Prenatal Physical Therapy: What to Expect
Insight into what to expect during prenatal physical therapy sessions.
Pelvic floor physical therapy is gaining popularity in the modern day. Many people understand the benefits of physical therapy when it comes to helping to heal postpartum, but unfortunately few understand the benefits of pelvic floor physical therapy while one is pregnant.
We hear it all the time: “I will just wait until the baby is born to go to pelvic floor physical therapy”. This thought is further perpetuated by the medical community because we are a society that helps people only when they have a problem. We as a medical community, are terrible at referring for wellness and preventative services.
There is so much benefit to receiving pelvic floor physical therapy prior to delivering. Logistical reasons, the fact that symptoms not addressed during pregnancy may linger into postpartum, and that pelvic floor physical therapy is extremely helpful at preparing you and your body for birth are all valid reasons to seek out help from a physical therapist while you are pregnant.
First, is the logistical aspect that once you have a newborn, you will not be able to focus on yourself as much as you are right now that you are pregnant. Take advantage of giving yourself a little TLC right now. Once your baby comes, it may not be a convenient time for you to take care of your symptoms!
Not to mention, the more resilient that your pelvic floor is going into labor and delivery, the less therapy you will likely need postpartum!
Next, many of the concerns that you may be experiencing while you are pregnant are not necessarily guaranteed to go away once you deliver the baby. In fact, you are at an increased risk of having low back pain and urinary incontinence postpartum, if you experience it during pregnancy. (1)
There is no guarantee that delivery of the baby will resolve any pelvic floor dysfunction or compensations that have developed during pregnancy, nor is there a guarantee that your body, posture, muscle changes and joint changes will go away upon delivery.
When a pregnant woman is experiencing symptoms such as urinary incontinence and low back pain during pregnancy, these symptoms should be addressed during pregnancy. You should not wait until postpartum to try to get these symptoms resolved, as therapy is successful at reducing or completely eliminating symptoms during pregnancy, and there is no guarantee that delivery of the baby will resolve the symptoms.
Lastly, pelvic floor physical therapists can help you prepare your pelvic floor and body for birth. Through specific exercises to help open up the pelvis, instruction on proper pushing mechanics, instruction on breath work, and incorporating techniques to teach you to relax your pelvic floor muscles, pelvic floor physical therapy helps to improve birth outcomes and reduce the incidence of grade 3 and grade 4 perineal tearing. (2)
What to expect during prenatal physical therapy.
Prenatal physical therapy first starts off with an initial assessment. Your therapist will discuss any symptoms that you may be having, as well as your pregnancy and childbirth history.
After a long talk, your therapist will then perform functional movement assessments to look at your posture, how you are moving, and may decide to take a closer look at specific joints that she may notice are not moving as well as they should be.
During pregnancy, we highly recommend doing an internal (vaginal) assessment of the pelvic floor muscles. This assessment helps the therapist understand how your pelvic floor muscles are moving and she can give you cues and exercises to help you get your pelvic floor moving better.
Your therapist will conclude your first session by summarizing her findings and then will suggest a home exercise program and treatment plan.
Follow up sessions typically build upon the last session and your therapist will progress your exercise routine so that as your pregnancy progresses, your pelvic floor control and ability to relax and open the pelvis improves.
Overall prenatal physical therapy is extremely important and should be a part of everyone’s pregnancy journey.
1: https://www.tandfonline.com/doi/abs/10.1046/j.1600-0412.2003.00235.x
2: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/aogs.14744
Other resources for pregnancy physical therapy:
