Finding a pelvic floor therapist (PFPT) or postpartum specialist to help you recover optimally after baby is one of the best decisions you can make regarding yourself and returning to life after pregnancy. After delivery, everyone’s attention shifts towards baby, with frequent pediatrician visits, weigh-ins and checks with little to no focus on mom. There is a 4-6 week check-up with your OB or midwife, but here, it is mainly to ensure uterus is returning to size, incision/suture lines look good and establishing contraceptive use. But what about everything else? You have spent the last 10 months growing and carrying a baby in your body. What things do we need to think about as we recover from this miraculous and insane task? There are a few.
In other countries, seeing a PFPT after delivery is standard of care and available to every woman! Here in America, we aren’t there yet, but requesting to see one is okay and I encourage every momma to do so, especially those showing any signs of pelvic floor dysfunction (urine leakage, pain with sex, pressure/heaviness in your vagina)! The more you know about your body, your specific status and how to heal will only set you up to feel your best and return to live optimally.
Okay, so what can I expect from a postpartum physical therapy appointment? I’m so glad you asked!
60 minutes dedicated to you.
At PeakRx Therapy, our initial evaluation is 60 minutes long. Your plan to heal and progress is intimately related to where you have been. Having time to talk specifically about your pregnancy, labor and delivery is a necessity. We will dive deep into prior pregnancies, any issues you have had or currently are experiencing. Each plan of care is different and is dependent on the specific stressors and experiences you have had. Making sure we have the time to talk about all the things is important. Please feel free to bring your baby and let me hold them for you. Or come solo, and allow yourself a full hour that is focused on you and you only. That is your choice and I am down for whatever it is that makes you most comfortable.
Pelvic floor education.
I like to spend some of our time together educating you on exactly what your pelvic floor is, how it was effected over the last 10 months and how important it is to us as humans. The trend has been women deliver babies with no focus or education on this area of our bodies and then are left with things like urinary incontinence, pain with sex, pain or heaviness in our pelvis. Delivering a baby (vaginally or cesarean) is a major acute injury. Being knowledgable on how your body was affected can make all the difference in the world on how you heal.
A full external musculoskeletal screen.
Yes, after baby, a big part of our focus is going to be on your abdomen and vagina. Makes sense. But we want to make sure we gain a full picture of where you are at. Some of the common problems new moms have after baby are things like neck and shoulder pain, wrist pain, headaches, and even plantar fasciitis! During our eval, we will assess body based on your symptoms. We will take a look at and address how you hold your body now that you are no longer having to support your belly. We will discuss your method of feeding and give you tips to decrease injury and pain. We want to make sure all joints and body parts are assessed!
An internal exam.
One of the greatest tools and pelvic floor specialist uses is the ability to assess women internally after birth. This exam is not the same as a pelvic exam given by your OB where is she mainly checking your cervix. This exam focuses more on the integrity of the muscles (pelvic floor) in your pelvis. Is there tension? Can you coordinate the contraction? What is the strength? If you experienced any tearing or an episiotomy, assessing scar tissue will be done as well a screen for pelvic organ prolapse. Your therapist will always discuss this option with you and gain your consent before evaluation. We encourage everyone to ask questions and gain clarification before to gain comfort! Consent can always be taken back, and forgoing this part of the session is always okay, as pelvic floor muscles can be assessed externally if needed.
Abdominal and core assessment.
Your therapist will spend some time checking the integrity of your abdomen now that baby has vacated the premises. This will include a diastasis recti check, strength test of your core muscles as well as a c-section scar assessment if needed.
Create a plan.
Based on all the above screens, your history and most importantly, your goals, we will be able to establish a plan of care for you. This looks different to each momma, but with the common goal of addressing your needs and educate you on how to heal the best you can.
Making time to address “you” is one of the best ways you can serve your family and new baby. Waiting around to see if things will feel better (especially if you are >3 months postpartum) can end with longer dysfunction and heartache. Get things taken care of soon!
Feeling confident in your body and the healing process over the 12 months after birth will allow you the experience freedom in the decisions you make regarding your body, exercise, and activities.