Pelvic Floor Health Exams and Pessary Fittings

Sacopee Midwives Services
Pelvic Floor Health Exams
Brenda Surabian
Maine Licensed Certified Professional Midwife
207.329.2111 ext. 1

Let's Talk About Our Pelvic Floor Health!

Speaking openly about the health of our pelvic floor and how to care for it throughout our lives is important to me. I have done specialized training with Herman and Wallace and Pelvic Health Solutions in Toronto. I hope to share my knowledge with people and help them with any Pelvic floor dysfunction they may be experiencing. It can impact our lives adversely and we can do something about it!

People that are at risk for Pelvic Floor Dysfunction are not just those who have given birth vaginally. Straining with bowel movements and poor toilet position, lifting heavy loads, high impact sports, C sections and other abdominal surgeries, lack of core strength, poor posture, excess weight, perimenopause, and menopause can all impact the pelvic floor.

There are various preventative practices and holistic health routines that can help you maintain a healthy pelvic floor. I have listed some informative links below.

One of the most important practices that we can change easily and daily is how we sit on a toilet. Squatting instead of sitting puts less strain on your pelvic floor and supports the abdominal wall.

You can purchase a specialized foot stool that positions your body so that you are squatting when you sit on the toilet called a Squatty potty or Wells step. Bricks or small stools can also be used. This is an important addition to everyone's routine.

It is wise to see a physical therapist that specializes in pelvic floor health if you have incontinence, pressure, bulging, constipation or a feeling of fullness. Both the lack of strength and inability to relax the pelvic floor muscles are often the cause of incontinence and pain during sex. This can lead to more severe prolapses.

The treatment plan begins with pelvic floor exercises, biofeedback, and mechanical devices with the goal to build coordination in the forgotten muscles of the pelvis.

If the primary treatment plan does not result in desired improvements- a pessary may be of benefit. It is a useful choice for stress incontinence, bladder or rectal dysfunction. Pessary use dates back to the 5th century. A pessary is a silicone device similar to a vaginal contraceptive diaphragm. It is a low risk treatment option. In order to use a pessary, a person needs to be comfortable with their body and able to insert the pessary in their vagina. Simple ring or dish pessaries are valuable for first and second degree prolapse and space filling pessary use helps 3rd degree. In cases where surgery is not an option then pessary use for 4th degree prolapse can be tried. Surgery is generally the last option in treating pelvic floor issues.

The key to comfortable use of a pessary is a good fit. A practitioner needs to allot the time needed to fit a person well and provide education and future support. A client will need to be willing to try more than one type of pessary.

If your pelvic floor therapist recommends a pessary please call for more information.

I provide:

  • 45 min virtual consult to review your symptoms and history and to answer any questions you may have
  • an initial fitting visit that lasts about 1.5 hours
  • a hour long follow up visit in order to confirm the fitting
  • I provide ongoing virtual support as needed.
  • discounted fee schedule 150.00- 500.00
  • I do not bill insurance but will provide you a statement to request reimbursement. 
Helpful Resources

Info for Postpartum care-

Now that you and your baby are settling into the rhythm of early parenting.... It is time to catch up on self care! Generally I offer a pelvic floor exam for you at about 8 weeks postpartum. We may have found a healthy pelvic floor or some weakness in your pelvic floor, like a cystocele or rectocele or perhaps A prolapse that may feel heavy and bulging and you may be having some incontinence and urgency to urinate. We have spoken about the importance of pelvic floor therapy. You may have not had an opportunity to go see a therapist as of yet or perhaps you have! Yeah for you !

I may have fitted you for a Pessary after you have seen a PT and used exercise to overcome any issues you have. It is a great tool but I always encourage PT first!

I know that PF Therapy is not always covered by insurance and sometimes you cannot justify spending the money. Fear not! Go to the internet and check out these amazing Pelvic Floor Therapists that will give you a great Intro and explanation of the pelvic floor and some beginning exercises to do on your own at home until you can make it to see your local Pelvic Floor Physical Therapist!


This Aussie PT has an extensive video collection


Fem fusion with Doctor Bri videos are great. There are many! Explore!


Yoga with Adriene. She is great and this video is dedicated to strengthening the pelvic floor. 


The benefits of Pessary Use in Prolapses


The benefits of Pessary Use in Prolapses



UK and Australian info websites where people routinely see a Pelvic Floor Therapist after birth!


Michelle Lyons explains non surgical treatment of pelvic organ prolapse

Squatty Potty

Toilet devices to encourage squatting