Physical Therapy Care for the Pregnant & Postpartum Mama

Physical Therapy Care for the Pregnant & Postpartum Mama

Lizanne Pastore PT, MA, COMT

            Pregnant and postpartum mothers comprise a significant segment of our population that is too often underserved by our medical community.  As we all know, a woman’s body goes through profound changes during pregnancy.  Bodily systems are taxed to the max.  The vascular, respiratory, endocrine, and certainly the neuro-musculo-skeletal systems are overloaded with extra stressors.   They say pregnancy is like training for a marathon, but when the marathon ends with the birth of baby, that’s only the first finish line, because mom has to lace up her running shoes again and continue running.  She must take care of her newborn, plus any other youngsters already at home; maybe she has to get back to her former job soon too.  The finish line is ethereal.

                  And as Mom is lugging those heavy, awkward car seats and strollers and lifting loads of laundry and bending deeply and often to maneuver ever-heavier infants into and out of cribs, she is doing so with less-than-optimal muscular and skeletal strength and form, not to mention her sleep deprivation!  Her ligaments are still lax; she probably has a bit of rectus abdominis diastasis making her core even weaker; her tendons and nerves are still mushy making her more at risk for things like carpal tunnel syndrome, tendonitis, and sciatica.  (All that extra fluid from pregnancy takes a toll on connective tissue.)  

                  And let’s not forget her pelvic girdle.  Pubic symphysis, sacroiliac joint (SIJ) or coccyx pain, pelvic girdle and hip movement dysfunctions, pelvic muscle or pudendal nerve pain, incontinence of bladder and/or bowel, pelvic organ prolapse (POP) are just some of the maladies that can affect the pelvic floor and pelvic girdle during or after pregnancy.

                  These pelvic issues are common, but they are not “normal,” as many women are led to believe.  “Oh, leaking?  That’s normal.  All my friends have leaked, it should get better.”  Stress urinary incontinence (SUI), for example, is extremely treatable, especially if addressed quickly.  But if a busy mom ignores her leaking and begins preemptively voiding or gripping her pelvic muscles to avoid leaks, she could actually turn her “straight forward” SUI into an urge scenario, creating muscle tightness or bladder dysfunction and making her case harder to treat.  

                  Similarly, intermittent SIJ pain or pubic pain can become more severe the longer left untreated.   POP, again, while common, is not normal, and is highly distressing to new moms, who hadn’t expected to experience such blatant anatomical changes.  Pelvic concerns are huge, both physically and emotionally for a new mom struggling to care for a new baby.  She hadn’t factored in the care she might need following birth; rarely is she forewarned that she might need help adjusting to her new “body-after-baby.”    

                  But the great news is that pelvic floor physical therapists are experts in treating the pregnant and postpartum mom.  We help many of these women return to fully functioning, active, healthy lives.  In a perfect world, every pregnant woman and new mom would be able to see a pelvic PT, but our world isn’t perfect.   So remember to include a physical therapy referral when your next pregnant or postpartum mama enters your office.  Assure her that her complaints, while common, are not normal but that there is help out there.  Let’s support our moms!

                  Get to know the pelvic specialists in your area; here are 3 great links to help: