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Why it is important to get a six-week postnatal check with a pelvic physio even if you feel OK?

Mummas out there! We have lots of questions from new mums recently about how to safely return to exercise post bub.

Having a baby is one of life’s truly remarkable experiences and pregnancy and delivery (vaginal or caesarean section) are major events that bring about much change to your body and your life. Therefore, it is critical to understand how this process has affected you to enable optimal recovery postpartum and a safe return to exercise.

The first 3-4 months postpartum is a time for healing and repair. We are asked many questions on what new mothers should be doing in this time. A good pelvic floor and postnatal check will assist in reducing the risks of urinary incontinence, abdominal muscle separation, painful intercourse, hernias, and pelvic organ prolapse (movement of one or more of the pelvic organs into the vagina due to weakness). Therefore, advice and a postnatal assessment can be invaluable to women in preventing these poor outcomes and longer recoveries.

At Body Align Physio we offer physiotherapy postnatal assessments from 4-6 weeks post partum, which is strongly recommended as well as your GP or obstetrician 6-week check to assist in this education and rehabilitation process.

Our postnatal assessment will help to identify key issues that need to be addressed such as pelvic floor weakness, abdominal muscle separation, postural dysfunction and musculoskeletal aches and pains. The therapist will also educate you on the safest way to return to exercise, which is particularly relevant when returning to more demanding or high impact exercise because of the stresses placed on the body.

1. Starting your pelvic floor straight away

Ideally you want to keep up your pelvic floor exercises in pregnancy so you have a good base to start from. Pelvic floor exercises can begin as soon as day 1 or 2 post delivery. It is completely normal to feel minimal or just a flicker sensation in the first few days, and if you have had any trauma including tears, episiotomy or other intervention (forceps or ventouse) it may take a little more time. Either way its best to get started as soon as you can.

2. The first 4-6 weeks: A time for healing and repair

It's important to wait until your 6 week check to discuss with your GP any concerns you have and to allow your body to heal and recover. If your GP doesn't conduct a pelvic floor assessment (either internal or using real time ultrasound) it is recommended you have a pelvic floor assessment with a pelvic physiotherapist. They assess the activation and relaxation of the pelvic floor muscles, check for any tears, and the supportive tissues of the bowel, bladder and uterus for signs of prolapse.

3. Begin slowly and work up

Many women report they are in a hurry to return to their pre-baby body. Start with a walking program and work your way up in increments. Any signs of pain, bleeding, pulls or aches is a warning sign to slow down. More intense exercise can begin from 12-16 weeks

and as guided by your allied health care professional. Incorporating your pelvic floor exercises with strength training is also advised as you return to exercise with higher intensity and impact.

Written by physiotherapists Claire Denton and Amanda McDonald.

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