlfriend.

I usually have some sense of what I want out of a vacation—in the vein of “I want to be off my phone” or “off the grid” or “don’t think about work.” It’s often set as a negative—don’t be on social media, don’t drink too much, don’t eat too much, etc.

I’ve never set these kinds of positive intentions before, never really sat down to feel deeply what I wanted to get out of the time away. What I want to do in order to receive what there is for me.

These intentions became a mantra for me.

The 3-hour shuttle drive from the airport to our resort extended past sunset and into the dark. The roads were wildly bumpy, and as I felt more and more overstimulated and nauseous (despite donning my noise-cancelling headphones and sunglasses), I naturally wanted to be anywhere but in that vehicle. Instead of wishing myself to the resort or the airport or home or the future, I found my mantra: Be present. Have courage. Seek pleasure. I found the pleasure of the soft warmth where my legs were crossed. I focused on that sensation and breathed it in. I found my courage to know we were safe. I stayed. And the trip ended.

We had spa treatments scheduled during our first full day at the resort. We had spent the noon hour on the beach, basking in the equatorial sun, so when I looked at the spa menu, the Cooling Treatment sounded delicious. I hadn’t accounted for the fact that the room would be air conditioned. Understand me—I am not complaining about a bougie spa treatment at a resort in Costa Rica—I was so grateful and privileged to be there. Aaaaaaaand when she started pouring a concoction of chilled aloe vera and cucumber over me and covering me with banana leaves (again—in the air-conditioned room), I had to find courage through the shivers to not jump off the table. I did my best to stay present, embracing the experience that I can only imagine may have similar benefits to a cold plunge; I found a space in my belly that still felt warm and focused on that pleasure. The treatment ended with a warm shower, and I laughed with the woman treating me as she emphatically called it “una experienca!”.

On our third day, we woke early to take a tuk tuk to the headquarters of a zipline company. We got geared up in harnesses that went around our thighs, waist, and shoulders, and hopped in the back of a military truck that took us up a mountain, through a river, and under trees with monkeys watching us go by. As I donned my leather gloves and let a guide attach me to a cable slung across the rainforest canopy, oh did I have to find my courage. I was terrified. And I leapt. I felt the pleasure of the wind in my face, yelled so very loud, and took in the beauty all around me, the thrill, the adventure. My mantra was with me still.

I was present. I basked in moments of rest, calm, and joy with my friend. I was just so content, no matter what we were doing—or not doing. I found I didn't even want to read the one book I brought, because it was such a "take me away" kind of story (yes, it was part of the Twilight saga, if you're wondering).

I had courage. I did things outside of my comfort zone—even leaving Sky home with his dad to go on this trip was a stretch for me. (Yes, I missed him. But it was so very lovely to not have to worry about him for a few days.)

I sought pleasure. This came in the form of amazing meals full of plantains and papaya and pineapple and so much gallo pinto, fruity cocktails, and coconut water right out of the fruit. In downdogs and savasana, basking in sunlight and walking along dirt roads. In sitting in the ocean and on horseback and swinging in a hammock. Listening to the birdsong in the morning and the howler monkeys at sundown.

And while I couldn’t take most of this experience home with me, I can still keep these intentions as I re-join the current of life here at home:

Be present.

Have courage.

Seek pleasure.

Taking Up Space

It has been a practice for me to take up space. I was the kid who got in trouble for talking in class, who was called “boisterous” (I had to look that one up in the dictionary when my 6th grade English teacher labeled me as such), who was always told to be quiet. I learned that it was not ok for my voice to take up space.
 
We are conditioned by our culture to not take up space. When I was a kid, I remember playing this game with a friend where we would “sit like a lady”—crossing our legs, sitting up tall, all prim and proper while we batted our eyelashes. Then we’d say “sit like a man” (in a deep voice) and slouch, spread our legs, and man-spread (long before that was a term in our vernacular). This was in elementary school!
 
Throughout college, dating, early career, and marriage, I can think of dozens of times I didn’t ask for what I wanted, or advocate for myself. I went along with whatever the class or my boyfriend or my husband wanted. I took whatever salary was offered and said yes to any opportunity I was asked to do. I was being a good girl, going with the flow, and not taking up too much space.
 
And then I got tired of it. I realized I wasn’t living the life I wanted, and had missed out on so many opportunities that were easily within my reach if I had just reached for them. Or asked for them.
 
