If you’re pregnant or a new mum, you’ll know how much change the female body undergoes. Physiotherapist YIP WAN HUI specialises in pelvic health and explains how prenatal physiotherapy is key to good pelvic floor health. She also gives advice on why keeping up with physio post-pregnancy can prevent and resolve issues for a more active tomorrow.
What inspired you to pursue a career in women’s physiotherapy?
I developed an interest in women’s health during my undergraduate training because the faculty was so passionate. After having two children of my own, I realised how important it is to have women supporting women through important life stages.
What happens to our bodies during and after pregnancy?
In a healthy pregnancy, body weight should increase by about 12kg. Hormones are secreted so that the body can stretch to accommodate the growing child. In the later part of pregnancy, the ribs are pushed upwards to make room for the growing baby and ducts mature in preparation for breastfeeding. These changes increase load on muscles and joints, predisposing to pain. Increased pressure on the pelvic floor due to weight gain and hormonal changes can cause pelvic floor health to weaken and result in urinary leakage.
With vaginal delivery, the pelvic floor can weaken or tighten up in response to discomfort during the healing process. This can reduce bladder control or cause pain with sexual activity. With c-section delivery, abdominal muscles can weaken and tighten up causing back discomfort.
When is a good time to start seeing a women’s physiotherapist?
Around week 12 of pregnancy is ideal. This gives you plenty of time to work on targeted muscle strengthening before problems occur.
How is prenatal physiotherapy helpful for staying injury free and maintaining pelvic floor health?
Individualised assessment to identify specific tightness or weakness and addressing them with exercises before significant weight gain is helpful in preventing discomfort and urinary leakage in pregnancy.
Guidance on correct pushing techniques and perineal massage can reduce chances of bad tears during delivery. Even if you deliver via c-section, a physiotherapist can show you methods to reduce discomfort and fear about movement after delivery.
What issues do you regularly see as a physio post-pregnancy?
Urinary and flatus incontinence are two embarrassing conditions. Although common, they’re not normal and guided pelvic floor training can help. Abdominal muscle imbalance and separation can reduce overall strength and cause back pain, preventing mums from participating in baby care and returning to activities they enjoy. Blocked ducts and neck and wrist pain are other common conditions that physios can help with after childbirth.
How do you assess and treat perinatal women?
Detailed questioning is the first step to identify what bothers the individual, and to understand goals for therapy. Physical assessment of the abdomen, pelvic floor and relevant joints is then done, focusing on areas of concern. Manual therapy is then performed and a programme of exercises is designed to fit into their daily routine.
What role does ultrasound play in prenatal physiotherapy and post birth?
Real-time ultrasound is used to visualise the pelvic organs so that you can see how well supported your organs are in different positions, if you are performing your pelvic floor exercises correctly and even show you if you are pushing effectively while preparing for labour. Therapeutic ultrasound may be used to treat blocked ducts in a pain-free manner.
How quickly can women expect to see improved pelvic floor health?
You should expect improvement after two sessions. How many more sessions you’ll need depends on how long you’ve had the problem and how quickly your body strengthens up with exercise.
Any extra tips for what women can do at home for their pelvic floor health?
Engage in regular strengthening exercises, have a balanced diet and maintain good sleeping habits.
City Osteopathy & Physiotherapy has clinics at Novena, the CBD, Bukit Timah, Woodleigh and the East Coast. Book your pelvic floor health consultation and treatment using the website or QR code below.
Like this article on pelvic health and physio post-pregnancy? Check out our Health and Fitness section for loads of great content.
This article first appeared in the October 2023 edition of Expat Living. You can purchase the latest issue or subscribe so you never miss a copy!
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