the postnatal client overview guidelines presented by cherry baker
TRANSCRIPT
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