Six Week Postpartum Checkup

  1. Birth History

    Taking a detailed birth history is an integral first step when seeing patients for their six-week postpartum check. It is important to gain an understanding of the pregnancy and birth experience; be it vaginal, planned or unplanned cesarean. Knowing if labour was induced or came on spontaneously, the length of each stage of labour, whether there was any tearing or an episiotomy, how these scars are healing, pain relief that may have been used during labour and if any is still required, what forms of intervention may have been needed and if the patient felt they experienced any trauma, their general recovery and if they have the appropriate support inside and outside of the home. This information is essential to ascertain the individuals physical, emotional and social well-being, allowing you to treat the whole person.

  2. General History Taking

    Along with the patients' birth history it is important to be aware of the patients general health status. Some individuals have experienced other hospitalisations, surgeries, medical conditions, musculoskeletal complaints, previous pregnancies and births or take ongoing medication. Knowing and understanding this information allows us to gage how much load their body is currently under, if there are any red flags that contraindicate safely proceeding with treatment and how to appropriately treat and manage their complaint.

  3. Assessment

    Assessment begins as soon as we take our patient into the treatment room. A lot of information can be gathered by observing them walk into the room and the position they assume once seated.Once the birth history and medical history has been taken the "official" assessment begins. Starting with the patient standing, we observe their posture, breathing and functional movement. The patient then lies on the bed and we assess their abdominal muscles for any diastasis recti, if applicable we will feel for any tension that may be present around the cesarian scar. We also perform functional tests in this position before going on to assess the pelvic floor. The all important pelvic floor assessment! This involves observing the healing of any tears and episiotomy scars, checking for any signs of prolapse, assessing how the pelvic floor muscles respond to commands such as contracting and coughing, assessing the strength of the pelvic floor muscles and checking if any tension is present.

  4. Treatment

    Treatment objectives are based on the patients' history, examination findings and treatment goals. Treatment can incorporate both internal pelvic floor techniques and external treatment techniques integrating all findings to treat the patient as a whole.When treating the pelvic floor we focus on decreasing the load applied to the pelvic floor muscles and any strain patterns that may be present and impacting function. Techniques include internal and external myofascial release to the pelvic floor, other muscles in the body, any scars that are present and joint restrictions.

  5. Exercise Prescription

    Exercise prescription is a helpful tool to support patients in reaching their postpartum goals. This often begins with ensuring the patient is able to connect their breath with their pelvic floor. Many people are unaware that our pelvic floor actually rises and falls with concentric and eccentric contractions, as does the diaphragm, on exhalation and inhalation respectively. Occasionally, this movement is not synchronised or may not be present at all so it imperative that this is established first. From here we start including exercises aimed at easing tension or building strength of the pelvic floor in a functional manor and in combination with movement based exercise for the whole body.

  6. Lifestyle Advice

    Lifestyle advice is another tool that we use in conjunction with treatment and functional exercise to support patient's working towards their goals. We incorporate lifestyle advice as part of the 6-week postpartum check and future appointments. This may include tips for lifting and carrying their newborn (and other children), pushing the pram, pain management as well as tips around creating healthy bowel habits and strategies to aid in managing other symptoms that may be present like urinary urgency or light bladder leakage. We find that this thorough and holistic approach is most beneficial in achieving positive patient outcomes and helping patients feel supported and empowered during their postpartum journey.

@bump.to.babe.osteo

Everything you need to know about Pilates and Osteopathy for the Pre and Postnatal Period

Why should I participate in specific pre and postnatal pilates?

Prenatal Pilates at Eastern Osteopathy

Your body is doing amazing things to prepare for birth. As you progress through pregnancy, your body undergoes many changes. As osteopaths, we understands the physiological changes your body is going through throughout this period. Mia’s additional pilates training has deepened her understanding of what exercises are safe and relevant during the different trimesters of pregnancy. Exercises can be tailored to you and your individual needs throughout your pregnancy, with the focus of helping to prepare you for your birth and the postnatal period.

Postnatal Pilates at Eastern Osteopathy

Congratulations, you have had your baby and now you are ready to get back to your everyday activities and exercise!

Your body is recovering from the changes it has undergone throughout your pregnancy. Once you have your baby, the goal is to assist in restoring your body’s structure and function. At Eastern Osteo we work with a postpartum exercise guideline, which we tailored to you and your goals. Pilates is great for the postnatal period as we can begin to ease your body back into exercise with low impact activity. Regardless of your goal, if you want to exercise or not, there are many benefits to some postnatal pilates inspired workouts. You are now caring for someone else, this requires strength and function as your baby gets bigger and bigger! 

