Physiotherapy in the maternity setting (WS-02)

Workshop
Time:
Sunday 11 April 2021, 13:45-14:45
Location:
Channel 2
Chair/speaker
Speakers

Description

Worldwide, there are around 139 million births each year. Evidenced based physiotherapy has the potential to play an important role in improving health outcomes for women during pregnancy, childbirth and in the postpartum period. Recognition of the vital role of the physiotherapist in the maternity setting is increasing alongside recommendations for the humanization of maternity care around the world (WHO, 2018). However, the way in which physiotherapy care is delivered in this setting is variable, or non-existent, in different countries.In countries where pregnant women have access to physiotherapy, women can be offered supervised and safe exercise programs to prevent a number of pregnancy problems arising from physical inactivity (e.g. overweight and obesity), and to manage symptoms such as urinary and anal incontinence. Pelvic floor muscle training is the first line treatment of urinary incontinence during and after pregnancy (Woodley et al. 2017) and with other types of exercise has the potential to reduce the length of the second stage of labour (Du et al. 2015). Low back and pelvic girdle pain are the most common musculoskeletal symptoms during pregnancy that affect quality of life, and most women who receive physiotherapy intervention in different countries report benefit (Gutke et al. 2018). The pain experience associated with labour is complex, highly individual and our understanding should consider recent advances in pain science (Whitburn et al. 2018). Non-pharmacological resources are recommended for pain relief during labour (WHO, 2018), and physiotherapists have a good understanding of pain, and expertise in pain management. Knowledge of physiology, biomechanics and psychosocial influences on pain and birth outcomes provides physiotherapists with the necessary skills for planning, prescribing, and applying a combination of resources for women. Randomized controlled trials have demonstrated the effectiveness of methods such as massage and transcutaneous electro-stimulation (TENS) to provide pain relief during the first stage of labour (Silva Gallo et al. 2013; Santana et al 2016). In addition, posture adaptation and exercises are support measures for labouring women that not only relieve pain but promote better progress of labour, delay the use of pharmacological analgesia and improve women’s obstetric health outcomes (Gallo et al. 2018). Similarly, the physiotherapist can make a major contribution in the postpartum period. The effectiveness of treatment methods such as ice and TENS to relieve perineal and Caesarean Section pain has been demonstrated (Pitangui et al. 2012). Prescribed and supervised exercises not only improve mobility, but also contribute to the prevention of postpartum complications such as depression (Poyatos-León et al. 2017). The physiotherapist has an important role in guiding women on how to resume an active life, to progress with exercise intensity and in the rehabilitation of various muscle groups. The physiotherapist can therefore contribute to women's postnatal recovery and overall health, in view of the various demands related to motherhood

Objectives

  • To understand the potential role of the physiotherapist in the maternity setting, with a particular focus on labour and birth
  • To explore the models of maternity care available in different countries, and identify strategies that promote the role of physiotherapists