{"id":24093,"date":"2026-03-03T08:00:00","date_gmt":"2026-03-03T14:00:00","guid":{"rendered":"https:\/\/naturalwomanhood.org\/?p=24093"},"modified":"2026-03-07T09:47:01","modified_gmt":"2026-03-07T15:47:01","slug":"c-section-therapie","status":"publish","type":"post","link":"https:\/\/naturalwomanhood.org\/fr\/c-section-therapy\/","title":{"rendered":"Que se passe-t-il lorsque les m\u00e8res c\u00e9saris\u00e9es b\u00e9n\u00e9ficient d'une kin\u00e9sith\u00e9rapie en milieu hospitalier et d'une r\u00e9\u00e9ducation par t\u00e9l\u00e9m\u00e9decine ?"},"content":{"rendered":"\n<p><\/p>\n\n\n\n<p>Did you know that the single most common major abdominal surgery in the United States<em> isn\u2019t<\/em> typically followed by inpatient physical and occupational therapy (PT and OT)\u2014even though the patient goes home to care not just for herself but to be the primary caregiver for a brand new baby as well?<\/p>\n\n\n\n<p>It&#8217;s true.\u00a0<\/p>\n\n\n\n<p>Despite the fact that daily or twice-daily PT and OT are standard of care on the first post-op day for virtually every other inpatient surgery, from joint replacement to cardiac surgery to stroke surgery, women who undergo C-sections <em>are not<\/em> ordinarily evaluated before they go home. This is to say nothing of women who give birth vaginally, even those who suffer first-, second-, third-, or even fourth-degree perineal tears.\u00a0<\/p>\n\n\n\n<p>Something needs to change.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-maternal-health-in-america-is-not-trending-in-the-right-direction\"><span id=\"maternal-health-in-america-is-not-trending-in-the-right-direction\">Maternal health in America is not trending in the right direction<\/span><\/h2>\n\n\n\n<p>Natural Womanhood readers are no doubt aware of the<a href=\"https:\/\/naturalwomanhood.org\/addressing-our-maternal-mortality-crisis-with-fertility-awareness-postpartum-health-2020\/\" target=\"_blank\" rel=\"noreferrer noopener\"> abysmal statistics<\/a> when it comes to <a href=\"https:\/\/naturalwomanhood.org\/decreasing-infant-and-maternal-mortality\/\" target=\"_blank\" rel=\"noreferrer noopener\">maternal mortality<\/a> (death during pregnancy up through the first year postpartum) and morbidity (pregnancy- or postpartum-related medical conditions occurring during that same timeframe) within the United States. But what are the numbers in the U.S. so dismal compared to the rest of the developed world\u2014and why are they getting worse?&nbsp;&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"h-why-are-maternal-mortality-and-morbidity-on-the-rise\"><span id=\"why-are-maternal-mortality-and-morbidity-on-the-rise\">Why are maternal mortality and morbidity on the rise?<\/span><\/h3>\n\n\n\n<p>The reasons for these discouraging stats vary, and may include improved reporting (which is a good and necessary thing) as well as an <a href=\"https:\/\/abcnews.com\/Health\/us-women-waiting-longer-children-cdc-data-shows\/story?id=122818080\" target=\"_blank\" rel=\"noreferrer noopener\">increasing proportion<\/a> of (relatively) older women conceiving, including women who, mirroring the general public, <a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ppe.13100?msockid=19c321fdef89667916db2e03ee216756\" target=\"_blank\" rel=\"noreferrer noopener\">struggled pre-pregnancy <\/a>with their weight, blood pressure, diabetes, and\/or heart disease [1]. Another major interlinked <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC12653877\/\" target=\"_blank\" rel=\"noreferrer noopener\">contributing factor<\/a> is the high rate of C-sections, accounting for 1 of every 3 births [2].&nbsp;<\/p>\n\n\n\n<p>Added to all this, an increasing number of American women live in <a href=\"https:\/\/www.marchofdimes.org\/maternity-care-deserts-report\" target=\"_blank\" rel=\"noreferrer noopener\">maternity care deserts<\/a>, meaning areas where there are no birthing facilities or obstetric clinicians. Perhaps unsurprisingly, living in a maternity care desert is <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC12258799\/\" target=\"_blank\" rel=\"noreferrer noopener\">associated <\/a>with increased maternal mortality [3]. As of 2022, 1,104 counties were classified as maternity care deserts, and it\u2019s a number that continues to grow.