When we talk about prenatal care in the United States, we tend to focus on the wellbeing of the baby. This is with good reason; for all that we have been going through it for millennia, pregnancy is an incredibly complex process that carries serious risks to both mother and baby during both gestation and birth. Because the baby is perceived as being at greater risk, many interventions focus on protecting the baby.
Many interventions that may assist the baby, however, are expensive and may cause additional issues down the road. Meanwhile, two simple interventions can assist the mother in preparing for and going through birth, as well as supporting her recovery. Much less expensive than many high-tech interventions, physical therapy and experiential therapy require skilled practitioners, but can seriously improve maternal outcomes.
What is prenatal physical therapy?
During pregnancy, the woman’s body goes through a huge number of changes. The center of balance moves, the ligaments loosen in preparation for birth, and the abdominal muscles stretch. Many women experience back and shoulder pain, knee pain, and generalized joint pain. Discomfort can lead to poor sleep, which can lead to depression and anxiety, which can be worsened by hormonal changes.
Physical therapy during pregnancy often targets supporting the pelvic floor, maintaining solid posture, and maintaining overall strength to support the body during birth and recovery. Having a regular exercise routine has also been shown to reduce stress and anxiety, which is strongly correlated with better maternal health outcomes.
What is prenatal experiential therapy?
Experiential therapy helps patients uncover subconscious fears and issues through things like role-playing, guided imagery, and other therapeutic techniques. In a culture that actively supports birthing women, this might be less necessary, but in American culture, we are rarely exposed to any concepts of birth other than women screaming in stirrups on hospital dramas like Grey’s Anatomy.
By using different techniques to help women uncover their fears and concerns about birth, they can have more positive birth experiences, even if they are unable to have a non-surgical birth.
Compared to techniques like birth interventions, these therapies are less expensive, less invasive, and more woman-positive.
How do prenatal experiential and physical therapy support healthy birth?
The primary ways that these lower-cost therapies can support maternal and infant health are:
- Less Pain and Depression During Pregnancy. By helping a woman maintain strength, posture, and wellness during pregnancy, many women can reduce the amount of discomfort they face. They can, therefore, get better rest, and be less likely to suffer prenatal depression and anxiety. While postpartum depression gets a great deal of attention in certain circles, prenatal depression can be even more serious, because the options doctors are willing to use to treat it may be even more limited.
- Better Birth Outcomes. Many studies have shown that regular exercise and general maternal health during pregnancy strongly correlate with less medication during labor, fewer inductions, and healthier, more alert babies. Women are less likely to be diagnosed with high blood pressure or gestational diabetes, both of which are predictors for poor maternal and infant health. And even if women do end up having a surgical birth, they often feel more positive about the necessity.
- Better Recovery. By keeping the body healthier during pregnancy, and the incredible work of birth, women are in a better position to recover during the postnatal period, whether or not they have a surgical birth.
- Fewer Birth Injuries. Many of the common interventions used in American hospitals, such as forceps, are commonly associated with birth injuries. By supporting the natural process of birth, while being prepared to intervene if necessary, women can often be spared significant medical injury after birth.
- Reduced Postpartum Depression. By encouraging better outcomes, pushing to make sure that women are better prepared physically and psychologically for birth, and by ensuring that their mental wellbeing is supported during both pregnancy and birth, women are set up for a positive emotional state after birth. The postpartum period is difficult for many families, with reduced sleep, hormonal changes, and routine changes setting up a perfect storm for depression and anxiety.
In the United States, we spend a huge amount of money on maternal care without actually seeing a significant improvement in maternal outcomes. By shifting some funds towards these lower cost therapies, it is entirely possible that the country would see significant improvement in maternal health outcomes. This would be especially true if therapies were targeted in places where women and birth have traditionally been underfunded and under supported, such as the Southeastern area of the United States.