Physiotherapy in Obs & gynae

Obs and Gynae Rehabilitation

1. Scope o f Physiotherapy in O bs & G yne Department of Physical & Rehabilitative Medicine Dr. Mohabbat Ali

2. Common health problems in postpartum period: Cramps Urinary frequency - needing to pass urine often Urinary stress incontinence - leaking urine Backache Heartburn and indigestion Blocked nose Varicose veins - swollen leg veins Constipation More …

3. Stitches and swelling/bruising Stitches in the perineum. Even if don't have stitches, there may be internal swelling and bruising around the perineum Regular pain relief in the first few days is important for your comfort. Follow the  P.R.I.C.E  regime.

4. R.I.C.E Rest   flat (on your back or side) regularly until your stitches are healed. Try to not spend too long sitting, standing and/or walking in the first few days. Ice   packs can be applied to the perineum every 1 - 2 hours - only leave the icepacks on for 10 - 15 minutes at a time.

5. R.I.C.E Compression   rolled towel placed between the legs when sitting helps reduce swelling and bruising and also gives gentle support to the perineum. Elevate   the perineum area regularly by lying on your tummy for at least 15 - 20 minutes, with a pillow or two underneath the hips.

6. Caesarean Section This will help to prevent some of the common complications associated with abdominal surgery (of any kind) the first 24 - 48 hours .

7. Wound support and breathing Support your wound With your hands or a pillow if you need to cough, sneeze, laugh or go to the toilet to open your bowels. Relaxed abdominal breathing Can help to relieve the discomfort of wind pain and after birth pains)

8. Circulation It is important to get out of bed and moving early after your delivery to promote circulation. Simple leg exercises should be performed and about to increase circulation and reduce the risk of blood clots. 

9. Getting in and out of bed (Mobility) When rolling over out of bed, it is important to support your wound using your abdominal muscles. Don't try sitting straight up from lying on your back. Then push yourself up into a sitting position using your underneath elbow. Getting in and out of bed When rolling over or getting in and out of bed, it is important to support your wound using your abdominal muscles. Don't try sitting straight up from lying on your back. You need to roll onto your side with knees bent while bracing with your abdominal muscles. Then push yourself up into a sitting position using your underneath elbow. While in hospital, this is made easier by having the head of the bed raised up - you can do this using the remote control next to your bedside.                                                              

10. Bladder and Bowels adequate fluids (aim for 1 1/2 - 2 1/2 litres per day then drink to your thirst) and regular pain relief. Eating a high fibre diet and going for short regular walks. Sit correctly when opening your bowels with your bottom to the back of the toilet seat, legs apart, up on toes, keeping a straight back and then leaning forwards with your tummy and pelvic floor muscles relaxed. If you are troubled by haemorrhoids , try applying ice packs regularly.

11. Pelvic Floor Muscle Exercises: Tighten your pelvic floor muscles  every time  you lift your baby, cough, sneeze or laugh to protect your pelvic floor and help prevent leakage of urine or wind.

12. Abdominal Muscles Exercise tummy muscles regularly after the birth of your baby to regain strength and your pre-pregnancy shape.

13. Pelvic Tilt Exercises This can also help to relieve back pain when it is performed as a gentle stretch.

14. Abdominal Bracing Exercises Abdominal bracing uses your deep tummy muscles to help protect your back and pelvis from pain and injury.

15. Back Care Stand "tall". Change nappies, dress and bath baby at waist height. If you need to get lower, bend your knees and hips. If sitting to feed your baby, sit in a comfortable chair with back support. When carrying your baby, avoid carrying on one hip.

16. Reference The content of this topic was provided by the Women's Physiotherapy Department at the Woman's and Children's Hospital, South Australia.  http://www.wch.sa.gov.au/services/az/divisions/wab/physio/index.html  Pregnancy, Birth and Baby is a national Australian Government service providing support and information for expecting parents and parents of children, from birth to 5 years of age.  http://www.pregnancybirthbaby.org.au/