One of my biggest challenges since I have dived into the field of women’s health and orthopedic physical therapy,  has been working with women who walk in my door with a complete lack of education (not by any fault of their own) as it pertains to the pathology that they are coming to see me for.  With that being said, seeing an article (which you can find HERE) about the recognition of the 4th trimester by the  American Physical Therapy Association is a big leap, in my opinion!



The reality is that women have been having babies for thousands of years, and yet, our medical community is still lagging on the education and preventative measures in the women’s health field, particularly when addressing prenatal and postpartum women.



We are seeing more and more women with diastasis recti, pelvic organ prolapse, incontinence issues, and umbilical hernias, that HAVE NO IDEA they have it, or how they got it.  Furthermore, when I speak to them, I almost unanimously get the response that “no one told me” or “my doctor cleared me at my 6 week check up to resume my ‘normal’ activities”.

Think about it for a second.

hula hoop

hula hoop

We are in an era where healthy living, fitness, and self-care are becoming more paramount. Women are diving into weight training, high intensity training and bootcamp style workouts months, and sometimes even weeks, after birth!.  Twenty, thirty, and forty years ago, our mothers and grandmothers were cooking and doing laundry as their “normal” activities after babies, and if they were particularly into “exercising”, they were walking the kids around the block, or RUNNING.

Thirty years ago, we didn’t see a class full of moms at Orange Theory, powerlifting, the latest spin class, or Barry’s Bootcamp, etc.  Thirty years ago, the activities that our mother’s and grandmothers were taking part in, weren’t requiring the same level of core and pelvic floor control, or causing the same amount of internal pressure and possibility for exacerbation as they can today (without being properly addressed). 

So while we, as women, and mamas, have become a lot more focused on our physical (and mental) health, the medical community is still giving information and suggestions based on the activity levels of our grandmothers.

Let me dissect this a bit more so it can really resonate with you. Most women during pregnancy receive little to NO information on diastasis recti (WHICH AFFECTS up to 60% of POST-PARTUM WOMEN), pelvic organ prolapse, or incontinence (which affects 7 MILLION women and new mamas a YEAR, and 20+% even after 5 years postpartum)

In a poll I put up on two facebook groups last week, I asked if any moms had received information on diastasis recti, pelvic organ prolapse, incontinence, or other women’s health pathologies that are commonly associated with pregnancy and postpartum.  Of the 61 total responses, FIFTY-SEVEN (57) women said they received LITTLE TO NO INFORMATION from their healthcare provider.  THREE (3) women stated that they received SOME information, but only because they asked, and ONLY ONE (1) person stated that they received information and resources without prompting.  How is this even possible?!

The exciting part about this new recognition of the 4th trimester, is that hopefully, that means there will be more information circulating, more discussions amongst the medical disciplines, and a more active approach to educating patients and preventing some of these issues, as well as addressing them EARLY in the postpartum period so that they aren’t a lifelong burden.

Lastly, I don’t care who you speak to, or how many kids your mom, friend, aunt, or cousin has.  DO NOT LISTEN TO ANYONE WHO SAYS “you just have to live with ____________” (insert “peeing your pants”, “the mom pooch”, etc here).  Do NOT LISTEN to anyone who tells you that surgery is the ONLY option to address any of these.   Just remember that the more educated you are during your pre-natal months, the more quickly you can address issues that arise during your post-natal months, and the more quickly you can begin to feel like YOU again.

If you are experiencing any of the above issues, or want to share your experience, please reach out, I would love to hear!


Dr. A