Postpartum
Postpartum can look very different between women, both physically and mentally. Whether you have had a vaginal delivery, caesarean section, assisted delivery, or suffered tears/injuries, pelvic floor physiotherapy will play an integral role in assisting and guiding your recovery with an individualised approach.
Postnatal Assessment
A postnatal assessment is to evaluate how your body is recovering after birth and to construct a management plan to follow during your postpartum journey. In this appointment, we discuss details regarding your birth, current pelvic floor symptoms, medical history, social history, and personal goals. We also undertake a physical examination to assess pelvic floor function, diastasis recti (DRA or “abdominal separation”), posture and investigate any areas of discomfort. Based on the assessment, we develop a personalised recovery plan to address any issues and promote optimal healing.
When to book your postnatal assessment and what is involved:
3-4 weeks postpartum:
In depth discussion about your birth & recovery
Assess for diastasis recti
Caesarean scar management
Prescription of early recovery exercise program
6 weeks postpartum:
Internal vaginal examination - this is where we assess:
Clearance for return to low impact exercise
Progressions for home exercise program
Pelvic floor muscle function
Pelvic floor muscle tone
Prolapse & prolapse risk
Vulval health
Scar tissue i.e, perineal or episiotomy scar
C-section recovery
A cesarean delivery (c-section) is a major abdominal surgery that can be planned or unplanned. After a c-section, you might be dealing with added physical challenges as you navigate recovery and will require a longer period of healing compared to a vaginal birth. Physiotherapy will comprehensively guide recovery that will involve:
Scar management including massage and desensitisation
Deep abdominal and pelvic floor muscle rehabilitation program
Guidance with return to exercise
It is commonly thought that if you have a c-section (i.e, not birthing vaginally) then you won’t have any pelvic floor issues. However, your pelvic floor can be just as impacted from the physical nature of pregnancy as a vaginal delivery. It is also common for pelvic floor dysfunction to occur after a c-section which can include symptoms of urinary incontinence, constipation and pain with intercourse. It is recommended to have a pelvic floor assessment at 6 weeks postpartum as guided above.
return to running / high impact exercise
Returning to running or high impact exercise is recommended no sooner than 12 weeks postpartum. This is due to the extensive internal healing that occurs in the first 3 months post birth, known as the “4th trimester’.
This assessment is generally completed as one of your follow up appointments from your initial postnatal assessment and should be booked at or after 12 weeks postpartum. This assessment involves a review of your pelvic floor function as well as an impact load assessment to ensure you are symptom-free and ready to start or return to intense physical activity. This is highly recommended to reduce the risk pelvic floor dysfunction, prolapse or injury.
If you suffer from pelvic floor dysfunction or prolapse after your birth, there are many ways to manage symptoms in order for you to be able to return to the activity you love and enjoy.
Diastasis Recti
Diastasis recti (DRA) or “abdominal separation” is the stretching of the linea alba which is the connective tissue down the midline of your abdominal muscles, specifically the rectus abdominis (6-pack muscle). This a normal process that occurs during pregnancy to accomodate space for your growing baby and occurs in approximately 66% of mothers. Early intervention is optimal to support the recovery of DRA and is advised to seek assessment at 3-4 weeks postpartum.
mastitis
Mastitis is an infection or inflammation of the breast tissue, commonly occurring during breastfeeding. It typically causes pain, swelling, redness, and warmth in the affected breast, and may also lead to flu-like symptoms such as fever. It often results from blocked milk ducts or bacteria entering the breast tissue. Physiotherapy can help to limit the progression of a blocked milk duct to mastitis or assist in the treatment of mastitis. The use of therapeutic ultrasound helps to unblock milk ducts and reduce inflammation. It is advised to seek therapeutic ultrasound treatment as soon as symptoms arise to limit progression. You may require 1-3 treatment sessions on consecutive days to treat and clear blocked ducts.
Book via link below or call the clinic on (02) 4323 7680