Mia is currently doing 1:1 consultations, focused on getting back into movement in the postpartum period. This entails a 45 minute consultation where a combination of manual therapy, assessment and implementation of exercises are utilised. This allows for individual time, advice and technique review so that you have the tools to correctly implement these practices at home. 

How does Eastern Osteopathy use Pilates inspired exercises in conjunction with manual therapy?

The beauty of having the combination of osteopathy and pilates is that Mia is able to assist and treat your pain with manual therapy and then prescribe pilates inspired exercises to maintain and improve function. 

Mia and Kathryn work together to formulate the most suitable program for your individual needs. Kathryn treats pelvic floor dysfunction with manual therapy; as we utilise a holistic approach, we know that other structures in the body can contribute to your pelvic floor dysfunction, and Mia works on these through manual therapy. In addition to manual therapy, Mia and Kathryn work together to design movement programs specific to you and your presenting complaint.

Tips for Prolapse During Pregnancy

Have you been diagnosed with a prolapse and are wishing to conceive or are already pregnant?

This can be a scary time. Worried that pregnancy and birth might make your prolapse worse? Trust me this is common concern and a conversation we have with patients regularly. And it is scary and frightening, but it’s important to know that having a prolapse while pregnant is manageable and safe with some guidance, exercises and lifestyle modification. Our tips for managing this time are below.

Connect with your breath and pelvic floor

Spend time observing your breath, feel the subtle lengthening and decent as you breath in & as you breath out notice the pelvic floor engage and lift. Once you have connected with your breath you can add a gentle lift and engagement of your pelvic floor as you breath out. You can do this while in a semi-reclined position, seated, childs pose and standing.

SEE a Pelvic Floor practitioner

If you have a prolapse please make an appointment to see a qualified pelvic floor practitioner (osteopath/physiotherapis) to have your pelvic floor assessed and an individualised pelvic floor rehabilitation program created. This may involve strengthening exercises, breathing strategies and or ways to improve neuromuscular timing and coordination

Manage your constipation

Constipation is commonly experienced during pregnancy and along with straining is a major risk factor for prolapse. Consuming adequate water & fibre along with creating a healthy bowel routine while adapting good pooping posture & not straining is essential for minimising impact of prolapse on the pelvic floor. Oh and don’t forget the squatty potty to help achieve optimal pooping posture and the use of ooo cha to help expel the unwanted waste.

Listen to your body

Take the time to listen to your body; understand that your body, posture and centre of gravity is constantly changing and with this your prolapse symptoms can also change. A easy activity last week can cause a pressure and dragging sensation today. Knowing your body will allow you to alter your movements strategies to minimise impact on prolapse.

Use the Recovery Position

When feeling tired and extra pressure, bulging and dragging sensation in your vagina, taking some time to rest in a recovery position is important. Lying on your back with your legs up the wall or resting on a chair. Placing a pillow under your pelvis encourages your organs to move away from the entrance of your vagina. Then observe the natural rhythm of your breath & gently engaging your pelvic floor with your exhale. If lying on your back is uncomfortable, makes you feel dizzy or nauseous; please stop this exercise.

Exhale with Exertion

As you roll over, sit to stand, lift and other activities that involve some exertion; perform the activity with an exhale. As you prepare to move, exhale and gently blow out. By gently blowing & feeling your core engage & then moving, minimises the force directed to your pelvic floor and pelvic organs.

Look at your Posture

We know postural changes can influence the force and pressure applied to the pelvic floor. We also know pregnancy is a time of ever changing posture. Rather then sinking into these poor postural changes try to stand, sit and lye in alignment with our natural curvature. A quick way to test if your posture is optimal, check in and see if breathing is effortless, then we know our posture and alignment is on point. Having trouble try untucking your butt!!

Stay Active and whole body strengthening

Staying active & strengthening your whole body is great for overall pelvic health. It is important to exercise symptom free and under the guidance of your health care provider and/or within the pregnancy guidelines.

As a bonus regular exercise can help stimulate a bowel movement.

Manage your stress

When looking at our pelvic health we know stress can impact your ability to have a bowel movement and constipation is a risk factor for prolapse. We also know when stressed you will clench your pelvic floor muscles which in turn impacts the ability to contract effectively. Studies tell us when stressed our prolapse symptoms will bother us more. This doesn’t mean the symptoms are worse just that they bother you more causing more stress. Developing good stress management strategies is essential.

Common Questions about Pregnancy and Osteopathy

Can I see an osteopath while pregnant?

Yes. And the great news is, the osteopaths at Eastern Osteopathy have all completed further studies in the field of pregnancy including:

  • Spinning babies

  • Preparing the pregnant patient for birth

  • Active birth practitioners

  • Visceral osteopathy in the field of obstetrics and gynaecology 

  • Pregnancy and pelvic girdle pain

  • Prenatal yoga and pilates training

Our osteopaths provide the best osteopathic and pregnancy care in Melbourne and suburbs surrounding Kew and Hawthorn.

