Runner Moms Podcast | Episode 10

Normalizing Conversations Regarding Postpartum Health Challenges

Stephanie Harboe was the first runner mom to be featured over on our website after we launched in 2019 and she’s back on this episode of the podcast to talk postpartum health. Stephanie is on a mission to normalize conversations regarding postpartum health challenges. 

In this episode, we’ll dive into the importance of recognizing that postpartum health isn’t just about the months after giving birth. Stephanie will discuss her postpartum health and fitness journey and will also talk about how her journey of meeting with a pelvic floor physical therapist after giving birth to her third child ultimately helped her own mother overcome incontinence and regain normal function. We’ll also talk about ways that we as a community of mom runners can lead the charge on normalizing conversations around postpartum health.

Stephanie is a National Academy of Sports Medicine certified personal trainer and holds a Road Runner Club of America level-1 certification. She has completed numerous ultra-marathons, marathons and half marathons throughout the United States and Europe and won the 2012 Equinox 40-mile Ultramarathon in Fairbanks, Alaska, and also took first place in the 2013 Capital City Marathon in Olympia, Washington.

Connect with Stephanie:

Learn more about Stephanie Harboe on RunnerMoms.com:
Runner Mom Feature: Coach and Runner Stephanie Harboe

Support the show: https://www.patreon.com/RunnerMoms

Episode Transcript:

Introduction:

Welcome to the Runner Moms Podcast where we help women embrace their inner strength, take time for themselves and lead healthier lives. So, settle in and soak up some inspiration. Then rise, lace up those running shoes and embrace your inner strength because, momma, you run this world.

Shayla:

Welcome, Runner Moms! I’m Shayla Ebsen, Founder of the Runner Moms community. Today we’re going to take a deep dive into postpartum health. A mindset that I’ve struggled with in motherhood is kind of just shrugging at the parts of my body that don’t quite function as they used to. I’ve also been guilty of ignoring the aches and pains that creep up now and then – seeing them as the ails of motherhood rather than recognizing them as my body’s warning signs.

Only now, with three kids and 10 years after having my first child am I beginning to recognize that something can be done about the postpartum challenges I’ve silently shouldered. This recognition has grown through my conversations with other mom runners and really first began to click through my conversation a few years ago with Stephanie Harboe who is my guest on today’s show.  

Stephanie is a National Academy of Sports Medicine certified personal trainer and holds a Road Runner Club of America level-1 certification. She has completed numerous ultra-marathons, marathons and half marathons throughout the United States and Europe and won the 2012 Equinox 40-mile Ultramarathon in Fairbanks, Alaska, and also took first place in the 2013 Capital City Marathon in Olympia, Washington.

I first connected with Stephanie a few years ago and she was actually the first runner mom that I interviewed for a feature article on our website. It was a great conversation that centered on the importance of building an encouraging community of support around you. I’ll link to that article in this episode’s show notes in case you haven’t yet had a chance to read it.

Today, Stephanie is back to talk postpartum health. Specifically, we’ll be diving into the importance of recognizing that postpartum health isn’t just about the months after giving birth. Stephanie will discuss her postpartum health and fitness journey and will also talk about how her journey ultimately helped her own mother overcome incontinence and regain normal function. We’ll also talk about ways that we as a community of mom runners can lead the charge on normalizing conversations around postpartum health.

With that, welcome to the Runner Moms podcast, Stephanie!

Stephanie:

Thanks, Shayla! It’s great to be back!

Shayla:

Yeah! I’m so excited to continue our conversation and to reconnect. This is going to be great. Maybe just to start us off, do you want to introduce yourself to the listeners? Maybe tell us a bit about you and your family. A bit about your running history and maybe also a bit about your coaching business?

Stephanie:

Sure! So, as an athlete, I’ve always been active as a child and my running career just took a natural progression from middle school athlete, successful high school athlete, and then transitioning to an adult runner. As we moved around as a military family, I was exposed to so many different types of running and many different opportunities and I had a great support system and friends that would push me into discomfort.

There isn’t really anything that I don’t find enjoyable about running and challenges. I started coaching high school athletes when I started teaching high school in Washington state in 2000. Really enjoyed the high school athletic experience. Now I focus primarily on people wanting to run endurance races, all lengths and distances. Then, I work with active duty soldiers to improve their physical training, timed runs, prepare for different schools that have running components and time frames.

