The Fourth Trimester

Say it isn’t so!  Not to worry, mamas. We’re not talking about 3 more months of pregnancy!  The 4th trimester is the time after childbirth.  Whew!  During this 4th trimester, new moms are going through major physical, emotional, and lifestyle changes.  Newborn babies are monitored regularly by their pediatrician, so any issues are caught and addressed early.  But what about the mom who just gave birth? 

Postpartum Care

Most women are familiar with the routine 6-week postpartum check-up with the obstetrician or midwife.  At this appointment, new moms are checked to make sure she is medically stable, wounds are healed, and she is often given the OK to do, well…pretty much anything:  exercise, go back to work, have sex…  But, if you’re like over 90% of postpartum women, this feels overwhelming and almost impossible.  Why?  There is still quite a bit of recovery needed from the dramatic changes and trauma the body endured from pregnancy and childbirth.  Great news: The American College of Obstetrics and Gynecology (ACOG) has new postpartum care recommendations of ongoing care beyond the arbitrary 6-week check-up.  The new recommendations include an initial 3 weeks postpartum visit, with treatment as needed, followed by a comprehensive postpartum visit with within 12 weeks. The fourth trimester visits should include assessment in the following areas:

·         Mood/emotional well-being

·         Infant care/feeding

·         Sexuality, contraception, and birth spacing

·         Sleep and fatigue

·         Physical recovery from birth

·         Chronic disease management

·         Health maintenance

In other words, postpartum care is an ongoing process rather than a single encounter.  Treatment and support should be individualized and woman-centered.  

4th Trimester Physical Therapy

ACOG’s statement acknowledges physical therapy’s role and the importance of including PT in the standard of care after childbirth. 

The role of PT in the 4th trimester is to assess a woman’s physical function as her body recovers pregnancy and childbirth.  Common conditions treated include: urinary and fecal incontinence (leakage), abdominal muscle separation (diastasis recti), low back pain and other musculoskeletal issues, scar pain, and sexual pain/dysfunction.  The goal of postpartum rehabilitation is to regain control of your body functions and return to activity safely and effectively. 

Embrace the important fourth trimester!  Talk to your health care provider about ensuring proper recovery and make sure you get the care you deserve. 

Questions about postpartum physical therapy or want to schedule your 4th trimester visit?  Visit the Link Physical Therapy website: www.linkpt.org or contact us at (847)868-8396 or info@linkpt.org. 

Published in Evanston Woman Magazine Volume 2 Issue 10 Available Here

www.apta.org/PTinMotion/News/2018/07/11/ACOGPostpartumRecommendations/