A recent study focusing on mothers 9-12 months postpartum revealed that over two-thirds reported at least one physical health issue since giving birth. Commonly cited problems include back pain, urinary incontinence, fatigue, abdominal discomfort, and painful sex. These conditions are often linked to difficulties in daily activities, including childcare and work. Despite this, many women find it challenging to access appropriate healthcare.
In the U.S., the usual follow-up visit occurs six weeks after childbirth. However, many women experience lingering physical symptoms well beyond this point. Pregnancy leads to stretching and weakening of the pelvic floor and abdominal muscles, which can result in various unresolved musculoskeletal problems.
While it’s widely known that physical therapists can help with lower back issues and fatigue, there’s less awareness that they can also address urinary and fecal incontinence, pelvic organ prolapse, pelvic pain, and sexual dysfunction. Pelvic floor physiotherapy involves more than just exercises like Kegels; therapists can assist patients in strengthening, relaxing, and activating pelvic floor muscles, helping them regain their previous functions.
Numerous studies indicate that physiotherapy can effectively enhance pelvic floor strength and endurance, alleviate incontinence, and improve sexual health. A systematic review highlighted that women receiving pelvic floor physiotherapy were 5-8 times more likely to recover from urinary incontinence compared to those who didn’t pursue therapy. This approach is beneficial for managing postnatal disorders conservatively.
However, there are significant barriers to accessing physical therapy for postpartum women. There’s often a social stigma surrounding discussions about pelvic floor issues, making it uncomfortable for women to speak openly about problems like urinary incontinence and sexual dysfunction.
Because of this stigma, many new mothers might not realize that their experiences aren’t normal. As a physiotherapy student, I’ve realized the importance of patient education and active listening. Simply asking the right questions can greatly help those suffering from pain.
Even for those aware of physical therapy, costs can be prohibitive, and insurance coverage often falls short. Many women lose Medicaid benefits two months postpartum. To tackle these concerns, there’s a need for policy changes to extend Medicaid coverage for postnatal care. Ideally, expanding Medicaid benefits to 12 months would include rehabilitation and mental health services, improving access to care for new mothers.
While expanding these services may initially seem like a considerable expense, this legislation could ultimately save healthcare costs in the long run. There is a clear shortage of obstetric care in the U.S., and physiotherapists could alleviate the burden on obstetricians by managing postnatal musculoskeletal conditions, along with addressing mental health issues that might surface.
As a student, I am trained to identify potential mental health concerns and offer appropriate referrals when needed. Collaboration between new generations of physical therapists and obstetricians could lead to more comprehensive care for mothers.
Addressing these issues early could save substantial amounts of money related to chronic health conditions such as chronic lower back and pelvic pain, which collectively cost the healthcare system billions every year.
I encourage Congressional leaders to take action to improve postpartum care and reduce the financial impact of chronic illnesses on women.