So, I feel like I’m marinating in a lot of different running worlds but it’s all rewarding.

Shayla:

Awesome! Yeah, thanks for that introduction. So, you have three kids and you’ve been a runner and a coach for a long time. Has postpartum health always been a big focus for you as a mom runner and coach or how has that focus evolved over time?

Stephanie:

It has definitely evolved over time. I was 30 when I had the twins and I was not able to run throughout my pregnancy due to the high risk nature of a twin pregnancy. But, I did swim a lot and I walked a lot and I had a double vaginal birth with them and a great physical recovery from that experience. I didn’t have any of the postpartum issues that we will talk about later, with the twins. But, fast forward to being 39 and having a singleton and still racing, still coaching, still in the gym all the way up to delivery. And her delivery was fast. But, my experience at that older age with the singleton was radically different then with having twins at a younger age. I was not fully prepared mentally or physically for any of it!

So, I‘ve been on this journey of wanting to learn more so other women don’t have to feel alone or isolated, that there’s shame involved in incontinence or prolapse. Any of the fun postpartum health issues that can crop up.

Shayla:

So, what were some of those notable differences between the twins and your third child?

Stephanie:

The first notable change was that I had urine incontinence. Not only when I was running again but even in the day to day life and the ability of my pelvic floor to be able to hold urine was severely compromised. When, when I felt that I had to go, it was immediate. That was really disheartening. I did struggle with some of the fecal incontinence which was a whole embarrassing situation on its own. That’s the one that really made me say, “I can’t live like this.” And I had great help. I had the resources and the pelvic floor physical therapy and I didn’t have the network of other moms to prepare me for that possibility or to guide me through it. So, I really felt on my own with my medical providers where my girlfriends had always been my greatest resource both about what we had been through but also kind of what was coming up. And, I want to change that. I want to normalize these conversations with women and not only with our girlfriends but also as a coach. How do I have this conversation with the women that I am working with in a way that they feel empowered rather than embarrassed.

Shayla:

Yeah, I say, even within the mom runners community but especially outside, I mean, there’s just jokes made, but it’s just not something that you talk about often. At least not within the circles that I’ve been in. I went a long time without even realizing there’s something that I could do about the things that I was struggling with. It’s just not something that’s in the conversation in the hospital with your doctors. Not the postpartum visits. None of that. So, I think there’s just a lot of confusion and maybe just moms throwing up their hands personally and thinking, well, this is just kind of how my body is now after motherhood and I’m just going to have to deal with it.

Looking back between your twins and when you had your third child, have you seen the broader conversation about these things changes over that time or is it still kind of the same.

Stephanie:

It totally makes sense. I can’t speak to if it has changed because I didn’t have that postpartum experience after the twins. So, my awareness wasn’t even heightened because I didn’t need those services. Now, years later, I don’t hear that conversation coming up within women runner or even with my girlfriends. When I initiate that conversation or say, “I’m working on a certification in pre- and post-natal coaching, the floodgates come open and these women share their experiences and what they have been through and what they’re still going through and they feel like, this is the way it’s always going to be. I don’t want that to be the story they tell themselves. There are resources. There are coaches. There are medical providers that can help them regain normal function so that they don’t have to choose, say, what outfit they’re going to wear for a certain activity because they might have some leaking urine. That shouldn’t be a normal way of functioning.

Shayla:

Exactly. So, do you want to walk us through, maybe, your journey, how you went about finding the resources, the timeline, just kind of what that journey of overcoming these challenges looks like?

Stephanie:

Yes. The military, we’re a military family. So, we delivered at a military facility. That postpartum journey actually started before I delivered. My practitioner had said, “We offer and have a pelvic floor physical therapist up on the third floor. Would you like to see her?” And I knew enough to say, “Yes, sign me up now!” This was before I had even delivered. I was thankful that she was proactive in offering that because I knew that when the time was right, about four weeks postpartum, that I would be scheduled to start that work. But, I’ve gotta tell ya, that time in between delivery and starting pelvic floor physical therapy was really hard. Not just recovering from giving birth and adjusting to having another child in the house, but, like I said, the incontinence, the strong urges and the immediacy. Then, occasionally, the fecal incontinence, it was like, oh my gosh, I can’t live this way. This can not start soon enough!

