We prepare women extensively for birth. We discuss scans, nutrition, pain relief, breathing techniques, and the safe arrival of the baby. Then, remarkably often, the conversation stops.
The woman who has carried and delivered that child is expected to return to work, family life, and household responsibilities, while the physical aftermath of pregnancy and birth remains largely invisible.
On The Lisa Burke Show, physiotherapist Sarah Elmquist and healthcare communication researcher Dr India Pinker joined me to discuss two areas of medicine that are easily dismissed as private, awkward, or somehow secondary: pelvic floor health and empathy.
Yet both affect something fundamental, our ability to feel safe and understood within our own bodies and within the healthcare system.
Sarah works in postpartum rehabilitation and pelvic floor physiotherapy. She describes postpartum care as far more than the weeks immediately following delivery:
Postpartum is everything that happens after giving birth. Everybody is different and every body is different.
Pregnancy and childbirth can affect the abdominal muscles, pelvic floor, internal organs, and a woman's entire perception of her body.
Yet many women are quietly absorbing symptoms that should be discussed and assessed. They avoid trampolines, running, lifting shopping bags, laughing too freely, or playing energetically with their children because they fear leaking urine.
The most troubling part is that many do not consider this a medical problem. They assume it is simply the price of motherhood:
It's almost normalised as part of motherhood. 'It happens to me as well. It's just how it is.' It doesn’t have to be.”
Incontinence can affect women and men, and it can appear long before old age. Shame can gradually restrict exercise, intimacy, travel, and social life.
And because people rarely talk about it, the true scale of the problem is difficult to measure.
Luxembourg has an advantage in offering many women pelvic floor reeducation after childbirth, sometimes before any serious problem has developed. Sarah compares this to strengthening any other muscle group as protection for the future.
For those who never received postpartum care, the message is equally important:
Things can be reversed. Just as you can retrain a leg muscle, the same goes for the pelvic floor. You can always train it again.
Pelvic floor physiotherapy is not simply about preventing an embarrassing moment, it is about restoring choice. A woman who can laugh, jump, exercise, or move without fear has recovered a degree of freedom.
As Sarah put it, learning to sense and control this frequently ignored part of the body can itself be empowering: "If you can feel your own body and know how to engage those muscles, that's empowerment as well."
Dr India Pinker, a postdoctoral researcher at the Luxembourg Institute of Health working on healthcare communication in oncology, brought a different but connected angle: the taboo isn't just about what patients won't say to doctors, it's about what medicine itself doesn't know how to teach.
Pinker's PhD research at the University of St Andrews looked at clinical empathy: not the everyday kind, but a trainable, boundaried skill doctors need to protect both the patient and themselves.
She notes:
Empathy is arguably one of our most natural sort of elements of conversation, elements of connection as human beings. However, it's highly controversial, believe it or not, in medicine itself.
Her research has found that empathetic communication correlates with higher diagnostic accuracy, better patient adherence to treatment, and, counterintuitively, lower burnout among healthcare professionals themselves. She pointed to universities like St Andrews and Leicester that now build communication skills training in from year one, producing measurably more confident clinicians by graduation.
One of the more striking threads of the conversation: patients increasingly turning to AI chatbots as informal counsellors. Pinker flagged the risk plainly:
AI is usually, depending on how you program it, essentially made to please you... it's not going to push back at key moments where you need pushback from a trained professional.
She noted that AI is fairly predictable: patients, and good clinical care, are not. Validation without push-back can feel good in the moment, but it isn't the same as care.
Whether it's a pelvic floor exercise a doctor never prescribed, or a diagnosis delivered without space to ask a second question, both guests circled the same idea: Powerlessness follows patients who aren't given information, and communication, spoken or physical, is the cheapest, least-used treatment in medicine.
As Pinker put it:
Communication is the thing that we do every single day in care. It's used more frequently than drugs, for example, for treatment, yet it's the thing that we don't test in the same way.
Connect with our guests:
Listen to the full episode on RTL Play, RTL Today Radio, Apple Podcasts, or Spotify.