I practiced asking for what I want. I let others be uncomfortable if I was talking too loud or taking up too much space. I finally realized that it had nothing to do with me, and that I was not responsible for their discomfort.
 
One of the ways I learned to take up space was intentionally spending time in spaces that invited it. I made friends who appreciated the bigness inside of me. I joined networking groups that asked me to literally put myself out there, on stage, in the spotlight. I attended a monthly moon circle during the year of IVF, pregnancy, and Sky’s birth that let me be who I was on that particular day—which was often tearful or grieving or scared. I practiced taking up space.
 
I’m hosting Full Moon Circles throughout 2023, and my hope is to create this kind of space for you. That it is a place that you can come and be seen, ask for what you need, and take up space.
 
The next gathering is on Friday, January 6. I’m planning a playful yoga practice so we can practice the embodiment of taking up space. There will be an invitation to participate in ritual and share in the circle of community. You can bring your full self, and show up as much or as little as you’d like.
 
And of course, we’ll celebrate the moon shining in all her glory—taking up space in the dark night sky.
 
I hope you can join.

Adjusting Expectations: Holiday Edition

We’re supposed to be in Arizona right now.

We planned this trip months ago. An early Christmas with my in-laws. Specifically planned between Thanksgiving and Christmas so we could avoid the big travel days, save some money, and most importantly, hope to avoid getting sick.

But alas, we are sick. Sky started with a cough, then a fever, now is just on and off again miserable then happy with the only consistent thing being his snotty nose. G went to bed before him tonight, and thankfully my sore throat got better through the day.

We were hemming and hawing last night about whether we would go or not. The original plan was to wake up at 5 and go for a run (ok that was just my husband’s plan), leave for the airport shuttle at 7:45 to catch our 11am flight to sunshine and dry air.

Then last night Sky woke up 3 times before midnight, only happy being held in the recliner (presumably so he could breathe easier). At 2 am we made the decision with a tickle in each of our throats starting to grow and memories rushing back of those hard newborn days.

Then we were just sad. We haven’t been to Arizona since the Christmas before Covid. These Grandparents haven’t had a Christmas with Sky. It was disappointing to tell them we aren’t coming and disappointing to know we aren’t going. It’s disappointing to adjust expectations.

After sitting with the sad, bless my husband—he picked up a pen and a notecard and started writing things down. We adjusted our expectations. Instead of flying to be with family, we’d make his grandma’s rocky road and peanut clusters, the ones she used to send in a box to each of us at Christmas, with little compartments separated by tinfoil walls and a handful of mixed nuts too. I decided we’d make my mom’s peanut blossoms too. We pulled out Grandma Betty’s cookbook and found the recipes (along with a recipe that called for 12 boxes of jello, celery, and pineapple...)

We could go to Zoolights on a weekday and miss the crowds.

We could go to Seattle to check out the Talking Book library we’ve been wanting to take Sky to.

We could get a new Christmas tree. That’s the one that got me teared up.

You see, we hadn’t adjusted expectations two weeks ago when we went to get our tree. We have made it a tradition to drive to the forest and cut one down ourselves. But we have a toddler this year. So it meant we spent 3 hours in the car so that I could hold hands with Sky toddling on a forest road while Graham went and found and cut down a tree. We ate a quick snack and then got back in the car. It was a disappointing trip, and honestly—kind of a disappointing tree.

A disappointing tree that for some reason did not take on any water once we put it up in the house. I noticed a pile of pine needles at its base the other day and realized that just the smallest tap of a branch led to a rainfall of needles. It was bone dry—and honestly, a fire hazard, considering the proximity to our fireplace.

It was a sad Christmas tree, with 2 weeks to go till Christmas. It’s felt like a sad Christmas season—it got off on the wrong foot. Woke up on the wrong side of the bed. We haven’t even been wanting to listen to holiday music like we typically do.

So it’s a do over. We took down the tree today and plan to burn it for Solstice. We’ll get a new tree tomorrow. I did a big grocery run to Trader Joes (where I happen to find a cactus that came with a string of lights—perfect for a holiday where we missed the desert!). I also made a stop at Home Goods to get some holiday napkins and a throw pillow. I always hold back on buying holiday stuff and I think that’s a whole other essay to dig into on another day.

We adjusted our plans, and adjusted our expectations. My husband saw a big pile of lemons, and decided to make some holiday lemonade out of it. We’re all a little under the weather, but honestly, a forced staycation isn’t the worst thing in the world. We will make the most of it, even if it does mean that one or the other of us is going to bed before the toddler.