I had no idea what to expect. As a coach and a runner, I appreciated the process for the pelvic floor physical therapy because it’s much like training. It’s using our perceived effort and our muscle contractions to connect with the mind to control. There’s different methods of physical therapy for the pelvic floor. I had electrode sensors placed down that would measure my muscle contractions and I would see that on a screen and I would get immediate feedback and my practitioner was putting me through all of these different skills. In my mind, I thought I was doing great, but when you see the actual strength of the contraction and how I wasn’t able to hold it for as long as I thought, I was like, I’ve got work to do.

It was really humbling, but also really incredibly exciting because I could see parallels between the work I was doing with her and the work I do when I’m training. It involved a lot of mental discomfort and, runners, we marinate in discomfort on a regular basis. I just saw this as an extension of my run training. It took about eight weeks of targeted training to get to normal function again. Normal pelvic floor function and strength. So, solving the incontinence issues and the urgency issues. Shorter than some. Longer than others, but that’s what it took for me to get back to that point of normalcy.

Shayla:

Do you have any tips for women in finding a pelvic floor physical therapist? I know a lot aren’t as lucky as you were in having someone recommend or speak about this even before you had your baby. So, this might kind of be a new concept for some people who are listening, so, if they are just kind of going out on their own and finding a therapist, do you have any tips for how they can go about doing that and finding a good professional?

Stephanie:

Sure, the first thing that I would encourage women to do it to talk to their OBGYN and see what network of providers they have relationships with for pelvic floor physical therapy. There’s also a website that you can probably but at the end of the show notes where you can search by zip code for different practitioners in your area for pelvic floor physical therapy. It’s harder than you think. It’s a very small specialty but one that I hope grows over time because the need is definitely there.

Shayla:

Yes, absolutely. And a lot of the conversation about postpartum health really focuses on those first few months and few years after having a baby. How do you view the postpartum health journey?

Stephanie:

Postpartum is the rest of your life after you’ve had your first child. You’re postpartum forever and, the irony of getting older is that you can still be postpartum and have unresolved issues but you can also be transitioning into menopause and have those issues at the same time. That’s not ideal! Those two things are very difficult in and of themselves. So, to compound them by having them happen at the same time, just makes that much more life stress and takes away the mental energy that we need to spend our family, and our relationships, our work, our training. In my opinion, postpartum is the rest of your life after you’ve had kids.

Shayla:

Yeah, absolutely. So, in walking through your own journey and kind of healing your body postpartum, did it have any impact on other women in your life in kind of helping them register that there are things they can do about their own issues that they’re struggling with?

Stephanie:

Immediately after I started pelvic floor physical therapy, I called my mom. She lives 20 minutes away at the time and I said, “Oh my gosh. Mom. You should do this.” And by do this, I meant pelvic floor physical therapy because for as long as I can remember, my mom had struggled with incontinence due to childbirth. My youngest brother just turned 40. That’s a really long time to struggle with disfunction but, in her mind, she thought that was normal. I was sharing the workouts that I was receiving and speaking with her about how difficult it was for me to relearn what I was thinking with what I was able to contract in my pelvic floor muscles and she goes, “I just thought Kegels would be enough.” I’m like, “Well, it hasn’t changed your issues, so it’s not.”

We were very lucky in our very small town that our local physical therapist also was a pelvic floor physical therapist. So, my mom started working with a civilian provider and had a really wonderful experience. Challenging, different methodology than what I was experiencing, but she bought in and did the hard work and now does not have to worry about, do I have pads to wear because I might have an accident. I might have an incontinence issue. That is such a sense of freedom for her and I’m so incredibly proud because it shows that even women in their 60s can make a change because there are still a lot of years to live at that point and to not have to worry about incontinence being one of them has got to be incredibly freeing. So, it was really fun to share that experience, not at the same time, with my mom and watch her become more confident just in her daily activity because she didn’t have that little thought in the back of her mind, “Am I going to have an issue?” And that’s mental freedom.

Shayla:

Yeah, absolutely. I mean, that’s just so amazing. If you hadn’t gone through your own journey in healing and then brought that forward to her, yeah, this is something that she would have dealt with for the rest of her life. Just looking at, you know, a lot of jokes are made around incontinence in the early postpartum era, but the same thing is done with older individuals. It’s just this kind of general acceptance that, it is the way it is, and you just have to deal with. But, this is obvious proof that you don’t just have to deal with it. You can resolve these issues at any age.

