Letter from an acute care physical therapist

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One of the most impactful moments in my career was providing physical therapy services to a resident physician who had given birth by cesarean section 2 days before I came by her room.

She was in significant pain and was having difficulty getting in and out of bed without support from her husband. 

When I offered her the option of receiving physical therapy services during her postpartum hospital stay, she responded, “I am so happy you’re here.”

She explained that her c-section was unexpected, and she was worried about the stairs she would need to go up to get to her bedroom.


She consented to a physical therapy evaluation where I educated her on comfortable positions she could lie down or nurse in to relieve the pressure on her incision and to prepare her to return to her flat bed at home.


I taught her how to use an abdominal binder which provided pain relief to the extent she told me that she could breathe better and it didn’t hurt as much to clear her throat or laugh.


I taught her husband how to help her in and out of bed without pulling on her arms which she told me was hurting her before.


I did all of this in one visit and she and I planned to tackle stairs the next day to allow her to recover after the activity we did on the first.


When I returned the next day, her husband led me out of the room to speak with me. He said that his wife slept through the night for the first time in 3 days. He wanted to thank me for the attention I gave to them that they didn’t know they would receive during their hospital day after delivery.

Most people will not have access to an occupational therapist or a physical therapist in the hospital after birth. 

 

One may argue, this woman is a physician – of course she gets special treatment. 

And they would be right.

Every individual that receives occupational therapy and physical therapy in the hospital after birth receives special treatment.

Most would not consider this the case, given the fact that occupational and physical therapy are standard of care after knee replacement or hip surgery.


However, for women after the most common surgery performed in the United States, known as a c-section, it is a privilege to have a Doctor of Physical Therapy and Occupational Therapy at your bedside educating you on how to physically and mentally recover following delivery.


Receiving physical therapy during her hospital stay after birth was a privilege to the woman I treated who had Medicaid and had to return to work in two weeks as a housecleaner.


It was a privilege to the new mom I treated who was a pediatric nurse who experienced a significant tear that didn’t allow her to sit comfortably and feed her newborn.

It was a privilege to the single woman I treated who lost her infant at the time of delivery and wanted to be able to walk without pain to the cooling bassinet to pick up her baby without asking for help.

It was a privilege to the individual I treated who was a doctor after an unexpected c-section who had a husband to support her. I fundamentally believed it would change the way she viewed the care that she was provided to her through the lens of individuals who were less fortunate.

Optimizing Postpartum Outcomes Act (H.R. 2480) offers mothers the dignity of enhancing their recovery after delivery with rehabilitation services starting in the hospital and home during the postpartum period of lactation or six months from the last day of pregnancy, whichever is later.


Please pass H.R. 2480 Optimizing Postpartum Outcomes Act of 2023 to ensure that individuals and their families have access to these basic services of human dignity which are currently a privilege for a small minority in our country. Make occupational and physical therapy services a standard component of care in the hospital and home after birth and throughout postpartum recovery.

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