It’s Christmas season, and even though our plans changed, we can still make a choice for what we do with it. We are not a victim of our circumstances; we have agency.

This is parenthood: Plans change. Nannies call out. Kids get sick. We get sick. We make the best choices we can with the information that we have (which is often too much these days). We commiserate with friends. We call our parents. We feel our feelings—the sad ones and the happy ones—and help teach our kids to feel theirs too. We watch cheesy holiday movies and make nostalgic recipes.

And we adjust our expectations—for the stage we’re at, the circumstances we’re in, and with whatever the universe happens throws at us.

I hope your holiday is exactly what you expect—or adjust to. Tell me in the comments about how you’ve had to adjust your expectations this year, or in years past! I love reading what you share.

50 Things I Learned in my 30's

 It’s my 40th birthday today.

As one does on a milestone birthday, I’ve been reflective lately, looking back on the past decade and looking forward to what’s to come. Last week I would have told you that my 30’s were all about trying to start a family. While that’s true (we started TTC when I was 30, and Sky was born shortly after I turned 38), making this list made me realize how much more this decade held.

I spent my 20’s being a good student, a good daughter, and learning to be a good wife.

In my 30’s I started to learn who I am as a Woman, as Myself, and eventually as a Mother. I wonder if I would have had a baby when I had planned, I might have skipped the whole learning who I am part and just skipped straight to my role as a mom. I would have missed a lot.

So here is a list—incomplete and in no particular order—of 50 things that I learned in my 30’s:

1.     “I can’t afford that” is a disempowered lie; instead, I’ve learned to own that I choose what I do or don’t spend my money on. If I want something that costs a lot, I choose if I want to save for it, even if it takes a decade.

2.     I can work less than 40 hours/week.

3.     I am not for everyone, and everyone is not for me. #nocompetition

4.     Shine Theory: Instead of getting jealous when I see another woman shining or doing what I want to do, I try to get close to them.

5.     I don’t have to follow anyone’s rules.

6.     I can trust my gut. In fact, I need to trust my gut. She has never failed me.

7.     My body is good. No matter her shape or size or weight. It is good.

8.     You can’t always get what you want if you just work hard enough.

9.     I am not infertile. But I needed the help of science and doctors to have my child.

10.  I am fucking strong.

11.  My body has never failed me.

12.  I can choose when to keep fighting for something and when to walk away. I am not a victim of my circumstances.

13.  In an unwinnable game of tug-o-war, I can choose to stand my ground and put down the rope.

14.  I don’t have to wait until I [fill in the blank: have a kid, get another certification, have more experience, etc.] to start something.

15.  The Universe is in fact conspiring in my favor.

16.  It’s ok to have friends for a season then part ways.

17.  Therapy is just so good.

18.  It is ok for my partner to disappoint me; it’s ok for me to disappoint my partner.

19.  I can choose me first.

20.  Everything is temporary.

21.  Stillness serves me.

22.  Yoga doesn’t have to be done for 60+ minutes at a studio in a class in expensive leggings; it can be done anywhere for any amount of time in whatever I happen to be wearing.

23.  Yoga is so much more than just a form of exercise.

24.  I am worth so much more than I ever thought.

25.  Vulnerability is a gift.

26.  It is ok to ask for help.

27.  People want to help.

28.  Life is not fair.

29.  Parenting is harder than I expected, and easier than I expected, and so much better than I ever expected.

30.  When it feels like I am paddling upstream, I stop and ask myself if I’m on the right path. I’m usually not. So I stop and wait till I find the flow again.

31.  Try things. Even if you fail, you’ll learn something.

32.  The life/death/life cycle is all around us, everywhere, every day. We can learn so much from paying attention to it.

33.  I was complete before I had a child. I am somehow even more complete now.

34.  Movement is medicine, and doesn’t have to look a certain way.

35.  Instead of restricting what I eat or drink, I can ask myself: how will this nourish me? and make choices from there.

36.  I am inherently good.

37.  I can feel my feelings without them overtaking me. I can sit in my sadness/grief/anger/overwhelm and trust that I will be ok.

38.  I don’t have to fix everything; sometimes I just need to listen.

39.  Setting boundaries serves both parties.

40.  Both/And: I can be happy for someone and also jealous. (Two things can be true.)

41.  Resentment is like drinking poison and waiting for the other person to die.

42.  The loneliness of infertility is in the fact that no one else can see the loss of what could have been every cycle, over and over again.