What impacts of incontinence have you seen on the performance of mom runners that you coach?

Stephanie:

It’s going back to mental energy. I have a mom runner that her pelvic floor muscles can only work properly up to a certain distance and after that, the muscle tone is just completely fatigued. So, she has the desire to go farther, but the functionality piece is missing. So, when I’m working with either newly postpartum or runner moms that have some of these underlying issues, you really have to resolve the function first. I can do my part as a certified strength coach as a certified running coach, but I also know that some of the work is going to be out of my scope of practice. So, that may mean referring out to a pelvic floor physical therapist or different urology specialists depending on what the issue and take care of the physiological part first before I can work on the strengthening and toning and correct breathing and work up to that muscle endurance. So it really comes back to getting function first. That may mean a regression and none of us like to backtrack in any capacity but, if we’re looking for true long term healthy functioning, a short term regression is worth the time and the effort. So, we aim for function first. Once the function is in place and that’s not meaning that it’s perfect, but we’re not having any prolapse, major incontinence, leaking, heaviness that can occur down in that pelvic area, then we can move into earning the progressions.

We earn our progressions in run training but that also translates to in the gym and the strength training that we might all be doing at home right now. Just because we were able to do something before we had our wonderful kids, doesn’t mean that we’re going to do right back to it. A regression just means that we’re meeting and engaging the correct muscles and then working on building that strength so we can do more complicated or more demanding tasks in the gym or at home but without adding more disfunction on top of it. We have to be humble enough to say, “I need to step back and rebuild my foundation and go from there.”

That’s where I come in both as a coach and a mom. It’s like, it’s ok, I’m giving you permission. It’s ok to regress if down the road, you’re going to be a fully functional athlete. So, we earn the progressions and sometimes that mean a regression. And then, once that piece is in place and we have gradually built strength, we’re meeting them where they are, not what they were or where they want to be, but where they are that day. Then we can start building a bullet proof running body. They have the mental freedom to not worry about any of the postpartum health issues because they’ve done that work. Now, this process can take a long time. There are no quick fixes. We’re definitely delayed gratification people, runners are, and so, we can’t skip from function first to having a bullet proof body! That’s not how it works. It’s having a good coach or a good mentor, a good medical team in place to guide the expectation and chart the course forward and to celebrate the small victories. But, then to continue to push out of the comfort zone so we continue to grow and build these bodies in a healthy manner. It’s incredibly rewarding for me to be part of that journey but it’s also very gratifying for my runner moms who are going through that process. They have a support system that I didn’t have and that’s my mission is to make these conversations acceptable, normal. The floodgates come open when I open the door but, I want other women to realize that their story also has power and that they should share that with their friends and to network and seek resources because, if we’re not talking about it, we can’t help each other and that’s not ok. That goes against everything that this community is about!

Shayla:

Well, I mean, just as you’re describing it, I really just want to say that I think your mom runners are lucky to have you as a coach in their field because, as you said, they have to give themselves permission to accept that regression and a lot of moms aren’t willing to give themselves that permission or don’t know that they can give themselves that permission if that makes sense. So, just having a trusted outside influence to say, “No, it’s ok, you have to walk before you run. You need to focus on this first and then the progressions will come down the road. You just have to trust the process and give yourself that permission and then looking to the future, just that mental freedom that comes with not having to worry about these things. Yeah, then, kind of the sky is the limit when you get to that point as far as I can see.

Stephanie:

Yeah, you have described it perfectly. Just because I’m open and willing to talk about anything about my personal experience in this doesn’t mean that other women are though. And I think that’s important to remember, is that it’s asking permission and asking what women are comfortable talking about. Are they ok talking about their monthly cycle? Are they ok talking all of those other things? Do they want to talk about their birth story if it was traumatic or didn’t go the way they wanted it to? It’s me making sure that I have permission to talk to them about the topics that they’re comfortable with and, inevitably, when that trust is built that they will share others parts that they weren’t comfortable sharing before and that’s a really amazing process. But, as a coach, not to force my openness and willingness to talk about these things on others because I think it is so stigmatized. It’s really building that rapport and that support system and building trust that needs to start first.

Shayla:

Do you have any tips for what we as a community of mom runners can do to help women feel more open to discussing these things or about normalizing these conversations and also in finding support to heal their bodies?