Can Osteopathy help during pregnancy?

Yes. Our osteopaths have lots of experience treating pregnant patients for a variety of pregnancy related aches and pains including back and pelvic girdle pain, carpal tunnel, light bladder leakage, headaches, hip pain, and round ligament pain. 

Research has shown that pregnant patients who receive osteopathic treatment throughout their pregnancy experienced a reduction in pain intensity during birth, a reduction in the length of their birth and a reduction in episiotomies. 

Osteopathy and pregnancy near me

With two convenient (Kew and Hawthorn) locations in the Eastern Suburbs, Eastern Osteopathy provides expert pregnancy care for the following suburbs, Kew, Hawthorn, Richmond, Abbotsford, Collingwood, Camberwell, Malvern, Hawthorn East, Balwyn, Ivanhoe, Fairfield, Thornberry, Alphington, Toorak, Prahran, South Yarra, Surrey Hills and Melbourne CBD. 

Our osteopaths experience and reputation has seen them treat and help pregnant patients from all over Melbourne and Victoria. 

Our osteopaths provide the best osteopathic and pregnancy care in Melbourne and suburbs surrounding Kew and Hawthorn.

Osteopath treatment after pregnancy

Our Osteopaths are just as passionate about helping the new mother in the postpartum period as they are about helping with pregnancy osteopathy.

We have highly skilled and trained osteopaths in the fields of:

  • Pelvic floor assessment and treatment

  • Coccyx pain

  • Wrist pain

  • Upper back pain associated with feeding

  • Back and pelvic pain

  • Scar treatment

  • Mastitis manual treatment and the use of ultrasound

  • Diastasis recti treatment and rehabilitation

  • Prolapse treatment and rehabilitation

  • Return to running and exercise post baby

  • Our Osteopaths provide the best osteopathic and pelvic health care for new mothers and are passionate about helping our patients transition into their new role as a mother/parent. 

Osteo treatment for Pregnancy and Sciatica

Our Osteopaths have years of experience helping the pregnant patient with sciatica using a variety of osteopathic techniques to help relieve the symptoms associated with pregnancy and sciatica. 

What can an Osteopath treat when pregnant?

Our osteopaths have experience treating pregnant patients with a variety of conditions including: 

  • Lower back pain

  • Pelvic girdle pain

  • Round ligament pain

  • Diastasis recti (abdominal separations)

  • Light bladder leakage

  • Childbirth education

  • Preparation for birth

  • Rib pain

  • Pubic bone pain (pubic symphysis dysfunction)

  • Wrist pain and swelling

  • Mid back and neck pain

  • Foot pain and swelling

  • Headaches and neck pain

Osteo treatment for pregnancy and pelvic girdle pain

At Eastern Osteopathy, all of our osteopaths have completed further studies in the field of osteopathy and pregnancy including pelvic girdle pain. They come with 35 years of combined experience and pride themselves on providing the best osteopathic care for pregnant patients in Melbourne. 

Can my Osteopath help prepare me for birth?

Yes. All of our osteopaths are passionate about creating space in the pelvis of their pregnant patients and enjoy educating their pregnant patients on their upcoming birth and breathing techniques, active birth positions and the use of robozou and exercise balls to help create space during the birth. This education extends to the birthing partners.  

At Eastern Osteopathy we have Osteopaths who are childbirth educators, pelvic health trained, have completed further studies around creating space within the pelvis and who have completed further studies with spinning babies.

Our osteopaths pride themselves on providing the best possible osteopathic care and education for expectant parents. 

Do I need a referral to see an osteopath when pregnant?

No. You do not need a referral to see an osteopath when pregnant. Our osteopaths,  with your permission, will communicate with your medical team including midwife, obstetrician, doula and other allied health professionals to help create the best possible care for you while pregnant.  

Can I have pelvic floor therapy while pregnant?

Yes. Unless you have been told by your healthcare provider not to have vaginal penetration you are able to have internal assessment and treatment of the pelvic floor. 

Our pelvic floor specialist osteopath is expertly trained and experienced in helping to prepare the pregnant patient for birth and assisting with light bladder leakage, pelvic girdle, lower back and pelvic pain associated with pelvic floor dysfunction during pregnancy. 

I’m suffering with light bladder leakage while pregnant, can pelvic floor treatment help?

Yes. Research and professional experience has shown that pelvic floor treatment and rehabilitation can prevent and improve the symptoms of light bladder leakage while pregnant. 

Why would I see a pelvic floor therapist (osteopath) while pregnant? 

You can see a pelvic floor trained osteopath if you are experiencing back, hip or pelvic pain or requiring advice on specific exercise and movement practices.