43.  It’s ok to walk away from what you thought was your dream. It’s ok to take a break from your calling.

44.  It’s ok to sit at home in my sweats while I am bleeding. It’s ok to slow down during that phase of my cycle. My energy will return.

45.  I gain nothing by comparing my hard things to someone else’s hard things. My hard is the hardest hard for me. (roughly based on something David Kessler said in a Brene Brown podcast)

46.  The world keeps going when I am incapacitated. It really does. Which means it’s ok to take a break sometimes too.

47.  Epsom salt baths are medicine.

48.  It is not enough to talk about trauma; you have to treat the body & nervous system too.

49.  It is not enough to treat the physical body after trauma; you have to address the psychoemotional parts too.

50.  I can ask for what I want.

 (I can’t wait to see what my 40’s have in store for me…)

Does any of this resonate for you? Share in the comments what you’ve learned in the past decade!

Is it normal to only have an external orgasm?

I get asked this question all. the. time. And I’m both super happy and a little sad to see all the responses, as I’ll dive into below.

First, let’s go back to the basics and define some terms. As a reminder from my last post, an orgasm is a typically pleasurable, “sudden release of sexual tension, which can be generated in various ways” (Emily Nagoski, PhD in Come As You Are).

So what’s this about “internal” and “external” orgasms? First off, Dr. Nagoski poo poo’s the whole “different kind of orgasm” concept. An orgasm is an orgasm, and she recommends “instead of thinking about ‘kinds’ of orgasm, we can think about different ways to have an orgasm.” That might mean an orgasm from clitoral stimulation (what we typically call “external”), or vaginal stimulation (aka “internal”), or a bazillion different other ways.

And I love this:

“Just as all vulvas are normal and healthy just as they are, so all orgasms are normal and healthy, regardless of what kind of stimulation generated them or how they feel. Their value comes not from how it came to be or whether it meets some arbitrary criteria but from whether you liked it and wanted it.”

So back to the common question about vaginal (internal) vs. clitoral (external) orgasms, because as I said, this is one I’m asked all the time. BOTH ARE NORMAL. In fact, according to Nagoski, less than 1/3 of women or vulva-owners are reliably able to have an orgasm with vaginal penetration alone. It seems to me that the myth that something is wrong with us if we aren’t able to have an orgasm with vaginal penetration comes from the story that a vulva needs a penis to have pleasure—which means it’s based on men’s pleasure.

Yes, we can blame the patriarchy for this. But it’s also history. Science really only explored men’s bodies for the longest time, therefore early anatomists (mostly yep—men) long ago decided that the female body should be just like the male, finding pleasure the same way and responding to sexual stimuli the same way. Most men reliably find pleasure with penile penetration in a vagina, therefore this must be what women/vulva-owners should reliably get off on too.

Real talk: the only reason you NEED to have penis-in-vagina sex is if you are actively trying to get pregnant. The clitoris is the major pleasure center for the female body, so it’s totally normal to only have orgasm with clitoral stimulation. In fact, many times an internal/vaginal orgasm is actually due to stimulation externally of the clitoris by the male partner’s pubic bone. Some research points to the distance between the vaginal opening and the clitoris as the primary factor in whether or not a woman/vulva-owner is able to have an internal orgasm, because the closer it is to the vaginal opening, the more likely the clitoris—in particular, the vestibular bulbs—will be stimulated during penetrative sex.

Is your mind blown yet?

Of course, there’s more. But I’m going to leave you hanging again. If you haven’t recently seen a picture of a clitoris (or been in my office to see my golden model of one!), I think it’s due time to explore it.

As always, hit me up with questions! And again, I can’t recommend Come As You Are enough. It’s so good, and so worth the read.

The Big O

Here we go: let’s talk about sex.

Or more specifically today, orgasms. Two of the questions I got from a recent email asking for questions from readers were about what an orgasm is, and the difference between “internal” and “external” orgasms.

So let’s start there!

My go-to resources for all things related to sex are two books (because you don’t want to google everything...): Come As You Are by Emily Nagoski, PhD, who is a sex educator and author among other things, and The Guide to Getting it On by Paul Joannides (which I refer to as “everything you ever wanted to know about sex and maybe more). I’m going to lean heavily on Dr. Nagoski’s words today.

