'Fourth Trimester:' The need for postpartum care

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For years I have believed that new Moms and their families can benefit from prenatal and post pregnancy care. In our offices we have been taking care of moms during pregnancy and after the birthing process for years. Often moms in our clinics present back, pelvic and hip pain; bladder and bowel issues; pain during sexual intercourse; inability to have an orgasms; no sex drive; changes in their posture due to breastfeeding and carrying their baby on their back or chest and poor rib expansion and breathing issues, just to name a few. Often our moms don't have the opportunity to talk to their M.D.s about all these issues after the birth of their baby, as they usually only see their O.B. physician for one follow-up visit, at the six-week mark after labor and delivery. All this is about to change however, as the American College of Obstetrics and Gynecology (ACOG) is recognizing that the “fourth trimester” of pregnancy should include more than one visit after the birth of a women's baby with the OB physician.

According to the ACOG, ongoing communication between the new mothers and their obstetric care providers during the first three months after birth is essential to the new mother's and family's well-being. That means more than one visit may be more realistic for providing the multifaceted care that is actually part of returning a new mom to her prior level of function.

There is a new ACOG committee opinion that is addressing this optimal postpartum care, by stating that, “better care for women's physical and mental health after giving birth may help reduce maternal morbidity and mortality.”

Alison Stuebe, M.D., an associate professor of maternal-fetal medicine at the University of North Carolina in Chapel Hill, and colleagues, write in the committee opinion, which was published online April 23, in Obstetrics and Gynecology, “In addition to being a time of joy and excitement, this 'fourth trimester' can present considerable challenges for women, including lack of sleep, fatigue, pain, breastfeeding difficulties, stress, new onset or exacerbation of mental health disorders, lack of sexual desire, and urinary incontinence.

“New mothers need ongoing care. We want to replace the one-off checkup at six weeks with a period of sustained, holistic support for growing families,” added Stuebe in an ACOG statement. “Our goal is for every new family to have a comprehensive care plan and a care team that supports the mother's strengths and addresses her multiple, intersecting needs following birth.”

This discussion by ACOG included the need for our profession of physical therapy, and specifically women's health P.T.s, to be directly involved in this process of caring for women during and after the birthing of their children. This direct nod from ACOG is a powerful statement recognizing and indicating that the expertise of a women's health physical therapist can make a valuable difference in the quality of life of all women after having their babies.

Lake City Physical Therapy is proud to be part of this comprehensive plan of care for the women in our community during and after pregnancy. Our goal is to help you return to your optimal physical health, as quickly as possible, so you can return to your busy, active lifestyle with no health issues.

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Sheree DiBiase, P.T., is the owner of Lake City Physical Therapy. She is excited to announce that one of her amazing physical therapists, Laura Steininger, D.P.T., has just received her Obstetrics CAPP certification through the Women's Health Section of the American Physical Therapy Association, which is a high honor in our field of P.T. and indicates her specialty in this area of prenatal and postpartum care. This time of life is important to our moms and their families. Please call us as we can help prevent long term health issues during this time of a woman's life.

Lake City PT has been serving this community for more than 25 years. Please come see us at our three locations. Coeur d'Alene office, 208-667-1988; Hayden office, 208-762-2100; and in the Spokane Valley at 509-891-2623. 
For information, visit lakecitypt.com