The 6 – 12 week postnatal period
The 6 – 12 week postnatal period – from a Physio point of view
So, the first 6 weeks since your baby has been born have FLOWN BY! Am I right? You have been busy feeding and looking after your newborn child – some women are getting sleep, some are not. Some have a bit of a routine going, others – their baby changes every day.
6 weeks is usually when you will have your check up with your obstetrician or GP after giving birth. It is also usually the time around when women will come and see their physiotherapist for a postnatal review.
So what can you expect from the physio?
Your physiotherapist will check your abdominal separation – and they will let you know how that is travelling. Most women will have some degree of abdominal separation after birth, and this changes A LOT during the first 6 weeks postnatally. You can get some tips from your physiotherapist on how to protect your abdominal separation if needed and what exercises are appropriate for you.
Your physio will ask you about your bladder and bowel – your physio will ask if you have had any issues with constipation after your birth (eg due to medications for example) and will ask you about your bladder eg are you experiencing any leaking, have you had any sudden urges to urinate. Your physiotherapist can let you know if what you are experiencing is normal or if there are some things you can do to help improve these (eg constipation management or pelvic floor exercises).
Have you been doing any pelvic floor exercises? Let’s be honest – in the first 6 weeks after giving birth, pelvic floor exercises are really low on the priority list. If you have been doing some – good on you!! If you haven’t – please do not panic. Your physiotherapist can let you know if you need to be doing some exercises for your pelvic floor, and how many to do and how often. If you have not done your exercises, you have not set yourself up to fail and you have not done harm. But if you need to be doing some, your physio can let you know and you can work out the optimal times and make a plan how to fit it into your busy day.
Getting back into exercise – at this point postnatally, it is probably safe for you to start getting back into some exercise. The best way to know what is appropriate for you is to see your physiotherapist so they can give you an individualised plan. During the first 6 weeks, if you can get some walking in that is awesome. At the 6 week mark, some lower impact exercise is probably appropriate. If you join a mums and bubs exercise class, the instructors normally have extra training to know which exercises are appropriate or not. When you do get back into exercise, look out for these symptoms
- Leaking of urine
- Doming in the abdomen
- Heavy sensation in vagina
- Dragging back pain
These can be signs that you have put a bit too much pressure on your pelvic floor, and perhaps you need to take it a bit easier. It does not mean you have done permanent damage, just have a rest lying flat and when you try the exercise again, reduce the pressure or intensity.
Think about if you would like an internal exam – an internal exam is the best way for a physiotherapist to assess your pelvic floor. They can assess the strength, endurance and coordination of your pelvic floor muscles. They can assess if you have any signs of prolapse. You do not need to have an internal exam, but if your physiotherapist is assessing your pelvic floor with real time ultrasound or feeling your abdominal muscles to assess their contraction, you will not get a true idea of how your pelvic floor is going. If you have no issues, an internal exam will simply give you a very precise idea of your pelvic floor strength and ideas about how to plan your exercise program. It will also give you peace of mind that you can safely return to exercise. If you are experiencing some pelvic floor dysfunction (leaking of urine, sudden urge to urinate, prolapse symptoms) then an internal exam will let you know exactly what is going on.Your body changed in many ways to grow and birth your baby, and it will change a lot after you have given birth. #performbetter @pogophysio Click To Tweet
Your body changed in many ways to grow and birth your baby, and it will change a lot after you have given birth. Your assessment at 6 weeks postpartum is not an indicator of your full recovery, but it gives some insight into how you should proceed going forward with your recovery.
Emily Georgopolous (APAM)
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