What exactly is an orgasm? So many answers may come to mind here. A good feeling? A climax? Elusive?  Yes and yes and yes, all may be true. I love Dr. Nagoski’s simple definition of this complex event. She defines an orgasm as “the sudden release of sexual tension, generated in different ways.” (She has an entire chapter on the topic in Come As You Are that I highly recommend you check out!)

One of the primary physical markers of an orgasm is a rhythmic contraction of the pelvic floor muscles, and there is a correlation between weak pelvic floor and decreased orgasm ability or sensation. However, one can have an orgasm without this muscle contraction, and one can have a muscle contraction without an orgasm. Which means that it’s not just a physical event. It happens in your brain, which means the physical, emotional, mental, psychologic components of an experience all play into it.

I know people who have had an orgasm at the gym, when it was certainly not called upon (nor enjoyable in the situation!). And people who have been unable to “get there” despite trying very hard by themselves or with a partner. Like I said, it’s complex.

One question I got was about feeling the build up, then “poof, it’s gone.” She asked if this was a pelvic floor issue, and my answer is the ever-frustrating “maybe”. Because it’s never just physical.

A lot of my readers are parents of young children. So when you think about sex, you have to consider all the components: where the baby/kids are, if they are asleep, how tired you are, how touched out you are, my goodness are both of you in the mood at the same time? What contraception do you have on hand? Is there time? Would sleep be better? How sexy do you feel? Will it hurt? Do we have lube?

If your brain is thinking about all of these things, it doesn’t have as much space to just focus on the pleasure of intimacy.

To sum it all up: an orgasm is a typically pleasurable, sudden release of sexual tension, which can be generated in various ways. Tune in next week and I’ll address the latter part of that statement and the external vs. internal question (ha that I thought I could address them both in one little letter...!).

One of the surprise bonuses of my work as a pelvic floor PT is how much education I get to provide for y’all. I didn’t have the most comprehensive sex ed myself, and I loooooove being able to talk about it with other folks like you. I believe knowledge is POWER, and this is stuff we should have all been taught when we were much younger. Your body is amazing. It does amazing things. In my experience in the clinic, two of the factors that leads to anorgasmia (lack of orgasm) is a) this lack of knowledge, and b) shame. When we aren’t taught about our bodies, we’re left in the dark, and shame thrives in the dark. When we know more, we can do more, and we can take ownership of our bodies—and our pleasure—in a whole new way.

Thanks for being on this journey with me. I have so much more to share.

What have you done for YOU?

We started a childbirth education class last week and the instructor asked this question: 

What have you done for yourself this week that was just for yourself, for no one else?

I thought about it for myself, and realized I didn’t have a great answer. The next day was gorgeous, so my natural inclination was to take advantage of the sunshine and go to the park for a walk with Reba, my pup. 

Then I realized: I don’t enjoy walks as much when she is with me. She pulls, I get frustrated, and heaven forbid we see another dog on the trail. 

And so I got in the car, brushing off a little bit of dog-mom guilt (it’s real, folks), and went to Point Defiance by myself—for myself—to go for a walk. And it felt amazing.

Our instructor’s point in asking the question was to realize that time like this is fleeting, when we can leave our “dependent” home alone and jaunt off to the woods or what have you. As much as I’m looking forward to their arrival, I want to take advantage of this time, too.

So I’m turning question to you: 

What have you done for yourself this week that was just for yourself, for no one else?

If you, like me, don’t have an answer for last week, what can you plan to do in the next week—or maybe today or maybe tomorrow—that’s just for yourself and for no one else? 

Maybe it won’t be 2 hours in the forest--maybe it looks like 5 minutes locked in the bathroom with your phone. Maybe it’s a short walk before the kids get up. Maybe it’s watching an episode of Bridgerton by yourself, without your partner. Maybe it’s sipping coffee (still hot!) in silence.

Make a plan to take a few moments for yourself. Because when you take care of yourself, you can take better care of others, too.

Xo, Mandi

The Most Powerful Thing a Woman Can Do

I came across an Instagram post the other day from a new first-time mother. In the post she made the claim that “giving birth is the most powerful thing a woman can do.” My reaction was complicated—a mix of jealousy, sadness, anger, and eager agreement—and I’ve been chewing on that sentence for weeks now.

My question is this: if “giving birth is the most powerful thing a woman can do,” what does that mean for those women who can’t have a child? What about those who CHOOSE to not have children—are they less powerful, less Woman than those who do? Are we incomplete? I know women who have walked away from years of infertility and loss and CHOSE to be child-free—something so brave I personally can’t imagine doing.

