The role of Physiotherapy in improving prenatal fitness
A woman’s body undergoes a number of physical changes due to pregnancy. With the increase in weight to be carried, the pressure applied to the organs increases and the body becomes the center of major changes. This often results in severe problems like back pain, pelvic pain, and urinary incontinence.
As a matter of fact, over two-thirds of pregnant women experience back pain, one-fifth experience pelvic pain and over 40% experience urinary incontinence during their first pregnancy. New onset of incontinence is experienced by over one-third woman after childbirth.
Medical studies highlight that physiotherapy is effective in alleviating lower back pain, pelvic pain, and urinary incontinence during pregnancy. Its use in preventing lumbo-pelvic pain at 36 weeks of pregnancy was emphasized by various group training programs. There was a major decline in the number of women in the training program that experienced lumbo-pelvic pain during pregnancy and after delivery.
Several reviews and evidences pointed out towards the fact that strengthening exercises, pelvic exercises, and water gymnastics reducing lower back pain intensity are more effective than standard prenatal care. Undergoing a 12-week intensive pelvic floor muscle training supervised by physiotherapists during 36 weeks of pregnancy and 3 months post-partum can help in preventing urinary incontinence.
A study based on pregnant women focused on the effect of post-partum pelvic floor muscle training in eliminating post-partum urinary incontinence. In 2005, a joint policy statement on Postural Health for Women and the role of Physiotherapy was issued by the Canadian Physiotherapy Association and the Society of Obstetricians and Gynecologists of Canada. As per the joint policy statement, the pelvic floor muscle training supervised by physiotherapists helps in preventing urinary incontinence during pregnancy and after delivery. It also recommended the use of physiotherapy for preventing and treating back and pelvic pain during pregnancy.
Regardless of the benefits offered by pre and postnatal exercise programs, they prove to be harmful to a number of people. A survey conducted recently revealed that most of these programs do not have access to basic screening, assessment or continued monitoring. The programs did not address the prime factors such as the presence of diastasis recti or cesarean section delivery. The exercises included in them were contraindicated or not suitable for pregnant women in general. They lacked the accommodation for the stage of pregnancy or post-partum status.
Thus, a good physiotherapist program for pregnant women should ensure that the patients participate safely in it. It should focus on the assessment of patients for posture, strength, flexibility, balance as well as any musculoskeletal issues that can have a major impact on pregnancy. The patients should be instructed to perform the exercises safely and effectively. The training program should be based on an individualized approach and cover all the pre and postnatal issues.
The benefits offered by physiotherapy for improving prenatal fitness, make it one of the most effective ways to ensure a healthier and easier pregnancy and delivery.