POSTPARTUM PHYSIOTHERAPY.

Pregnancy is the most beautiful and also most difficult phase in a women's life. Pregnancy triggers numerous physical changes in a woman’s body, including water retention and weight gain. After delivery, many women have difficulty returning to their prepregnancy weight with average weight retention of 0.5 to 3.8kg (1.1 to 8.4lbs) noted per pregnancy. (Brad A.roy)

A postpartum (or postnatal) period begins immediately after the birth of a child as the mother's body, including hormone levels and uterus size, returns to a non-pregnant state. The terms puerperium or puerperal period, or immediate postpartum period are commonly used to refer to the first 6 weeks following childbirth.

According to WHO, describe the postnatal period is the most critical and yet most neglected phase in the lives of mothers and babies; most maternal and newborn deaths. 

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Complications 

(EA BlomPW JansenGilbert N. CasadyCaroline L.StellaMDAndra H.James Diabetes Control and Complications Trial Research Group Xiao-xing MaAn Liu

  • Postpartum Depression
  • Postpartum Hypertension
  • Postpartum Headache
  • Deep Vein Thrombosis
  • Gestational Diabetes
  • Urinary Incontinence

Treatment:

1.Pelvic floor muscle strengthening:

Clinical studies reported that electric stimulation combined with pelvic floor muscle exercise can treat postpartum urinary incontinence effectively. (Xiao-xing MaAn Liu, et.al. Medicine (Baltimore). 2019 Mar)

Leg lift, plank, and bird dog exercise help in strengthen and lengthen the pelvic floor muscle and also affect the area of levator hiatus, and leg lift exercise also generates the stronger contraction than Kegal exercise (Siff LN1, Hill AJWalters SJ et.al. Female Pelvic Med Reconstr Surg. 2018 May 2)

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2. Postpartum depression

It is estimated that depression will be the second most common cause of disability worldwide by 2020. Postnatal depression is a serious problem across cultures and affects about 10-15% of women sometime in the year after giving birth. 

A meta-analysis found some support for exercise as an adjunctive treatment for postpartum depression but the methodological inadequacy of the few small studies included means that it is uncertain whether exercise reduces symptoms of postnatal depression. (Amanda John Daley, Kate Jolly et. al.) 

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3. Core Muscle Stability:

By strengthening the core muscle around the pelvis and spine and improving the breathing pattern mother’s body ready for facing the challenges like back pain and breathing issues. Pilates is based on the principle that a central core is developed and then movements are introduced to challenge this core stability. (Balogh A RCM Midwives. 2005 May)

4. Physical exercise or Activities:  

Regular aerobic exercise during pregnancy appears to improve physical fitness. The study found that pregnant women who engage in vigorous exercise at least two to three times per week improve (or maintain) their physical fitness. (Michael S Kramer Sheila W McDonald Cochrane Systematic Review 19 July 2006 )

Physical exercise for women during pregnancy and in the postpartum period reduces the risks for the newborn and gives long-term benefits in lifestyle changes. (Nascimento, Simony L et.al. Obstetrics and Gynecology: December 2012 )

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Benefits Of Postpartum Exercise: 

 (Roy, Brad A. ACSM's Health & Fitness Journal: November/December 2014)

  1. Reduces fatigue and increases vigor.
  2. Improves mood states and mental acuity.
  3. Improves fitness
  4. Promotes return to prepregnancy weight
  5. Decrease the risk for developing future chronic health conditions
  6. Provides important mom time and social interactions.

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