What to Expect at a Prepartum/Postpartum Evaluation

In Female Pelvic Pain, Pelvic Health, Pelvic Pain, Pregnancy and Postpartum Pelvic Health by Stephanie PrendergastLeave a Comment

By Stephanie A. Prendergast, MPT, Cofounder, PHRC Los Angeles

During prepartum/postpartum evaluations, a physical therapist will take an extensive medical history. Following the history, the PT will perform a thorough external and internal musculoskeletal exam.

 

Your evaluation should include:

Musculoskeletal: An assessment of structure, muscles, tissue, joints and manual evaluation of the pelvic floor muscles. We can identify problematic muscles/scar tissue and develop a treatment plan based on our findings.

 

Diastasis Recti: Patients with diastasis recti are given specific exercises to correct the problem. Standard exercises, pilates, and yoga can make this problem worse and should only be introduced after the diastasis recti is addressed.

 

Scar mobilization for Cesarean section, episiotomy, and other vaginal scars: Scar tissue can cause persistent pain and lead to discomfort and pain with intercourse. In addition, scars from a C-section can contribute to urgency/frequency. Scars from childbirth can cause problems because they can become adhered to nearby structures due to excessive amounts of disorganized collagen produced during the healing process.

 

Manual PT for concerns of pain with vaginal intercourse or penetration: Postoperative/post vaginal delivery can result in tissue hypersensitivity and restrictions around the incision or episiotomy scars as well as create myofascial trigger points or tightness in traumatized muscle in and around the pelvis.

 

PFM motor control exercises and training to treat urinary incontinence: Most women are told about Kegel exercises; however, most women report confusion about how to do them properly or how often. According to recent research, 51% of women could not perform a Kegel properly with verbal cueing alone. 25% of the women in the study were actually performing the attempted Kegel in a manner that could promote incontinence. Treating incontinence requires proper Kegel instruction as well as training in other key exercises to eliminate the problem. 

 

molly telehealth

Prenatal and postnatal pelvic floor physical therapy begins with an evaluation with your physical therapist. During the evaluation, the physical therapist reviews your history with you, your current symptoms and functional challenges, and discusses your birth plan if you are prepartum and if postpartum, how your delivery went.

Importantly, we understand the challenges of pregnancy and the postpartum period. During the physical examination the physical therapist examines muscles, tissues, joints, nerves, and movement patterns. Once your physical therapist completes the examination they review your findings with you. The physical therapist creates an assessment and short and long-term goals for your treatment plan. Typically, the frequency of physical therapy treatment is one time per week but this can vary greatly depending on the physical findings.

You are given a home exercise program to compliment your in-person sessions, and your physical therapist will help to coordinate your recovery with your Obstetrician and the other members of your treatment team. We are here to help you recover and live your best life! You can schedule with us both in person or virtually with Molly for your prepartum and postpartum needs!

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We are excited to announce Molly will be helping PHRC open their 11th location in Columbus, OH in September of 2023. Join the waitlist and be the first to be contacted!

Are you unable to come see us in person in the Bay Area, Southern California or New England?  We offer virtual physical therapy appointments too!

Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.

Melissa Patrick is a certified yoga instructor and meditation teacher and is also available virtually to help, for more information please visit our therapeutic yoga page

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