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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

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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 orthopedic 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!

What Our Patients Have to Say

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Testimonial by Carolina J.

I had tried Pelvic Floor Physical Therapy before (with another PT) and I had a really bad (painful) experience. A friend of mine and fellow patient, told me about Heather, Laureen and Femina PT (née Fusion Wellness & Physical Therapy) and I decided to try again. I am so happy I did! Femina PT have, literally, changed my life. I was able to do again things I couldn't do for over 10 years!! Their bedside manners are impeccable, their knowledge and understanding make me feel comfortable to recommend this place to anyone in pain. Specially if you have Endometriosis. 100% recommended!!

-- Carolina J., 12/28/16 via Yelp!

Testimonial by Mary L.

I started seeing Heather to treat my Interstitial Cystitis in November 2016. At this time, I was extremely miserable, in constant pain, and felt as though no one was listening or understood what was going on with my body. I have just finished my last appointment and I can honestly say that my life has completely changed for the better because of Heather and her team of PTs! I live almost completely pain free, and when I do have flare ups, I am able to treat them at home on my own. I am so grateful that this office was recommended to me a honestly cannot recommend them enough!

Read more: Testimonial by Mary L.

Testimonial by Mary L.

I started seeing Heather to treat my Interstitial Cystitis in November 2016. At this time, I was extremely miserable, in constant pain, and felt as though no one was listening or understood what was going on with my body. I have just finished my last appointment and I can honestly say that my life has completely changed for the better because of Heather and her team of PTs! I live almost completely pain free, and when I do have flare ups, I am able to treat them at home on my own. I am so grateful that this office was recommended to me a honestly cannot recommend them enough!

Read more: Testimonial by Mary L.

Testimonial by A.B.

Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the dilators with absolutely no advancements in my condition. However, that all changed when I went in for my first visit and Heather took the time to explain my condition and how we were going to work together to overcome it.

I remember leaving her office with a glimmer of hope that I could live a normal life. As my sessions continued I began to see immediate results. With only four sessions and a strict dedication to my home programs I was cured of Vaginismus. In the beginning of this process I was made aware that my health insurance company might not cover the costs, which was disappointing but today I can say one hundred percent that it was the best money I ever spent. Now thanks to Heather I am finally enjoying my life to the fullest with my husband. Thank you Heather, I can’t begin to tell you how much I appreciate all that you have done for me. I will never forget it. Those who are suffering from these types of conditions don’t be afraid because she makes you feel so comfortable and the end result is worth it. Good luck to you all and I hope you experience the success I have.
-- A.B.

Testimonial by S.H., age 24

I just wanted to thank you for everything you've done for me for the past 19 months. I literally could not have reached my goals without you and your practice. You gave me the courage to keep moving forth with my treatment no matter how afraid and anxious I was. You were always there to answer questions and made this whole process so much easier than I expected it to be.

It's because of you that my marriage is on the right track, that I can get pregnant and that this part of my life is finally over. I really feel that Fusion Wellness is a team of people you can call family and are there to root for you and cheer you on until you reach your goals. There is nothing better than knowing I accomplished this with you guys by my side and as calmly and patiently as I needed. Thank you from the bottom of my heart for always being there and helping me reach my goals.

S.H., age 24

Testimonial by T.C.

While pregnant with my twins, Heather took care with keeping me on my feet and pain free. She saved my back, my sanity and the holidays! I would recommend her to every “mom” looking to stay on her feet during pregnancy and post-partum.

-- T.C.

Our
Locations

Beverly Hills:

9012 Burton Way
Beverly Hills, CA 90211

Telephone: (310) 871-9554

The Beverly Hills office is convenient to Mid-Wilshire, West Hollywood, Hollywood, Beverlywood, Korea Town, Downtown LA, Culver City, Century City, Santa Monica and Malibu.

Hours:

Monday 12:00-5:00
Tuesday 7:00-6:00
Wednesday CALL
Thursday 2:00-6:00
Friday 7:00-6:00

Pasadena:

350 S. Lake Avenue #220
Pasadena, Ca 91101

Telephone: (818) 873-1403

Our Pasadena location is convenient to Glendale, Montrose, Burbank, Silver Lake, Los Feliz, Atwater Village, and Eagle Rock.

Hours:

Monday 7:00-6:00
Tuesday 7:00-4:00
Wednesday CALL
Thursday 7:00-4:00
Friday CALL

Sherman Oaks:

13425 Ventura Blvd. Suite 200
Sherman Oaks, California 91423

Telephone: (818) 877-6910

The Sherman Oaks office is adjacent to Studio City and serves the Bel Air, Brentwood, West LA, Mulholland, Beverly Hills, Encino, Calabasas and San Fernando Valley area.

Hours:

Monday 7:30-6:00
Tuesday 7:00-6:00
Wednesday 7:00-6:00
Thursday 8:00-6:00
Friday 7:00-6:00