Pregnancy Care

Your condition can be assessed and managed either face to face at our rooms, or via video consultations (Telehealth). Check the Telehealth section for details.

 

Pregnancy can be an exciting (and challenging) time in your life! As your body undergoes hormonal and postural changes, our post graduate trained physiotherapists at the Pelvic Health Clinic Body Logic Physiotherapy can help you stay fit and healthy throughout your pregnancy and help your recovery after childbirth.

Is exercise safe in pregnancy?

Absolutely! Exercise is safe during pregnancy for the vast majority of women, and research shows that the benefits of exercise far outweighs the risks, and so we encourage every woman who does not have a contraindication to exercise to get their beautiful bodies moving.

Women who do exercise in pregnancy tend to have:

  • More energy
  • Better quality sleep
  • Lower rates of gestational diabetes, high blood pressure and pre-eclampsia
  • Better experience of pregnancy with less aches and pains and swelling in the limbs
  • Reduced rates of constipation
  • Lower rates of anxiety and depression

 

Research has also shown that:

  • Women that exercise regularly have shorter and less complicated labours and tend to recover more quickly following the delivery
  • Women who are doing regular pelvic floor exercises during pregnancy, have a lower rate of incontinence as well!

The baby also benefits, with positive effects on childhood cardiovascular health, nervous system development and healthy weight gain

 

If you have not exercised regularly before your pregnancy:

  • Speak to your GP or obstetrician before commencing an exercise program.
  • Once you have the clearance to start, see your pelvic health physiotherapist to help you set up an exercise program.

 

If you have been exercising regularly before you were pregnant:

  • It is considered safe to continue with those activities during your pregnancy.
  • Listen to your body and be prepared to make changes to your exercise schedule as your body changes throughout your pregnancy to ensure you stay comfortable.
  • Changes to the type and tempo of exercise happens at different times for every woman. It is normal to progress to lower impact options, eg running to walking, as pregnancy progresses.
  • Pregnancy is not the time to start any new type of high impact exercises.

 

If you have had any complications or have been told you have a high-risk pregnancy:

  • Discuss exercise with your GP or obstetrician before starting any exercise program, to understand your options in the event of medical and obstetric concerns.
  • If you are unsure, ask your antenatal medical team and they will be able to answer any of your questions.

 

What exercises/activities are best avoided in pregnancy?

  • Contact sports or activities where there is a possibility of impact to the abdomen, like football, hockey or martial arts.
  • Exercise where falling is more common, like skiing or skating.
  • Activities with significant pressure changes such as scuba diving.
  • Exercise in high-temperature environments with poor air circulation, where the body can overheat.

 

What are the signs you need to stop exercising?

  • Vaginal bleeding.
  • Regular painful contractions & premature contractions.
  • Amniotic fluid leak.
  • Breathlessness even prior to exercise or shortness of breath during exercise is a sign to stop, you should always be able to talk during exercise.
  • Dizziness, light-headedness or if you are feeling faint (presyncope).
  • Headache.
  • Chest pains, tightness or palpitations.

 

What is the best exercise to do in pregnancy?

The best exercise to do during your pregnancy is exercise that you enjoy because you are more likely to do it!

Safe exercise options in pregnancy include:

  • Walking.
  • Swimming.
  • Cycling.
  • Pregnancy Pilates or yoga.
  • Aqua aerobics.
  • Body weight strengthening exercises or lighter weights in the gym.

 

The recommendations for exercise in pregnancy are:

  • Aim for 150-300 minutes of moderate exercise a week.
  • Use the ‘talk test’ to make sure you are working at the appropriate intensity. This means being able to keep up a conversation during the exercise but working at a high enough intensity where you are unable to sing.
  • Women should also aim for two sessions of strengthening exercises per week. If you need any help setting up with a strength program during your pregnancy, please discuss with your physiotherapist and we can design a program for you.

 

Do pelvic floor muscles exercises really help in pregnancy?

YES! The evidence overwhelmingly shows that PFM (pelvic floor muscle) exercises are very effective during your pregnancy and beyond!

More than one-third of women experience urinary incontinence in the second and third trimesters of pregnancy. About one-third leak urine in the first three months after giving birth.

