Login
Register

Home

About Us

Diagnoses

Treatments

Classes

Resources

Media

Testimonials

Blog

Account

Blog
Register
postpartum care in the fourth trimester

Redefining Postpartum Care in the “Fourth Trimester” by Utilizing Pelvic Floor Physical Therapy

Last month the American College of Obstetricians and Gynecologists (ACOG) updated their position on postpartum care in the “fourth trimester” - the first 12 weeks after your baby is born. This is such a huge step for better healthcare and support for women after delivery. In other countries (France, Belgium, Northern Ireland and other European countries), postpartum physical therapy is a routine referral for women both in the hospital and for ongoing support when they are discharged.

The statement updates the previous recommendation of a 6 week visit, and instead supports a paradigm shift of postpartum care that not only adds contact with their Ob-Gyns within the first 3 weeks of delivery, but also address the need for ongoing care:

“Timely follow-up is particularly important for women with chronic medical conditions. The initial assessment should be followed up with ongoing care as needed, concluding with a comprehensive postpartum visit no later than 12 weeks after birth. This visit should serve as a transition to ongoing well-woman care and the timing of the visit should be individualized, woman-centered and the follow-up should include a full assessment of the following:

• mood and emotional well-being

• infant care and feeding
• sexuality contraception and birth spacing
• sleep and fatigue
• physical recovery from birth

• chronic disease management
• health maintenance

Maternal Mortality and Improving Care

The ACOG statement came initially to address maternal morbidity and mortality in the US. This past weekend our pelvic health physical therapists represented Femina PT in Downtown Los Angeles at the inaguaral rally -- March for Moms

IMG 1657

This event is a national movement to address the maternal health crisis in our country. As far as industrialized countries go, the United States has the highest mortality rates--three times that of Canada and six times higher than Sweden. Awareness was raised to improve support before, during and after childbirth. It is their mission, as well as ours, to educate women and provide support during critical times. A University of North Carolina study on postpartum problems found that:

  • 15% experience breast infections
  • 27% have heavy bleeding
  • 29% have frequent headaches
  • 23% have hemorrhoids
  • 31% have urinary problems
  • 30% have bowel problems
  • 15% experience postpartum depresssion, and many more have feelings of sadness and stress

And until now, healthcare providers have sadly normalized these symptoms "because you've had a baby". From a physical persective, it is important to notice if both sensation and function are working for you the way you want them to. How is urinary and bowel function? Any bladder leakage? Bowel leakage? Issues with straining and constipation? How is sexual function? Are your orgasms the same as before baby? Are you having pain during intercourse? Are you having clitoral pain? Tailbone (coccyx) pain? Pain from your scar tissue (vaginally or c-section)? Have you developed a "weird hip pain" since delivery? Or other orthopaedic pain, such as lower back pain? Some of these issues do not show up until several months after delivery. But they are far too often passed off in our medical system.

Postpartum Recovery Program

At Femina Physical Therapy, our physical therapists provide one-on-one services and support for women during one of the biggest transitions in their lives. Our methods of postpartum care in the fourth trimester address the physical needs and provide support during this transitional time.

The initial evaluation will begin with an assessment of your childbirth history, other related history and gathering your current complaints or concerns. During the physical exam we will check your posture, identify muscle imbalances (strength and flexibility), check for diastasis rectus abdominus (aka diastasis recti or DRA), land look for restrictions in joint, muscle and connective tissue. Once we determine the factors that are contributing to your complaints or dysfunction, an individualized treatment plan will be developed. Our programs are centered around the needs of women in our society. Our facility is baby-friendly, as moms should not have another barrier to receiving the care they need and deserve.

Want to meet our therapists? Check out their bios and we look forward to seeing you soon!

More Great Products We Love

When Sex Seems Impossible by Peter Pacik, MD

Have fear and pain stopped you from having intercourse?
Are you unable to use tampons, or feel like they won't fit?
Do you physically withdraw or panic during gynecological exams?

If you answered "yes" to any of these questions, you may be suffering from vaginismus, a condition that affects millions of women worldwide.

This book offers important medical information and first-person stories, including a new treatment option that has helped over ninety percent of my patients with severe vaginismus overcome this condition to go on to have pain-free, intimate relationships.

My treatment of vaginismus has put me in contact with patients from around the world and many different cultures. While each patient is unique, their stories evoke common themes-the shame of not being able to experience intercourse; guilt over lost relationships; a deep fear that their childbearing years will come and go. The stories shared by these women moved me deeply, and I felt their voices needed to be heard.

When Sex Seems Impossible: Stories of Vaginismus and How You Can Achieve Intimacy provides medical information about this condition and how it can be overcome. Equally important, the book shares the personal experiences of several of my vaginismus patients. These women volunteered to tell their stories in an effort to let their sister sufferers know that they are not alone, and do not need to suffer in silence. I admire them more than I can say.

Testimonials from Patients of Dr. Pacik for the Treatment of Vaginismus:

It has been three weeks and two days since my procedure. I was finally able to achieve intercourse tonight (full penetration)! I have learned so much about myself and my body since the procedure. I woulld highly recommend this treatment to anyone who suffers from vaginismus."

I feel like I have a real marriage now. I feel triumphant!"

Today we finally made love. It was actually incredible. I finally got to connect with him on this amazing level."

What Our Patients Have to Say

Prev
Next

Testimonial by M.M.

A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

Read more: Testimonial by M.M.

Testimonial by T.H.

I started seeing Heather in October 2014. For more than two years, I had been suffering from painful urinary tract infection type symptoms after my bartholins gland surgery which included constant burning and urinary frequency sensation that led to more and more painful intercourse. I had made multiple visits to internist, obgyn and urologist's offices, went through a range of treatment with UTI and bladder frequency medication that included antibiotics, vesicare, estrogen cream, but nothing worked.

Read more: Testimonial by T.H.

Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

Testimonial by A.W., age 32

I wanted to let you know that my pelvic floor held strong and gave me no trouble whatsoever in my trail race this morning (12 miles)! In a way, I felt like I ran better than ever because my core feels so rock solid from all the exercises you have me doing. That was especially valuable on the technical downhill - I just flew down the trail because I had confidence in my balance and form. Thank you for helping me get back to doing what I love.

-- A.W., age 32
(completed Post-partum Renewal Program using the InTone biofeedback/stim unit)

Testimonial by Amanda W.

Heather's unique physical therapy program literally changed my life! After years of struggling with vaginismus, a condition that made it impossible for me to have intercourse and very difficult to use tampons without pain, a gynecologist referred me to Heather. I was nervous for my first appointment, but Heather's professional and friendly demeanor put me at ease. She did a great job explaining each technique she was using to help my muscles relax. Heather uses a combination of internal and external stretches and exercises to relax the pelvic floor and build muscle strength. Her specially developed home program helped me quickly recover from an issue that seemed insurmountable before meeting Heather. She was optimistic about my progress and incredibly encouraging. Less than 6 months after my first session, I was able to have pain-free sex for the first time in my life! If you are suffering from vaginismus or any other pelvic floor issues, I highly recommend making an appointment with Heather and reading her book!

-- Amanda W., 2/15/16 via Yelp!

Testimonial by Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

Read more: Testimonial by Jamie M.

Subscribe To Our Newsletter

Get access to our free downloads and a 15% discount on Heather's book "Sex Without Pain"!
captcha 
I agree with the Terms and Conditions and the Privacy policy