Women’s Health

Our postnatal check up is an appointment designed to assess your stage of recovery following birth and guide your return to your goals (be that not pee-ing when you stand up, cough or sneeze or running a marathon!). The appointment is designed to teach you about your new body, educate you on how to improve your function as well as understanding your new normal.

The session is 1 hour long and includes;

• A full history of your pregnancies, births, recoveries, health conditions, menstruation and past surgery
• A discussion about your pelvic floor including urination, bowel opening, sexual intercourse and pain or discomfort
• A discussion about your challenges, symptoms and goals
• A review of your posture and pelvic position
• Assessment of your spine, hips, upper back and pelvis
• An internal examination of your pelvic floor to assess; muscle tone and strength, prolapse, risk of prolapse, pain, tightness and scar tissue. The nature of this examination will be fully explained to you by your therapist and carried out by a Women’s Health Specific Physiotherapist with post-graduate training on the pelvic floor.
• A hands on assessment of your abdominal wall (to check for diastasis)
• An ultrasound examination of your abdominal wall to assess the linea alba (fascia connecting your abdominal muscles) and to teach you how to effectively contract your lower abdominal muscles
• An assessment of your scar and education around scar massage (c-section or vaginal tear)
• An individualised plan for your pelvic floor, abdominal wall and return to your goals

Following the session your therapist will discuss with you if there is any ongoing need for further appointments and give you guidance on the next steps.

Even if you are over 1 year postnatal this appointment is still suitable for you! Anyone who has had a baby at any point in the past and wants to learn to understand their new body better can benefit from a women’s health assessment.

A pelvic floor examination is an assessment technique used by qualified healthcare professionals to examine the vulva, vagina and muscles of your pelvic floor, the position of your pelvic organs and to better understand your muscle strength and tone. This requires using a gloved finger internally to palpate the muscles and vaginal wall to ensure correct diagnosis and subsequent treatment plan. Your therapist will fully explain the procedure, the need for the examination and the alternatives.  They will ensure to gain your full consent and you may decline the assessment or discontinue at any time.

Almost all of our clients notice their pelvic floor symptoms when doing tasks in an upright position (coughing / jumping / running / weight lifting). A standing pelvic floor assessment can help you assess your pelvic floor function against gravity, assess your pelvic floor coordination with tasks, assess your ability to manage load through the pelvic floor and is a great way to progress your rehab to a more functional activity. Generally a lying assessment is carried first.

A pelvic floor examination can still occur during menstruation – in fact often our clients are more symptomatic at this time and therefore assessing in that phase can help us understand even better what is going on. As long as you are comfortable then there is no reason to need to reschedule your appointment.

Please note that for some individuals the first or second day of your menstrual cycle you may have heavier flow and elements of the examination may be carried out at a subsequent session. If you are uncomfortable with having the assessment during this time please contact the team. We can assess using ultrasound instead or we can arrange for a rescheduled appointment. We totally understand.

Many women experience pelvic floor issues following a caesarean birth. They can result following hormonal changes, stress or strain to the pelvic floor during pregnancy or from muscular coordination changes postnatally. Commonly women may notice discomfort with sexual intercourse or changes in their bladder frequency and urgency. Generally we carry out a pelvic floor examination (with full informed consent) during all postnatal appointments to assess and guide treatment.

Absolutely, whilst many women will have some symptoms in the first few weeks postnatally, you certainly do not need to suffer these without help. Although we will not carry out a full internal examination until 6 weeks postnatal, we can assess externally, give guidance and education and start on a treatment program. Additionally we can screen for any concerning symptoms and refer on as required.

Yes – absolutely. Whether you are 6 weeks, 6 months or 6 years postnatal – this appointment is still totally suitable for anyone who has had a baby at any point in the past and wants to learn to understand their new body better. Whether that be related to symptoms, feeling weak or just wanting to get back to exercise and not knowing where to start – we can help you!

The 6 week medical check is generally not a sign off for intense exercise. The medical check is commonly checking if there is any medical reason why you should not return to exercise. However – just like after an ankle sprain – every individual’s birth and recovery is different and an individual assessment of your pelvic floor, core and pelvis is recommended before returning to intense exercise.

As a general rule running (a high impact) exercise is recommended from around 3 months postnatal providing you have no symptoms, good pelvic floor recovery and good single leg strength. As part of our return to running program we provide a lying and standing pelvic floor examination and follow a return to run guideline to help you determine when you are ready.