the 6 week check...what it is and what it is not

Many of my Pilates clients and patients have expressed a dissatisfaction around their experience of their GP postnatal six week check. This check up is seen as a rite of passage - the point at which your GP will usually ‘sign you off’ as OK for resuming usual activities and exercise post pregnancy and birth.

So many ladies find this event a disappointment. The baby check aspect is well regarded by most but many feel the maternal check did not meet their needs.

Although you may expect this, your GP will probably NOT;

- examine your scar or stitches, - examine you for a prolapse, - check your pelvic floor function, - check you for an abdominal separation, - discuss your continence, - or assess your readiness for returning to exercise.

To be fair, most of the things on this list are not areas of expertise for a GP.

They will probably discuss your contraceptive plans going forwards and discuss your mood.

This blog is not about GP bashing but more about managing expectations. GPs are not funded to provide more than the baby check up as far as I understand, which is also why this element is fairly standardised. We can’t expect GPs or Surgeries to work for free - the lack of postnatal care is not their fault but due to a lack of funding from a higher level.

Thorough postnatal assessments ARE available with arguably a more relevant professional - the ‘women’s health Physiotherapist’. I have worked on this field for a few years now - just last week a client said to me she ‘didn’t even know that it was a thing’ after I told her what I did for a living! Sadly our role in women’s healthcare is a well kept secret.

Right now these assessments are not readily available on the NHS, as they are in other countries for example France and Germany - however Physios across the UK are working exceptionally hard on your behalf to change this.

#PelvicRoar is a Physiotherapy led public health campaign aiming to raise awareness about all things pelvic health, including working with the Department of Health to improve the access to postnatal Physiotherapy for ALL Mothers.

A postnatal Physiotherapy assessment will usually involve the following, depending on the focus of the check up;

- abdominal muscle check, - postural/breathing assessment, - internal vaginal pelvic floor assessment, - check for prolapse in lying and/or standing, - assessment of bladder/bowel function, - spine/pelvis assessment, - C Section/episiotomy scar check, - guidance in appropriate expectations of return to exercise.

You can expect to receive a comprehensive overview of your postnatal recovery and a bespoke pelvic floor rehab programme based on the assessment findings. Physios use scar massage techniques on C Section and episiotomy scars to promote healing and normal tissue movement within a scar. We teach therapeutic exercises which can help restore the tension and strength of the abdominal muscles if you’ve had a significant separation. We use an internal pelvic floor assessment as an opportunity to check how you do a pelvic floor contraction, and where necessary coach you into a better technique. This assessment will also identify a high tone pelvic floor - a situation where pelvic floor exercises may actually be unhelpful/contraindicated.

I provide such assessments at St Judes Clinic in Leighton Buzzard and can assist you in your postnatal recovery. These check ups hugely insightful and are recommended for all Mothers after every birth - make the best start to Motherhood that you can by recovering fully from pregnancy and birth with our help and support.

Please get in touch with any queries about your suitability or specific needs. If you want to help push for better postnatal care in the UK, please support/follow the work of PelvicRoar.

I offer free 10 minute chats in clinic/by phone if you wish to discuss an queries or concerns, or feel free to drop me an email. Babies are welcome at all my appointments.

Jo