PHYSIOTHERAPY DURING PREGNANCY AND AFTER CHILDBIRTH

Pregnancy and childbirth are one of the most challenging events for a woman’s body. During this era women often struggle with pain and discomfort within the back and in their pelvic joints. Dr. Mukesh Mahajan who is one of the best doctor practicing in Pune explains how women can prevent a number of these problems from occurring and offers guidance on appropriate treatments.

WHAT ARE THE PROBLEMS?

These problems are usually associated with the abdominal and pelvic floor muscles. They will present as pain during intercourse, difficulties in holding urine, stools or wind, feeling of increased pressure within the perineum or a niche between the abdominal muscles called diastasis of the rectus abdominis.

“These are all problems which will result from pregnancy and childbirth which can have a big negative impact on women’s mental and physical health.” Says Dr. Mukesh Mahajan.

WHAT HAPPENS TO AN ADULT FEMALE BODY DURING PREGNANCY?

During pregnancy even before the baby bump is visible, the body goes through several major changes.

The posture and therefore the way the body moves changes, the load on the joints increases and therefore the muscles, ligaments and soft tissues get more flexible and elastic to permit the pelvis to stretch to accommodate the baby.

Some women feel rather well during pregnancy with almost no symptoms. However, approximately 20% of pregnant women suffer from pelvis pain and lower back pain during pregnancy, and approximately 7% of girls still struggle with pain even after child birth.

It is also known that 30 to 50% of girls will experience enuresis during pregnancy and albeit these symptoms seem common, they're not normal and that they are often treated and prevented.

WHY THESE PROBLEMS OCCUR DURING PREGNANCY?

Not every woman will experience these symptoms during pregnancy so if you're pregnant or are brooding about becoming pregnant, you don’t got to worry.

We know that there are risk factors which may make women more predisposed to those problems. Women that have a previous history of lower back pain, pelvis pain or pelvic floor dysfunction and have a high workload are more predisposed to struggle with pelvis pain and lower back pain during pregnancy and after child birth.

As for enuresis, being overweight, the pregnancy itself and childbirth (vaginal delivery or c-section) seem to be the danger factors associated in developing it. The risks of developing pelvic organ prolapse in women are associated with increasing age and number of deliveries, a case history of pelvic floor muscle weakness, obesity, prolapse, and repetitive constipation and straining.

SEEING A PHYSIOTHERAPIST CAN PREVENT AND TREAT PROBLEMS

The hormonal changes liable for increasing the capacity of the muscles to elongate and stretch during pregnancy (pelvic floor, abdominal and soft tissues surrounding the pelvis) also can make the joints more hypermobile.

When we then add the additional weight (the baby, amnionic fluid , breasts then on) and any possible previous pain/dysfunction or weak muscles – we potentially have an ideal condition for developing lower back pain, pelvis, enuresis and pelvic floor dysfunction.

The muscles that were already tight, weak and suffering from previous problems might not be ready to deal with having to stabilise a pelvis that's now more hypermobile.

In addition to that, the muscles need to hold everything in proper place while the intra-abdominal pressure (the pressure inside the stomach caused by the baby growing and everyday actions like laughing, coughing, and lifting weights) will keep increasing during the nine months.

During pregnancy your women’s health physiotherapist will assist you by:

• Prescribing safe exercises and advice for you to remain fit and healthy.
• Teaching you about posture and methods which will assist you to scale back the danger of strain and discomfort on your lower back and pelvic joints during pregnancy.
• Treating and preventing low back pain or pelvis pain.
• Teaching you about the pelvic floor muscles and how to do pelvic floor exercises correctly for better results.
• Preparing your pelvic floor for labour and teaching you about perineal massage and other strategies that will help to reduce the pain.

After child birth a physiotherapist is going to help you by:

• Guiding you on the way to recover after childbirth (whether you had a vaginal delivery or a C-section).
• Assessing your posture, breathing, abdominal muscles gap (diastasis rectus abdominis) and pelvic floor muscle function.
• Creating an exercise module to rehabilitate your pelvic floor muscles and your abdominal muscles.
• Guiding you on the way to exercise safely after the child birth.
• Treating any symptoms of pelvic floor dysfunction which have arisen from childbirth.
• Teaching you about sexual health, bladder, bowel and improve your pelvic health.

For most women receiving advice alone isn't enough. Evidence shows that an enormous percentage of girls fail to perform pelvic floor exercises correctly without being formally trained and without supervision. So a trained physiotherapist will help you in this.