The postpartum care model…are we doing enough?
Number of antenatal appointments = 11
Number of baby appointments = 10
Postpartum appointments = 1
In Australia, women with uncomplicated pregnancies generally have between 10-12 antenatal appointments starting from between 6-8 weeks of pregnancy and their baby will have approximately 10 developmental checks from birth to 4 years of age. Yet after delivery, the standard care for women in Australia is to have ONE postpartum appointment with their GP or obstetrician at 6-weeks. We hear many women referring to this appointment as a “6-week clearance” rather than check.
In all our years of being physiotherapists, we have never once assessed a woman at 6-weeks postpartum who we have been able to give full clearance to return to all types of activities. Not to mention the guidelines actually recommend that women do not return to running or higher intensity activity before 12 weeks after delivery for risk of developing longer-term issues including prolapse. So for us, the single 6-week postpartum check in isolation is not enough.
Don’t get us wrong, we do have a very deep respect for our GP and obstetrician (OB) colleagues who are highly skilled in the care that they provide for both mother and baby, and we work very closely with these professionals however, when we are talking about returning to exercise and ensuring pelvic floor dysfunction does not occur, we need to make sure women know that they should have this check with their GP/OBGYN AND see their women’s health physio as part of standard practice.
What needs to happen as part of standard postpartum care is a scheduled check up with both their GP/OB AND a check up with a women’s health physiotherapist who is highly skilled and trained in providing a specific postpartum assessment. During this assessment, the women’s health physio will check the function of the pelvic floor (including strength, coordination and endurance), pelvic organ prolapse, scar tissue following tearing, episiotomy or Caesarean section, abdominal wall function including strength and abdominal muscle separation plus SO much more. If this assessment is not done, then we have no way of telling whether prolapse, incontinence or other dysfunction will occur when women start to return back to normal life and exercise after the birth of their baby. Unfortunately without these checks, many women do develop the above, which is what we see far too often in the clinic.
Why is it that our orthopaedic surgeons call for both pre and post-operative physiotherapy to improve outcomes after joint replacement but our healthcare system doesn’t advocate for standard ante and postnatal women’s health physiotherapy regardless of the type of delivery when arguably, pregnancy and birth cause much more trauma to the body? Prevention is SO much better than cure and we think we as a society can do better!
So please, spread the word to your friends, sisters, nieces, mothers, grandmothers (because yes, we can help them too!) and let us advocate for our bodies as women because until these checks become part of routine healthcare, it is solely up to us!
If you are in the Canberra region, you can book your 6-week postpartum assessment here.
