3 min read
BY KELLY JONES | Physiotherapist | Women's & Pelvic Health | Pre and postnatal
1. Why should you see a Women’s Health Physio during pregnancy?
If you are going through your pregnancy, it’s likely that you’ve heard or been told to visit a Women’s health physio. Why, may you ask?! Women’s health physios are specialised in supporting you through your pregnancy journey, and there are so many reasons why you might consider seeing one - even if you aren’t experiencing any symptoms!
Some of the ways a women’s health physio can support you during pregnancy include:
- If you are experiencing pelvic symptoms or condition, such as urinary or faecal incontinence, constipation, heaviness, dragging or pressure in your pelvic area, a vaginal bulge, or pelvic pain. Yes, these symptoms are quite common, but they are definitely NOT normal. Regardless of whether you started experiencing your symptoms/condition during or prior to pregnancy, it is SO important to address them as soon as possible and there are so many ways to treat and manage your condition!
- Addressing and managing any other pregnancy related conditions, such as pelvic girdle pain, rib, back, hip or wrist pain, and abdominal separation.
- To help optimise your pelvic floor function: your pelvic floor needs to be strong enough to support your body during pregnancy, as well as be able to relax and lengthen during pregnancy and childbirth. Your women’s health physio will be able to assess your pelvic floor and give you individualised exercises specific to you.
- Preparation for birth and postpartum: regardless of type of birth, a women’s health physio can help you to prepare for birth and postpartum. Of course, this is different for everyone; depending on you, your body, your history and the type of birth you are planning. It might include:
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Pelvic floor preparation.
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Education and advice for c-section deliveries.
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Education/advice around preparing for vaginal deliveries e.g. pain management techniques during labour, birth positions, perineal massage, learning how to push.
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Ensuring your body can move well and is strong for the rest of your pregnancy and birth.
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Postpartum care advice for both vaginal and c-section deliveries.
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- Guidance around exercising during pregnancy: if you are unsure about exercising during pregnancy, a women’s health physio can provide guidance around suitable exercise for you and your body during pregnancy.
2. Should you have your pelvic floor checked, even if you aren’t experiencing symptoms or if you are planning a caesarean section delivery?
The short answer: YES, absolutely! Even if you are planning to have a caesarean section delivery or aren’t experiencing symptoms, there are still so many benefits of having your pelvic floor assessed.
Over the course of your pregnancy, the load placed on your pelvic floor increases. Therefore, having your pelvic floor assessed can help in terms of seeing how to best optimise your pelvic floor function to help support your changing body over the course of your pregnancy and into postpartum. This might look like improving pelvic floor strength or down-regulation and relaxation, working on surrounding muscle strength (looking right at you hips, glutes and abs!), or changing the way you breathe. Of course, birth preparation for vaginal delivery also forms a part of this; pelvic floor relaxation practice, practicing your exercises in different positions, learning how to do perineal massage and learning how to ‘push’.
3. When is the best time to see a Women’s/Pelvic Health Physio during pregnancy?
If you are experiencing any symptoms, it’s highly recommended to see a women’s health physio as soon as you can to help optimise your management and treatment of your symptoms.
Otherwise, there are a couple of times that I generally recommend seeing a women’s health physiotherapist throughout your pregnancy.
1) The first time is early on in your pregnancy, after the first trimester - generally between 16-20 weeks pregnant. This allows us to check in with your pelvic floor function, overall body function and devise and plan for the rest of your pregnancy earlier on.
2)The second time is at the 34 week mark - this is when I recommend people to come in for specific birth and pelvic floor prep if you are planning a vaginal delivery e.g. perineal massage, pelvic floor relaxation, pushing. Of course, there are plenty of things that can be done earlier and I do highly recommend coming in earlier if you are able to!
4. Can I still exercise during pregnancy? What is ‘safe’ to do during pregnancy?
Yes, you absolutely can exercise during pregnancy, provided that your pregnancy is uncomplicated and you have been cleared by your medical team. If you are unsure, your first point of call is to always check in with your medical team - whether that be your OB, midwife, GP or any other relevant health professional.
RANCOG and Australian Physical Activity and Exercise guidelines recommend:
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Being active most days (preferably every day) for a weekly total of:
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2.5-5hrs of moderate intensity activity OR
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1.25 - 2.5hrs vigorous intensity physical activity OR
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an equivalent combination of moderate/vigorous physical activity
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Use the talk test to measure how intense your exercise is -
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Moderate intensity activity: you should be able to hold a conversation
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Vigorous intensity activity: you would find having a conversation difficult
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Two days of strengthening/resistance activities
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If you lead a sedentary lifestyle, start slowly and then build up to the recommended amount.
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Ensure that you listen to your body and make relevant changes to your routine and exercises over time - this is NOT a time to be trying to hit a PB!
For further guidance around specific exercise that is appropriate for you and your body, discuss with a qualified professional, including your women’s health physio.
5. How can I best manage abdominal separation during pregnancy?
First things first - abdominal separation is a very very normal part of pregnancy and postpartum. Up to 100% of women will experience abdominal separation, and appropriate management during pregnancy and postpartum is highly dependent on the individual.
An important part of managing abdominal separation during pregnancy is seeing a women’s health physio for an assessment, guidance and treatment specific to you, your body and your pregnancy. Your assessment and treatment might include:
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Assessing your abdominal wall functions
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Assessing your general movement as well as how you use your pelvic floor and diaphragm (your breathing muscles!), as they work closely with your abdominal wall
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Abdominal, breathing, pelvic floor and other relevant exercises specific to you
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Addressing any other areas that may influence your pelvic floor
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Recommendations for support for your abdominal wall, such as TheRY compression shorts/tights.
-Kelly
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Kelly Jones is a women's and pelvic health physiotherapist based in Melbourne, Australia. She is passionate about educating and empowering women to move well, feel strong and confident in their own body, and do the things that they love.