The “Fourth Trimester” and Physical Therapy

By: Dr. Laura Wenger, PT, OCS

The old adage, “Happy Mom equals Happy Baby”, is one stated often to new moms but, frankly, can be difficult to implement. With the physical and emotional changes that occur after giving birth, moms can often have a hard time being “happy” in their sleep-deprived, uncomfortable state that they often find themselves in after the blissful oxytocin hormones of birth wear off. Plus, now you’ve got a tiny human to learn how to care for which can provide its own emotions and anxieties and ultimately ends up putting the needs of the mom to maintain physical and mental wellness to the side for many women. These effects are all related to someone who had a healthy pregnancy and delivery, so they can often be compounded for women who had high-risk pregnancies, traumatic deliveries, or are dealing with clinical postpartum depression or anxiety. Recently, the American College of Obstetricians and Gynecologists released a Committee Opinion to stress the importance of caring for new mothers during the “Fourth Trimester” in the first few months after birth (you can find the press release with more information at https://www.acog.org/About-ACOG/News-Room/News-Releases/2016/Ob-Gyns-Stress-the-Importance-of-Postpartum-Care-The-Fourth-Trimester).

Laura getting back to physical activity with hiking during her “Fourth Trimester”

In this opinion statement, the group stresses the importance of coming up with a plan for postpartum care for the woman and her infant during pregnancy, with identification of the health care professionals to make up the woman’s postpartum health “team”. This team can include the obstetrician, pediatrician, nurses, mental health providers, the woman’s family and friends, community support groups, and… physical therapists! With one of the key aspects of fourth trimester care including facilitating the return to physical activity coupled with the fact that more than a third of women who have back pain during pregnancy continue to have back pain one year after giving birth, physical therapists are primed to play an integral role in getting women feeling better so that they can take care of not only themselves, but their families, in a more healthy and happy way.(1) I can speak from personal experience in that it’s easy for moms to just “deal with” aches and pains in their back, but there are actually simple exercises and muscle retraining exercises that can be done to address this prevalent condition. A skilled physical therapist can help you create an individualized exercise program that is easy to work into your busy days with baby to optimize how you feel. With physical therapy being one piece of the “Fourth Trimester” puzzle, don’t hesitate to contact us if you are planning for or are already in this stage, to learn how we can help you out during this very important time in your life. Also, don’t forget to plug into important resources such as https://www.postpartum.net for addressing mental health and wellness in the postpartum phase. For all you moms out there- remember that the best way to take care of others is to make sure you are taking care of yourself!

JOSPT Perspectives for Patients: Pregnancy and Low Back Pain- Physical Therapy Can Reduce Back And Pelvic Pain During and After Pregnancy. J Orthop Sports Phys Ther. 2014;44(7):474.