Having a baby is one of life’s truly remarkable experiences. Pregnancy and delivery (vaginal or caesarean section) are also major events and bring about much change to your body and your life. These changes impact mothers in different ways and to different degrees. For optimal postpartum recovery, it is critical to understand how the process has affected you. This enables you to rehabilitate your body properly, especially your pelvic floor and abdominal muscles.

It is very common for post-natal women to experience pelvic health conditions, and appropriate exercise and treatment effectively rehabilitates the majority of symptoms. To determine your rehabilitation needs, we offer a Post-Natal Assessments for mothers six weeks after delivery which will include the following:

Please Note: We advise you to contact our clinic as soon as possible after your delivery date in order to be accommodated for a post-natal check up within the timeline.

Pelvic Floor Assessment 

Your Pelvic Floor Muscles (PFM) play a major role in continence, pelvic stability and sexual function and these vital muscles are impacted through pregnancy and delivery. We assess the impacts of pregnancy and birth on your pelvic floor muscles and determine the strength, endurance and coordination of your PFM. This is important after both vaginal and caesarean deliveries.

A pelvic floor muscle assessment may be performed via an internal examination or real-time ultrasound.

Internal assessment: Often times people don’t really get what a pelvic floor contraction is and this is where an internal assessment can be done to see if you are getting the knack.

External assessment: We use real time ultrasound to assess the pelvic floor muscle contraction.  This can be done at the bikini line and does not involve doing an internal assessment.

Throughout this assessment our physiotherapist will also assess for the presence of pelvic organ prolapse. This is where one or more of your pelvic organs (bladder, uterus, or bowel) have less support and drop into the wall of the vagina. It is estimated that approximately half of all women who have ever had a baby will experience some degree of prolapse. However, not all women will experience bothersome symptoms.

Abdominal Diastasis Recti  –  Tummy Seperation Check

A normal physiological change that occurs in pregnancy is the stretching of the abdominal wall. In some women, this results in a Rectus Abdominus Diastasis (RAD). This is where the supporting fascia/ligament that runs between the rectus abdominus (6 pack muscle) is stretched. This can result in there being a gap between the edges of your muscles. We measure the depth and width of any separation you may have developed in your pregnancy.

We assess and measure your abdominal separation using Real Time Ultrasound.  We can measure any gap on screen and use this as a guide to monitor your progress.

Pubic Symphysis Diastasis

Pubic symphysis diastasis is defined as the separation of the pubic bones, without fracture. The pubic symphysis joint is made up of two pubic bones and a cartilage disc, which sits in between the two bones. With a diastasis or separation, the pubic joint dislocates. Not only can this happen due to the trauma from childbirth and hormonal changes and pressure during pregnancy, but also via a horseback riding incident, sports injury, motor vehicle accident, or fall. Our physiotherapists will work with you to recommend a treatment plan, and we will help you with a safe, tailored exercise plan. We will adapt the treatment to suit your needs.

Perineum Tears with childbirth

Your perineum is located between your back passage (anus) and your vaginal opening. It is common for this area to tear while giving birth.

There are different types of perineum tears:

  • First-Degree Tears – These are small tears that only impact the skin. They tend to quickly heal without any treatment.
  • Second-Degree Tears – These are tears that impact the muscle of the skin and perineum. Stitches are usually needed.
  • Third and Fourth-Degree Tears – For some mothers (around 3.5 out of 100), the tear can be deeper. These tears, which are also known as obstetric anal sphincter injuries (OASI), extend into the muscle that controls the anus. These tears sometimes tend to need surgery.

Treatment may involve:

As physiotherapists, we can help you to treat any sort of birth tear that you are experiencing. We will teach you perineum massage and recommend a tailored exercise plan. A perineal massage involves massaging the area between your anus and vagina to increase blood flow and help the tissue skin stretch with greater ease. The massage can actually begin during pregnancy from 36 weeks onwards to prepare the perineum for birth and to reduce the likelihood of experiencing a tear.

Mastitis and blocked milk ducts

Mastitis is an inflammation or infection of the breast tissue that causes breast pain, swelling, warmth and redness in one or both breasts. While it can affect anyone, it is much more prevalent in breastfeeding women and usually occurs in the first few weeks of breastfeeding. Common causes include oversupply of milk, blocked milk ducts, infection, and injury to the breast tissue.

Blocked ducts is a condition that refers to a blockage of the ducts that carry milk to the nipple for breastfeeding. Early intervention – such as home strategies, advice for feeding, and exercise to promote lymph drainage, and therapeutic ultrasound with a women’s health physio – is key with this condition because it prevents engorgement and infective mastitis by clearing the blockage.

Treatment for Mastitis and Blocked Milk Ducts is: 

Depending on your presentation, we can recommend a range of treatments for mastitis and blocked milk ducts, alongside providing education on home-based management strategies. Massage can help lymph drainage and relieve milk duct blockage, while ultrasound therapy encourages circulation and reduces inflammation. In most cases of blocked ducts, symptoms can be resolved in fewer than four short sessions.

Returning to exercise 

Based on your assessment we design exercises to help you return to your previous strength and mobility in a safe manner.  We go through the exercises to ensure you understand what type of postnatal exercise is safe to do and why.  These exercises are sent to you on our exercise app with video clips. We provide advice on when it is safe to return to running and weight lifting.  We can also communicate with your personal trainer on some safe adaptations for you.  The post-natal examination will determine your safety to return to specific forms of exercise. Rest assured, if you do have bothersome symptoms, your physiotherapist will provide you with a rehabilitation plan to place to safely facilitate your return to exercise and sport.