BUT… A recent review of the literature suggests that starting a structured pelvic floor muscle training program during pregnancy can prevent the onset of urinary incontinence in late pregnancy and the postnatal period.

Pelvic floor exercises can be tricky to do correctly. Seeing a pelvic health physiotherapist during the early weeks of your pregnancy is recommended, to ensure you have the correct technique and set you up with an individuated pelvic floor muscle training program.

At the Pelvic Health Clinic, we recommended you visit us during your pregnancy. We are very comfortable talking about wee, poo, pain, prolapse and pelvic floor, as well as sex, and strive to make you feel as comfortable as possible to discuss your own concerns. We are here to answer your questions and support you as you progress through your pregnancy and beyond.

So, if you are pregnant and want to know more about your pelvic floor, call or book online to make an appointment with one of our pelvic health physiotherapists.

 

Back and Pelvic Pain During Pregnancy

Back and pelvic pain are common during pregnancy and after giving birth. Some studies suggest over 50% of women have low back or pelvic pain in pregnancy. However, if managed well, women find they can cope well, and the pain does not significantly impact their journey through pregnancy. For the majority of cases, this pain will recover within three months of the birth of the child, but in a small group, pain persists beyond that time frame.

Although the common belief is that pelvic pain is due to laxity of the pelvic ligaments (ie “loose joints”), there is actually little evidence for this. In fact, research suggests that it is the changing body postures, low or very high physical activity levels, stress levels, depressed mood and sleep deprivation that combine to increase the sensitivity of the tissue structures around the pelvis, resulting in pain.

Our physiotherapists are able to help you understand the factors that may be important in your case and design a management program. This would include pelvic floor and abdominal muscle exercises as well as addressing lifestyle factors, to help improve your symptoms.

 

Myths and Facts

There are many myths that surround lower back and pelvic girdle pain in pregnancy. Let’s explore some of those.

The Myths

✖    Back pain in pregnancy is a sign you have damaged structures.

✖    Pain in your pelvis means your ligaments are lax and pelvis is unstable.

✖    If you have back or pelvic pain it means your core is weak.

✖    If you have back or pelvic pain you should rest and avoid exercise.

✖    If you have pain, you just have to live with it.

✖    Exercise during late pregnancy is dangerous.

 

The Facts

✔      The structures of the lower back and pelvis are really strong and don’t become unstable during pregnancy.

✔      Back and pelvic pain in pregnancy and the postnatal period is common.

✔      Most back pain that commences during pregnancy or the postnatal period gets better.

✔      Major predictors of back and pelvic pain during pregnancy are poor sleep, stress, low mood and inactivity.

✔      Keeping active and strong during pregnancy is recommended for overall health, reducing the risk of gestational diabetes and preeclampsia, and helps recovery after childbirth.

✔      Pelvic floor exercises during pregnancy reduce the risk of back pain, pelvic pain, urinary incontinence and prolapse after childbirth.

✔      Pelvic floor and abdominal exercise in pregnancy reduces the risk of tummy separation or rectus abdominus diastasis.

✔      Urinary incontinence is common but not normal after having a baby and can be improved with the correct exercises.

✔      Pain with sex after giving birth is common but not normal and can be helped.

So, if you have low back or pelvic pain in pregnancy or the postnatal period, don’t suffer in silence. Contact us for an assessment and management plan.

 

What does a physiotherapy assessment involve? How can physiotherapy help?

During pregnancy, a thorough assessment is essential to best understand your problem. Our physiotherapists will take a thorough history, consider factors that could be influencing your problem and establish your goals for treatment. This is followed by a comprehensive physical assessment, including a check of your abdominal muscles and ability to perform correct pelvic floor muscle contractions.

Assessment of the pelvic floor muscles can be done either fully clothed using real-time ultrasound, or via vaginal assessment. This more comprehensive method may be recommended, after the first trimester, to determine the strength of the pelvic floor muscles and for anyone experiencing pain. The method of assessing your pelvic floor muscles is always thoroughly explained and guided by your comfort and consent.

Following the assessment, we will explain to you in simple terms the factors that may be impacting on your problem and design a collaborative treatment plan to help you achieve your goals.