Pregnancy brings on significant changes in women's bodies. They experience urinary incontinence, back pain, pelvic pain and other conditions. Here, our Stittsville physiotherapists describe how prenatal and post-natal (postpartum) physiotherapy can help with pain prevention and recovery from childbirth.
Physiotherapy for Prenatal & Post-Natal Pain
For pregnant and postpartum women, pre-natal physiotherapy and postpartum physiotherapy have an integral role to play in pain prevention, treatment and recovery from childbirth.
Women's bodies go through many changes during pregnancy. The centre of gravity changes as weight gain occurs, which puts more pressure on internal organs and may lead to a variety of neurological, orthopedic and pelvic issues during the pre-natal and post-natal stages.
Some common conditions reported by women include:
- Incontinence
- Joint pain
- Bladder prolapse
- Pelvic or back pain
- Pelvic misalignment
- Numb, painful or tingling fingers and hands
- Blocked breast ducts
- Abdominal separation
Even before pregnant women's bumps begin to "show", they experience major changes internally. Posture and body movement changes.
Muscles, soft tissues and ligaments become more flexible and weight pressure on their joints increases. This elasticity and flexibility enables the pelvis to stretch and accommodate the growing baby. These shifts are triggered by hormonal changes, all of which play an integral role in the health and development of mom and baby as the body prepares for birth.
Why do some women experience these conditions during pregnancy?
Pregnancy won't be accompanied by pain and discomfort for every woman, and this need not lead you to reconsider becoming pregnant if you had planned to. However, many women are at risk for some type of pain or discomfort during pregnancy. Certain factors may mean they are more susceptible to these symptoms.
If you have a previous history of pelvic floor dysfunction, lower back pain or pelvic girdle pain, you will be predisposed to experience these types of pain during pregnancy and post-birth.
Increasing age, number of deliveries and family history of pelvic organ prolapse are risk factors for the condition. Being overweight, in addition to being pregnant and giving birth (vaginally or via C-section) seem to put women at higher risk of urinary incontinence.
How can these conditions be prevented and treated with prenatal and postpartum physiotherapy?
To lay the foundation for preventing and alleviating prenatal pain and to set the stage for a good recovery, it's important to prepare the abdominal area, lower back muscles and pelvic floor pre and post-pregnancy.
If you experience any of the symptoms listed above during or after your pregnancy, a physiotherapist can evaluate your specific circumstances and the factors contributing to your pain or discomfort.
Prenatal and postpartum physiotherapy can benefit mothers-to-be and new mothers in a number of ways.
Prenatal Physiotherapy
Your physiotherapist may recommend a range of physiotherapy treatment options to help you prepare for labour and delivery. These methods may include:
- Maintain pelvic alignment and symmetry to reduce pain
- Strengthen and lengthen the pelvic foor muscle to minimize pain and improve continence and mobility
- Optimize birthing positions to leave as much room as possible for the baby to come through the birth canal
- Prepare the vaginal connective tissue and pelvic floor muscles with perineal care and stretching to prevent and minimize tearing
- Minimize pain of musculoskeletal conditions that pregnancy, labour and delivery can exacerbate
- Provide education for expectant mothers on pain management and discuss fears, concerns and labour goals to help calm stress and anxiety
Postpartum Physiotherapy
Post-delivery reconditioning focuses on safely and progressively returning various parts of the body to pre-pregnancy and or delivery function most impacted by pregnancy, labour and delivery.
Your physiotherapist may prescribe an active core strengthening program, including specific pelvic floor muscle strengthening exercises to correct back or pelvic dysfunction.
Additional treatments may include massage, joint mobilizations, stretches, acupuncture, myofascial release and heat.
Here are some specific physiotherapy treatments that can help new mothers regain function, experience less pain and discomfort and return to their daily activities:
Acupuncture
Acupuncture may be recommend to relax muscles, encourage circulation and promote healing and recovery from pregnancy for both prenatal and post-natal treatment.
This type of therapy may also help to alleviate some aspects of postpartum depression. It is often combined with other strengthening and treatment options. A pelvic floor physiotherapist can develop a comprehensive treatment plan to fulfill your unique needs.
Manual Therapy
Manual therapy can help alleviate lower back and hip pain for pregnant people. This pain may be brought on by bearing a baby's growing weight. Post-natal manual therapy can help improve the breastfeeding process, increase circulation and blood flow and reduce swelling.
Pelvic Floor Exercises
Hormonal changes and changing weight during pregnancy cause the pelvic floor to bear a lot of extra weight before mom gives birth. The pelvic floor can become stretched and weakened (or injured), often leading to reduced control of bowel movements post-pregnancy.
This can cause urinary post-natal urinary incontinence. In more serious cases, lifelong urinary incontinence can occur. By addressing these issues early in a first pregnancy and during subsequent pregnancies, your physiotherapist can help reduce the toll these chances take on your body, as well as their consequences for function and posture.
Our Stittsville physiotherapists can offer tips and advice to resolve issues you may face during pregnancy and after the birth of your baby. Depending on your specific requirements, you may consider consulting with a pelvic floor physiotherapist at our Manotick or Orleans locations for special analysis of pelvic floor muscle issues.