Pelvic Health & Orthopedic Physical Therapy
Addressing your questions about pelvic, women's, and musculoskeletal health. Health is a journey. Movement is healing!
Recently I was on Twitter and I saw a woman discussing the lack of postpartum care she received. It was distressing to say the least, but not necessarily unique. In fetal-maternal medicine most of the resources and focus are geared towards the baby. Even after giving birth the focus is on the new bundle of joy. Which is contributing to the rising rate of complications leading to death of mothers in the United States. Now fortunately this individual was very well educated in terms of her health, she seemed to advocate for herself and knew she needed to see a women's health/ pelvic PT. Unfortunately the one in her rural area was out on maternity leave. Thus she could not get the care she needed.
Most of the time women feel that the symptoms they experience postpartum are "normal" or they are embarrassed to talk about them so they don't share them with their OB/GYNs. Their OB/GYN may not even ask about symptoms of diastasis recti, urinary incontinence, organ prolapse, constipation, fecal incontinence, or pelvic pain at their check-up. If you are feeling symptoms of any of these things ADVOCATE for yourself! You know your body best! There is help out there. No one will know what is going on if you don't speak up and tell someone and then push for the services you want. Now here is my second soap box. The specialty of women's health and pelvic physical therapy is the second smallest specialty in the field of PT. This means that in some parts of the country, usually in more rural areas, there are no health care providers that treat individuals with these conditions. They are not trained to. Personally I have patients that travel over an hour to a few hours every week to get treatment and that is just unacceptable. We need more current and future PTs to be trained and treat men, women, and children with pelvic floor dysfunction in all parts of the country. There is no reason that individuals can't get care because they have to drive a few hours away every week. That is a large burden! If you feel that you require pelvic floor or women's health PT services please check these two databases for providers in your area. Just as an aside, not all clinicians may be listed as they must add their names to the list so I would also do a google search and ask your doctor if they know anyone locally before referring you to a different area. https://pelvicrehab.com/ http://www.womenshealthapta.org/pt-locator/ After having a child, women in the United States return to their OB-GYN approximately 6 weeks after having a typical birth for a check-up. The physician performs an internal examination and check how you are healing from the birthing process. They may mention the importance of performing Kegel exercises or the issue of rehabilitation is skimmed over. At this point in time referring women to see a women's health or pelvic health PT following the birth of a child is not the standard of care in the US. It really should be. There are a lot of aspects of rehabilitation from birth that need to be managed (ie changes to pelvic floor structures). I mean think about it, birth is a huge process for a body to go through! A PT should be part of the team managing postpartum care with such a complex process that alters the musculoskeletal system. The pelvic floor is often overlooked in the recovery process and as a result down the road this can lead to urinary incontinence issues, prolapse, or issues with intercourse.
Now compare this to the model in other countries. In France after giving birth women are given up to 20 visits with a women's health PT to rehabilitate. It is also a common standard of care in the UK, Netherlands, as well as Australia to visit a "physiotherapist" (the equivalent of a Physical Therapist) for postpartum care. In the United States the Section on Women's Health (the professional organization representing the PT's treating women's health and pelvic health patients) is one of the smallest, but fastest growing physical therapy specialties. There still need to be more PT's in this specialty field in the US as in some parts of the country access to PT's practicing this specialty is limited. So what can you do? As a patient you can and should advocate for your healthcare. At your postpartum 6 week appointment with your OB-GYN you can ask your physician for a script to a women's health PT in your area to assess your rehabilitation needs. Don't be afraid to research what this postpartum PT care involves and talk to your physician about why you are interested in pursuing this care. |
AuthorHello! I am Caitlyn, Doctor of Physical Therapy and Board Certified Women's Health Physical Therapist working in St Louis, Missouri. Faculty in developing residency program. Endowarrior Categories
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July 2021
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