Pregnancy & Postnatal
During pregnancy a woman’s body experiences extraordinary change - the pelvic floor, for instance, significantly stretches during pregnancy and can be damaged during childbirth. Yet after the baby is born, the mother’s needs can be neglected and often women cannot access the necessary expert information, treatment and rehabilitation. Likewise, there is a lot of pressure on women to return back to their pre-pregnancy form and exercise levels. It is important to acknowledge that the body needs time to heal and recover. Every woman deserves well-considered advice and guidance on which exercises to do, and when, according to their ability and the rate at which their body is healing.
During pregnancy the pelvic floor (the sling of 23 muscles at the base of the pelvis) lengthens and becomes thinner to accommodate the growing baby. Women’s Physiotherapy Reigate helps women prepare for birth by teaching women how to strengthen the pelvic floor muscles through exercise. These exercises will maintain, and sometimes improve, the strength of the pelvic floor helping to support the pelvic organs such as the bladder and prevent post-birth problems such as urine leaks. Advice can be provided on prenatal exercise, birth positions and perineal massage, which can help prevent tears during childbirth.
Women’s Physiotherapy Reigate also treats problems that may occur during pregnancy, for example, pelvic girdle pain (any pain felt in the pelvis and hips), low back pain, carpal tunnel syndrome (when pressure on a nerve in the wrist causes pain and numbness in the hand and fingers) and leaks of urine.
Women’s Physiotherapy Reigate offers a postnatal MOT for women following vaginal or caesarean births. The MOT involves discussing the birth and recovery, assessing the pelvic floor muscles, assessing any scars and offering treatment/guidance on how to best manage these, a postural screen, assessing the stomach muscles to check for any separation, screening for bladder, bowel and sexual dysfunction. It also includes education and advice on safe activities such as lifting the baby or pushing the pram and provides a bespoke rehabilitation programme to ensure recovery after the birth is optimised.
There are a number of problems that can occur after childbirth including vaginal and perineal tears, episiotomy or caesarian section scar tightness, a gap in the midline of the abdominal muscles (known as diastasis rectus abdominus), leaks from the bladder or bowel, a vaginal prolapse or a feeling of weak muscles and wanting to strengthen them before returning to hobbies or sports. More information about these conditions can be found below or under the conditions section of this website.
Women's Physiotherapy Reigate offers a postnatal MOT to ensure safe return to the activities you love.
Post-birth vaginal and perineal tears
During vaginal birth the pelvic floor stretches to up to three times its normal length. This can cause tears to the vagina and perineum (the area between the vagina and the anus), which sometimes extend to the anal sphincter muscles (this is the ring of muscles that surround the anus and prevent leaks of faeces). It is critical that the pelvic floor and any tears are assessed postnatally and appropriately rehabilitated to ensure women regain normal function, and can confidently return to the activities, including sport, that they enjoyed pre-pregnancy.
Some women require an episiotomy (a cut into the perineum and vaginal wall) to make space for the baby to come out, which is stitched up after the baby is born. The episiotomy site can be painful and stiff after it has healed. Women’s Physiotherapy Reigate can provide guidance on managing this problem.
After caesarean section
A caesarean section is major abdominal surgery and women need time to heal and recover. Once the wound has healed (which can take up to 6 weeks) women may benefit from guidance on massaging the scar to make it feel less sensitive, soften it and improve its appearance. They may also benefit from a strengthening programme to rehabilitate abdominal muscles that have been affected by surgery so they can resume their pre-pregnancy activities and avoid secondary problems, such as lower back pain.
Diastasis Rectus Abdominus (DRA)
Towards the end of pregnancy all women develop a gap down the centre of their abdomen. This is completely normal and necessary to accommodate the growing baby and is called a Diastasis Rectus Abdominus (DRA ). For 60% of women the DRA will resolve within eight weeks of delivery but for 40% of women the gap persists. Women with a DRA require rehabilitation to close this gap and regain strength in their abdominals. If the abdominals remain weak, everyday activities such as getting out of bed, lifting, or even coughing, can put stress on other parts of the body, particularly the lower back, and cause pain.
Returning to exercise after childbirth
There are so many benefits to exercise. It can reduce low mood, stress and anxiety and can help prevent cardiovascular disease, cancer and diabetes. Women’s Physiotherapy Reigate can create a bespoke programme that enables postnatal clients to safely return to the physical activities they enjoy at a time and pace that feels right.