I have spent the last couple years fighting the cultural narrative that childbearing is the utmost purpose of a woman. And the belief that I will not be fully woman until I have borne a child. That I will be more loved by my family, of more use in society if I can bear children. This sounds so antiquated, but I think it’s a belief that is still alive and well today. It’s in our bones.

I don’t question that for the author of that post, giving birth is the most powerful thing that SHE has ever done. I know enough about pregnancy & birth that I won’t question that it IS powerful.

But perhaps it is just one of many powerful things a woman can do.

This feels like something I’m going to keep chewing on. What are your thoughts?

Does the statement ring true for you?

What’s the most powerful thing YOU have done in your life thus far?

Online PT: Recap + Recommendations

Moving to online visits was brand new to me in 2020. In 11 years of practice, I had never treated online before, and frankly, wasn’t sure how it would go. I like using my hands and know the people I work with get a lot of benefit out of hands-on therapy. It forced me out of my comfort zone to focus only on education, exercise, and self-assessment.

Do you know what I found out? A lot of the people I had been working with got better faster doing online visits. I assume it’s a combination of people figuring some things out for themselves about their body instead of me telling them what I’m finding, creating space in their own environment for their home program, and truly healing themselves.

This Pandemic proved something to me that I might not have learned otherwise: I am not the reason people get better.

I help guide you, but your body is truly healing itself.

And I know at the same time, some people need a little input to their body via hands-on treatment to help guide that healing and recovery.

I want to keep this option open in my practice moving forward. Especially since the pandemic is far from over. Here’s a little breakdown of which option is best and when, including some hard boundaries I’m setting for exposure prevention:

I asked a few folks who transitioned to—or started with—online visits what they thought about it. Keep reading to hear what they said:

“I visited 9 doctors over the course of 5 years trying to get my pelvic pain under control. I even went to two other board certified pelvic floor PT’s before I found Dr. Murtaugh. After just 6 weeks of virtual visits with Dr. Mandi I have made more progress than ever before. Dr. Murtaugh’s education, encouragement, and expertise have helped me understand my body in a way that has revolutionized my treatment. She truly listens and has a heart for these incredibly sensitive issues. I finally have hope again that pain-free sex is in my future.” - K.K.

"I was surprised at how much we could accomplish with telehealth visits! Mandi is somehow able to express physical ideas with words and translate them in such a way that I could reproduce actions in my own body. I learn very well from seeing people actually do the activities and telehealth works really well for that. While there's something very comforting about a PT being able to feel your muscles and tell you if you're doing an exercise well or not, Mandi's really great about watching intently and making sure proper muscles are activating. I appreciate how Mandi can interpret and communicate physical movement by showing, articulating what should and shouldn't be happening as well as provide helpful feedback if even the slightest muscle was trying to compensate when it shouldn't. I know telehealth isn't an ideal or even possible for some people, but I trusted Mandi to tell me if our PT plan would be productive via telehealth and I've made a lot of progress in the last few weeks and I didn't even have to get out of my pajamas! No regrets, just gratitude and progress." - C.F.

“I usually have my apartment to myself, so it’s nice and private and very comfortable and convenient. It’s nice to kinda have the extra time to prepare for the visit then I’d otherwise be driving to see you. I think one of the most important things about PT in general for me is having trust. Trusting you to teach and help me and trusting myself and my body, so having that established already makes the transition easier.” - B.M.

“Telehealth has been great! If we can't be in the clinic together, it's nice to be able to continue working on my exercises virtually. The process is easy and I'm making progress!” - K.J.

Let it Go: A Burn Ritual

I love fires. I have early memories of sitting around the fire at camp roasting marshmallows. Or sharing stories with my family. Or sitting in the backcountry, the only lights our fire and the moon. There is something magical about it.

As I became an adult, I started to see the power in burning things I wanted to release. I have burned journals, old letters, even once a baby shower invitation (they sometimes feel like a stab in the heart in the midst of infertility). There’s something magical about the release in burning something.

A Burn Ritual can be especially powerful during transition, like the Solstice, or a personal transition. Say you quit your job, or left a relationship, or lost a loved one. Maybe you are burning your business cards, love letters, or something that represents your loss. Maybe it’s the end of a season that you’re ready to move on from. Maybe it’s the beginning of something else.

