Currently, in the United States the standard of care for postpartum mothers is a comprehensive 6-week check in with your OBGYN or midwife provider. The contents of this check up may vary, however it generally will cover any concerns, issues, or questions you may have following the birth of your baby.
This appointment should cover topics such as physical healing from a vaginal or cesarean delivery, how you are doing emotionally and your mood, as well as returning to sex and exercise. This is often considered the “all clear” appointment, where you provider may give you the go-ahead to return to activities.
Here are some general topics that your provider may cover at your check in:
- Physical recovery from birth
- Sexuality, contraception, and birth spacing
- Mood and emotional well-being
- Infant care and feeding
- Sleep and fatigue
- Ongoing preventive health maintenance
- Exercise
However, more recently, it has been discussed that due to the emotional and physical trauma surrounding childbirth, this may call for a more extensive healing time. The American College of Obstetricians and Gynecologists (ACOG) have recommended mothers have initial contact with their providers within three weeks after their delivery, followed by ongoing care as needed followed by a 6-12 comprehensive postpartum visit. This time frame is now being referred to as the “fourth trimester” or the first 12 weeks following delivery.
Although this is part of a newer recommendation, there are still major gaps surrounding postpartum care. A surprising study reported only 40% of mothers attended their postpartum follow up visit.
We recognize the postpartum period as well as beyond can be a challenging, yet wonderful time for mothers and caregivers. As pelvic physical therapists we would like to help fill in the gaps and give you ideas for questions regarding your physical healing at your postpartum appointment.
6 Questions to Ask Your Provider:
- How are my tissues healing for a c-section scar or vaginal tearing? Am I okay to return to sexual activity?
- Could you check me for a prolapse, do I have one? If so, what grade is it?
- Can you assess my pelvic floor, do I have both a good contraction and relaxation of the muscles?
- Do I have a diastasis recti present? Am I safe to return to exercise?
- Ask them about any other physical symptoms you may be having such as but not limited to: low back pain, hip pain, pelvic pain, bladder leakage, internal pelvic pain, pressure or heaviness in the vaginal canal.
- Lastly, if your provider does not have time or the ability to complete a full assessment during you check in ask for a referral to a pelvic health physical therapist.
A pelvic physical therapist is a necessary addition to your postpartum care team. Following up with a PT throughout the fourth trimester/ postpartum phase will allow for further insight into your physical healing. As specialized physical therapists we can thoroughly examine your pelvic floor muscles as well as any to assess for any pain that may be present due to a vaginal/perineal tear during delivery, tension present in the muscles, as well as weakness. A full assessment of your abdominal muscles can be made for a diastasis recti and assist you in making a plan to return to exercise.
At Legacy Physical Therapy, we love working with postpartum moms to help them optimize their recovery. Whether you have had a c-section or a vaginal delivery we recommend you ask your OB or Midwife for a referral to pelvic physical therapy.
We are so passionate about postpartum mom’s getting to see a pelvic floor physical therapist, that we offer a free postpartum screening appointment, so that you can talk with a pelvic physical therapist to learn how to optimize their postpartum healing. Call us at 636-225-3649 to set up your postpartum screening appointment.
References: Acog.org. 2022. Optimizing Postpartum Care. [online] Available at: <https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/optimizing-postpartum-care> [Accessed 25 March 2022].
