Adopting a Higher Quality Obstetrical Care Model for Women in the United States Dr. Sara Bolden is a women’s health physical therapist, board-certified women’s health clinical specialist, owner of Women First Rehabilitation in Woodstock, GA and author of What a Girl Wants: The Good Girl’s Guide to Great Sex. If you’ve ever had a baby, witnessed one being delivered or heard of someone’s detailed labor and delivery story, one thing’s for sure, there was pain involved. We’re not talking about a little discomfort here, folks. We’re talking about deep, intense, I-could-kill-the-man-that-did-this-to-me pain. Quite honestly, we’ve come to expect extreme bodily pain during a situation like this. It would be absolutely crazy to think otherwise. I mean, we’re talking about a small melon exiting out of an opening the size of a child’s sock. Yes, the sock will stretch, the melon will emerge, but not without some repercussions…sometimes big repercussions. Often, these consequences can be serious and have lasting musculoskeletal effects. So what’s a girl to do? Physical Therapists are NOT Massage Therapists Many would say, childbirth trauma is inevitable so proverbially “push” through the pain and try to get over it quickly. Unfortunately, this is frequently the default response to childbirth in the United States. There is little to no preparation of the pelvic floor muscles, the low back, the abdomen, nor education for proper breathing, delivery positioning, energy conservation or anything, for that matter, that adequately prepares the body’s musculoskeletal system for the delivery of a small human being. However, for many years now, international countries, such as England, Germany, Australia, Brazil and South Africa (to name a few), have taken proactive measures to assist women with labor and delivery and thus lower the risk of long-term musculoskeletal injuries or urogenital dysfunctions. One way they have elevated the standard of obstetrical care is to include physical therapists throughout pregnancy, during labor/delivery and for postpartum recovery. You might be saying to yourself, “physical therapists? Don’t they just give massages?” Brace yourselves…wait for it…no, they don’t. Physical therapists are not massage therapists. They are, however, musculoskeletal experts that have unique knowledge of the evaluation, assessment, treatment, disease/injury prevention and general wellness of the human body. The Difference a Women’s Health Physical Therapist Makes In other countries, the physical therapists that assist with prenatal and postpartum women are called obstetrical physiotherapists and have advanced skill and training in women’s health. In the United States, we call them women’s health physical therapists. I know, ingenious. They, too, have advanced knowledge and extensive training in women’s health; however in the U.S., their services have only been considered for the prenatal patient with abnormal or life-altering pain or for the complicated postpartum patient with pain and/or pelvic floor dysfunction (i.e. urinary incontinence, organ prolapse or pain with intercourse). Higher Standards of Obstetrical Care If the U.S. adopted a more comprehensive standard of obstetrical care, every pregnant women would be evaluated by a women’s health physical therapist. During the prenatal phase, she would get education and training on pelvic floor stabilization, core strengthening, body mechanics, birthing positions, perineal massage, breathing, relaxation and proper Valsalva for effective pushing, etc. Then, a women’s health physical therapist would be included in the delivery room to help with pain management, assist with birthing positions that open the pelvis and decrease risk of vaginal tearing, perform perineal massage to allow adequate room for the decent of baby, provide biomechanical support and coach the patient on the when’s and how’s of proper pushing…just like obstetrical physiotherapists are doing right now in other countries! After the birth of the baby, postpartum women would follow up with their women’s health physical therapist to assess healing of vaginal and/or abdominal tissues, be educated on scar management and facilitated tissue recovery, learn mechanics for lifting baby as well as for breastfeeding and restoring pelvic strength. Of equal importance, women’s health physical therapists would help new moms get their bodies back in shape, set realistic goals and expectations of motherhood and restore her vibrant, sexual health. Yes, I said “vibrant!” Who wouldn’t want that?! Good news! You belong to a cutting-edge OB/GYN practice and are hearing about women’s health physical therapists! I invite you to do a little research and see for yourself how effective this type of physical therapy is for pregnancy, labor, delivery and postpartum. Don’t be shy: ask your doctor to include physical therapy as part of your prenatal and postpartum experience. Company Bio Women First Rehabilitation is an elite healthcare practice devoted exclusively to treating individuals with pelvic pain, urogynecologic disorders and pelvic floor dysfunction in all phases of life. All of our practitioners are licensed women’s health physical therapists with advanced knowledge and training in women’s health. For more information, visit www.WomenFirstRehab.com.
