Okay, so you had a baby. Then 6 weeks later, you had your follow up appointment with your OB, and you were cleared to resume exercise and sexual activity, and then off you go! But… now what? You still feel like a stranger in your own body. You’re leaking and maybe even still bleeding, your abdomen feels like mush, and you’re in pain. Or, maybe you feel great, but know that you’re miles away from your pre-pregnancy fitness level, and have no idea how to go about getting back to exercise safely. Your beautiful newborn is getting the love and attention he or she needs from the medical community to continue to grow, develop, and thrive, but what about you, Mama?
Follow up care for postpartum women in the United States is largely disappointing. There is a huge lack of education for women in how to navigate the postpartum recovery period, especially for those who have impairments following delivery, whether you had a vaginal delivery or caesarean (c-section). These impairments can include, but are not limited to, incontinence, pelvic and abdominal pain, pelvic organ prolapse, diastasis recti (separation of the abdominal muscles), scar tissue build up from an episiotomy or c-section, and a lack of awareness of your pelvic floor and core muscles. Your risk for developing one or more of these impairments increases with multiple deliveries, making it even more imperative that you seek out help for recovery and return to full function.
Physical therapists (PTs) who have specialized training in Women’s Health (WH) are your #1 postpartum ally during your recovery period and can work with you to address your symptoms, and get you back to feeling like a human again. A WH PT will help you to relearn how to engage your pelvic floor and core muscles, both of which go through a lot of trauma during pregnancy and delivery, no matter the delivery method. For women with a diastasis recti, a WH PT can help guide you through exercises to properly load your abdominal wall and deep core muscles to facilitate closure of the separation, which will look different for each and every person going through recovery. A vital aspect of this is also learning pressure management strategies, which includes proper breathing facilitation. This is important in management of pelvic organ prolapse in addition to diastasis recti. It’s crucial to restore function to the pelvic floor and core during postpartum recovery, but it is equally important to consider the rest of the body as well, as the changes to posture, hip stability, hypermobility, rib and diaphragm function, and muscle tension that occur during pregnancy can all carry over into postpartum, and are deeply connected to the core and pelvic floor.
Additionally, a Women’s Health PT will teach you how to engage your muscles to move safely throughout your day to day activities using proper body mechanics, particularly during things like lifting and carrying your child, getting up and down from the floor, managing heavy strollers and carseats, and for those who are breastfeeding, proper positioning to limit strain to your middle and upper back. For example, a WH PT can instruct new moms in the importance of frequently changing sides when carrying your baby rather than always using one side over the other. Using proper body mechanics is crucial, particularly when you have more than one child at home pulling you in all different directions.
What is perhaps most important of all is that a Women’s Health PT will help you reach your postpartum recovery goals, whatever those goals may be. While it’s important to have the guidance of a WH PT during this process, recovery also requires patience and grace, and it is certainly not an easy process. Your body just created life, and it’s beautiful. Remember to be kind to it.