What it Really Means to be "Cleared for Exercise" at 6 Weeks Postpartum

Updated: Apr 9, 2020

This pic is a throwback to my 6 week postpartum checkup. Can you believe what a little squish this guy was? I canโ€™t believe how much has changed in a few short months. But, I digressโ€ฆ What I really want to talk about is what happened at that appointment.

At that appointment, my midwife checked my tear and my stitches. She checked my cervix, confirmed bleeding had stopped and my organs were in the right places. She screened me for postpartum mood disorders. We discussed birth control. Surprisingly, she evaluated me for a diastasis recti (this isn't standard at the 6 week checkup, but it was a welcome surprise!). ๐€๐ง๐ ๐ฌ๐ก๐ž ๐œ๐ฅ๐ž๐š๐ซ๐ž๐ ๐ฆ๐ž ๐Ÿ๐จ๐ซ ๐ž๐ฑ๐ž๐ซ๐œ๐ข๐ฌ๐ž. And friends, two things: One, this is a normal run down for a 6 week checkup (minus the diastasis check, that was a pleasant surprise!). Two, I SHOULD NOT HAVE BEEN CLEARED TO EXERCISE. Not with my pelvic floor. But hereโ€™s the thing, she didn't know. Midwives and OB-GYNs, even ones that are very good at their jobs, are not trained to evaluate pelvic floor function and dysfunction. They arenโ€™t experts in rehabilitation or exercise prescription. In short, they shouldnโ€™t be clearing people for exercise. In fact, I would argue ๐ข๐ญ ๐ข๐ฌ ๐Ž๐”๐“ ๐Ž๐… ๐’๐‚๐Ž๐๐„ ๐Ÿ๐จ๐ซ ๐ญ๐ก๐ž๐ฌ๐ž ๐ฉ๐ซ๐ข๐ฆ๐š๐ซ๐ฒ ๐œ๐š๐ซ๐ž ๐ฉ๐ซ๐จ๐ฏ๐ข๐๐ž๐ซ๐ฌ ๐ญ๐จ ๐›๐ž ๐ ๐ข๐ฏ๐ข๐ง๐  ๐ฉ๐จ๐ฌ๐ญ๐ฉ๐š๐ซ๐ญ๐ฎ๐ฆ ๐ฉ๐ž๐จ๐ฉ๐ฅ๐ž ๐š๐ง ๐š๐ฅ๐ฅ-๐œ๐ฅ๐ž๐š๐ซ ๐ญ๐จ ๐ž๐ฑ๐ž๐ซ๐œ๐ข๐ฌ๐ž unless theyโ€™ve had additional training. What should they be doing? Working within their (valuable) expertise- and then referring people to pelvic health physical therapy for evaluation of readiness for exercise. Not only was I on the receiving end of a bunk โ€œall-clearโ€, but I frequently talk to new parents who have the same experience. Theyโ€™re โ€œclearedโ€ and then they find out the hard way, they werenโ€™t really ready. At best this results in a setback, at worst an injury. Something needs to change. No provider can be everything to everyone. Postpartum care requires a team approach. And we need a revolution in the way we care for birthing people so that we can get appropriate care. In the mean time, understand that the 6 week checkup is limited in scope, be your own advocate and ask for a referral to pelvic floor physical therapy if you are interested in an evaluation of readiness to return to exercise.

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ยฉ2020 by Laura Jawad, LLC.