This pic is a throwback to my 6 week postpartum checkup. Can you believe what a little squish this guy was? I can’t believe how much has changed in a few short months. But, I digress… What I really want to talk about is what happened at that appointment.
At that appointment, my midwife checked my perineal 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!).
And she cleared me for exercise.
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 here’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 aren’t experts in rehabilitation or exercise prescription. In short, they shouldn’t be clearing people for exercise. In fact, I would argue it is OUT of SCOPE for these primary care providers to be giving postpartum people an all clear to exercise unless they’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 “all-clear”, but I frequently talk to new parents who have the same experience. They’re “cleared” and then they find out the hard way, they weren’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.
Learn how to dial in your breathing strategy to harness control of your pelvic floor and feel stronger in your workouts. Download a copy of The No B.S. Guide to Breathing for a STRONG Pregnancy and Postpartum.
My mission is to make sure that having a baby is not a reason why you can’t do all the things.
Contact me if you have questions about exercise or pelvic health pertaining to pregnancy or postpartum. I work with people locally (Seattle’s Eastside: Redmond, Bellevue, Kirkland and surrounding areas) and online to develop personalized pregnancy and postpartum personal training plans. I also offer labor support (doula services) within the greater Seattle-Metro Area.
