PREGNANCY AND PELVIC FLOOR PHYSIOTHERAPY
When to check in with a physiotherapist and how we can help.
Written by Jodie Pulsifer
We get this question A LOT! Currently the best answer is, it depends!
When it comes to seeking out physiotherapy in pregnancy we have a dream world that takes down the barriers to accessing care and then we have the real world!
In our dream world, we are a part of your healthcare team to support your obstetric care from pre-conception to long after delivery helping you to manage your health through lifestyle maintenance, practical adjustments for improving outcomes and preventative care to help reduce the risks associated with your long term health because of pregnancy and delivery injury. We don’t live in that perfect world… but strongly contemplating a PhD adventure to hope that someday we could live there.
In the meantime, in this current world our recommendations for care can include reaching out for support early and helping you make a plan for moving through your pregnancy.
We help to troubleshoot a number of lifestyle things:
What is up with your period and what is this health optimization for conception all about?! We can support you in this phase to get a baseline understanding of your health by taking a look at sleep, nourishment, activity and lifestyle contributors to your entire neuroendocrine system. We can help consider habits and assess pelvic floor function and core function and strategies to help you feel strong, stable and resilient for conception that can carry you through pregnancy and beyond.
This is a time where you are fully pregnant, even if you are not yet appearing it. Body changes begin immediately, including bowel changes, increased urinary frequency, fatigue +++ and insomnia, uncertainty about physical activity and possibly discovering you have loss of urine control with a sneeze or vomiting! We are here to help you make sense and manage any of these changes, get and stay physically active and think about strategies for support for the pregnancy ahead.
Often things smooth out here, you might have more energy to start getting back into your regular flow of life. We continue to support your activity strategies for the prevention of low back and pelvic girdle pain, gestational diabetes, preeclampsia. We can assess the pelvic floor internally to help you understand your anatomy, engagement patterns and support your body learning for prevention of stress incontinence. This is a great window of time to help you build stamina and strength for delivery.
Early third trimester, we love to connect with you about your upcoming birth and birth choices. We can begin to discuss perineum protection strategies, including the role of perineum massage and stretching. We can discuss options and strategies for vaginal delivery, including birthing positions, pain management and things to discuss with your birth providers regarding strategies for reducing risk of severe tears. We also support questions around cesarian section delivery and recovery strategies following all forms of birth. We continue to help you stay active and comfortable right to the end of your pregnancy, including supports to manage low back and pelvic girdle pain if it arises. Other healthcare supports start to ramp up at the end of third trimester and a lot our work with you can begin to wind down. We are always happy to continue to support you right to the end if that feels right for you. Post Birth
Virtual support is a great strategy to debrief birth and make a plan forwards that makes sense. If you sustain a severe tear, checking in at 2 weeks is recommended. Six weeks is not a magic window of time for recovery, you can reach us anytime you have questions or feel ready to connect and make a plan for you. We can help tailor your recovery to the experience of birth that you had and from there, decided together when seeing us in person might make sense, if a pelvic exam is beneficial for you, and support you with strategies for pain management and how to get moving again. We do this with you in a timeline and way that fits for your life and the things you are juggling.
Anytime, our role is to help you look at bowel, bladder, sexual health, sleep hygiene, basic nourishment, activity demands, emotional wellbeing, life stressors and your life responsibilities. We help build strategies that make sense to you to help you feel well for where you are and as life shifts.
Finally, since this isn't our dream world, we also want to note that we are always trying to consider how to give you the best support within the resources you have. We understand that jobs that allow you resources to access our services and extended health benefits are not something we can all are able to have. We try to work with you and the means you have (eg. geographical location, time, finances, life capacity) to make sure you can still get as much benefit as you can!