Postpartum Rehabilitation: Supporting the Well-being of the Mother and Child

Every mother knows that having a child changes you:  physically, mentally, and socially.  What I didn’t realize was how poorly our country compares to others in helping its new mothers adapt to these changes. 

This summer I flew to New Zealand to visit my best friend and her new baby.  Having a two-year old myself, I thought that the greatest gift I could give was the comfort of an old friend to help with the cooking, cleaning, diapering, and simply talking about motherhood.  I personally experienced a difficult time during the postpartum period and wanted to be there for my friend as much as possible. 

As soon as she picked me up at the airport, I realized she was adjusting to motherhood just fine!  While we chatted and caught up, I realized the differences between her postpartum experiences and my own were more than two women handling the introduction to motherhood differently.  It reflected a cultural difference. 

In New Zealand women learn about pregnancy, childbirth, childcare, and postpartum rehabilitation.   A midwife visits the new mother and child at their home regularly, often multiple times every week, for the first six weeks after birth, checking on the baby’s progress as well as the new mother’s physical and mental well being. The new mothers are screened for postpartum depression and the level of support given by family and friends is evaluated. 

Further, the new mothers are physically monitored and are referred to a women’s health physical therapist on a regular basis.  The physical therapist specializing in women’s health and postpartum rehabilitation checks for musculoskeletal concerns, which include diastasis (abdominal separation), posture, and pelvic floor strength and suggests appropriate exercises.  These interventions often result in reduced incontinence, back pain and diastasis, and provide a faster return to normal posture and body mechanics, including sexual intercourse. New Zealand’s culture embraces the notion of supporting and nurturing the mother’s mental and physical well-being as well as the infant’s.   

In the United States, pregnancy and childbirth overshadow the postpartum needs of the mother.  Women learn about childbirth and childcare, but ignore the importance of postpartum rehabilitation.  Instead, the nurse gives the mother a quick bit of postpartum instruction at check out, often buried in a packet of other information. The mother’s six-week check-up does not usually address the musculoskeletal components so carefully checked in other cultures. 

There are no medical postpartum supervised exercises offered, and prevention, or at least alleviation, of incontinence, back pain, diastasis and poor abdominal function is rarely discussed.  Additionally, there is rarely any advice given regarding normal posture and body mechanics.  Often new mothers return to normal activities too soon, despite a nagging feeling (call it women’s intuition) that their bodies just are not right.  Our bodies are not the same after childbirth, yet we are not being taught how to regain our lost musculoskeletal function. 

In fact, the United States is significantly behind many developed countries in its care for women and postpartum rehabilitation. Canada, Australia, France, Germany, and the Netherlands all have postpartum programs developed to improve the musculoskeletal health of women during their child bearing years.  

Thankfully, with education we can change our culture to value the mother’s health as much as the health of her baby.  There is a small but growing group of healthcare providers who understand this and embrace the importance of postpartum rehabilitation.  Women’s Health Physical Therapists have unique musculoskeletal knowledge.  Working with them and your physician on postpartum education and assessments can improve your physical health, and your joy of life.

In Richmond, Women’s Health Physical Therapy offers a musculoskeletal check of your abdominal muscles, pelvic floor, posture, and the biomechanics you use in taking care of your baby.  Most insurance companies will cover postpartum care under the category of disuse muscle atrophy.

If you are expecting, I encourage you to continue to read up on the issues discussed above. If you are lucky enough to have already joined the ranks of new mothers, I urge you to request postpartum physical therapy.  Learn about musculoskeletal postpartum rehabilitation, and share what you learn.  Together we can change our culture, one mother at a time.    

–This article written by Jane Ireland Broadbent and was sponsored by Women’s Health Physical Therapy. www.obgyn-physicaltherapy.com    For more information about their services including treatment prenatal and postpartum services, incontinence, pelvic pain, orthopedic, breast cancer, osteoperosis, constipation, fetal incontinence, fibromyalgia, balance, lymphedema, pelvic pain, and headaches.  804-379-3002