We believe all women should have a postpartum pelvic exam and a supportive treatment plan with guidance from a specialized physical therapist. This is usually initiated 6 weeks after vaginal birth or 8 weeks after cesarean birth and should absolutely be a standard of healthcare in the US (another blog post, perhaps?). New moms have numerous physical postpartum concerns. Whether it is a urinary or bowel concern, a sense of pelvic heaviness/pressure, perineal discomfort, diastasis recti, or back pain, these can all be symptomatically overwhelming. And often these are the symptoms that can fall through the medical ‘cracks’ with standard postpartum care.
Ginger Garner sums this up with a beautiful blog where she quotes Robyn Lim, a maternal health advocate.
“All too often, the only postpartum care an American woman can count on is one fifteen minute appointment with her doctor, six weeks after she has given birth. This six-week marker ends an arbitrary period within which she is supposed to have worked out most postpartum questions for herself. This neglect of postpartum women is not just poor healthcare, it is abusive, particularly to women suffering from painful physical and/or psychological disorders following childbirth.”
So, hopefully we can agree that a skilled pelvic examination 6-8 weeks postpartum should be a standard for women’s health and wellness. However, I have also seen the value supporting women even earlier in the postpartum period.
We believe new moms greatly benefit from early access to a pelvic physical therapist for general postpartum education.
We believe, with early postpartum support and education, (and with continued guidance beyond 6 weeks), women can become more mindful of postures and behaviors that exacerbate symptoms. A pelvic examination would NOT be indicated at this time, but general education and support is indicated. Small bits of immediately applicable information help women feel supported and confident that they can have a positive impact on their postpartum body. Navigating the do’s and don’ts is overwhelming and, quite frankly, the approach should be individualized rather than integrating general info available on the internet.
We believe it is important to provide a safe, open and supportive environment where new moms get extended one-to-one time with a specialized health care provider (that’s us!). Because of this, we are able to screen and make early referrals as necessary for any other medical concerns.
We believe (and know!) that women want reliable and individualized postpartum medical information sooner rather than later and seeing a pelvic physical therapist is certainly a safe and cost-effective resource. A recent client of mine was referred in her early postpartum period, about 1 week after giving birth. She had numerous concerns about the physical sensations she was experiencing in her newly postpartum bod. Most concerning for her was a sense of heaviness or ‘falling out feeling’ in her pelvis and stress on her perineal tissue every time she moved. Although pelvic exam was NOT indicated at the time, here is what her session still included:
Standing postural education to reduce pressure in her abdominals and pelvis
More appropriate ways to hold and wear baby to promote postpartum healing
How to breathe correctly, which is essential for increasing blood flow, circulation and gentle mobilization to perineal scar tissue
Recommended baby-feeding postures to reduce strain on her neck, shoulders, abdominals and pelvis
Water intake and output goals to decrease urinary urgency, frequency and incontinence concerns
Positioning on the toilet and behavioral techniques to ease pain with bowel movement.
The above education is a partial glimpse into the information pelvic physical therapists can provide for women, which is information all should have access to! Daily I hear “I wish I would have had access to this information sooner” or “Why didn’t I know about this?” or even worse “Why did I just suffer through this for so long?” My opinion continues to be that early postpartum education, specific to each woman’s unique concerns, can help a woman feel more empowered and supported when navigating her newly postpartum body.
All women’s bodies are unique. If you would like to talk about how the above relates to your specific condition, feel free to contact me on FB. If you'd like to read more, you can visit our blog here or our YouTube Channel here.