Pre-Natal/Post-Partum Care

The pregnancy term ranges between 38–40 weeks and is divided into three trimesters. In each trimester, the pregnant woman undergoes various physiological changes with resultant physical changes. These physical changes may reverse post-partum. However, an understanding of the pregnant body is crucial to adapt to its changing state.

Most physical "ailments" experienced during pregnancy can be treated with physical therapy. A common pregnancy woe is low back pain, but it is treatable with physical therapy which includes relaxation techniques, proper body mechanics, and stretching and strengthening exercises. Some of these carry over into the post-natal period. Thus, it is important for pregnant women to receive pre-natal care and if required, post-natal care.

View our newsletter about pre-natal physical therapy >>

Conditions

Below is a summary of some changes that may occur during pregnancy:

First Trimester:

  • Low back pain
  • Nausea ("morning sickness")

Second Trimester:

  • Diastasis Recti
  • Low back pain

Third Trimester:

  • Low back pain
  • Frequent urination
  • Back pain
  • Leg edema
  • Fatigue
  • Shortness of breath
  • Constipation

Back Pain:

Back pain may manifest in the lumbar spine, sacro-iliac joints, or lumbo-sacral joint. Commonly, the pubic symphysis is also affected. Back pain may appear in any of the trimesters and may result in sciatica.

Causes: Postural changes to accommodate the growing foetus/uterus, ligament laxity, weak abdominal wall, hormonal influence (relaxin), posterior core muscles or hip muscle tightness, etc.

Treatment: postural evaluation and correction, body mechanics, myofascial release, deep tissue massage, stretching, strengthening

Diastasis Recti:

It is the separation of the rectus abdominis muscle from the mid-line; above, at, or below the umbilicus. A separation of 2 cm and more is considered significant. Predisposing factors may include weak abdominal tone or hormonal influence (relaxin) in pregnant women. The diastasis may appear during the second trimester and result in low back pain. A diastasis renders abdominal support weak, and may result in herniation of abdominal contents through the separation.

A diastasis can be corrected with the use of support belts and exercise.

Shortness of Breath:

During pregnancy, the growing uterus blocks the descent of the diaphragmatic muscle and by the 3rd trimester results in its elevation (passive) by approximately 4 cm. An elevated diaphragm may result in shortness of breath or dyspnea with mild exertion. Proper posturing, breathing mechanics, and myofascial release can alleviate symptoms.

When a pregnant woman lies on her back, the uterus compresses the diaphragm which increases the pressure on the inferior vena cava. Thus, it is advisable for a woman to lie on her left side or on her back with a rolled towel placed under her right hip. These positions place the least pressure on the blood supply.

We use pregnancy tables and pillows to make your treatment sessions as comfortable as possible.

Post-Partum Care:

After childbirth, women should have a follow up with a physical therapist in order to put back on a proper exercise and stretching program. Some women notice changes after childbirth, that might have not been present during pregnancy. Again, these discomforts can be treated.

  • Back pain
  • Diastasis recti
  • Scarring
  • C-Section, episiotomy, or perineal tear
  • Pelvic floor weakness
  • Prolapse
  • Urinary or fecal incontinence
  • Pelvic pain

Physical Therapy Treatment Includes:

  • Soft tissue mobilization, myofascial release, deep tissue massage
  • Muscle energy techniques
  • Therapeutic exercise
  • Posture, lifting techniques and biomechanics