Most women these days are at least passingly familiar with the term “pelvic floor”—perhaps from your Pilates class (as in “scoop in from your pelvic floor”). But, if you’re like me, you probably just nod at your instructor and tighten something down there, not totally sure where—or what—the pelvic floor is. So, here’s the scoop: it’s the space between your vagina and anus that supports pregnancy—not to mention continence and fabulous sex.

It stands to reason that if we’re not too dialed in with this part of our body, then it probably is in need of some love and attention. Enter Holistic Pelvic Care, a burgeoning area of women’s health that puts the pelvic bowl (and its floor) in the spotlight.

“This is literally where creation happens,” says Kate Coletti, a midwife, bodyworker, and practitioner of Holistic Pelvic Care. “It’s the space we hold for what we’re trying to birth and create in our life, and with a healthy root system it just works better. I know it sounds woowoo and such a huge thing to say, but if you think about the pelvic bowl being the root chakra, the base of all the chakras and our energy system, when we restore our root we have the potential to heal our lives.”

Holistic Pelvic Care (HPC) is an intravaginal therapy practice combining physical and energetic tools, and was created by Portland-based master physical therapist Tami Lynn Kent in the early aughts. Since developing this treatment, Kent has taught intensive workshops to hundreds of practitioners, like Coletti, who is currently one of just 40 preferred practitioners in the country. Eager to check in with my pelvic bowl—after all, I was 8 months postpartum with my second baby, whom I delivered 18 months after my first, both at home—I accepted Coletti’s invitation to visit her studio in Sonoma for a first-hand experience at HPC.

I’m greeted warmly at the door: “It’s so great to see you again, mama!” (Full disclosure: Coletti was my midwife at both of my births.) I follow her back into a cozy room, tucked inside a gyrotonic studio a few blocks away from Sonoma Square. Laying down on a massage table, I gaze around the space, images of sacred feminine iconography fill my vision, and a shelf laden with crystals glint in the dim light. Coletti sits beside me and explains what the next hour or so will entail.

“I encourage you to feel it to heal it,” says Coletti. “This is an opportunity for deep feeling. We tend to think that all of the emotions are stored in our brains, but so much of it is stored here in our tissue. This practice is for clearing those tensions and traumas from our body.”

With my permission, she gently inserts one finger (sheathed in a pink glove) and begins to very slowly sweep through my pelvic bowl. “There are a few energies I call in for HPC, the first of which is a grounding cord visualization. Imagining a spiraling cord sending a deep root into the earth will help create a drawing effect out of the body. As you release the tissue, and the fascia release, anything that needs to leave your body will more easily be able to with this visualization.”

I close my eyes and breathe deep, sending my breath down through my body and further still down the cord. Coletti’s presence is felt, but not uncomfortable—we’re able to maintain the conversation as she moves through a series of gentle pressure points. Ever so subtly, I feel a tiny fold unfurl. “Ooh, did you feel that,” asks Coletti, with an excitement that must be specific to this line of therapy. I was actually very proud to say I had indeed felt that, which I took as I sign to mean that I was pretty in tune with my pelvic bowl after all.

Afterwards, I sat down with Kate and asked her to break down the practice for me—what it entails, and why it’s effective.

Physiologically, what kind of change occurs in an HPC session?
“The way acupuncturists read pulses, I read vaginas. Sometimes it’s a small change. What I’m really doing is following your tissue, letting you guide me where I need to go. After applying light pressure, holding the fascial layer, I can revisit the same spot and feel it completely transformed. For instance, women in menopause or those who are nursing, like you, have depleted estrogen and the tissue becomes dry. This practice restores the fluffiness to the tissue again.”

Is there any woman who can’t benefit from HPC?
“I think most women will find benefit, even if they haven’t been pregnant or birthed. I think it’s an amazing way to connect with your body and self. The only circumstance in which I won’t treat someone who comes to me is if it’s clear she’s not ready to delve into this process. For example, if she disassociates while discussing her history, discussing a trauma. It’s essential that patients stay present when we’re working in such a sacred space.”

Can HPC be used as a fertility tool?
“Holistic Pelvic Care does not get you pregnant, but it can be very supportive on that journey. When we do our intention setting we get grounded, we start to release tension and find balance. We prepare the soil and plant seeds of intention and that is incredibly powerful.”

