Pregnancy and childbirth are transformative experiences that impact a woman’s body in profound ways. While much attention is given to the pregnancy and delivery stages, the postpartum period—often referred to as the "fourth trimester"—is critical to a mother’s health and recovery. During this period, many women experience physical challenges related to childbirth, particularly concerning their pelvic floor health. Fortunately, pelvic floor physical therapy can offer essential support. In New Mexico, legal protections and healthcare laws help new mothers access the care they need during this time.
This post will explore the concept of the fourth trimester, the importance of pelvic floor physical therapy, and the New Mexico laws in place to support postpartum recovery.
What is the Fourth Trimester?
The "fourth trimester" refers to the first 12 weeks after childbirth. This period is marked by significant physical, emotional, and hormonal changes as a mother’s body begins to recover from pregnancy and delivery. Dr. Harvey Karp, a renowned pediatrician, popularized this term to highlight the need for ongoing care and support for both mother and baby during this critical time (Karp, 2002).
While the focus often shifts to caring for the newborn, the mother’s recovery is equally important. Many postpartum women experience issues such as:
Pelvic floor dysfunction (e.g., incontinence, prolapse)
Perineal pain
Diastasis recti (abdominal muscle separation)
Lower back pain
Addressing these issues early can improve a mother’s long-term health and well-being.
The Importance of Pelvic Floor Physical Therapy
Pelvic floor muscles support the bladder, uterus, and bowel. During pregnancy and childbirth, these muscles can weaken or become damaged, leading to pelvic floor dysfunction. Studies show that up to 30% of postpartum women experience urinary incontinence, and approximately 50% have some degree of pelvic organ prolapse (Nygaard et al., 2008). Pelvic floor physical therapy is a specialized form of rehabilitation that helps address these issues.
Benefits of Pelvic Floor Physical Therapy Include:
Improved Bladder and Bowel Control: Therapy can help resolve urinary or fecal incontinence.
Reduced Pain: Alleviates perineal, pelvic, and lower back pain.
Core Strengthening: Addresses diastasis recti and improves overall core stability.
Prevention of Long-Term Issues: Early intervention can prevent chronic pelvic floor disorders.
A study published in the American Journal of Obstetrics and Gynecology found that pelvic floor physical therapy significantly improved symptoms of incontinence and pelvic pain among postpartum women (Hagen & Stark, 2011).
New Mexico Laws Supporting Postpartum Care
New Mexico recognizes the importance of supporting new mothers during the fourth trimester. Several key laws and healthcare provisions help ensure women can access the care they need:
Postpartum Medicaid Coverage: In 2023, New Mexico expanded Medicaid coverage for postpartum care from 60 days to 12 months. This expansion ensures that low-income mothers have continuous access to medical services, including pelvic floor physical therapy (New Mexico Human Services Department, 2023).
Paid Family and Medical Leave: New Mexico’s Healthy Workplaces Act (2021) allows employees to accrue paid sick leave, which can be used for postpartum recovery and medical appointments. This law helps mothers take the necessary time to address their physical health without financial strain (New Mexico Legislature, 2021).
Breastfeeding and Pumping Protections: Under New Mexico’s "Breastfeeding Rights Law," employers are required to provide reasonable break time and a private space (not a bathroom) for breastfeeding or pumping for up to two years after childbirth (New Mexico Statutes § 28-20-2, 2007).
These laws reflect a growing recognition of the importance of comprehensive postpartum care, supporting both physical recovery and overall maternal health.
How Pelvic Floor Therapy Fits into Postpartum Care Plans
Pelvic floor therapy should be a standard part of postpartum care. In France, for example, all postpartum women are automatically referred to pelvic floor physical therapy after giving birth (Guérinet, 2018). In the U.S., including New Mexico, referrals are less standardized, but awareness is growing.
During your postpartum medical visits, it’s essential to:
Discuss Symptoms: Talk to your OB-GYN or midwife about any pelvic pain, incontinence, or other concerns.
Ask for a Referral: Request a referral to a pelvic floor physical therapist for evaluation.
Advocate for Yourself: Know your rights under New Mexico law to access postpartum care services.
The fourth trimester is a crucial period for a mother’s physical and emotional recovery. Pelvic floor physical therapy offers proven benefits for addressing postpartum challenges and improving long-term health. In New Mexico, expanded Medicaid coverage, paid sick leave protections, and breastfeeding laws help support new mothers during this time.
By prioritizing pelvic floor health and understanding the laws that protect postpartum care, women can advocate for their well-being and experience a smoother recovery. If you’re navigating the postpartum period, our team at Balanced Physical Therapy and Wellness is here to support your journey toward optimal pelvic health.
References:
Hagen, S., & Stark, D. (2011). Conservative prevention and management of pelvic organ prolapse in women. American Journal of Obstetrics and Gynecology, 204(5), 375-380. https://doi.org/10.1016/j.ajog.2011.01.001
Karp, H. (2002). The Happiest Baby on the Block. Bantam Books.
Nygaard, I., Barber, M. D., Burgio, K. L., et al. (2008). Prevalence of symptomatic pelvic floor disorders in US women. JAMA, 300(11), 1311-1316. https://doi.org/10.1001/jama.300.11.1311
New Mexico Human Services Department. (2023). New Mexico Extends Postpartum Medicaid Coverage to 12 Months. Retrieved from https://www.hsd.state.nm.us