Women's pre/post birth support and pelvic health
Many women across Australia consult an osteopath for their movement and musculoskeletal care needs.
Pre/post birth musculoskeletal care and pelvic health support is a key focus area in osteopathy.
Osteopaths working in pre/peri and cost birth support and pelvic health provide manual clinical interventions, exercise programming and coordinated care for:
Women preparing for a pregnancy (endnote 1)
Women during pregnancy (endnote 2)
Women after the birthing process (endnote 2)
Women with a musculoskeletal pelvic floor injury or pain (endnote 3)
Women experiencing altered movement and function of the pelvis
Women benefiting from a referral or other health professional support for fertility management, education or health promotion.
What do osteopaths do in this field?
Osteopaths assess for and identify musculoskeletal movement, movement adaptations postural or positional issues that may impact a women’s bodily capacity to carry a child and/or the birthing process.
An osteopath may also develop a management plan, consisting of exercises, movement based approaches and manual therapies targeted to aspects of the body needed to prepare it for optimal birthing outcomes. Osteopaths work with women across the trimesters of pregnancy to prepare the physical body, including muscles and soft tissues for strength and durability throughout the pregnancy.
In the last trimester, the osteopath will put management strategies in place to support the musculoskeletal structure to recover optimally post birth.
Osteopaths work to support women in the minimisation of labour pain, pelvic floor management, load management and comfort using exercise programming, positioning advice, movement options, and other non-pharmacological approaches. red flag and yellow flag management and pathologies that can occur during pregnancy for appropriate referral and support.
After the birth of a child, the osteopath will assess physical components of the body that have been impacted or weakened by the birthing process, any traumas sustained, and develop a management plan to strengthen and condition the impacted areas. Pelvic floor screening and physical external exams for related pelvic injuries or prolapse issues is often an aspect of the assessment and management plan. Where necessary, a referral is given to other practitioners able to perform internal screenings.
Osteopaths in the field may perform ergonomic assessments of the woman to identify load bearing or carrying concerns. When performed, a management plan would include positional, postural or environmental prescriptions to improve performance of daily tasks and parental activities. Ergonomic assessments are individualised and relate to the lifestyle and activities of each woman and/or the significant others in their lives.
The osteopath will also take a health history for issues such as post-natal depression, urinary incontinence, mastitis or post birth complications (e.g. haemorrhage or infection) that may need immediate referral to another health professional (endnote 4).
Pre and post birth
Another aspect of the work undertaken by osteopaths in this field is what is known as ‘biopsychosocial support’. Osteopaths work with women and significant others in their lives to screen for flags that may need immediate referral to other health professionals and assist in connecting women to appropriate social support.
Pelvic health support without pregnancy
Osteopaths in the field are consulted by many women, including those not experiencing a pregnancy, for general pelvic health issues including:
- Pelvic pain
- Other pelvic floor complaints.
The osteopath may design an exercise program targeted to the pelvic floor and/or apply manual therapies directed to the pelvic region.
Other health professionals
Osteopaths managing women pre or post birth and pelvic floor presentations work with a range of other health professionals to optimise health care outcomes. Other health professionals referred to or coordinated with include:
- General medical practitioners
- Pelvic floor physiotherapists
- Exercise physiologists
- Personal trainers/Pilates or yoga instructors
- Obstetricians and Gynaecologists
- Maternal child health nurses and Lactation consultants
- Other professionals as required for an individual woman’s needs.
(1) Depledge J, McNair PJ, Keal‐Smith C, Williams M. Management of symphysis pubis dysfunction during pregnancy using exercise and pelvic support belts. Physical Therapy 2005;85(12):1290‐300. [PUBMED: 16305268]
(2) Stuge B, Laerum E, Kirkesola G, Vollestad N. The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy: a randomized controlled trial. Spine 2004;29(4):351‐9. [PUBMED: 15094530]
(3) Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. European Spine Journal 2008;17(6):794‐819. [PUBMED: 18259783]
(4) Gutke A, Lundberg M, Ostgaard HC, Oberg B. Impact of postpartum lumbopelvic pain on disability, pain intensity, health‐related quality of life, activity level, kinesiophobia, and depressive symptoms. European Spine Journal 2011;20(3):440‐8. [PUBMED: 20593205]