This can be a personal ritual, or can be done in a group. When we moved from Portland to Seattle, we gathered with friends and invited everyone to bring something to burn. Some were starting to build a family. Some were transitioning out of work or personal identities. Some were releasing unhealthy relationships. We stood in solidarity around the fire and watched it all burn.

Ready to have your own Burn Ritual? Here’s how to do it:

What you’ll need:

• Paper & pen, or something that represents what you are letting go of. (Note: please don’t burn important things such as legal documents, or someone else’s stuff. This ritual should not be performed out of anger or spite).

• A fireplace, pit, or fireproof vessel such as a glass or metal bowl

Center yourself

• Take a moment to check in with your body. Take a few grounding breaths, noticing what you are feeling and where you are feeling it.

• If you feel angry, consider that this might not be the best time to burn something. Take a walk, meditate, or find something to discharge that energy, then come back to the ritual.

Write it down

• If you have a physical object that is burnable, hold it and notice what you feel in it.

• If you don’t have a physical object, write down what you are releasing. Perhaps it’s a name, perhaps it’s an action (or inaction); it may be one word or a 3-page letter. Make it yours.

Let it go

• Burn it. Throw it in the fire, or light the corner with a match & drop it in the bowl.

• Watch it burn, it’s smoke releasing into the sky.

• Breathe in the release.

Sit quietly with yourself as it burns. Notice again how your body feels, and where you feel it. Sit with the fire. Tend to it. Tend to yourself. Let the fire burn down as you sit with the space it opened up.

And come back whenever you feel the need.

*NOTE: Please use common sense fire safety measures if you do this! Have an extinguisher nearby, do it in an open space without any wind, and make sure there is nothing flammable nearby. Also check to see if there are any burn bans in your area. If you question the safety of burning in any way, consider tearing up any paper products and burying them. Be safe.

At Capacity

May 25, 2020 marked one year since I had my miscarriage. The weeks leading up to it were heavy, remembering every day that I was pregnant a year ago. I felt it all.

May 25, 2020 is also the day that George Floyd was murdered by a white police officer. I came out of my own grief to read the news and see social media flooded with petitions and protests and the uprising.

I didn’t feel like I had capacity for it. I told my therapist that week that I didn’t have the capacity to do anti-racism work in the wake of my own grief, in this time of my life.

She challenged me.

She told me I always have capacity, but that I have to choose when and where to shift my capacity.

I have thought of this every day since then. I would always rather be busy than bored, so I fill every spare second of time and add projects whenever there is an ounce of space—like a vacuum.

So, I shifted. I dropped a couple work projects that have been taking up space and energy. I started my own education on anti-racism work, like I mentioned in last week’s post. I held and felt my own grief, then made space to hold the collective grief as well. I didn’t deny my own experience, rather tried to integrate it.

Maybe when we make space for collective grief, the Collective actually picks up some of our own. We all carry each other.

How have you shifted? What do you do when you feel like you’re at capacity? I realize my privilege in being able to shift. As a white person I have the privilege to not do the work of anti-racism. I have the option to turn away. I acknowledge that not everyone has that option. And we all have capacities. We all get to make some choice of where to shift our capacity.

What are you making space for right now? Is it doing this work too? Is it shifting to make time for yourself by asking your partner to watch the baby so you can take a bath? Is it intentionally sitting with your kid without multi-tasking on your phone? Maybe it’s turning off social media so you can write or journal or meditate or walk or just sit and stare at the sky.

When you feel like you’re at capacity, ask yourself:

Where can I shift?

What can I let go of?

What is the most important thing right now?

Make space for it.

Black Lives Matter

Recent events—the murders of George Floyd, Breonna Taylor, Ahmaud Arbery, and Manuel Ellis, here in Tacoma—have led to an uprising of protests and revolution. Many of us are waking up for the first time to really see the ways our country does not provide “liberty and justice for all.”

I am a white woman and am in no way a leader in this fight for racial equity. I am actually quite late to it. But I’m listening, and I’m learning, and I’m speaking out. I’m sharing a list of resources I’ve come across and am learning from, and will continue to build this as I go.

Learn from black people. Don’t ask them to teach you—there are plenty out there doing the work already—pay them for it. Some of the links below are for paid resources, and they are worth paying for. I have no affiliation with them and get no money myself. These are voices that I trust and that I’m listening to.

