Physical Therapy or Doula Services? Why Not Have Both?
As you navigate pregnancy, there’s so much information out there to sift through for birth and postpartum. You’ll quickly find there are more support options than ever before, which is amazing, but can also feel overwhelming.
What does everyone actually do?
And how do you know what kind of support will be most helpful for you?
One topic that’s been coming up a lot lately in our practice is the difference between doula and pelvic floor physical therapy services (especially when it comes to birth prep and maternal support). This is a great time to highlight both of these services and discover how complementary they are to each other.
So let’s break it down! And spoiler alert: it’s not really about choosing one or the other. When it comes to PT and doula support, we’re team, “why not have both?”
Doula
Doulas are all about you and your pregnancy journey. These trained professionals provide physical, emotional, and informational support before, during, and shortly after childbirth. Think of them as your prenatal mentors and birth coaches—there to help you create a birth plan that reflects your wishes, offer reassurance and guidance during labor, and provide nurturing support as you transition into life with your new baby.
Here's what the support of a doula often looks like:
Prenatal
Commonly 1-2 visits pre-labor during the late third trimester, but some offer more or even unlimited visits.
Access to unlimited messaging and phone calls.
In-depth creation of a birth plan, including but not limited to:
Delivery location
Preferred delivery method
Preference for assisted tools during delivery (example: forceps, vacuum, etc.)
Primary support person/people
Medicated and non-medicated pain management options
Delivery room preferences (lights, noise, clothing, comfort items, touch, movement, amount of monitoring)
Delivery position options
Options if a c-section is required (draping, monitoring)
What to do with the placenta and cord blood
Post-birth newborn care (cord cutting, skin to skin, first meds and vaccines, bathing, feeding, circumcision, where baby sleeps)
Post-birth maternal support (sleep allowance, breastfeeding, parent with child at all times)
Provides support as a birth coach and mentor.
Helps educate about nutrition, lactation, overall wellness, emotional support, and pregnancy complications.
Labor and Delivery
Remains by your side throughout labor and delivery.
Helps communicate your birth plan to medical staff.
Works to include your partner to help them feel involved.
Advocates for your needs.
Provides comfort measures (breathing, massage, position changes, relaxation, heat packs, shower or bath, etc.).
Coach through pain management.
Keeps you updated on labor progress.
Provides emotional support.
Supports immediate newborn care, including calming, soothing, and breastfeeding.
Postpartum - Daytime
Typically from birth to up to 12 weeks postpartum.
Physical, emotional, and other non-medical support for the family.
Helps with household chores (light cleaning, baby’s laundry, dishes, etc.).
Caring for older children.
Preparing snacks and meals.
Breastfeeding tips and support (as well as pumping and bottle-feeding).
Holds your baby while you shower or care for other children.
Accompanies you during your first outings with the baby.
Listening to your concerns about the baby, yourself, older siblings, partner, etc.
Provides additional mental health or medical resources.
Postpartum - Nighttime
Similar duties to a daytime postpartum doula, but includes nighttime care of the baby so you can get more sleep.
Brings the baby to you for feedings or feeds the baby from a bottle.
Helps bring water and snacks for feeding.
Assists with latching.
Changes diapers and helps the baby settle back to sleep after feeding.
Cleans bottles and pumping supplies.
Pelvic Floor Physical Therapist
Pelvic floor physical therapy is a specialized branch of physical therapy that focuses on supporting and strengthening the muscles of the pelvic floor and core—especially during pregnancy and postpartum. These muscles play a major role in stability, bladder and bowel function, sexual health, and preparing your body for labor and delivery. Prenatal physical therapy helps address common discomforts like back pain, pelvic pressure, or incontinence, while also helping you build strength, improve mobility, and feel more physically confident as your body changes. It's all about setting you up for a smoother birth and a more complete recovery afterward.
Care is typically offered monthly, bi-weekly, or weekly throughout your pregnancy—from fertility support all the way to your due date—and can resume as early as 3–4 weeks postpartum to help with recovery.
Fertility Support (Preconception)
Cycle tracking.
Hands-on manual treatment to help with the mobility of reproductive structures (some PT’s offer Mercier Therapy, an innovative modality focusing on pelvic organ mobility to enhance reproductive wellness).
Beneficial for those facing fertility challenges.
Prenatal
Helps prepare the body physically for the demands of labor, delivery, and newborn care, setting you up for a successful recovery.
Care can be provided anywhere throughout the 0-40+ weeks of pregnancy.
Helps manage pelvic floor conditions including incontinence, constipation, pubic pain, tailbone pain, and pelvic pain.
Perineal tissue stretching to reduce the risk of tearing.
Breathing education and practice for labor and delivery.
Practice birthing positions.
Practice relaxation strategies to reduce muscle tension.
Incorporate Spinning Babies® techniques to encourage optimal baby positioning and improve pelvic balance and mobility for labor.
Discuss birth plan options including pain management, type of birth, and helpful items during birth.
Address any musculoskeletal concerns or discomforts that occur during pregnancy.
Recommends pregnancy/postpartum support wear (e.g., belly bands, perineal compression shorts).
Hands-on techniques to reduce muscular tightness and pain (soft tissue massage, fascial release, cupping, dry needling, and kinesiotaping).
Stretching to help hip and spine mobility during labor and delivery.
Global body strengthening to support newborn care and improve postpartum recovery time.
Modifying sleep positions.
Safe body mechanics for workouts, tasks around the house, work duties, caring for other children, and pets.
Postpartum
Postpartum PT can begin as early as a few days postpartum, but most commonly, the first visit is 3-4 weeks postpartum and continues until you’ve met your postpartum goals
Assess and treat pelvic floor muscles, diastasis recti, pelvic organ prolapse, urinary or bowel issues, and painful intercourse.
Bladder training and urge suppression techniques for better bladder control.
Re-establish good breathing mechanics.
Postural strengthening and appropriately progressing strength to reduce the risk of injury.
Help with scar tissue healing (vaginal tears or c-section).
Manage musculoskeletal concerns that commonly occur with newborn care.
Safe and helpful body mechanics for newborn care (feeding, car seat carrying, baby wearing, etc.).
Creating an at-home exercise program to support progress and recovery.
Guidance for return to running and working out postpartum.
So…What’s the Main Difference between Doulas and Physical Therapists?
There’s definitely an overlap. Both doulas and physical therapists assist with pain management strategies, birth plan discussions, and labor and delivery positions. But the biggest difference is:
Doulas are able to provide crucial support during labor and delivery, as well as help with care and support in the home for the entire family as you recover postpartum.
Physical therapists are trained to help get your body physically ready for the birthing process and follow-up afterward to help your body recover so you feel strong, capable, and confident.
Why Don’t We Have Both? Why They’re Better Together.
Because of the differences between our two professions, they complement each other beautifully! Having both doula services and physical therapy services fills in the gaps that one profession may not be able to provide alone. Working together as a team, you’ll get the best of both worlds to help you have a successful pregnancy, labor and delivery, and postpartum recovery.
About Pelvic Health & Wellness
Pelvic Health & Wellness was built with you in mind. We practice whole-person, individualized pelvic floor physical therapy in a caring and safe environment. Our physical therapists specialize in treating pelvic health concerns such as pelvic floor dysfunction, bowl and gut health, pain, prolapse, constipation, incontinence, fertility, and various pregnancy and postpartum-related conditions.
We understand that being ready to talk about and address your pelvic floor wellness concerns comes from a place of strength. We are here to support and encourage you on your journey back to health so you can return to doing what you love! If you are ready to take the first step in reclaiming your pelvic health and wellness, don't hesitate to get in touch with us today.