Pregnancy: Prenatal and Postpartum Care
Pregnancy: Prenatal and Postpartum Care
Throughout pregnancy, many physical and hormonal changes occur in the woman’s body that can lead to pain, weakness, and other uncomfortable conditions. The shift in gravity due to gained weight alone will often alter posture and body mechanics, causing discomfort and muscle spasms in the low back. During this difficult period, added stressors such as these can contribute to further emotional stress, seriously impacting overall quality of life.
While these issues are commonplace among pregnant women, they shoulder not be ignored. Physical therapy can help mitigate these issues both before and after childbirth. By treating spinal and pelvic dysfunction and administering an exercise program, the entire process of child birth––from prenatal to postpartum––can go much more smoothly than otherwise possible.
Common Prenatal Problems
- bowel/bladder incontinence
- core weakness
- diastasis recti (separated abdominal muscles)
- fatigue
- hip/pelvic pain
- low back pain
- nausea
- pelvic floor disorders
- upper back pain
Common Postpartum Problems
- core weakness
- diastasis recti (separated abdominal muscles)
- low back pain
- pelvic floor disorders
- sexual discomfort
- upper back pain
Prenatal Care
Spine
The most common musculoskeletal complaints during the prenatal period revolve around the spine and pelvic region. As the baby grows and the mother gains weight, her center of gravity is shifted forward. This places added stress on the spine––particularly in the lower back––resulting in a great deal of discomfort. This strain also commonly results in poor posture, increasing the risk of neck and upper back pain.
Exercise and instruction in proper body mechanics can help mitigate these problems, though they are not guaranteed to eliminate pain. Manual therapy, particularly the strain-counterstrain method, is effective in decreasing pain and restoring function, especially when combined with an exercise program. Pain-relieving modalities such as electrical stimulation with a vasopneumatic device will typically be used as well.
Pelvic Region
A variety of pelvic floor dysfunctions and other complications can arise during pregnancy, the most common being symphysis pubis dysfunction (or SPD). During pregnancy, the pubic symphysis joint loosens up to allow for some flexibility in the pelvic bones in preparation for childbirth. Unfortunate side effects of this natural mechanism can include pain in the pelvic region, hip weakness, incontinence, and sexual dysfunction.
While the pelvic bones will typically correct themselves after childbirth, the symptoms associated with SPD during pregnancy can be a great burden. Although they usually can’t be eliminated completely, physical therapy can help reduce the symptoms with exercise for increased strength and support, modalities for pain relief, and manual therapy for muscle spasms and myofascial release.
Postpartum Care
Spine and Pelvic Region
Many prenatal conditions can continue into the postpartum period. Although issues such as weight gain and SPD are mostly resolved after childbirth, some of the accompanying symptoms such as back and pelvic pain can continue. Unlike during the prenatal period, however, many of these problems can be eliminated with physical therapy at this stage. They are usually treated as before, with manual therapy and modalities in combination with an exercise program.
Core
There are a variety of issues with the core that may become more apparent after childbirth. Core weakness during this period can prolong other conditions such as low back pain, so it’s important to address such conditions as quickly as possible in order to return to a regular lifestyle.
Diastasis recti is a fairly common condition caused by the pressure of the womb pushing against the abdominal wall, separating the abdominal muscle down the middle. Though this condition can be prevented with proper core conditioning, it is not easily rectified once it has occurred. Treatment is only administered after childbirth, and primarily consists of an exercise program administered by the therapist.
In all of the above cases, physical therapy is an effective form of treatment for muscular conditioning, pain relief, and functional improvement. In Yakima, Central Washington Physical Therapy can provide the compassion care needed for new and soon-to-be mothers. Contact us below to get started.