Often during pregnancy, women experience discomfort, pain, and even urinary incontinence. Frequently, physicians who treat them—whether general practitioners or obstetricians—give similar advice: "It's because you're pregnant. It will go away after you give birth." But that's not what research shows, Research has shown that for 80% of women, if pain or urinary incontinence hasn't resolved itself 3 months postpartum, it's not going to go away on its own. Some leaking is normal for 3 to 4 weeks postpartum, as the pelvic floor got stretched out from pushing out the baby, however, that overall leaking really is not common or normal."

During pregnancy, the most common areas where women experience pain are the pelvic girdle, lumbar region, and hips, In pregnancy, women are more predisposed to these conditions because of the ligamentous laxity that results from hormonal changes, and because a woman's center of gravity and body mass are changing. Women who have had multiple babies are at higher risk for pelvic girdle pain, as are those with hypermobility, an increased body mass index, and/or history of trauma to the pelvis. During pregnancy, every system of the body sort of morphs and then morphs back again, Just because you're pregnant doesn't mean you have to live with acute back pain. It's treatable through physical therapy." A PT can help a woman with this by suggesting she lie on her side instead of on her back. "Changing positioning while lying down, and during labor, helps the coccyx to move, Much of the pain comes from the coccyx being compressed and unable to freely move."

"We can treat any pain pregnant women are experiencing: neck, shoulder, back, mid-back, or hip pain. Part of our job is to teach our patients how to reengage their body and to move again in a way that makes sense with what is happening during pregnancy. We want our patients not only to be able to move but also to be able to move well. We can teach them how to move, lift, and stand,f they're hurting while sitting or standing, we can help them find a different way to do those things. We encourage that kind of creativity of movement. We help them get stronger."

Implementing Exercise

"The American College of Obstetricians and Gynecologists recommends 30 minutes of moderate- intensity exercise most days of the week throughout pregnancy," Litos notes. "Women who exercise throughout pregnancy recover faster and lose their weight faster. They're at a reduced risk for problems with their pregnancy, and their babies are healthier."

"The primary thing PTs do is neuromuscular reeducation—fancy words for exercise, but we are reeducating those muscles. We use exercises that often focus on back muscles, the core muscles, and sometimes pelvic floor strengthening, depending on the patient, We educate patients about body mechanics. If a patient has other young kids at home, we teach her how to lift and carry them while minimizing repetitive stress. We make sure she understands not to hold a child on the same side all the time but, rather, to switch back and forth.

Labor and Delivery

Women who does proper prenatal care exercises, walking and Positioning tend to have much better and smooth Labor and Delivery.

Postpartum Care

Every woman should have a physical therapy pelvic health checkup postpartum, especially if she had a tear and/or episiotomy (a surgical cut to enlarge the vaginal opening). "Women who have cesarean deliveries should have a postpartum checkup with a women's health PT, because no obstetricians we have worked with have talked with patients about scar mobilization, which can lead to adhesions, bladder pain, and pelvis pain as much as 2 years later,Problems with scar adhesions can persist well into the future, but they are easy to prevent."

Exercise is important after delivery, We often will focus on strength and stability, giving patients the most effective exercises they can do within a limited period of time. women who have diastasis recti (abdominal separation). For most women, the 2 rectus abdominis muscles that have separated during delivery will resolve and close on their own. There are exercises that can be done to improve the woman's motor control during the time that the diastasis is closing. Physical therapists have the skills to examine, test, and find what activities each woman is capable of doing while maintaining closure of the diastasis.

.

Mummy Tummy Misinformation

There's a lot of interest in exercises that women can and should do postpartum. Unfortunately, there's also a lot of misinformation. A recent example that began with a report on National Public Radio (NPR) on diastasis recti (abdominal separation) illustrates the point.