Benefits of Post Natal Physical Therapy

The post natal period can be a stressful one for many mothers. In addition to looking after their baby, they are sometimes affected by health problems of their own that require attention. Common medical problems that occur following delivery include pelvic floor muscle weakness, urinary and faecal incontinence, depression and other psychological stresses. Numerous factors can influence this, including support from friends and family and the mother’s own perception of how she is coping.¹

Physical therapy has been widely utilised as a treatment strategy to manage mothers in the post natal period. In this article, we shall briefly review their role and how they help new mothers through what can be a stressful time.

Physical therapy and incontinence

Following delivery, it is not uncommon for women to develop pelvic floor muscle weakness. This can result in embarrassing urinary and faecal incontinence. Treatments range from simple exercises to hot and cold therapies and electrical stimulation. One recommendation that is often made is to train the muscles before stress incontinence kicks in. This works based on the principle that trained muscles can withstand stress a lot better, and the trauma from childbirth to the muscles does not cause as much damage as it would do if the muscles were not trained.²

In fact, a meta-analysis demonstrated that women who underwent supervised or intensive pelvic floor muscle training through physical therapy had a significantly lower chance of developing stress incontinence. This was regardless of the type of childbirth the mother underwent, including forceps delivery or delivery of a big baby.^2,3 While there does exist evidence to the contrary, these were riddled with confounding factors.⁴ It appears however that physical therapy bears a great deal of benefit in the post natal period.

Physical therapy and depression

It is well recognised that exercise helps elevate mood and promotes well-being. Studies have shown same outcomes in younger and older women as well.⁵ Greater levels of activity are associated with greater satisfaction amongst mothers regarding motherhood, and this effect can be seen after one exercise session.⁶

In a more recent study assessing the specific impact of physical therapy in women in the post natal period, exercise significantly reduced the risk of developing post natal depression by 50%. The effects of exercise persisted over 8 weeks after treatment as well. Exercises including aerobic exercises seem to have a more positive impact when compared to non-aerobic exercises.

Conclusion

Physical therapy is an often offered treatment for women in the immediate post natal period. Treatments are offered in a structured manner and are aimed at strengthening pelvic muscles and elevating overall mood. This allows mothers to concentrate on what is important – looking after their child’s and their own health.

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REFERENCES

1. Milgrom J, Martin PR, Negri LM. Treating Postnatal Depression: A Psychological Approach for Treating Health Care Practitioners. London, United Kingdom: John Wiley & Sons Ltd; 1999
2. Hay‐Smith, Jean, P. Herbison, and S. Mørkved. “Physical therapies for prevention of urinary and faecal incontinence in adults.” The Cochrane Library (2007).
3. Reilly EIL, Freeman RM, Waterfield MR, Waterfield AE, Steggles P, Pedlar F. Can postpartum stress incontinence be prevented? [Abstract]. International Urogynecology Journal and Pelvic Floor Dysfunction. 2001; Vol. 12 (Suppl 3):S1.
4. Meyer S, Hohlfield P, De Grandi P, Megalo A. Is pelvic floor reeducation after vaginal delivery effective? A prospective double-blind randomized study in primiparae [Abstract]. Neurourology and Urodynamics 1999;18(4):290.
5. Armstrong K, Edwards H. The effects of exercise and social support on mothers reporting depressive symptoms: a pilot randomized controlled trial. Int J Mental Health Nurs. 2003;12:130–138.
6. Sampselle CM, Seng J, Yeo S. Physical activity and postpartum well-being. J Obstet Gynecol Neonatal Nurs. 1999;28:41–49.
7. Norman, Emily, et al. “An exercise and education program improves well-being of new mothers: a randomized controlled trial.” Physical therapy 90.3 (2010): 348-355.