The Postnatal ClientOverview Guidelines

Presented by Cherry Baker

Postnatal periods

It is illegal to return to work within 2 weeks of delivery

Early postnatal period 0 – 6 weeks

Full postnatal period 6 weeks to 12 months

Postnatal ScreeningIt is important you ask the following specific questions to ensure the class is suitable for your client:

1. Have you stopped bleeding?

2. Have you had your postnatal check?

1. Do not accept in class if still bleeding chance of air embolism or haemorrhage

2. Client should not return to a main stream class until they have had their postnatal check

Postnatal Screening Cont….

3. How old is your baby?

4. What type of delivery did you have?

5. Do you feel well?

6. Do you have any joint pain?

7. Are you breast feeding?

Don’t accept without postnatal check

C- sections may take longer to recover surgery is super imposed on childbirth. Scarring & loss of feeling

Client should not feel ill or feverish

Check for back / sacroiliac pain.

Consider calorie and hydration implications

Rec Check

Benefits of Postnatal Exercise

The correct type of exercise in the postnatal periods may: Promote circulation and aid repair Maintain energy levels Aid physical recovery Aid psychological recovery Aids symptoms of mild postnatal depression Aid recovery of the abdominal area Repair pelvic floor prevent prolapse and stress incontinence Prevent or improve back and sacroiliac pain Aid weight reduction Lessen recovery time Ability to cope with new born

Adaptations

Carpal Tunnel

Pelvic Girdle Pain

Abdominal weakness and stretch

Breast feeding

Abdominal Separation

Gap between muscles due to excessive lengthening & influence of pregnancy hormones or labour

Specific transitions getting up and down from step & lifting weights needs extra care

Avoid direct work on rectus abdominus till the gap is two finger widths or less

It is the linea alba that thins rather than ‘splitting’

Testing for Diastasis

Postnatal-2 finger gap Test below and above

the belly button Support during the sit

up phase Protect modesty Self testing

Factors affecting Stability in the postnatal phase

Posture Lots of bending, lifting and sitting Centre of gravity changes Stretched abdominal muscles Round and broad ligaments stretched Diastasis Lengthened glut max and med

Core Stability

Transversus / internal oblique's

Pelvic floor

Multifidus

Facia

Connective tissue Thoracolumbar facia Sacral Facia Facial lines

Core Stability

Deep and superficial muscles Back pain can occur due to the spine being

able to ‘wobble’ through lack of stability Correct movement patterns Correct muscle balance Deep muscles restrict unwanted or excessive

movement

Trunk stability against limb loading

Standing stability!

Focus on pelvic stability – lumbar pelvic rhythm and lifting techniques

Abdominal Repair

Teach abdominal hollowing Challenge abdominal hollowing against limb loading Abdominal hollowing and posterior tilt Abdominal hollowing, posterior tilt and sit up activity Teach correct lifting Teach good posture thoracic and lumbar extension Shoulder and pelvic stability

Shortening within the inner range

Shorten within the inner range Abdominal hollowing Maintain hollowing & pelvic tilt Maintain abdominal hollowing

add pelvic tilt & thoracic flexion Combine the above and lift into

the inner range Muscle balance from lower

fibres of rectus to upper fibres of rectus

Setting up classes

NCT Local Community

midwifes Doctors surgery Health visitors Friends who are

pregnant TIME!!

Contacts

Local maternity hospital Community midwifes NCT Guild of postnatal teachers