Women’s health physiotherapist and mother

Samantha Craddock, Physiotherapist and mum of three energetic boys, shares her knowledge on women’s health during pregnancy and postpartum.

Your body goes through incredible physiological changes during pregnancy and postpartum. Understanding your body and its capabilities is an important part of your prenatal journey. From pelvic floor examinations to managing pregnancy aches and pains and providing birth and postpartum education, a women’s health physio is here to help.

Sam is a physiotherapist of 6 years with a special interest in prenatal, postnatal and paediatric physiotherapy. She is also a qualified PE school teacher. Together, her unique skill set enables her to educate women with confidence as they adapt to their changing pregnant bodies. Sam works at Baimed Bumps Physio in Wollongong, and is the co-creator of Mãe retreats which will launch early 2022.

What does a pregnancy/women's health physio do?

Women’s health is thankfully a growing area of Physiotherapy. Women’s Health Physio’s are mostly thought of by the general public to be all about pelvic floor but it is actually so much more than that. Yes, we have Women’s Internal Pelvic Health Specialists (they’re the ones that you should definitely see post vaginal delivery, especially if you’ve had perineal trauma), we also have Women’s Health trained Physio’s like myself who look not only at the pelvis (from the outside) but the whole woman and their functional health across the lifespan, particularly in pregnancy and postpartum. There are also Women’s Health Physios who look specifically at the athletic population because of course women are significantly different to men when it comes to athletic performance.

As a Physio focusing on pregnancy, I take a look at:

- How women move and help them to move better as their body changes.

- Adapting to new, or modifying current exercise programs to suit their stage of pregnancy and their individual body.

- Assessing and managing aches and pains that might arise such as low back, sacro-iliac joint (SIJ) and pubic symphysis complaints.

- Helping women who have Gestational Diabetes Mellitus to manage through exercise

- Prevention and management of abdominal separation

- Other general musculoskeletal aches and pains too such as DeQuervains or Carpal Tunnel Syndrome

- Birth education

- Early postpartum recovery education

Do Kegel exercises during pregnancy actually help? And how much?

Certainly, learning how your pelvic floor works and how to optimise it for vaginal birth if that’s what you choose and recovery postpartum is something that no doubt is on every pregnant woman’s mind. “Kegels” traditionally refer to strengthening of your pelvic floor and I think the conversation needs to lead more towards a functioning pelvic floor. Often times women don’t need to strengthen but to lengthen or improve functionality, whether that be through coordination, endurance or power. SO, the short answer is YES pelvic floor exercises are important in pregnancy to ensure you have adequate at the very least and optimal at best, function pre and postpartum. Mind muscle connection is a thing and if you suddenly find yourself postpartum needing a better functioning pelvic floor to prevent incontinence then it’s better to know earlier and to have established that mind-muscle connection. Ideally, check in with your local women’s internal pelvic health specialist in your third trimester if you’re unsure.

Should I see a pelvic floor therapist before birth?

You should see a pelvic internal specialist before birth if you:

- Have a dysfunctional pelvic floor e.g. experience incontinence with cough, sneeze, laugh or lift or suffer from urgency with urine or if you have painful sex.

- Are after some tips for preventing perineal trauma

- Are interested in learning about optimising your healing postpartum

- Are interested in active birth techniques

Running during pregnancy. Will it impact my pelvic floor? How long into your pregnancy can you run for?

The answer to this is different depending on your own individual needs, goals and experiences. Yes, running will impact your pelvic floor when pregnant but that doesn’t mean you can’t do it. If you plan to run postpartum then one way to help with earlier return (if that’s what interest’s you) is running during pregnancy. Some things to look out for that may be indicators that your pregnant body isn’t keen on running anymore (or that you should see a Women’s Health Physio) include:

- Incontinence – even just a little bit

- Pubic pain

- Significant general fatigue

- Heaviness or bulging feeling in your vagina or bottom

Unless you are an elite sportsperson generally running into the second half of the third trimester isn’t going to feel comfortable and although there is no specific time, I generally don’t see women running a lot post 28 weeks.

Can I exercise if I have low blood pressure?

Exercise in pregnancy should not be feared and should be maintained for all women unless strictly told not to by their care provider. If you have low blood pressure and your care provider has suggested not to exercise, I would question as to why that is personally for you. Some low impact strengthening exercises may be all your body can tolerate (I certainly learnt this lesson in my first pregnancy), so changing your mindset towards exercise may be the hardest part. Remember, it’s not forever, it’s just for now.

Should I be worried about abdominal muscle separation?

Abdominal separation is a physiologically normal part of growing a baby – your abs have to stretch to allow the baby space to grow. It is not something that you should be fearful of. In most cases postpartum abdominal separation requires minimal input in order to heal. In some case you might need some extra support postpartum and to begin some basic rehabilitation exercises before returning to regular exercise.

Do I only need to see a physio if something 'goes wrong' (eg. Back pain)?

I honestly believe every woman would benefit from seeing a women’s health physio, at the very least for peace of mind. Learning how your body functions during pregnancy and postpartum, and how to optimise that function, is fascinating. Having the support of a qualified professional goes a long way. Often times midwives and obstetricians only have time in their appointments to check on baby, whereas a women’s health physio is all for the women.

What is the best sitting posture when pregnant?

The best sitting posture is the most comfortable one. Any posture or movement in pregnancy, particularly towards then end, can be uncomfortable and so I would recommend movement as opposed to static postures. If you must sit because of work then sitting on a fitball is usually more comfortable but changing positions or moving regularly helps to stop those aches and pains setting in.

Tell us more about Mãe retreats. What inspired you to create this experience?

For as long as I can remember I have wanted to create a retreat space for women. The year I finished my Physio degree I also was pregnant, birthed and experienced postpartum for the first time. That year cemented my belief that the pregnancy and postpartum support space for women was severely lacking and that fed my desire to specialise into women’s health with a musculoskeletal focus for my Physiotherapy practice. Retreats were never something I wanted to do on my own and I spent a good few years trying to convince 2 of my midwife friends to join me on my passion project but they both had other ideas and their own growing families as well so they couldn’t commit. One day I received a text from Jenna (my now Mãe partner) who is an absolute boss babe about having a property that would be perfect for pregnancy retreats. I couldn’t believe my luck because the space had always been my struggle and along came Jenna so our retreat finally came to be born! We complement each other so well in our beliefs and experiences combined with our skills and knowledge in the pregnancy and postpartum space and our retreats will reflect exactly that. We hope pregnant women (and eventually we’ll run Mama retreats too) will come to our space to relax, learn and grow into motherhood with confidence and support. You can find out more here.