Caring for yourself in the 4th Trimester

The term 4^th Trimester has been widely used to explain a newborn infant’s transition into the world. While this is extremely important and should be a large part of your focus after giving birth to your little one, it is also wise to not forget about yourself. I’d like to take some time to discuss how mothers should take care of themselves during this 4^th Trimester. New research states it can take 18 months for a woman’s body to heal post-partum and this 4^th Trimester can be the foundation for a complete recovery.

Most importantly, surround yourself with a supportive team with YOU being the main focus. Let them care for you, cook and clean for you while you rest. Make things as easy on yourself as you can.

Lie down as much as possible. This is important as you heal and your uterus shrinks back down. This added pressure can cause the vaginal wall collapse (prolapse) so take this weight off by lying horizontally or even prop your tush up on pillows.

This is the perfect time to start doing kegels. Due to swelling and the recent trauma, you might not be able to feel your pelvic floor muscles contracting. One trick is to sit in a chair and feel your perineum (the area between the anus and the scrotum or vulva) lift from the chair. Another trick is to lie on your back with pillows under tush and let gravity help you contract and lift those muscles. If you have incontinence, see a pelvic floor therapist.

Lastly, protect and assist your Rectus Abdominis muscle (6-pack muscle) by using tape and avoiding “sit ups”. Diastasis Recti has been getting a lot more attention lately but it still can be misunderstood or even overlooked by your doctor. All pregnant women who carry to term will have a separation of the rectus abdominis muscle along with stretching of the linea alba. Use the log roll technique to get in and out of bed by rolling on your side to get on or off you back to avoid opening a diastasis more. Also, I have found that taping can help assist with the closure of the Rectus Abdominis as well. A therapist can place this on you and teach you how to do independently as well. I would be careful with the popular corsets or girdle shapers out there as they increase abdominal pressure and place additional force on your pelvic floor worsening prolapsed.

In summary, use this 4^th Trimester to take care of yourself and listen to your body. If you think you are not healing properly make an appointment with your doctor, see a pelvic floor therapist; be your own advocate. After all, you have a little precious baby depending on you now.

Here at Duffy and Bracken Physical Therapy we have great pelvic floor therapists that can help equip you both pre and post natal. Give us a call to schedule your assessment. 

Candice Amat, PT, DPT

Pelvic Floor Therapist

(212) 402-5430

Six Reasons to See a Pelvic Floor Physical Therapist Postpartum

Having a baby is a joyful and fulfilling experience but also can take a heavy toll on your body. Growing and carrying a baby for nine months followed by delivery might cause new aches and pains that a Pelvic Floor Physical Therapist can help you address. 

Here are six reasons you may need to see a Pelvic Floor Physical Therapist postpartum

1.      Musculoskeletal pain

-          Growing and carrying a baby for 9 months really can take a toll on our musculoskeletal system. Some common postpartum issues include: tight hip flexors, poorly activating abdominal muscles, low back pain and instability through the pelvis.

2.      Weak Pelvic Floor Muscles (PFM)

-          Pelvic floor weakness can lead to symptoms such as poor or weak orgasm, urine leakage and/or a feeling of “falling out” vaginally.

3.      Prolapse

-          “falling down” or “downward displacement” of the bladder, uterus and/or rectum

-          This can happen in varying degrees and symptoms can include “falling out” feeling vaginally or even vaginal tissue extending externally.

4.      Diastasis Recti

-          The separation of rectus abdominis muscle which can happen during pregnancy.

-          You might notice you have this if you attempt to do a crunch and see a half football shaped bulge vertically on your stomach.

5.      Incontinence

-          Urine leakage, a common compliant post-partum, is another reason to see us!

-          Prolapse, weak PFM and poor neuromuscular control of PFM can all cause this annoying symptom.

6.      Scar sensitivity

-          A sensitive scar can be the cause of painful intercourse, can limit your ability to perform a kegel and/or can cause tension in pelvic floor muscles leaving you with pain.

We, at Duffy &Bracken PT, have the skill set and tools to help you feel like yourself again. We use biofeedback equipment to measure pelvic floor muscle strength, manual skills to treat pain and our skill and experience to teach and encourage you along the way. Let’s not forget what our bodies went through over the last nine months! We need to take care of ourselves and be proactive about our health and wellness; after all we are now responsible for a little one. See you soon!



Candice Amat, PT, DPT