As a Physical Therapist, I see patients after surgery or other procedures all the time. I see patients for rehabilitation after PRP injections, cortisone injections, achilles tendon surgery, ACL surgery, Rotator Cuff Surgery, Total Hip Surgery, Back Surgery, and many others. It is usually 6 weeks to 6 months of rehabilitation including using manual therapy and exercise to decrease swelling, improve blood flow for healing to the area, and improve alignment of the bones affected in the area and other areas where the body was compensating. We also focus on
improving strength of muscles surrounding the area and re-training the body with its new normal. These are very common rehab protocols that are accepted by any insurance company all over the US.
So then why is there no protocol for having a a vaginal birth with tearing or a C-Section? Other countries, there are weeks and months of health care provided after having a baby and even more if you had a C-Section. Why is that missing in the US?
During pregnancy, a growing belly does two very obvious things to the inner unit (inner core muscles): It restricts the full range of motion of the diaphragm and it stretches the TVA (Transverse Abdominus-lower core muscles). Like other pregnant and post partum muscles, the multifidi, pelvic floor, TVA and diaphragm will be more prone to be relaxed.
After childbirth, some women will need to retrain the entire postnatal body, but most postpartum women will need to specifically rehabilitate (re-strengthen) the diaphragm, TVA and pelvic floor musculature. During childbirth, there is high likelihood that there will be severe damage to the pelvic floor and the TVA. The Pelvic floor usually is stretched and possibly cut during a vaginal birth and the TVA is surgically severed in a C-Section.
There is currently no standard rehabilitation protocol. Lack of standard rehabilitation for a C-section, considered major surgery, is like having a hip replacement surgery and telling the person to "Go home and heal; I'm sure it will work out OK." "Oh and don't forget you'll need to tend to your newborn 24/7, have a nice day."
As a Women's Health Physical Therapist, I treat many conditions. Most of them are preventable, if only women got the treatment they needed to earlier on. It should be a standard in our country to go through an exercise program during pregnancy and follow-up with a health care provider 2-6 weeks after having a baby to start the rehabilitation process. There would probably be less post-partum depression, improved energy, improved stability and less problems down the road.
If you are a pregnant mom or post-partum ( 6 weeks or 40 years) please see a women's health physical therapist! We can help you! Please contact Christina Trautman at firstname.lastname@example.org for more info!