Obs and Gynae Rehabilitation

1. Scope of Physiotherapy in Obs &
Gyne
Department of Physical & Rehabilitative Medicine
Dr. Mohabbat Ali

2. Common health problems in
postpartum period:
• Cramps
• Urinary frequency - needing to pass urine often
• Urinary stress incontinence - leaking urine
• Backache
• Heartburn and indigestion
• Blocked nose
• Varicose veins - swollen leg veins
• Constipation
• More …

3. Stitches and swelling/bruising
Stitches in the perineum. Even if don't have stitches,
there may be internal swelling and bruising around
the perineum
Regular pain relief in the first few days is important for
your comfort.
Follow the P.R.I.C.E regime.

5. R.I.C.E
• Rest
flat (on your back or side) regularly until your stitches are
healed. Try to not spend too long sitting, standing and/or
walking in the first few days.
• Ice
packs can be applied to the perineum every 1 - 2 hours - only
leave the icepacks on for 10 - 15 minutes at a time.

6. R.I.C.E
• Compression
rolled towel placed between the legs when sitting
helps reduce swelling and bruising and also gives
gentle support to the perineum.
• Elevate
the perineum area regularly by lying on your tummy
for at least 15 - 20 minutes, with a pillow or two
underneath the hips.

8. Caesarean Section
• This will help to prevent some of the common complications
associated with abdominal surgery (of any kind) the first 24 -
48 hours .

9. Wound support and breathing
• Support your wound
With your hands or a pillow if you need to cough,
sneeze, laugh or go to the toilet to open your bowels.
• Relaxed abdominal breathing
Can help to relieve the discomfort of wind pain and
after birth pains)

10. Circulation
• It is important to get out of bed and moving early after
your delivery to promote circulation.
• Simple leg exercises should be performed and about to
increase circulation and reduce the risk of blood clots.

11. Getting in and out of bed
(Mobility)
• When rolling over out of bed, it is important to support
your wound using your abdominal muscles.
• Don't try sitting straight up from lying on your back. Then
push yourself up into a sitting position using your
underneath elbow.

12. Bladder and Bowels• adequate fluids (aim for 1 1/2 - 2 1/2 litres per day then
drink to your thirst) and regular pain relief.
• Eating a high fibre diet and going for short regular walks.
• Sit correctly when opening your bowels with your bottom
to the back of the toilet seat, legs apart, up on toes,
keeping a straight back and then leaning forwards with
your tummy and pelvic floor muscles relaxed.
• If you are troubled by haemorrhoids,
try applying ice packs regularly.

13. Pelvic Floor Muscle Exercises:
• Tighten your pelvic floor muscles every time you lift
your baby, cough, sneeze or laugh to protect your
pelvic floor and help prevent leakage of urine or
wind.

14. Abdominal Muscles
• Exercise tummy muscles regularly after the birth of
your baby to regain strength and your pre-pregnancy
shape.

15. Pelvic Tilt Exercises
• This can also help to relieve back pain when it is
performed as a gentle stretch.

16. Abdominal Bracing Exercises
• Abdominal bracing uses your deep tummy muscles to help
protect your back and pelvis from pain and injury.

17. Back Care
• Stand "tall".
• Change nappies, dress and bath
baby at waist height. If you need to
get lower, bend your knees
and hips.
• If sitting to feed your baby, sit in a
comfortable chair with back support.
• When carrying your baby, avoid
carrying on one hip.

18. Reference
• The content of this topic was provided by the Women's Physiotherapy
Department at the Woman's and Children's Hospital, South Australia.
http://www.wch.sa.gov.au/services/az/divisions/wab/physio/index.html
• Pregnancy, Birth and Baby is a national Australian Government service
providing support and information for expecting parents and parents of
children, from birth to 5 years of age.
http://www.pregnancybirthbaby.org.au/