The 4th Trimester

Technically, the 4th trimester is the first 12 weeks postpartum. I’ve also seen some people refer to the first 2 years as the 4th trimester.

I think of it in 3 phases:

0-6weeks

7-12 weeks

12 weeks to forever.

So what does that look like, from a pelvic PT’s perspective?

I like to get people in after their 6 week checkup; sooner if they have pain or worsening symptoms.

At that session, I perform a full body evaluation.

Typically, I perform a pelvic exam after the 6 week clearance from the OB. This is different from what they do, as I don’t use a speculum and I’m assessing the muscles for strength, coordination, tone, endurance, injury, as well as prolapse.

We address any weakness (pelvic or body), scars, diastasis (DRA), prolapse, pain, and teach appropriate mechanics (getting stroller out of car, holding carrier, etc.).

Strengthen as appropriate and indicated. There are protocols to assess people's readiness to return to activity, so I’ll perform those tests to give people a picture of what we need to work on and where we’re going. I typically progress people, starting with horizontal exercises, then move to standing, and then later add high impact activity.

I refer to appropriate providers (i.e. chiropractor, acupuncturist, therapist, postpartum trainers, etc). I truly believe I am one person on the team and we are better together.