Pelvic Floor 101: Why Every Woman Should Care—Long Before Pregnancy
When most people hear “pelvic floor,” they think postpartum. Maybe leaking, maybe Kegels. But the truth? Your pelvic floor matters long before you’re thinking about babies—and long after. In a conversation between holistic health practitioner McKenna and pelvic floor physical therapist Jackie Roelofs (aka Dr. Juicy Jackie on Instagram), we got a deep dive into this crucial and often overlooked aspect of women’s health.
From fertility and painful periods to digestion and nervous system regulation, here’s why understanding and supporting your pelvic floor can transform your health—at any stage of life.
What Is the Pelvic Floor?
Jackie explains it simply: “It’s literally the floor of your pelvis.” But this “floor” does a whole lot more than most of us realize. The pelvic floor is a group of muscles that stretch like a hammock from your pubic bone to your tailbone. And these muscles have five key functions, often remembered as the “Five S’s”:
- Support – They help hold up internal organs like the uterus, bladder, and rectum.
- Stability – They stabilize the pelvis and trunk during movement.
- Sump Pump – They support lymphatic flow and circulation, helping remove waste and bring in nutrients.
- Sexual Function – These muscles contract during orgasm and need to relax for penetration or inserting a tampon or menstrual cup.
- Sphincter Control – They play a role in controlling bladder and bowel function.
Most surprisingly? These muscles are deeply connected to almost every body system—musculoskeletal, digestive, reproductive, and even your nervous system.
From Injury to Insight: Jackie’s Story
Like many in holistic health fields, Jackie’s path was personal. Originally an athlete with dreams of playing Division I volleyball, an injury rerouted her toward physical therapy. But it wasn’t until she experienced debilitating chronic pelvic and low back pain—and eventually an endometriosis diagnosis—that she found pelvic floor therapy as a patient herself.
She shares:
“I had been living with chronic low back pain, pelvic pain, and burning nerve pain down my leg. It got so bad I couldn’t climb stairs. The symptoms lined up with my cycle. That’s what eventually led me to see an endometriosis specialist.”
Even as a doctor of physical therapy, Jackie hadn’t fully understood how integral the pelvic floor was to issues like bloating, painful periods, or ovulation-related pain until she experienced it firsthand.
Pelvic Floor, Periods, and Pain
Many women have been taught that cramps, constipation, or pelvic discomfort are “just part of being a woman.” Jackie gently pushes back on that:
“If you’re taking ibuprofen for five days straight, that’s not normal. Severe abdominal pain in a teen? That’s a red flag for endometriosis.”
In pelvic floor therapy, Jackie often finds tightness and tension in the abdominal muscles and fascia (the connective tissue around muscles and organs). This tension can restrict organ mobility—especially the colon, uterus, and bladder—making digestion sluggish and periods more painful.
Fascia needs to be soft, hydrated, and mobile—able to expand, contract, and move with your body. Stuck fascia can make it hard for your colon to contract properly or for your uterus to release menstrual blood effectively. The result? Cramping, bloating, painful periods, and digestive dysfunction.
Digestion, Fascia & the Nervous System
“I had severe bloating even after surgery,” Jackie recalls. “I had restricted my diet so much and was doing all the right things, but pelvic floor therapy was the missing piece.”
This connection between gut health and the pelvic floor is physical—but also neurological. When fascia is tight or organs are inflamed, the nervous system interprets this as stress or danger. And when your nervous system is stuck in “fight or flight,” it deprioritizes non-essential functions—like digestion, ovulation, or even sleep.
Jackie sees this all the time:
“So many of my clients are over-trained, clenching their abs, sucking in their belly for years. That chronic tension impacts their digestion and their reproductive health.”
Why Pelvic Floor Health Matters Before Pregnancy
In the fertility space, pelvic floor health is often skipped over—until something goes wrong. But Jackie is seeing a shift.
“More women are coming in saying, ‘I want to start trying to conceive in six months. I know my pelvic floor is important.’ And that’s thanks to social media and education.”
Here’s why it matters long before you conceive:
- You need to relax to conceive. Many women unknowingly clench their pelvic floor constantly, which restricts blood flow and lymphatic drainage. This can interfere with ovulation and cervical mucus production.
- Sex should be enjoyable. Jackie notes that painful sex is often tied to pelvic floor dysfunction—and that pleasure and relaxation are essential for fertility.
- Fertility isn’t just about hormones. Issues like bloating, painful periods, or constipation might be signs of deeper dysfunction that can impact fertility outcomes—even with IVF or IUI.
The Nervous System-Fertility Connection
Perhaps the most profound part of Jackie’s philosophy is her belief in the nervous system as the gatekeeper to fertility.
“I treat the nervous system first. If your brain doesn’t feel safe, it won’t prioritize conception.”
This doesn’t mean you need to meditate for three hours a day. Instead, Jackie recommends “micro-nurtures”—little acts that bring your system into rest and digest mode. That might be breathwork, a short walk, or just letting your belly soften.
C-Sections, Scar Tissue & Second Babies
What if you’ve already had a baby—especially via C-section? Scar tissue from C-sections can absolutely impact future fertility.
“A C-section cuts through seven layers of tissue,” Jackie explains. “That includes muscle, fascia, and the uterus itself. If that fascia heals tight, it can impact blood flow, digestion, and even ovulation.”
This is why Jackie urges women planning for a second or third baby to consider pelvic floor therapy preconceptionally—especially if they had a traumatic birth or long labor.
“There’s physical scar tissue, but also emotional trauma that can create tension in the body. We want to release both.”
What to Expect from a Pelvic Floor Appointment
Pelvic floor therapy may sound intimidating. Jackie breaks it down:
- You’ll talk—a lot. Your first session involves detailed intake and mapping your symptoms.
- You’ll move. Posture, breathing, and how your body compensates are observed.
- You’ll learn. Jackie prioritizes education and informed consent, always explaining what she’s doing and why.
And the internal exam? It’s optional and never should be done without consent.
“I walk you through exactly what to expect. I treat a lot of women with trauma histories and painful sex. My goal is to make your body feel safe.”
For virtual clients, she offers self-release techniques, breathing exercises, and customized movement practices to reduce tension and restore function.
How to Find a Good Pelvic Floor PT
Jackie recommends starting with a Google search (“pelvic floor PT near me”), but be choosy:
- Look for private practices or out-of-network providers if you can. Insurance-based clinics often don’t allow enough time or privacy.
- Red flags: Being placed in a group setting, doing the same exercises over and over, or being told to “just do Kegels” without assessment.
She also recommends using the Herman & Wallace pelvic rehab provider directory.
Final Words: Trust Yourself
Jackie leaves us with this reminder:
“You become a mother the moment you flip the switch from ‘I don’t want to get pregnant’ to ‘maybe I do.’ And at every stage of that journey, the key is trust—trusting your body, your instincts, and that healing is possible.”
Whether you’re 16 with painful periods, 26 and prepping for conception, or 36 navigating the postpartum world, your pelvic floor is part of your story. It’s time we stop ignoring it—and start listening.
