Virtual physical therapy after birth: 23 things you can do too

  1. I can look to see if a patient is dizzy moving from lying down to sitting. Someone who just had abdominal surgery just experienced a lot of blood loss. They continue to lose blood and are at risk of hemorrhage. I can be the first person to say, “Tell the nurse.”
  2. I can look to see if the patient is experiencing signs and symptoms of postpartum preeclampsia. I can ask if they have a headache, if they feel their heart racing, if they are having a difficult time breathing. Again, I can be the first person to say, “Tell the nurse.”
  3. I can educate the patient about signs and symptoms of postpartum preeclampsia and prevalence, particularly in the 6 weeks following birth
  4. I can instruct someone in how to get in and out of a hospital bed with less pain
  5. I can instruct someone how to stand up, lift their baby, move into a recliner if possible, and position themselves and their newborn more comfortably
  6. With training, I can instruct the patient in initiating basic breast/chest feeding
  7. I can instruct someone on how to walk to and from the bathroom
  8. I can instruct someone on how to breathe during a bowel movement
  9. I can problem solve with positioning for having a bowel movement, possibly using a stool under their feet while having a bowel movement
  10. I can problem solve if the patient is experiencing difficulty urinating, especially if they were catheterized, with breathing techniques and positioning
  11. If the patient is experiencing urinary incontinence, fecal or flatal incontinence I can provide education and recommend that the patient obtain a prescription from an MD in the hospital for continuity of care back into Pelvic Physical Therapy postpartum
  12. I can educate the patient about clogged milk ducts and how I can provide Therapeutic Ultrasound in the outpatient clinic to improve the patient’s ability to clear the ducts so that they can produce an optimal amount of milk for their baby
  13. I can provide education on pelvic organ prolapse and pelvic heaviness. Even patients who have given birth via C-section can have pelvic heaviness and swelling
  14. I can provide education on the lymphatic system and how to position your body and use breathing to reduce abdominal swelling around the incision site 
  15. I can provide education about hormonal changes that include a significant drop in estrogen that can contribute to mental health issues, joint and muscle aches and pain, and vaginal/frontal canal burning and dryness.
  16. I can guide patients in how to don/doff an abdominal binder that is hopefully provided in the hospital
  17. I can provide education and guidance about how long to wear the abdominal binder: how many hours per day, for how long after birth
  18. I can provide basic wound care education, including signs and symptoms of an infection, when scar mobilization will be appropriate and when it is appropriate, teach patients scar mobilization techniques either in person during an outpatient visit or over Telehealth after discharge
  19. I can provide safe mobility exercises to reduce the risk of blood clots, back pain and general muscle deconditioning
  20. I can prepare the patient for the car ride home, placing a pillow between the incision site and the place where the seat belt crosses over the lap. 
  21. I can prepare the patient for getting into their house, ask the patient to practice going up and down stairs with a physical therapist in the hospital. If they need to hold on to the bassinet while walking in the hallway, discuss obtaining a walker for home use. Using a bassinet on wheels with a newborn is both dangerous for the patient and the baby.
  22. If the patient’s baby is in the NICU, the patient will need to exert energy moving from home back to the hospital. Via Telehealth, the patient can begin to learn about energy conservation for safe cardiac health postpartum
  23. I can teach energy conservation techniques, such as baby-wearing, caring for multiple children, and nutritional intake

 


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