If you are suffering with any light bladder leakage or prolapse concerns

If you are wanting assistance with preparing yourself and your pelvic floor for birth.  

You need your pelvic floor to be working appropriately during pregnancy, during the birth and after the birth of your little one. Learning how to contract and connect with your pelvic floor and breathe prior to the postpartum period, when it has just stretched over 3 times its normal length with a vaginal birth or you’ve had cesarean birth; helps to facilitate a faster and better recovery post birth. 

Eastern Osteopathy has a pelvic floor trained osteopath who has extensive experience in assisting pregnant patients with pelvic floor assessment and treatment.

Can I have Pelvic floor treatment if I have no specific concern?

You need your pelvic floor to be working appropriately during pregnancy, during the birth and after the birth of your little one. Learning how to contract and connect with your pelvic floor and breath prior to the postpartum period when it has just stretched over 3 times its normal length with a vaginal birth or you’ve had cesarean birth helps to facilitate a faster and better recovery post birth.

Seeing our pelvic floor trained osteopath can assist with helping you connect with your pelvic floor and education on specific pregnancy safe exercises. 

I have abdominal separation and I'm pregnant. Is this ok?

It is estimated that up to 100% of pregnant patients by the third trimester will have abdominal separation (diastasis recti abdominis), this is normal and helps to create space from the growing baby. 

At Eastern Osteopathy, we have osteopaths who are specifically trained in the treatment and rehabilitation of abdominal separation, we believe despite it being normal there are breathing and movement strategies we believe a pregnant patient can integrate into their life to minimise the impact this separation has on their core system, pelvic floor and pelvic and lower back pain. 


Pregnancy and Exercise

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Exercise during pregnancy should be done and is safe, in a healthy, uncomplicated pregnancy. In fact, performing the recommended type and amount of physical activity during pregnancy achieves health benefits for mother and baby including reducing risk of pre-eclampsia, pregnancy induced hypertension, a reduction in instrumental delivery and unplanned caesarean section birth, and may help to reduce the severity of lower back and pelvic girdle pain.

According to the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) evidence-based guidelines for physical activity in pregnant women, it is recommended that in a normal pregnancy woman participate in 150-300 minutes of moderate intensity or if previously exercising can continue 75-150 minutes of vigorous intensity exercise per week.
This can be completed over a minimum of three days per week, however, being active every day (ideally 30 minutes per day, less if previously inactive) is encouraged and doing some physical activity is better than none.

Training should be a combination of aerobic (brisk walking, cycling, swimming, dancing, exercise classes) and strength (body weight, light weight or resistance band) exercises and exercise intensity will vary depending how physically active you were or we not pre-pregnancy. Women who were active prior to conceiving can continue with their usual activities for as long as they feel comfortable but are advised to check with a health professional if they would like to continue with vigorous intensity or high impact sports and exercise.

Additionally, some exercises may need to be modified as your pregnancy progresses due to biomechanical changes and pain i.e. after 16 weeks it is best to avoid exercises lying on your back.

Exercise is not recommended in all circumstances. The following are cases in which exercise is not recommended;

  • Incompetent cervix

  • Ruptured membranes, preterm labour

  • Premature labour

  • Persistent second or third trimester bleeding

  • Placenta previa

  • Pre-eclampsia

  • Evidence of intrauterine growth restriction

  • Multiple gestation (triplets or higher number)

  • Poorly controlled Type 1 diabetes, hypertension or thyroid disease

  • Other serious cardiovascular, respiratory or systemic disorder

Stop and seek advice from a health professional if you experience any of the following while being physically active:

  • Chest pain

  • Persistent excessive shortness of breath – that does not resolve with rest

  • Severe headache

  • Persistent dizziness / feeling faint – that does not resolve with rest

  • Regular painful uterine contractions

  • Vaginal bleeding

  • Amniotic fluid loss

  • Calf pain, swelling or redness

  • Sudden swelling of the ankles, hands or face

  • Decreased foetal movement

Still unsure what physical activity you can or cannot be doing during pregnancy speak with your health care provider before starting an exercising program.

*Exercise intensity ratings are based on ratings of perceived exertion on a scale of 1-10 where 1 is not moving and 10 is maximal effort. Activities in the range 3-7 indicate moderate-vigorous intensity and are considered safe and are recommended for health benefits in pregnant women. This can also be judged by the ‘talk test’ in which a conversation can be held during moderate intensity activities but difficult during vigorous activities.

Brown, W.J., Hayman, M, Haakstad, L.A.H., Mielke, G.I. et al. (2020). Evidence-based physical activity guidelines for pregnant women. Report for the Australian Government Department of Health. Canberra: Australian Government Department of Health.