The 4th Trimester: Postpartum PT & Caring for Yourself After Giving Birth!

By Nidhi Sharma, PT, DPT, OCS at FuncPhysio

From the first signs of pregnancy until the time you give birth, your body goes through some major changes. Fortunately, there is support to guide women through this process.  Obstetricians and midwives closely monitor your health, community classes prepare you for birth, and weekly guides talk about the expected progress.

What is not talked about enough are the changes that happen for months after delivery and how to take care of yourself after giving birth. This period of recovery for your body and development for your baby is sometimes called the "Fourth Trimester” and is extremely important for your long-term health. This is the time when your body is trying to find a new equilibrium. Not only is it trying to recover from the strains of pregnancy and childbirth, but it is also under the constant and new demands of childcare.

Here are the 4 most common physical complaints of the fourth trimester. Preparing yourself with this knowledge ahead of time will help you better understand how to take care of yourself after giving birth and avoid these symptoms:

1. Urinary Incontinence:

Compromised bladder control is a common complaint during pregnancy but can continue after childbirth. Often, the leaking happens with coughing, sneezing, running, etc. but can happen with almost any activity of daily life. One of the primary causes is the weakness of the pelvic floor muscles. With the trauma of childbirth and physiological changes of pregnancy, these muscles often become weak and are unable to perform efficiently.

Pelvic floor muscle strengthening exercises (Kegels) performed in physical therapy during and after pregnancy can help alleviate this problem. However, it is important to make sure that you are doing Kegels correctly by having a physical therapist check your technique. Through postpartum pelvic floor physical therapy administered by a specialist, you can build the muscles needed to reduce or prevent unexpected leaks.

2. Pelvic Organ Prolapse:

During pregnancy and childbirth, ligaments of the abdominal cavity and pelvic floor muscles structures often undergo chemical changes and get “stretched out” or become weak. As a result, the pelvic organs (bladder, bowel, uterus) can descend or droop outside the vaginal opening. The usual symptoms reported by women are a feeling of heaviness, fullness, or a bulge in the vaginal opening.

A combination of postural correction, lifestyle modifications, core, and pelvic floor strengthening can help manage these symptoms. Again, make sure a professional is present to oversee your postpartum physical therapy exercises to ensure you’re performing them safely and accurately.


3. Diastasis Recti:

In simple terms, it is a separation of the superficial layer of abdominal muscles due to excessive intra-abdominal pressure. Women usually notice a protruding belly or a “pouch/bulge” which is most evident right after childbirth. It might be noticeable only when the abdominal muscles are tense, such as during coughing.

    A comprehensive core strengthening program with the proper postpartum physical therapy exercises developed by a specialist is usually successful in managing these symptoms.

    4. Lower Back Pain:

    After giving birth,  back pain is extremely common and often multifactorial. All of the conditions explained above can compromise core stability and contribute to lower back pain. In addition to that, demands of childcare like frequent lifting, carrying, and breastfeeding, etc.can put repetitive stress on joints in the spine and pelvis.

    It is important to learn how to take care of yourself after giving birth with proper body mechanics and postural corrections while performing childcare to avoid continuous injury to the body. Postpartum physical therapy  can be the solution to sustaining a happy and healthy body in this crucial trimester – and beyond.  


    Postpartum Physical Therapy

    Postpartum physical therapy focuses on the health of new mothers by customizing the program to the unique physiological changes of pregnancy and demands of childcare. The program of expertly curated postpartum physical therapy exercises focuses on improving posture and alignment, strengthening trunk and pelvic floor muscles, and training in proper breastfeeding/childcare positions. It is important to know that all of the above conditions are closely related to each other and should be addressed as a unit as you consider how to take care of yourself after giving birth. Often after birth, the lower back pain is caused by underlying pelvic floor weakness and won’t improve until incontinence is addressed. A good program doesn’t only involve postpartum pelvic floor physical therapy, but also looks at abdominal, lower back, and pelvic floor muscles individually as well as a coordinated system.

    If you are pregnant or recently had a baby, give your body some much-needed TLC and see a Women’s Health Physical Therapist. You can find and schedule an appointment at FuncPhysio Physical Therapy in addition to hundreds of other clinics on the BetterPTwebsite and the BetterPT app.  You can start receiving postpartum physical therapy care WITHOUT a prescription from your medical doctor thanks to direct access. Make sure you feel your best in the "Fourth Trimester" and get back to doing the things you love.  Your precious little baby needs YOU to be feeling happy and healthy!

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