“It’s not uncommon for new moms to have problems following labor and delivery. It may feel different when they try to urinate; they may have difficulty with bowel movements; changes may occur in their sexual behavior, and about 35 percent of them will experience pelvic pain.”
With this information, Stephanie kicked off the latest episode of PT TV, a series of video chats produced by Therapydia.com. In this most recent episode, titled “Postpartum PT,” Stephanie discusses an issue that’s a hot topic here in the U.S.: The lack of pelvic floor rehab for new moms!
In the interview, she points out that in the U.S., pelvic floor symptoms that new moms complain of are dismissed by the medical community. Women are simply told that their symptoms are “normal,” and will resolve over time.
But, while these symptoms are certainly common, they’re far from “normal,” Stephanie stresses. And there are far reaching consequences of not receiving the proper pelvic floor rehabilitation post-pregnancy and delivery, including urinary incontinence and pelvic organ prolapse.
“Other countries, like France, Great Britain, Denmark, and Australia are proactive to prevent problems later in life or deal with current issues,” Stephanie points out, “rather than how we approach it in this country, which is to be more reactive if paying attention to it at all.”
“In our country, patients are discharged from the hospital, and they’re given a five to ten minute check up at six weeks to ensure that there’s no infection and that they’re healing, but no one talks about these symptoms or that many women feel quite different after they’ve had their babies,” she adds.
Stephanie goes on to describe the overarching purpose of postpartum rehab: “What a pelvic floor rehab session can do is really take a look at the pelvic girdle muscles, the connective tissue, and the pelvic floor muscles to try to determine what changes have occurred during pregnancy…and then a rehab plan is developed to deal with these changes.”
The fact of the matter is that physiological changes do occur after pregnancy and childbirth, whether a new mom is symptomatic or not, she stresses.
Going back to how postpartum rehab is dealt with in other countries, Stephanie points to France’s current postpartum rehab program, which is underwritten by the state and which stands as an ideal for postpartum pelvic floor rehabilitation. Under France’s program, the French government pays for 10 to 20 sessions of pelvic floor rehabilitation as well as abdominal rehab.
Stephanie goes on to describe the frustrating paucity of education that is at the heart of the lack of postpartum rehab that new moms receive in the U.S.
She points to one study that shows that 71 percent of women have no idea that their pelvic floor muscles are related to labor, delivery or pregnancy or are associated with stress urinary incontinence or organ prolapse. “That’s an astounding number!”
“[Moms-to-be] are just not being informed about the musculoskeletal system,” she says.
“But in all fairness, when I talk to my Ob/Gyn colleagues, it’s something they are not taught in school and it’s not being discussed at conferences either.”
However, the point remains that Ob/Gyns are in the best position to convey this information to moms-to-be. “I don’t know how the information is going to come across if it’s not coming from the OB, which is the woman’s primary point of contact,” she says.
“Currently, how are new moms getting to the Pelvic Health & Rehabilitation Center for postpartum rehab?” asks show hostess Alex Scioli.
“Doctors we already work with because of other pelvic pain diagnosis are referring them,” Stephanie answers. Or patients are finding out about postpartum rehab online, she adds.
“[Women] come to us extremely frustrated, particularly if they are symptomatic, that their Ob/Gyns haven’t referred them, and that postpartum pelvic floor rehab even exists and that no one told them along the way.”
So currently, whether moms receive proper postpartum rehabilitation in the U.S. lies either in the awareness of individual physicians as opposed to the existence of a certain standard of care as is the case in other Western countries such as France.
Stephanie then goes on to describe the two groups of women who receive rehab after childbirth.
“Some are symptomatic,” she says, “while others aren’t.” It’s important to understand, she explained, that those who may not be immediately symptomatic now may still have pelvic floor problems that simply have not have hit a level that are symptomatic yet.
Stephanie directs women who are in need of a physical therapist for any postpartum rehab problems to visit the women’s health section of the American Physical Therapy Association.
Other topics covered on the show include the current controversy surrounding vaginal deliveries versus scheduled C-sections and natural childbirth versus medical intervention.
If you have any questions about postpartum rehab, please leave them in the comment section below! We want to hear from you! Also, please let us know what you think of this latest episode of PT TV!
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