A presentation given at the Birmingham NCT Post Natal rehab evening on June 7th 2018.

1. Postnatal Physiotherapy
Sundeep Watkins MCSP HCPCreg
Specialist Pelvic Health Physiotherapist
www.harbornephysio.co.uk

3. Why might women need to be signposted

4. Literature reported incidence :
• 45% have UIC ( Wilson et Al 2002) 7 years postnatally (31% initially
continent early post partum)
• 45% have pelvic pain during pregnancy (Wu et al 2004) and 20 – 25 %
in the early postpartum period (Ostgaard et al 1991, Albert et al 2002,
Wu et al 2004).
• 50% of parous women have some degree of symptomatic or
asymptomatic POP ( Hagen and Stark 2011)
• 60% have RDA 6 weeks post delivery (Sperstad et al 2016)

5. 1-hour post-natal assessment with a Specialist Post-natal Physiotherapist
6 weeks or many years after birth aiming to prevent long-term childbirth related complaints.
• In depth check of pelvic floor strength and tummy gap
• Assessment of any physical problems arising from pregnancy and birth
• A bespoke post-natal recovery programme devised especially for the client, their lifestyle
and fitness goals. This includes specific and safe post-natal exercises to improve stability,
posture and core strength

6. Tummy Gap

11. C- Section recovery

12. Returning to Exercise

13. Returning to exercise
• Low impact initially
• Breathing technique & Pelvic floor engagement important
• Consider the post partum period = 1yr (or more)
• One size does not fit all!

14. Signs you are exercising too hard too soon
• Leaking
• Urgency
• Heaviness or bulge into vagina during or after exercise
• You have to hold your breath to do it

15. Summary
• Postnatal checks need to include Mum
• Tummy gap & continence issues are common BUT not normal
• Returning to exercise is important BUT …..
Physiotherapy works!

16. Helpful websites and info:
• http://www.birthtraumaassociation.org.uk/
• http://pogp.csp.org.uk/information-patients
• https://www.bladderandbowel.org/
• https://www.pelvicpartnership.org.uk/
• National Collaborating Centre for Women’s and Children’s Health; National
Institute for Health and Care Excellence (commissioner). Urinary
incontinence in women: management. London: Royal College of
Obstetricians and Gynaecologists; 2013. (NICE CG171). [Issued September
2013; updated January 2015]. Available
from: https://www.nice.org.uk/Guidance/CG171

17. Why might women need to be signposted :
sources of info
• http://www.abc.net.au/news/2017-03-07/motherhood-and-babies-
what-they-dont-tell-you/8318688
• http://www.bbc.co.uk/news/health-37506001