The process of getting pregnant, going through pregnancy and having a baby is possibly the biggest physical feat a woman could ever experience. But, it’s a HUGE event and a massive challenge on the body — both the outside, inside and mental aspects as well.
The early weeks and months following birth are a blur with the new challenges of motherhood. At 6 weeks post-partum, you’re expected to have a review with your GP, Child Health nurse, obstetrician or midwife and a paediatrician. The vast majority of what goes on in these appointments is centred around the health and wellbeing of your newborn baby. In general, the only check-ups that are involved in this for you as the mother are a screening test for postnatal depression, discussions around birth control, a pap smear and a check on the healing of any stitches. What about getting clearance to gradually return to exercise? Or getting a handle on this newfound back pain? Or this feeling of leakage whenever you cough or laugh? That’s where a check with a Women’s Health Physiotherapist comes in.
Here are a few things that a specialist Women’s Health physiotherapist can help you with at a postnatal check:
Pelvic Floor Muscle Assessment
The pelvic floor muscles are a group of muscles that form a hammock at the bottom of the pelvis from your pubic bone to your tail bone. These muscles are essential in keeping your bladder and bowel from leaking, keeping your pelvic organs in place and supporting our lower back. During the process of pregnancy, the increased weight of the baby and the placenta and the growing uterus can put immense pressure on your pelvic floor muscles. This means that the muscles can be under stress for 9 months at a time, regardless of if you had a vaginal or caesarean birth, increasing the risk of pelvic floor dysfunction. Amazingly, in a vaginal birth, the pelvic floor muscles stretch up to 4 times their normal size, can tear, pull off their bony attachments and become much weaker. Pelvic floor dysfunction may include symptoms of bladder or bowel incontinence or leakage, a feeling of heaviness or bulging in the vaginal area or any pain in the area. In the same way, you may require physiotherapy for a hamstring strain, you’ll need rehabilitation for pelvic floor dysfunction. In a postnatal assessment with a Women’s health physiotherapist, the physiotherapist will assess your pelvic floor muscle strength, tone, the orientation of the pelvic organs and walls with a vaginal assessment.
Bladder and Bowel Health
It’s extremely common to experience bladder and bowel leakage after giving birth. Your women’s health physio will ask you an array of questions, including:
- How much you’re drinking
- How often you’re opening your bladder and bowels
- Whether you feel an urgent need to get to the toilet
- Whether you have a history of pain with intercourse
- Whether you experience any urinary or faecal leakage
These concerns can all be treated with a personalised treatment protocol including exercise and advice, so that’s why knowing all the details is essential to help you, as embarrassing as the discussion may be!
Abdominal muscle assessment
During pregnancy, as the baby grows, your abdominal wall can stretch, causing a slight separation in your ‘six-pack muscles’ and connective tissue at the front of your belly. If the tissue in the midline isn’t back to being thick and strong by that stage, you will need to do specific exercises to rectify it. The physiotherapist can prescribe a personalised exercise program for you to be able to rehabilitate these muscles.
Assessment of other aches and pains During an assessment, your women’s health physiotherapist will ask and assess any other injuries or aches and pains you may have. Common complaints in the early phase include:
- Lower back pain
- Pelvic girdle pain
- Wrist pain
- Upper back and neck pain
Plan for Return to Exercise
As individual as every pregnancy is, as individual as every woman’s goals for postnatal activity is. Whether your goals are to run a half marathon in 6 months or be able to play on the floor with your baby pain-free, then discussing your goals with a physiotherapist is essential to be able to support you in getting you to safely achieve this. The physiotherapist will help to assess your core strength, functional movements and help to provide exercises at your level of strength to help get you to the impact that you need. Although the list of things women can experience after birth is long and scary, including incontinence, vaginal prolapse, back pain etc – there are things that can be put in place to help to prevent and treat these issues. You don’t need to wait for problems to occur or to worsen, you can be proactive by seeing a specialist Women’s Health & Continence Physiotherapist in the early months after delivery.