If someone is interested in HPC after birth, can you tell us what she could expect?
“One of the offerings I have is Postpartum Rehab. It’s Holistic Pelvic Care that’s tailored for the postpartum mom. We check for diastasis, prolapse, and as they’re learning how to connect their brain to their pelvic floor again, we do a more thorough teaching of conscious kegels. I offer lots of tips and tricks on how to retrain and strengthen the floor after birth. I like to give an honest reflection of what the journey is that lies ahead after birth—falling in love with her body again, connecting sexually with her partner, and feeling strong.”

Clearly, this is a more thorough and sensitive postpartum check-in than we get from our OB after six weeks.
“Don’t even get me started! The standard of postpartum care is just a void. At six weeks, it’s like ya, I’m fine now. In midwifery care, as you know, we give in-home visits 1, 3, 5, 7 10 days, two weeks, six weeks, and we give real care that could address an issue right away before it becomes severe. We can offer pelvic floor strengthening right away. But in general, there isn’t a lot of training that way. It’s like ok, it’s been six weeks, you can workout and have sex again.”

If you are a woman with a traditional OB, and you want to help yourself with postpartum pelvic care, what do you recommend?
“Everyone can start conscious kegels immediately after giving birth. Strengthening can begin right away. Most women have some form of incontinence—and it usually starts to improve on its own—but we can start helping very early by doing conscious kegels. I like to use the elevator kegel: Start with a deep inhalation, everything expands, and as you exhale, close the doors and lift the whole floor up, up, up. Pause. And then you go down, down, down. That’s a conscious kegel. You can add weight eventually, like Yoni eggs, you just have to make sure you’re doing kegels the right way before adding any weight. And, you should be doing them often, like 25-50 over the course of the day.”

Are there any particular weights that you recommend?
“I recommend LELO Luna Beads because they offer a lot of variations in weight and they’re beautifully done. Use them only while doing strengthening exercises and don’t keep them in all day. Occasionally I recommend jade, moonstone, or rose quartz eggs. If you have a prolapse of any kind an egg is way too heavy.”

And during pregnancy, can we benefit from a session with you?
“While Holistic Pelvic Care is not designed for during pregnancy, I offer something called bodywork for birth preparation in the third trimester to help pave the way for birth. I help find your pushing muscles and release tension that could make birth more challenging. I think it’s such important work in preparation for birth.”

If a woman has a caesarean, would HPC still be beneficial for her?
“Absolutely. Just the event of carrying a baby does a number on our pelvic floor with the increased weight and the softening of the tissues. Also, babies often hangout on one side of the uterus or the other, creating an imbalance. For caesarean deliveries in particular, scar tissue develops, so through HPC there’s a lot of release work we can do from the inside, and I would also do fascial release over her scar.”

Is there any take-home work we can do on our own?
“Definitely. In the book Wild Feminine, which my teacher, Tami Kent, wrote, she outlines how to map your own pelvic floor and do release work. When I teach it, I recommend using gentle pressure on areas that feels tight or tender, you don’t need to use very much pressure, let it release around your finger. I also think it helps to do this practice while you’re a little distracted so that you don’t place too much attention on what your finger is doing. S-curved wands are great too for reaching certain areas; the Crystal Wand—which is made from plexi—is one I recommend.”

Are there any particular herbs or nourishing infusions that we can take for pelvic care?
“Really the way we nourish our tissue is eating a good diet and taking care overall. If we’re depleted—in Chinese medicine they say it takes five years to restore our chi after birth—we have to feed ourselves to have optimal health. As far as pelvic health, vaginal steaming or yoni steams are a really beautiful nourishing way to infuse the tissue. It brings blood flow and energy flow to the root. It’s great to steam at the end of our moon cycle, after the PH changes.”

How about some additional reading on the subject?
“Wild Feminine, by Tami Kent, for sure. I would also strongly recommend Sherry Winston’s book, The Women’s Anatomy of Arousal. These are both good ones to keep in the bedside table drawer.”

For more on the practice, check out Temi Lynn Kent’s TEDX Talk, dubbed “The Vagina Whisperer.”