Stephanie:

I do. I would hope that our pregnant runner moms, when they are with us and we’re having the natural flow of conversations during runs that we could talk about the postpartum challenges just as easily as we would talk about potential NICU stays. I had twins, so one of the things that I made sure I was well versed in was the NICU because that was a possibility and I wanted to be prepared for that. That was a normalized conversation. Pelvic floor issues and postnatal issues aren’t there yet. But, I think that comes with starting that conversation with our trusted girlfriends. The ones that are pregnant. It’s like, “Don’t be surprised if.” Or, “This was my experience. I’m not telling this to you to scare you but to inform you and know that, if this comes up, that I am here to listen and guide and share any resources that I may have.”

I think that’s super important, very personal with a group of women that we already know. That would be my hope as a baby step within our communities of women runners.

Shayla:

Yeah, I think that’s great advice. Just starting there and then that mom will take that conversation to her expanded group and hopefully the conversation will just expand and continue and become more normalized over time. That’s what we need. We just need to have women feel comfortable talking about these things and know that resources are available and it will just benefit us all.

Is there one main takeaway that you want to leave with the Runner Moms community from today’s conversation?

Stephanie:

Not to feel shame or embarrassment about a process that may occur as a natural result of a pregnancy. I mean, pregnancy and postpartum is wonderful and these babies are completely worth all of the effort and the sacrifice that we give them but that also that, you can return to normal function even if there is adversity afterwards. It’s being vulnerable with people that you trust in order to help yourself, allow other people to help you through that process. We talked a lot about vulnerability last year and it really comes back to that. We have to allow ourselves to share some of those things that aren’t so pleasant and slightly embarrassing. Or, in my case, it was very embarrassing. So then, other moms will say, “Oh yeah, well that was nice hearing to.” That’s not a succinct answer but…

Shayla:

That’s a great answer. You had a good quote that I want to bring up. I won’t say it perfectly this time because I don’t have it in front of me but it has stuck with me so much from our conversation. You basically said that moms have different running lives. You had a running life before you became a mom. You have a new running life when they’re a baby. You have a different journey when they go to preschool and beyond and that really ties in with this conversation as well. Your body functioned one way before pregnancy and then you face a different reality postpartum and, through the years of postpartum, different things might come up but it’s just recognizing that journey and just tuning in with your body when those cues come up or when something new or when something that doesn’t quite seem right comes up, rather than just ignoring that, tune into it and have the conversation with your close friends and seek resources that can help you through your journeys.

Stephanie:

Yes! Absolutely and as I continue to get older, I know that the menopause journey is about to start and I’m eyeballs deep in that preparation and learning and reaching out. So, I feel like I’m marinating in two different worlds that are related and yet unique. So, we’ll have more to talk about in terms of that! But, those conversations, I want to normalize those conversations too about things that are coming up because it’s gonna happen sooner than later!

Shayla:

Yeah, and as much work needs to be done on the postpartum conversations, a lot more needs to be done on normalizing menopause conversations! So, I look forward to talking with you again on that front!

Stephanie:

Yes! And, you know, that’s just another phase of our running lives. So, it’s constantly evolving and changing and just having a decent sense of humor and a lot of grace and a great network of women to get us through. I mean, none of us get through life on our own and to maintain and grow this incredible community is, I feel like it’s my purpose in life.

Shayla:

Well, I really enjoyed having you on the show today, Stephanie, and I enjoyed reconnecting with you and I look forward to continuing the conversation in the future! So, thank you again for being here today!

Stephanie:

Thank you and I appreciate the platform to allow me to share some of this knowledge and hopefully jumpstart some of these conversations amongst our running community.

Shayla:

If others want to connect with you online, where should they go?

Stephanie:

They can find my business SSF Running on Instagram and Facebook and I also have a website. Any of those three options are great for reaching out and connecting with me.

Shayla:

Great! And I’ll be sure to link to those in the show notes. Well thanks again for being here Stephanie, I appreciate it!

Stephanie:

Thanks, Shayla!

Shayla:

Thanks for listening to this episode of the Runner Moms podcast. If you enjoyed the show, I’d greatly appreciate if you’d leave a review through your podcast player as it will help other runner moms find our content. Also, hit the subscribe button to get first notice when new episodes are released. And be sure to head over to our website runnermoms.com for more inspiring stories and also to check out our collection of energizing recipes. Until next time, happy running and happy momming.

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