Journal of Yoga & Physical Therapy
Open Access

Role of Physical Therapy in Antenatal and Postnatal Care

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Physical therapy being a multidisciplinary approach not only evaluates, diagnoses and treats disorders or diseases but also holds a significant role to improve quality of life by addressing each and every aspect and providing primary healthcare to all age groups and genders. When it comes to women’s health, physical therapist specialized in gynaecology and obstetrics, are highly consecrated for effectively providing both antenatal and postnatal care in order to avoid complications during and after childbirth. Physiotherapists help prevent physical and emotional stresses encountered during pregnancy and labour by improving mother’s overall physical fitness and educating her about physiological changes occurring in her body during pregnancy. Pregnancy care consists of two phases, antenatal (before birth) and postnatal (after birth). Routine antenatal care is provided under ‘early bird classes’ to prepare the partners for parenthood and is shared by physiotherapist, midwives, dieticians and their consultant gynaecologist [1].

Corresponding to physical therapist role in antenatal care is to prevent postural disorders susceptible to develop due to weight and hormonal changes and to ergonomically educate them about back care while sitting, standing, bending, lifting and driving. To maintain abdominal muscles strength, correct posture and relieve back pain, pelvic tilting exercises and pelvic floor muscle training can be helpful. Moreover pelvic floor muscles strengthening is highly advantageous to prevent stress/urinary incontinence, genital prolapse and sexual dysfunction. Some simple exercises are recommended to improve circulation and reduce oedema in lower extremities like frequent ankle pumps.

Cramps, commonly occurring in calf muscles, can be prevented by regular ankle exercises, calf stretches, pre bedtime walk and avoiding prolonged sitting. Stress management is very crucial because it may lead the body to adopt posture of tension. Alongwith other manuevers to relieve stress, physiotherapist can play his/her role by teaching the client ‘Michelle method of neuromuscular control’. Contrast method is also about recognition between tension and relaxation in muscles. Imagery, touch, massage and breathing exercises all are devised for stress management during antenatal period [2].

Role of physiotherapy cannot be underestimated in recovery period after childbirth also called postnatal period/postpartum. The body even starts returning to normal but muscular and ligamentous laxity yet exists to some extent predisposing the women to suffer diastasis rectii, pelvic floor weakness leading to urinary incontinence and organ prolapse. Gynaecological physiotherapist should examine and assess at least after 6 weeks of child birth. After picking up the real concerns, PT should begin exercise program which is particularized for neuromuscular, ergonomic and rehabilitative care according to need of clients. Pain management (electrotherapeutic) and pelvic floor strengthening exercises remain the most valuable intervention during postpartum. Some breathing and circulatory exercises are also encouraged to reduce oedema, release stress and improve cardiopulmonary fitness. To sum up, gynaecological physical therapist has significant role in monitoring, assessing and treating special concerns during and after pregnancy [3].

References

1. Pelvic, Obstetric and Gynaecological Physiotherapy - we have moved! www.thepogp.co.uk. 2020. About POGP. [online] Available at:  
2. Fordyce J. The antenatal period. In Physio in Obs and Gynacol. 2004( 93-139).
3. Barton S. The postnatal period. In Physio in Obs and Gynacol. 2004 (205-247).