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Pre and Postnatal Physiotherapy Assessment

At Alana we believe the best outcomes for both mother and baby come from informed decision making in birth. This one-hour session with your Alana Physiotherapist will discuss how you are progressing through your pregnancy, screen for any maternal prenatal risk factors that may affect birth outcomes, and provide education regarding your pelvic floor function in pregnancy, on labour day, and the postnatal recovery period. The Alana Prenatal Physiotherapy Assessment has three focus points: pregnancy, birth and early postnatal recovery.

Pregnancy

Niggling pregnancy complaints are common.  Studies indicate 70% of women will suffer from some level of back or pelvic pain during their pregnancy, and 80-100% of women will have some form of abdominal separation by the end of their pregnancy.  In this appointment we will assess and treat these conditions, as well as give you movement strategies and exercises to help manage them throughout the pregnancy.  Pregnancy exercise is discussed, and modifications can be made to programs if required.

Education is the key to informed decision making during your birth, and your pelvic floor anatomy, function and recovery will be discussed at length during this appointment.  On labour day for a vaginal delivery your pelvic floor muscles need to be able to relax and let go, and in the postnatal period the correct technique for your pelvic floor exercises is crucial.  The length of your perineal body may also influence your risk of significant perineal tears.  In the appointment a vaginal examination is undertaken to assess for over-activity and inability to stretch for labour day, correct exercise technique for pregnancy and the postnatal period, and your perineal body length will be measured.  The resting tone and strength of your muscles will be objectively measured so we have a baseline, which will guide goal setting in the postnatal period.  Perineal massage will be taught, as well as advice on the EPI-NO and postnatal recovery shorts.

Birth

All births are special, and either vaginal deliveries or caesarean sections require preparation.  In the first stage of labour, pain management will be your main goal.  Your Alana Physiotherapist will discuss your options for pain management as well as mindfulness techniques to keep you going.  With a vaginal delivery, the optimal technique for your second stage will be discussed and practiced.  Positions for first and second stage labour are also practiced and discussed.  For a caesarean section we will review what to expect, and the movement strategies required in the early recovery period.

Early postnatal recovery

In your prenatal appointment we will discuss your rehabilitation plan for the first 6 weeks following your delivery.  This will involve a pelvic floor rehabilitation program, as well as exercise advice.

The best time to schedule this appointment is when you are between 20 and 26 weeks gestation as this gives us time to address any issues prior to your delivery.  We will always do our best to schedule your assessment alongside one of your antenatal appointments with your Alana Obstetrician.  If you are not seeing an Alana Obstetrician for your pregnancy, you can still come in and see an Alana Physiotherapist for pelvic floor assessment at any stage after the first trimester.

Frequently Asked Questions

Do I need a referral to see a physiotherapist at Alana Healthcare?
If you are attending an appointment with our specialist physiotherapist you may be eligible to claim a Medicare rebate if you are referred from a GP under a GP Management Plan (GPMP). Not everyone is eligible and you will need to speak to your GP to find out. You can find more information about eligibility criteria on the Human Services website. If you are not eligible to claim your physiotherapy visit through Medicare, you may be able to claim through your private health insurance, subject to your level of cover.
Is my pelvic floor assessment covered by Medicare or Health Insurance?
Most insurance policies include some cover for physiotherapy services, however you would have to check this directly with your health fund.  Medicare may cover part of the cost of a physiotherapy appointment, but you must be referred under a GP Management Plan to be eligible.  Please contact our friendly staff for more information.
When should I have my postnatal follow up assessment?
It is normal to experience some bleeding similar to a period for up to 6 weeks post-birth, we therefore suggest a follow up appointment for an assessment of your pelvic floor muscles at approximately 6-8 weeks post-partum (when your bleeding has ceased).  This enables the earliest commencement of your pelvic floor recovery whilst also minimising any chance of infection.  For your convenience, we can schedule this assessment alongside your postnatal appointment with your Alana Obstetrician.
When should I have my antenatal pelvic floor assessment
The best time is when you are between 20 and 26 weeks gestation, and we will always do our best to schedule your assessment alongside one of your antenatal appointments with your Alana Obstetrician.  If you are not seeing an Alana Obstetrician for your pregnancy, you can still come in and see an Alana Physiotherapist for pelvic floor assessment at any stage after the first trimester.
What do I do if I am experiencing hand/wrist pain during my pregnancy or after the birth?
Correct diagnosis of a hand or wrist condition is important when considering appropriate management.  An early diagnosis allows for early intervention, which will favour promising outcomes. The Alana Physiotherapists are trained to identify the cause of your hand and wrist pain, and to assist each woman throughout her recovery. An appointment can be made with the reception staff and does not require a doctor’s referral.
Can I have physiotherapy for pelvic floor issues including urinary issues or pelvic pain?
Our specialised physiotherapy team offer services for women with problems related to pelvic floor function.  This may be issues related to bladder or bowel problems (leakage or needing to toilet frequently) and problems associated with pelvic pain.  Our team work together to formulate a plan specifically for you.
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