Everything you need to know
During pregnancy, women go through a huge amount of physical and hormonal changes to accommodate the needs of their growing baby.
Post-delivery, many women will have a degree of abdominal and pelvic floor weakness due to the physical demands of pregnancy, hormonal changes, and childbirth.
Some women will experience symptoms such as:
- Pelvic pain
- A weak pelvic floor
- A feeling of heaviness in the pelvis
- Back pain
- Urinary incontinence
- Difficulty controlling wind
- Pain during sex
- Diastasis Recti (tummy gap)
Although these symptoms are common, they shouldn’t be accepted as normal – physiotherapy can make a big difference.
A post-natal assessment by a specialist women’s health physiotherapist can address these symptoms and help stop them in the long term.
Women’s health physiotherapists are experts in understanding changes within the body during pregnancy and can help you in your post-natal recovery journey. If you’ve given birth, whether via vaginal delivery or caesarean, we would recommend having a post-natal assessment.
Before
A post-natal assessment is a comprehensive exam by a women’s health physiotherapist, which is usually done around six weeks after giving birth.
Although we recommend having an assessment in the early postpartum stages, it’s worth doing no matter how long ago you had a baby!
During your appointment, the physiotherapist will take a detailed history, ask you about your birth experience, general health, and any specific concerns you may have. Some questions may be quite intimate in nature. This is so your therapist can build a clear and accurate picture of your current situation. You will then have a physical exam.
This will include:
- Looking at your posture
- Assessing your abdominal muscles. This will include checking for tummy gap (diastasis recti)
- A pelvic floor assessment
- Screening for bladder and bowel problems
- Screening for sexual dysfunction, including pain
- Checking any scars
The physiotherapist will talk you through the results of your assessment and will use these to create a tailored treatment plan that is unique to you.
During
In a post-natal assessment, your physiotherapist’s aim is to work with you towards your lifestyle and fitness goals whether that be confidence to return to your usual daily activities, or high intensity workouts and long distance running!
To help you achieve your goals, your therapist will create a tailored treatment plan that could be based around a mixture of lifestyle advice, physical manipulation or massage, and exercises. You’ll try some of these exercises during your appointment, so that your therapist can check understanding and teach you the correct technique, and then you’ll need to practice these consistently at home between appointments.
Your treatment will generally incorporate
- A bespoke rehab programme
- Pelvic floor exercises
- Advice about safe and appropriate post-natal exercises
- Manual therapy
- Lifestyle recommendations
The type of pregnancy and labour you experienced will determine the type of safe post-natal exercises the physiotherapist recommends. Most women will experience pelvic floor muscles concerns to some degree. This is because during pregnancy, the pelvic floor muscles are put under pressure carrying the extra weight of a baby. If you have pelvic floor muscle concerns, your physiotherapist will focus on pelvic floor muscle exercises to improve strength, maintain muscle tone, and improve control. If you had a caesarean, your therapists may recommend a different mix of exercises, such as core strengthening exercises, as well as scar massage.
In pelvic health physiotherapy, our team also helps to promote healthy bladder behaviour and bowel habits by:
- Working with you to create a healthy and nutritious diet
- Helping you drink two litres of water a day (especially if you’re breastfeeding)
- Incorporating exercises that support your perineum
After
All exercises are practised in a safe space with your physiotherapist. Keep in mind that these exercises only work if you practice them consistently and it can take up to six weeks (or more) to see a difference. So, don’t give up on your exercise programme. With time and patience you’ll notice an improvement.
How to pay for your treatment
If you’re… paying for yourself
Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.
For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of therapist and appointment times.
If you’re… insured
St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.
First appointment
You will have your first appointment in our therapies department. During your first appointment, your therapist will take a thorough medical history and conduct a physical exam.
Treatment plan
Your therapist will create a tailored treatment plan, which could include lifestyle advice, an exercise programme, and massage, amongst other things. You’ll practice the recommended exercises together during each of your sessions. Once you’ve gone home, you will need to follow your therapist’s guidance and practice the exercises consistently.
Follow-ups
You may only need one appointment. However, a series of sessions could be recommended. If this is the case, your first few sessions may be scheduled closer together (for example every week or fortnightly) so your therapist can see how you’re getting on with the exercises and modify your treatment plan as necessary. Your individual circumstances and the progress you make will inform how many sessions you will need in total.