Birth Preparation with a Women's Health Physio.

Written by physiotherapist, Claire Denton.

Women's health physiotherapists all over Australia continue to hear a similar narrative and phrase at postpartum appointments - “I wish I had have known”. In order to try and change this narrative we have been increasingly encouraging women to seek assistance much earlier in their pregnancy journey.

Birth preparation with a Women's health physio is another tool you can use when you are navigating this special time. We believe it is an essential tool to getting your body ready for pregnancy, delivery and beyond by increasing your understanding and knowledge of the birth process, the external pelvis and the internal pelvis (pelvic floor).

Picture: Physiotherapy For Women, https://physiotherapyforwomen.com.au/services/

What to expect at these birth preparation appointments

During a prenatal assessment:

Subjective history:

During the first part of the assessment we will have a chat to you to get an idea of what we might want to focus on in the physical examination. For example, we want to know if you are experiencing any musculoskeletal pain, or if you have experienced any bladder or bowel changes e.g. leakage, if you have history of painful periods, constipation, pain with sex, or a history with your bladder prior to pregancy e.g. urgency or frequency. All of this information could indicate some tension through the body particularly the pelvis that will need to be addressed.

Pelvis externally:

We look at the pelvic position and hip rotation in standing or when performing functional activities e.g. squat. We then can help manage and treat any tight muscles and structures that could be contributing to the pain or changes throughout your pregnancy.

Pelvis internally:

GH+PB: this is a measure taken from the mid urethra to the mid anus at rest and then on bearing down manoeuvre (pushing like you are opening your bowels) . It gives us an indication of the distensibility of the pelvic floor or how well the pelvic floor can move through its full range of motion.

We will also assess the bearing down manoeuvre to check how efficient your pushing is during the second stage labour (this is all important to know if you are planning a vaginal delivery and we need that baby to come down and through the pelvic floor).

We assess for pelvic floor tone, strength and coordination and particularly look at any trigger points or tension through the muscles inside the pelvis.

What can we do?

1. Advice and education: we can talk to you about the normal birthing process, the cardinal movements, and what role the uterus, the pelvis and the baby all play in this process.

2. After identifying any findings during the physical assessment we can then treat through release techniques (both the external and internal pelvic muscles), verbal cueing to help you relax and open the pelvis, and provide home exercises and strategies you can use and practice before the big day.

3. We can give you some ideas of different birth positions in favour of opening the pelvis that are more ideal for different stages of your labour.

- We can discuss different birth skills and ways of dealing with labour pain ‘healthy pain’ using the following:

• Obstetric TENS - We hire these out for you to use during labour.

• Acupressure points - that you and your partner can use during labour.

• Perineal massage/advice on Epi-no to assist reducing your chances of tearing.

• Massage techniques to use during active stages of labour.

• Birth skills e.g. breathing techniques, visualisations, affirmations.

Ideally, we want you to be going into your birth feeling empowered, educated and with the most optimal pelvic floor! If you would like any more information please contact our friendly physiotherapy team who specialise in this area. We look forward to meeting you!