Pregnancy is an exciting time. Giving birth is natural, but that doesn’t mean it isn’t taxing on the body. Pregnancy, labour and delivery, and the post-natal period can be physically daunting. In addition to caring for a new baby, dealing with recovery in the postpartum period, and adjusting to a completely different life (including newborn care, feeding, discharge, and risks of the baby blues, postpartum depression, and post-natal anxiety), many women also face one or more musculoskeletal conditions due to pregnancy.
The good news is there are ways to correct many common issues caused by pregnancy and birth and restore health after childbirth. Many postpartum diagnoses are successfully managed or treated with the help of a pelvic physiotherapist.
Every new mother who gives birth wonders how their body will recover from a C-section delivery or vaginal birth. Both types of delivery affect the organs and muscles of the pelvic bowl. In both cases, postpartum women can benefit from a physiotherapy post-natal assessment as part of their post-natal care regimen.
Why Should You Undergo a Physiotherapy Post-Natal Assessment?
You probably prepared as best as you could for your delivery and postpartum recovery regimen. But while there are plenty of things you can prepare for, there are some things you might not have thought about or were completely unexpected. Your body undergoes several changes during pregnancy. For example:
You Gain Weight
The weight you gain during pregnancy puts temporary pressure on the joints in your spine, pelvis, and legs, altering your posture significantly. It also puts new stress on the muscles in these regions. Some of this pressure is relieved by giving birth, but many women still need guidance on how to adjust and rehabilitate to the changes in their body during and after pregnancy.
Your Ligaments Change
Pregnancy also affects the body’s ligaments. During pregnancy, your body secretes a hormone called relaxin, which is designed to make your ligaments more elastic to allow space in pregnancy and birth. These changes are necessary and normal, and taking an active approach to pregnancy will help your body manage these changes.
Birth Injuries Can Happen
Most women who give birth vaginally will experience some level of tearing in the perineum region. Often the tears are small and don’t require stitches and heal quickly. Other women may experience more significant tears that do require stitches, or at times, surgical correction. It is important to seek the help of a pelvic health physiotherapist to ensure you recover and have adequate function of your pelvic floor muscles to prevent bladder or bowel incontinence. Other injuries that may occur are levator avulsion, or bony injuries to the coccyx, pubic bone or scarum.
With education, pelvic floor muscle training, and simple treatments like perineal massage, it is possible to reduce the likelihood, severity and impact of any birth injuries. A pelvic health physiotherapist can help you along this path to regain control of your recovery.
Your Organs Shift
During pregnancy, your organs shift to make way for a growing baby. Over the 40 weeks of your pregnancy, your body changes to accommodate the baby, but this doesn’t mean that the changes that occur during pregnancy need to affect you for the rest of your life. It’s also important to undergo an assessment before returning to pre-pregnancy activities.
Before women return to pre-baby activities or physical training, getting their bodies checked or assessed postnatally is important.
Timing
So when should you seek a post-natal assessment? The best time for a new mother to seek a physiotherapy post-natal assessment is four to six weeks post-delivery. If you’ve missed this window, don’t worry. An assessment can still be relevant for a post-natal period of up to 12 months.
We also offer Telehealth appointments if you prefer not to come into the clinic, if you live outside of Sydney, or prefer not to wait for an in-clinic appointment – so you can access us at any time and anywhere!
Potential Risks
Many people call the three months following childbirth the ‘fourth trimester of pregnancy’. This is because the mother’s body continues to change during this phase. It’s important to allow your body to heal in addition to the adjustments you’re making now that you’ve welcomed your newborn baby into the world.
Failing to prioritise your health during this time can result in common, temporary conditions that may develop into chronic issues.
Pregnancy and childbirth affect the muscles around the mother’s pelvis and abdomen. A pelvic physiotherapist can complete a thorough assessment to determine the impact and how pregnancy affected your body.
One of the most common changes that occurs in pregnancy is the stretching of the abdominal wall. In some women, this causes rectus abdominis diastasis (RAD), when the supporting fascia/ligament that runs between the rectus abdominis (your so-called six-pack muscle) stretches.
When this muscle stretches as much as it does during pregnancy, it can result in a gap between the edges of your muscles. Your physiotherapist will measure the depth and width of any separation you may have developed in your pregnancy and create a treatment plan to help you heal this gap.
What Goes Into a Physio Post-Natal Assessment?
Undergoing a postnatal assessment helps us assist you with improving pelvic stability, restoring continence, and enhancing sexual function after giving birth.
The muscles impacted during pregnancy and delivery play an essential role in your health and overall quality of life. We assess the impact of pregnancy and birth on your pelvic floor muscles, which helps us determine:
- The current strength of your muscles
- Endurance
- Coordination of your pelvic floor muscles
These muscles are affected whether you had a vaginal or caesarean delivery, and in both cases, women benefit from undergoing an assessment and post-natal care.
A pelvic floor muscle assessment is performed via an internal examination or real-time ultrasound. As a result of the assessment, your physiotherapist can assess whether you’ve experienced pelvic organ prolapse. The pelvic organs include the bladder, uterus, and bowel.
Pelvic organ prolapse occurs when one or more of your pelvic organs does not have the support to prevent them from dropping into the wall of the vagina.
Approximately half of all women who have given birth experience some degree of prolapse, which is why so many women complain of incontinence after having children. It’s a common occurrence, but it doesn’t have to be one you live with for the rest of your life.
The post-natal examination also helps determine if and when it’s safe for you to return to specific forms of exercise. If you are experiencing any symptoms, your physiotherapist will provide a rehabilitation plan to facilitate a safe and healthy return to exercise.
The goal of an assessment is to determine:
- What should be a part of your custom PFM program for correcting, preventing, and managing your post-delivery symptoms
- The appropriate post-natal exercises that support a speedy recovery and reduce your risk of chronic back pain
- Whether any musculoskeletal issues warrant a treatment plan
We can also provide bladder and bowel management devices and recommendations for when you can return to your pre-pregnancy exercise routine. If a complete return isn’t possible or will take some time, we’ll recommend the best exercises for you to do in the meantime. We’ll also assist you with applying an abdominal binder to help you manage significant rectus abdominis diastasis.
In most cases though, an at-home program is enough to improve the strength and coordination of the muscles affected by childbirth. Follow-up visits are scheduled to assess your progression and change the program if necessary.
Contact Us to Learn More
If you’d like to learn more about a post-natal assessment or are ready to book an assessment at SPC, click here.
