Why you need to see a women’s health physio during pregnancy

Pregnancy is a time of significant physical growth and change. Bumps and lumps. Leakage of all kinds of fluids from all different bodily locations. It’s also a time for unwarranted comments from people around you, and advice that you didn’t always ask for. (You might get seriously sick of being told what you can and can’t do with your body.)

‘Squeeze your pelvic floor.’

‘Don’t eat that.’

‘Stop exercising.’

‘You can’t do that now that you’re pregnant.’

Don’t get me wrong. Pregnancy is a wonderful, interesting, and exciting time for your amazing mama body! But with so much physical change comes concern about the unknown.

‘Is this meant to be happening?’

‘Is this pain normal?’

‘Could this harm my baby?’

‘Is this going to cause permanent damage to my body?’

Enter: a women’s health physio.

To put you at ease

Women’s health physiotherapists are specially trained physios who work with pregnant women to help them make sense of the unknown.  

We work with all the P’s:

  • Prolapse
  • Poop
  • Pelvis
  • Pelvic floor
  • Pain.

We also work with women in preparation for labour and birth, or in keeping with the P’s: preparation, positioning, and pushing practice. (That’s right. Pushing practice. Did you know a women’s health physio can help you learn to push?) We’re here to put you at ease about what’s happening with your body, and prepare for one of the most intense physical experiences you’ll ever go through. 

To openly talk TMI 

In a prenatal physiotherapy session, we focus on YOU. We talk about all those things that might be TMI outside the privacy of our consultation room. Details like:

  • Do you have any back, tailbone or pelvis pain?
  • Have you had any surgeries?
  • What is your sex life like? (and do you ever experience pain or feel like you could leak?)
  • How often do you poo? (and what consistency is it?)
  • Have you ever lost control of your bladder or bowels?
  • What were your periods like? (and were you able to use tampons?).

You know… the stuff you don’t really sit around the dinner table and chat about.

No, women’s health physios don’t have some sort of weird fetish, nor are we just particularly nosey. There’s a valid reason we need to ask these things, I promise. 

Openly talking about everything that’s occurred with your body from the time you were born until now gives us a really great picture of YOU. It helps us identify certain areas of your body that we might need to assess, and make sense of the things that could have been ongoing for years. It helps us piece together all the different parts of you and your body that may have seemed like a puzzle up until now. 

We might even start asking you to chat with your family about their pelvic floor – also not your usual dinner table chit chat, I know. But it’s important to know if there are any genetic factors we should consider too (like prolapse, hernias or abdominal separation).

You might not think that your horrible period pain and bloating, or your surgery and subsequent sexual pain are related or important for pregnancy and birth. But for a women’s health physio it’s super important. Details like this might tell us that we need to assess your pelvic floor sooner for the possibility of tension, which we’ll work to reduce in preparation for a vaginal birth. 

(If we can get you having enjoyable, pain-free sex then that’s a huge bonus too, am I right?!)

To help you achieve your goals

Once we understand your history, we start talking about the present. Now that you’re pregnant or planning a pregnancy, what would you like to be able to do with your body?

For some women, it’s continuing to exercise (think pilates, yoga, Crossfit). For some women, it’s planning for a vaginal birth. For some it’s ways to avoid abdominal separation. (Spoiler alert: we can’t promise to avoid this as it’s a natural part of your growing body to accommodate a baby! And research doesn’t show any way to avoid it.)

We’ll discuss your plans and hopes for your pregnancy, and help you understand your body so you can make informed decisions that suit you and the little human you’re growing. 

For example, yes you may be able to physically do handstand pushups at 30 weeks (and that’s very impressive by the way), but do you really need to? 

To assess your changing body

What we assess in your physio session will be based on your goals, your concerns, and how far along you are.

  • If you want to have your pelvic floor checked, we need to ideally wait until you’re 20 weeks along, as this is when we know the position of your placenta.
  • If you want to have your abdominal wall assessed, we can do that anytime.
  • If you’re in pain – think tailbone, ribcage, lower back, and hips – we can also do this at any time.

If my mention of a pelvic floor examination has you ripping your women’s health physio referral into a billion pieces, don’t stress! It’s not as mortifying as it sounds, trust me.

To plan and prepare for your pregnancy

Once we’ve chatted and assessed – which will look different for every woman – we make a plan (attack of the ‘P-word’ again!).

This may look like following up later in pregnancy to work on relaxing your pelvic floor and practising pushing strategies. It may look like weekly sessions to reduce pain and get you moving better. It might be checking in every couple of weeks to identify suitable exercises.

There isn’t a one-size-fits-all approach to women’s health physiotherapy, and what you work on with your physio will look different to what your friends are working on. Our goal is to give you the ability to make informed decisions about your body and your birth, so you feel confident and have a safe space to ask questions. 

By this point I hope you’re all P-worded out, but also thinking, ‘I must see a pelvic floor physio, NOW!’ In which case, my job here is done and you can refer to an online directory to help you find a women’s health physio in your area. 

Now, please share this article with your pregnant friends so they can get on board too!

Expert author: Brooke Blair

Brooke is a female health physio based in Sydney. You can find her on Instagram here.

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