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Prenatal and Postpartum Screening

Prenatal and Postpartum Screening

Prenatal Screening

There are many myths around pregnancy. Physiotherapists who specialize in pre/post natal care can help debunk these myths, playing an important role in the management of physical changes that occur through these precious 9 months. Briefly, as growth occurs, center of mass and posturechange, pressure on internal organs increases and this can lead to back pain, rib pain/thoracic discomfort, abdominal weakness, pelvic pain, pubic symphysis pain, prolapse and urinary incontinence. Although occasionally we hear women are told these symptoms are ‘normal’, they are not. If they are not addressed in the prenatal period the underlying impairments causing these symptoms can pose problems in delivery, the post partum period and beyond.

Postpartum Screening

Every year millions of women deliver babies and go on to lead pain free functional lives; however, there are many who do not. Some continue to have persistent low back or pelvic pain while others fail to regain their urinary continence or lose support of their pelvic organs. And there are some Moms who 'appear' to recover, only to suffer a recurrence of back or pelvic girdle pain with or without incontinence/organ prolapse years later.

Pregnancy and delivery can significantly alter the anatomy and function of the abdominal wall and pelvic floor. To compensate, women often develop suboptimal habits for standing, sitting and lifting. These habits can further overload the joints, muscles and organs and lead to complications.

Diane Lee received a research grant from the University of Queensland in Australia to investigate a condition called diastasis rectus abdominis, a separation of the abdominal wall that occurs in all women during the third trimester of pregnancy, and in most, will close naturally in the early postpartum period (three months). For some women, this ‘gap’ persists. The cause is often a muscle imbalance in the trunk and with proper training full function can be restored. For others, that gap is too wide, or too lax and the abdominal muscles are unable to generate tension in the midline. We now have clinical tests (combined with real-time ultrasound imaging) to determine when surgery should be considered and can refer you to a Vancouver plastic surgeon for further advice.

Most women take prenatal classes during their first pregnancy to learn about what's ahead for them with respect to their delivery, but very few take a postpartum class to learn about things they should do to get their body back after having their baby and why this is so essential for their long-term health.

We consider the postpartum screen an essential component of peri-natal care and should be done around 6-8 weeks post delivery. Interestingly, in Europe and Scandinavia this post partum screen is mandatory to evaluatethe anatomy and function of the musculoskeletal system, abdominal wall and pelvic floor. Women are provided with a12 week post partum rehabilitation program developed specifically for them to ensure optimal recovery and return to activity. This is paramount to prevent future complications and for overall health and wellness throughout the lifespan. At Diane Lee and Associates, specialized physiotherapists are passionate about empowering women through their pregnancies and postpartum experience to understand more about the changes that occur to their bodies and what they should watch for and do to prevent future complications.

Together, Rachael Corbett, Diane Lee and Tyla Schlender spearheaded the development of an educational brochure in association with the physiotherapists at Women's Hospital and the Physiotherapy Association of British Columbia to inform ALL women of key things to consider and watch for in the early postpartum period. The intent was to inform women as to when they should consult a physiotherapist for rehabilitation after delivering their baby. This brochure is available on this page as a free downloadable PDF file. PLEASE, if you have had a baby, have a quick look at this brochure, do the simple tests and come see us if any of the tests are positive.

At Diane Lee & Associates, we have developed a postpartum screening visit (a 1 hour session), which will help you decide on the next best steps for your health and fitness, and how to manage any complications you may have in the post partum. Following this examination, we will let you know ifyou require a complete evaluation for your abdominal wall (including decisions around how to best treat your diastasis rectus abdominis, if youstill have one) and/or pelvic floor before returning to your fitness class/routine (Yoga, Pilates, Boot Camp etc).

Call the clinic (604 538 8338) and ask to book a one-hour Postpartum screening appointment. Please complete the Postpartum screening questionnaire and bring it with you to your appointment.

For more information on things you should know in the postpartum period download this postpartum education flyer written by Tamarah Nerreter of Diane Lee & Associates

Diane Lee & Associates
#102 - 15303 31 Avenue
South Surrey, BC V3Z 6X2

Phone: 604 538 8338
Fax: 604 538 3277
Email: info@dianelee.ca