Stardard of Care

As a Physical Therapist, I used to see patients after surgery or other procedures all the time.  Before I became a Women’s Health Specialist, I would see patients after injections, surgery, and many other procedures.  Treatment usually would last anywhere from 6 weeks to 6 months. Treatment usually consisted of manual therapy and exercise to decrease swelling, improve blood flow, and improve alignment of the bones affected in the area.  We also would focus on improving strength of muscles surrounding the area and re-train the body with its new normal.  These are very common physical therapy protocols that are accepted by any insurance company all over the US. However, this is not the case with issues that come on during the post-partum period.

Standard of Care Post-partum

So, why is there no protocol for physical therapy after having a vaginal birth or a C-Section? There are still bones, muscles, ligaments, nerves and vascular tissue that have either been injured or stretched out. Shouldn’t they be treated just like a procedure on someone’s shoulder? In other countries, there are weeks and months of post-partum care and even more if you had a C-Section.  Why have we failed moms so bad in the US?

What happens to the Core and Pelvic floor during Pregnancy and Labor/Delivery?

During pregnancy, a growing belly does two main things to inner core muscles. It restricts the full range of motion of the diaphragm and it stretches them.  Like other pregnant and post partum muscles, the core, pelvic floor, and diaphragm will be more prone to be relaxed.  As far as the pelvic floor, the growing baby places pressure downward and will cause the pelvic floor to stretch.

After childbirth, some women will need to retrain the entire postnatal body, but most postpartum women will need to specifically strengthen the diaphragm, the core and pelvic floor musculature.  During childbirth, there is high likelihood that there will be severe damage to the pelvic floor and the core.  The Pelvic floor usually is stretched, torn and possibly cut during a vaginal birth and the core is surgically severed in a C-Section.  

Core Muscles Include:

• Multifidus
• Transverse Abdominus
• Psoas Major
• Pelvic Floor

The US standard of Care After Having a Baby

There is currently no standard physical therapy protocol for post-partum care.  A C-section is considered major surgery, just like a hip replacement. However, its not considered an injury so, it is not treated the same. However, not getting treatment after a C-section is like having a hip replacement surgery and telling the person to “Go home and heal; I’m sure it will work out OK.” Not to mention the added challenge of having a newborn baby with a recovering mind and body.

If the government isn’t going to mandate good post-partum care automatically in the US, women need to advocate for themselves and get the care they need now.  The pelvic floor and core should be treated like any other part of the body and needs specific treatment in order to prevent further problems later on in life. 

Lets Create the Standard of Care

As a Women’s Health Physical Therapist, I treat many conditions.  Most of them are preventable, if only women got the treatment they needed to earlier on.  It should be a standard of care in our country to go through an exercise program during pregnancy and follow-up with a health care provider 2-6 weeks after having. This will start the rehabilitation process with treatments up to 3 months post-partum at the minimum.  There would be less post-partum depression, improved energy, improved stability and less problems down the road including diastasis recti, pelvic organ prolapse and incontinence.

We can Help!

If you are a pregnant mom or post-partum ( 6 weeks or 40 years) please see a women’s health physical therapist!  We can help you get the care you need!  Please contact Christina Trautman at www.thepelvicfloorplace.com for a free 15 minute consultation! On our website, you will find more education on prenatal https://thepelvicfloorplace.com/prenatal-physical-therapy/, post-partum https://thepelvicfloorplace.com/postpartum-physical-therapy/ and general pelvic floor rehab https://thepelvicfloorplace.com/pelvic-floor-physical-therapy/.