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She booked the appointment. She showed up. She wants something to change. And she still hasn't done her exercises.

Sónia Coelho Cristóvão, physiotherapist and PhD researcher at the University of Gothenburg, kept seeing that in her clinic. So when she started building a digital pelvic floor program for Sweden's public healthcare system, she went to the research first. Her new review pulled together 18 studies to ask two questions: do digital pelvic floor programs actually work in pregnancy and postpartum, and what do women say helps or gets in the way?

🔹 Why pregnancy and postpartum told two different stories in the research
🔹 The surprise: women using digital programs stuck with their training more, and got stronger
🔹 The 5 things women say make or break their pelvic floor training (spoiler: they WANT to do it)
🔹 Why tracking features can turn into one more burden
🔹 Why women still want a real person in their care, not just an app
🔹 Where AI could help programs adapt to YOU, and why she's a little more cautious lately
🔹 Kegels vs no Kegels, and why that's the wrong fight
🔹 What's next: exercise dosing and C-section recovery

If your home exercise program lives in a drawer somewhere, press play. And clinicians… when a patient tells you she didn't do her exercises, what do you say next?

This episode is education, not medical advice. Talk with your own maternity care team or pelvic floor PT about your situation.

The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there.

Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now).

Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it.

Questions or topic requests? DM me 💌

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Don't jump. Don't lift heavy. Exhale on the way up. Protect your pelvic floor from all that pressure.

Funny thing, though. Nobody ever tells you not to cough.

So where did the "too much pressure" advice actually come from? Dr. Sabine Vesting, a physio in Gothenburg, Sweden, and researcher with the MFM lab at the University of Ottawa, went back through studies dating to 1978 to find out. More than 4,000 papers screened. 52 that measured it. And not one measured it directly inside the abdomen.

She's back on the show (Ep 184 was her first visit), and we get into:

🔹 What a sensor in the vagina, rectum, stomach or bladder is really picking up when you move
🔹 Why the scary jumping numbers don't mean what you've been told
🔹 Coughing vs running, and why how LONG matters as much as how high
🔹 What the pressure data can and can't tell us about leaking on the run
🔹 How urethral support changes after a run, in runners who leak AND runners who don't
🔹 Why passive support may matter more than strength for some runners who leak
🔹 Pessaries for active women, and why "isn't that for old women?" needs to retire
🔹 Over-the-counter devices, sizing kits, and why bigger isn't better

If you've ever been told to skip something "because of the pressure," press play before you take that advice.

What's one thing you've been told to avoid because of pressure?

Find Sabine on Instagram: @BineVesting

Research mentioned:
-Vesting S, Rodrigues MP, McLean L. Measurement and interpretation of intra-abdominal pressure during physical activity: a scoping review. Int Urogynecol J. 2026. doi:10.1007/s00192-026-06635-2

-Rodrigues MP, Vesting S, Bérubé MÈ, Collins G, McLean L. The posterior urethrovesical angle in continent and incontinent women before and after a treadmill run. Int Urogynecol J. 2025. doi:10.1007/s00192-025-06460-z

This episode is education, not medical advice. Talk with your own care team or pelvic floor PT about what's right for you.

The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there.

Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now).

Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it.

Questions or topic requests? DM me 💌

Send us Fan Mail

In June, my very first mom friend texted me about a relay for her 50th. I said yes. THEN I asked what I'd signed up for.

3 running legs in less than 24 hours including night running. And I'm a morning runner, because over the years, evenings are exactly when leakage sneaks in for me, even on a walk.

So I did what I'd do with any patient. I fit myself for a pessary. It took 4 devices, a lot of frustration, self-talk, and a brain trust of PT friends talking me off the ledge.

This is a solo, fully TMI episode (you've been warned) about the whole process, start to finish line.

What we get into:
🔹 Why I stopped blaming "endurance" for leakage that shows up later in the day
🔹 Support pessaries vs space-occupying pessaries, and why that difference ended up mattering for me
🔹 The dish, the ring, the Soma and the cube: what each one did (and didn't do) for MY anatomy
🔹 Why "that didn't work for me" says nothing about what will work for you
🔹 What it was actually like wearing a cube through a relay, including the one gravel stretch where I wondered if I was about to lose it (literally)
🔹 The running research out of Linda McLean's lab in Ottawa that changed how I looked at my own problem

If you've ever been offered a pessary and thought "not for me," or tried one, hated it and quit... listen to this one. And clinicians, this one's for you too.

Oh, and our team of masters women came in second. We also brought the music. Leave it to the moms to make it fun.

Have you ever been offered a pessary? Tell me how that conversation went.

Questions about my pessary journey, or trying to find someone near you who fits them? Email me at carrie@carriepagliano.com or DM me on Instagram @carriepagliano. I'm happy to help.

This episode is education, not individualized medical advice. My anatomy, my solution. Yours may be completely different.

Chapters (approximate)
00:00 Why a solo pessary episode
02:21 How I learned to fit pessaries
05:30 My history: 2 C-sections, perimenopause, evening leakage
07:40 Is later-day leakage really just endurance?
09:40 Support vs space-occupying pessaries
12:00 Trial 1: the dish
13:00 Trial 2: the ring
18:00 Trial 3: the Soma, and why "it didn't work for me" isn't a verdict
20:30 Trial 4: the cube
24:00 Race logistics: when to put it in and take it out
27:25 Night leg: 5 miles downhill in the dark
30:30 A 5:30 a.m. porta potty and posterior wall support
34:36 Final leg: 7 miles uphill
37:00 Awareness vs discomfort
38:30 The research that changed how I saw my own problem
41:54 Your story isn't my story, and where to get help
44:16 Next up: the DC half

The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there.

Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now).

Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it.

Questions or topic requests? DM me 💌