About Credence Therapy Notebook

I am Esther Vaughan. What follows is not a mission statement, it is a diary of four appointments.

March 2021

Six months after my second child, I mentioned to a clinician that I was leaking when I ran. The appointment lasted about eleven minutes. I was told it was extremely common after two babies, that it usually settles, and to keep doing my pelvic floor exercises. Nobody asked me how I was doing them, or whether I could. I left reassured, which in hindsight is the wrong word for what had happened.

November 2021

I went back because it had not settled. This time I was examined briefly and told that everything looked normal, so I should try not to worry about it. I understood the sentence to mean there was nothing there. What it actually meant was that a two minute look had found no abnormality it was designed to find, which is a much smaller claim. I stopped running in the mornings and started planning routes around public toilets.

June 2023

Eighteen months later, a third clinician told me my body had been through a lot and to give it time. By then I had given it two and a half years. I asked directly whether I could see somebody who specialised in this, and was told there was a long wait and that it probably would not be worth it. I did not push. That is the appointment I would change if I could change one.

February 2024

I referred myself, which it turned out I had been able to do all along. The physiotherapist took a full history, asked about my bladder, my bowels, my births and my training load, and then measured what my pelvic floor was actually doing using a pressure sensor. She showed me the number. It was low, she said so plainly, and she told me she would measure it again in six weeks. Then she wrote me a programme with sets, holds and a progression, and booked the review before I left the room.

Sixteen weeks later the leaking had almost stopped. Not entirely, and not for ever, because I still let the maintenance slide in a busy term. But the difference between appointment three and appointment four was not that somebody finally cared. All four of them were kind. The difference is that the fourth one measured something.

What this site is

A notebook. I wrote down what I learned in the order I learned it, then went back and checked every clinical claim against the guidelines and the trial evidence, because a personal account is worth very little on a subject where the wrong advice makes people worse. It covers what an assessment involves, how a programme is prescribed and progressed, what the evidence says pelvic floor muscle training fixes and what it leaves alone, how long a course runs and what it costs across several health systems, and the point at which surgery enters the conversation.

It is not a clinic. Nothing here treats you, nothing here books you in, and there is no list of practitioners anywhere on the site. The registers page exists so you can check somebody for yourself, which is a different job.

How the clinical detail stays right

I am a teacher, not a clinician. Bethan Rowsell, a specialist pelvic health physiotherapist, signs off every article before it appears, and the process she is signing off is set out on the editorial policy page. The lived experience is mine. The exercise doses, the figures and the red flags are hers to approve.

A note about this domain

Until 2024, credencetherapy.com belonged to a counselling practice in the United States. That practice closed, the domain was later sold, and I bought it afterwards. This site has no connection to that practice, no continuity with it, and no way of helping with anything relating to it. If you are looking for records, a former therapist or an appointment from that organisation, nobody here can help you, and I am sorry to be the page you landed on.

Getting in touch

I read what people write. Please read the contact page first, because it is specific about what I can and cannot answer, and about what should never go in an email.