Local:

List of Black-owned businesses in Tacoma

Donate money or time:

Tacoma Urban League

Washington Therapy Fund

Online:

Unpacking White Feminism by Rachel Cargle

Anti-Racism for Wellness Professionals with Chrissy King

Anti-Racism & Allyship for Rehab  and Movement Professionals with Dr. Jennifer Hutton

Dear White People on Netflix

Follow:

@rachelcargle

@kimberlecrenshaw

@_wholebodypregnancy_

@iamchrissyking

Read:

How to Be An Antiracist by Ibram X. Kendi

Antiracist Baby by Ibram X. Kendi

White Fragility by Robin DiAngelo, PhD

Listen:

1619 - A podcast from NY Times about the history of slavery

On Being podcast interviewing Resmaa Menakem

Watch:

I Am Not Your Negro

Dear White People

On Mother’s Day

Motherhood takes so many forms. Why am I stuck on feeling like I need to carry and birth my own child naturally to be fully known as woman and mother?

In the course of one week this winter I talked with several women on different paths.

One was totally into the thought of being a mother, but not at all interested in carrying her own; we discussed surrogacy.

Another was waiting for her partner to say they were ready to foster-adopt.

A third was single and considering foster-adoption as well.

Then another was navigating the ups and downs of life with a newborn, who was conceived via IUI with donor sperm.

All this was while I was preparing to start IVF, and still grieving the fact that I hadn’t been able to conceive on my own, after 6 years of trying.

Not one of those women were talking about becoming a mother the way I envisioned that I needed to. Maybe there isn’t anything wrong with me. Maybe the point isn’t how you come to it. Maybe the point isn’t even holding my child. Maybe it’s more about knowing that I am already a woman, I am already complete, though always and forevermore becoming.

Motherhood is all of these things.

I am a mother, though I’ll never meet the child I carried.

I have birthed a business, and too many creative endeavors to count. I am constantly creating. It is not the same as pregnancy and raising a child, but it is the same energy that I put forth into the world. It is still beautiful.

There is no guarantee that IVF will result in a child in my arms, but I know already that I am fully Woman, and forever a Mother. I’ve done a lot of work to get to that point of knowing.

I’m not done with that work.

If you’re in the midst of that work yourself, I see you. It’s hard. But it’s worth it.

Motherhood looks like so many different things. All beautiful. All right.

What does it look like for you?

Happy Mother’s Day to all of you, in all your beautiful forms.

How to Be in Your Body

Where do you feel stress in your body? Stop for a moment, close your eyes, and just feel. What sensations are present? Where do you feel the fear, the grief, the loss?

Do you feel it at all?

Coping mechanisms are often simply numbing behaviors. The pandemic is a collective loss—we are all grieving canceled trips, birthday parties, and hugs. We have all lost so much in the past few weeks. And if we sit still long enough, we will feel that loss. And it won’t be comfortable.

So we numb. We binge Netflix. We eat Doritos for dinner. We have a couple more glasses of wine than usual. Or at least this is my list.

I mean—and feel—no shame in this list. It’s quick comfort in an uncomfortable time. But it’s not sustainable.

My favorite coping mechanism, however, is work. And I’ve felt this lately. When the Stay Home orders were issued I dug in. I added more to my plate. I advertised an online workshop and figured out how to broadcast and sell it, while my patient care continued almost as busy as usual. I went to bed thinking about it and I woke up with Instagram posts rattling in my head. I told myself it was “good” because I need to keep my business running. But this is not sustainable. It took me 6 weeks of overdrive to realize that this is me grasping at whatever I can find to stay out of my body. I wanted to ignore the tightness that settles in my chest, and the flutter in my solar plexus.

Can you relate?

I mentioned to a friend on Friday that I was looking forward to finishing Saturday’s workshop so I could feel back in my body, and she beautifully replied:

“I would ask you, how could you get back into our body BEFORE the workshop? What kind of difference could that make for both you and the participants?”

I took a breath. Then I listed off 5 things right away that I could do. Then I did them.

I closed my computer.

I turned on some music and danced in the kitchen.

I re-potted all my houseplants.

I knelt barefoot in the grass and dug my hands in the dirt.

I took a bath.

I came home to my body.

So I ask you the same: How can you get back into your body? What kind of difference would that make for you? For your family, your colleagues or your children?

Take a breath. Make a list of 5 things. And keep that list somewhere visible so you can remember. Because when we are in our body we are home.

Image credit: @onbeinginyourbody