Did you read our previous blog about what is involved in a postpartum women’s health physiotherapy assessment? If not, check it out first before you dive into this one. Today’s blog will be looking at each stage of the postpartum check in more depth to give you a better idea of what is involved and how a women’s health physiotherapist can help you after you’ve had a baby.

So, what can you expect from your appointment?

Your women’s health physio will begin by taking your history and asking you questions about your delivery, bladder, bowels, sexual function, medical and gynaecological history.

Once they have developed a thorough picture of where you are currently at postpartum, they will then determine what further assessments they need to do. This may involve a pelvic floor examination.

Pelvic floor examination

The pelvic floor is a network of muscles and connective tissue that span across the base of the pelvis and support the pelvic organs including the bladder, bowel and uterus (womb) in women. It functions to provide you with the ability to control the release of urine (wee), faeces (poo) and flatus (wind). It also plays an important role in sexual intercourse and birth. To assess the health and function of these muscles, a vaginal examination is generally conducted due to these muscles being internal. It is always your choice whether you decide to continue with this part of the assessment and the physiotherapist will ensure you have the opportunity to say no. During the assessment, the physiotherapist will separate the labia and look externally at the vulva. They will assess any tears or episiotomies that may be present and will likely ask you to activate your pelvic floor, cough or bear down. With your consent, they will then insert a single finger into the vagina to assess the superficial and deep pelvic floor muscles and their function, strength, coordination, the position of your pelvic organs including your uterus, bladder and bowels, anal sphincter function, your risk of prolapse and whether or not there has been any damage to your pelvic floor or connective tissue.

This assessment will provide you and your physiotherapist with a huge amount of information, which will be used to determine whether you may need further treatment based on the goals you would like to achieve. Best of all, this assessment will identify any issues that may currently be present and also your risk of developing issues later down the track, giving you and the physiotherapist the opportunity to both FIX and PREVENT - something that our older generations did not have the opportunity to do!

Assessment of abdominal muscle separation

After giving birth to your baby, you may or may not have had a physiotherapist visit you to assess your abdominal muscle separation, depending on where you gave birth.

At the postpartum assessment with your women’s health physiotherapist, they will assess how wide and long your separation is, how firm the connective tissue is along with the strength of your abdominal muscles, to determine your overall core function. Afterwards, the physiotherapist will provide you with a specific abdominal rehabilitation program to help reduce the separation, increase strength and improve your core function so that you can return to all the activities you’d like to without any concerns.

Other musculoskeletal assessments

Based on your history, your physiotherapist may also look at your breast or bottle feeding posture, your pelvis and other areas of your body that you may be experiencing discomfort in such as your neck, back and wrists.

Return to exercise

All too often, we see women returning to exercise and sport way too early for their recovering postpartum body, leading to pelvic floor dysfunction, incontinence and prolapse.

A big part of what your women’s health physiotherapist will do during your initial postpartum appointment is discuss with you, based on all the information they have gathered throughout the assessment, how to safely return to whatever activities may be part of your goals. They will provide you with a step by step plan so that in one, five or 20 years, your body will feel just as strong and functional as it was prior to giving birth, if not more so.

Is this appointment funded by medicare?

Unfortunately, postpartum women’s health physiotherapy in Australia is not currently part of publicly-funded routine care unless you are experiencing issues, and even then many women fall through the cracks. In many European countries, all women have access to and are encouraged to see a women’s health physiotherapist regardless of the type of delivery they have and these sessions are all paid for by the government. This is exactly how it should be in Australia, but we’re just not quite there yet.

Just remember, whether your baby is 6 days, 6 years or 16 years old, it is never too late to be assessed. If you are in the ACT or surrounding areas, you can book an appointment with one of our women’s health physiotherapists here. They also do telehealth consultations!

Until our government prioritises the recovery of women after having a baby, it is up to us to self-refer for postnatal physiotherapy regardless of whether symptoms are present or not, and spread the word to as many women as we can. Prevention is much better than cure!

Every woman should have a postnatal assessment with a women’s health physio and here’s why - Part 2