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Physiotherapy care during pregnancy, birth and beyond

Every woman needs the right support throughout their pregnancy experience. Living with a disability and being pregnant may mean that additional support is usually required. Physiotherapists, who specialise in women’s health can be a great resource for these mothers during pregnancy, birth and early motherhood. Read on to find out how physiotherapy support can help you.

1. Reduce pain and discomfort during pregnancy

Most women develop aches and pains as their baby grows and hormones change. For women who have chronic pain before pregnancy begins, these normal pregnancy changes can make pain worse. If you are planning a pregnancy, and taking medications, it is important to talk with your doctor about how they may be reduced to help grow a healthy baby.

Physiotherapists can provide different options to manage pain and help you to move well and live better. This includes massage therapy, dry needling, joint movements, electrical stimulation, exercises, and hydrotherapy.

Dry needling is where a fine needle is placed into a painful point in a muscle to relieve pain and improve movement.

Needling scaled
Needling scaled

2. Develop a tailored exercise program to suit you

During pregnancy:

Regular exercise throughout pregnancy is beneficial for every woman. It is so important for well-being and keeping weight gain within the recommended range. It minimises pregnancy complications and maximises strength and mobility for when the baby arrives. Exercises can be performed at home, in a gym setting or in a pool. An individualised program that considers each woman’s needs, interests and disability can be developed by our physiotherapists.

We do this by arranging a 1-hour appointment with you in the clinic or in your home to discuss your main concerns. Home visits can be particularly helpful if you have mobility problems, as you are being assessed within your own home environment.

We perform physical assessments like looking at how well you are moving and how strong you are during the appointment so that we can design a program that specifically improves your pain and function.

 

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Loose pelvic floor muscles can lead to urinary leakage

We will also guide you on how to find your pelvic floor muscles and keep them strong to maintain continence.  As your baby grows and places more pressure on your bladder and bowel, you might experience stress incontinence. This is when women pass small amounts of urine when sneezing or coughing.

After creating an exercise program together, you can choose to perform exercises independently, in a group setting or one-on-one. This can be particularly useful for pregnant women with physical disabilities who are experiencing changes in balance from a growing belly and more flexible joints, as well as increased spasms from medication changes. It is important to note that all women are different and chronic pain or symptoms related to physical disabilities can sometimes actually improve with pregnancy.

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Research has shown that preparing your body physically during pregnancy can reduce birth intervention, and increase mental and emotional wellbeing during early motherhood.

3. Help you prepare for birth

Physiotherapists like Kirsty who have additional training in pelvic floor function can assist with pelvic floor stretches to prepare for vaginal delivery and to prevent birth injuries.

For women who want to reduce using chemical pain relief during birth, you can also learn how to use a  transcutaneous electrical nerve stimulation (TENS) machine on your back during labour to help manage painful contractions. This works by giving a small electrical stimulation to the lower spinal nerves, which then reduces the amount of pain perceived in the brain.

TENS scaled
TENS scaled

4. Help you get back in shape after birth

A check-up with a physiotherapist who has extra training in women’s health is highly recommended 6 weeks after birth. Your check-up appointment can include an assessment of your abdominal muscles and core strength, pelvic floor strength, bladder control, bowel control and sexual function.

You also have the option of having an internal vaginal examination so your physiotherapist can assess your pelvic floor strength and position of your pelvic organs in the most accurate way possible. A home program can be developed with you during the appointment to help you restore your core and pelvic floor muscle strength and eliminate any aches and pains.

During your appointment, it is important to ask questions, so you can be sure of your home exercise program. We can also give you access to pictures, videos, and descriptions of your exercises using a mobile app called PhysiApp.

Kirsty in Changing the conversation Tee scaled

At Sports & Spinal Physio,  please contact us if there’s anything you need to know about how physiotherapy can provide support for women who are living with a disability and are pregnant,

Author – Kirsty Hassett

Kirsty@sportsandspinalphysio.com

Resources

Further information on Pelvic floor can be found at the Continence Foundation of Australia

Research articles:

de Freitas, S. S., Cabral, A. L., de Melo Costa Pinto, R., Resende, A. P. M., & Pereira Baldon, V. S. (2019, Jun). Effects of perineal preparation techniques on tissue extensibility and muscle strength: a pilot study. Int Urogynecol J, 30(6), 951-957. https://doi.org/10.1007/s00192-018-3793-1

Leon-Larios, F., Corrales-Gutierrez, I., Casado-Mejía, R., & Suarez-Serrano, C. (2017, Jul). Influence of a pelvic floor training programme to prevent perineal trauma: A quasi-randomised controlled trial. Midwifery, 50, 72-77. https://doi.org/10.1016/j.midw.2017.03.015

Watson, S. J., Lewis, A. J., Boyce, P., & Galbally, M. (2018, Aug). Exercise frequency and maternal mental health: Parallel process modelling across the perinatal period in an Australian pregnancy cohort. J Psychosom Res, 111, 91-99. https://doi.org/10.1016/j.jpsychores.2018.05.013

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