Every single woman should have a consult with a Pelvic Floor Physical Therapist after birth. I can’t stress this enough.
It doesn’t matter if you have had a textbook pregnancy with an easy delivery, cesarean section, or two days of labor. If you have gone through pregnancy and given birth your abdominal wall and pelvic floor have experienced stress.
Pelvic floor physical therapists in the United States see only a fraction of the postpartum moms we should be seeing. We should be seeing every single one in order to give moms their best chance at having a full and healthy life after birth.
Some reasons for this disruption of care may include:
Lack of therapists in area where moms live
Lack of understanding of pelvic floor PT by primary referral sources
Time constraints/child care issues for patients
Awareness and time are the most common barriers I see to new moms attending Physical Therapy postpartum. This is a problem, moms will be happier and much more effective as parents, employees, and partners if they are healthy!
Consider this scenario:
Lisa gave birth to a healthy baby with no tearing and no complications, and therefore was not referred to pelvic floor PT. Over the next couple of months she did not develop urinary incontinence or pelvic pain and assumed she would return to her prepartum size with time.
As the months go on she lifts heavy strollers, toddlers, and car seats into the car with limited core strength. She doesn’t notice any problems, but she does notice after 6 months her body is not where she would like it to be. She enrolls in ab classes at the gym where she works on crunches, sit ups, planks, plyometrics, and v-ups.
Unfortunately because Lisa has not rehabbed her core appropriately these exercises are doing more harm than good because they are too challenging for her to perform correctly.
Lisa is disappointed and confused as to why she has seen very few improvements despite eating well and working out. She figures she is not working hard enough and enrolls in a half marathon to push herself. She trains for the half battling overuse injuries such as knee and foot pain throughout her training time, but figures these will all resolve after she tapers her training.
Lisa notices small improvements in her figure and starts to accept her “mommy body.” Overtime she tapers her exercise routine and eventually she has another child with a healthy pregnancy and birth. She notices she has even less core definition after the second child. Ten months after the birth of her second child, she develops debilitating back pain as the result of a herniated disc. This is the result of too much activity with a weak core. It’s not her fault, she was doing her best!
Lisa is also at risk of developing pelvic organ prolapse and incontinence down the road for these same reasons.
A trip to a Pelvic Floor Physical Therapist after birth could be the pivotal point where a mom learns how to protect her body from the challenges of motherhood and prepare for another pregnancy safely.
I have seen women who have silently dealt with urinary incontinence since the birth of their last child and have been unable to run, jump or play with their children for over 10 years. They have expressed to me their disappointment with feeling unable to set a healthy example for their children.
These problems can be addressed! No one should live in shame of their body or feel limited in their ability to move, especially as a result of giving birth. Give your body and chance and make sure you get in to see a Pelvic Floor PT as soon as six weeks after birth. You deserve it.