3 Things That Surprised Me So Far as a Pelvic Floor Physical Therapist Who Is 20 Weeks Pregnant

Surprise! Our own Dr. Rachael McGuinness PT, DPT is pregnant and we wouldn’t be happier! Read below to see the top 3 things she’s surprised by being a pregnant Pelvic Floor Therapist!

As a pelvic floor physical therapist, I’ve worked with hundreds of pregnant and postpartum patients. I’ve heard countless stories, given plenty of reassurance, and felt confident in my understanding of what to expect. But now that I’m 20 weeks pregnant myself—wow. Experiencing it firsthand is a whole different story. Here are three things that have truly surprised me so far:

1. First Trimester Fatigue Is No Joke

I’ve heard it from my patients, my friends, my family: the first trimester is brutal. But hearing it and living it are two different things.

From weeks 8 to 15, I was clocking 14 hours of sleep a day. That included 10 hours at night, a 1-hour lunchtime nap, and a 2–3 hour nap after work. I was canceling weekday plans, skipping workouts, and ignoring calls from my mom (sorry, Mom!)—because I was asleep.

As someone who thrives on social connection and loves being on the go, these changes hit me hard emotionally. I expected to feel this kind of shift after the baby arrived—not right away. That surprise brought on a wave of anxiety about the changes to come, which I now understand is completely normal.

The good news? At 20 weeks, I feel like I’ve gotten about 90% of my energy back. Happy hour at Black Lamb, anyone?

2. Strength Training Is Still Going Strong

Another surprise: my strength has stayed relatively stable.

Even though I missed some workouts during the first trimester, I’ve been able to maintain my routine better than expected. I am a creature of habit and love movement - and am proud to say that I’ve been following the same weekly strength program for 10 years. So missing workouts—combined with being pregnant—brought up some anxious thoughts. Even I, as a pelvic floor PT, couldn’t completely silence the inner voice saying, “What if I lose all my strength and never get it back?!”

Rationally, I know that’s not true. Emotionally? It’s harder to believe.

I haven’t made huge gains, but I haven’t regressed either. I’ve modified some core exercises—not because they’re “easier,” but because they’re better for me right now. This has felt empowering, not limiting. I’m genuinely proud of myself for embracing this mindset shift. I wasn’t sure if I could.

Consistency before pregnancy definitely helped. But I also know I’m lucky that nausea and sickness weren’t part of my first trimester. That would have made this journey completely different.

3. Strange Sensations Are Part of the Deal

I haven’t felt fetal movement yet, but I have felt some strange new sensations since about week 6.

As a provider, I understand how relaxin increases joint mobility during pregnancy. As a pregnant woman—I now know exactly what that feels like. It’s the odd tug across my lower abdominals when I stand up from the floor. It’s the tailbone “shift” I feel during long walks. It’s the different kind of muscle recruitment I experience during core work in fitness class.

None of this is painful or injurious. But feeling it all firsthand has helped me empathize with my pregnant patients on a new level. I now better understand how, without knowing the “why” behind these sensations, they could feel really alarming.

Even though I do know the why, I’ve had to remind myself of it more than once!

Stay Tuned!

I’ll be back with another update after the next 20 weeks. Until then, I’ll be continuing to learn, grow, and support my patients with a whole new layer of understanding.