\u00a0\u00a0<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"h-the-majority-of-maternal-deaths-occur-after-birth-and-before-the-6-week-checkup\"><span id=\"the-majority-of-maternal-deaths-occur-after-birth-and-before-the-6-week-checkup\">The majority of maternal deaths occur after birth and before the 6-week checkup<\/span><\/h3>\n\n\n\n<p>Fully 57% of all maternal deaths <a href=\"https:\/\/journals.lww.com\/jwphpt\/Fulltext\/2023\/01000\/Initiating_Occupational_and_Physical_Therapy_in.4.aspx\" target=\"_blank\" rel=\"noreferrer noopener\">occur<\/a> <em>during<\/em> the first 6 weeks postpartum (note: this is <em>before <\/em>the traditional six week postpartum checkup), and the top two causes are infection and hemorrhage [4]. This means that, on a systemic level, large numbers of women are falling through the cracks.<\/p>\n\n\n\n<p>This is why for the past eight years, the American College of Obstetricians and Gynecologists (ACOG) has actually <a href=\"https:\/\/www.acog.org\/clinical\/clinical-guidance\/committee-opinion\/articles\/2018\/05\/optimizing-postpartum-care\" target=\"_blank\" rel=\"noreferrer noopener\">recommended<\/a> a much earlier touchpoint for women and their obstetric clinicians,<em> even though the vast majority of OB practices do not follow this guideline<\/em>.\u00a0<\/p>\n\n\n\n<p>Common sense suggests that newly postpartum women would benefit from <a href=\"https:\/\/naturalwomanhood.org\/maternal-and-infant-mortality-rates-in-the-us\/\" target=\"_blank\" rel=\"noreferrer noopener\">additional oversight and guidance<\/a>, especially before discharge from the hospital. Enter acute care PT and OT.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-what-does-pt-ot-for-brand-new-moms-look-like\"><span id=\"what-does-pt-ot-for-brand-new-moms-look-like\">What does PT\/OT for brand-new moms look like?<\/span><\/h2>\n\n\n\n<p>Starting with one hospital in 2023, and expanding to a second in early 2025, women who give birth at either of two<a href=\"https:\/\/obgyn.duke.edu\/blog\/duke-health-inpatienttelehealth-postpartum-pt-program-benefits-patients\" target=\"_blank\" rel=\"noreferrer noopener\"> Duke University Health System hospitals<\/a> have access to PT and OT care. What\u2019s being assessed? Therapists ask about, demonstrate, and educate on similar skills and questions as other post-op patients would receive, plus some specific to C-sections.&nbsp;<\/p>\n\n\n\n<p>This <a href=\"https:\/\/journals.lww.com\/jwphpt\/Fulltext\/2023\/01000\/Initiating_Occupational_and_Physical_Therapy_in.4.aspx\" target=\"_blank\" rel=\"noreferrer noopener\">includes<\/a> things like asking about the number of steps in the home, ability to get in and out of bed, chair, and bath or shower with the least pain, assistance with movement and activity for gas pain, and teaching diaphragmatic breathing [4]. Additionally, therapists cover ways a new mom can carry and care for her newborn (including protecting her incision during baby care), lifting guidelines, scar massage, etc. Therapists can make recommendations on activity modifications, strengthening exercises, and more.&nbsp;<\/p>\n\n\n\n<p>Since a mother\u2019s needs don\u2019t end when she leaves the hospital, Duke University Health System and others also offer <a href=\"https:\/\/www.aptapelvichealth.org\/info\/implementation-of-an-acute-care-ob-and-postpartum-telehealth-program-at-duke-health\" target=\"_blank\" rel=\"noreferrer noopener\">telehealth options<\/a> for ongoing support, including using a <a href=\"https:\/\/www.youtube.com\/watch?time_continue=1&amp;v=-6nPoSfO43I&amp;embeds_referring_euri=https%3A%2F%2Fwww.bing.com%2F&amp;embeds_referring_origin=https%3A%2F%2Fwww.bing.com&amp;source_ve_path=Mjg2NjY\" target=\"_blank\" rel=\"noreferrer noopener\">screening tool <\/a>for post-birth complications, and\/or regular and early in-person visits (as we at Natural Womanhood have <a href=\"https:\/\/naturalwomanhood.org\/pelvic-floor-physical-therapy\/\" target=\"_blank\" rel=\"noreferrer noopener\">advocated for repeatedly<\/a>).&nbsp;<\/p>\n\n\n\n<p>Are you thinking this sounds expensive? Think again. Since implementing their collaborative approach to inpatient PT\/OT for newly postpartum moms, Duke University <a href=\"https:\/\/www.instagram.com\/p\/DULiBHFEYZv\/\" target=\"_blank\" rel=\"noreferrer noopener\">saved<\/a> an estimated $500,000 over 18 months due to prevention of readmissions\u2014proving that good, timely care is better for everyone (moms, babies, <em>and<\/em> hospital systems).&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-pullquote\"><blockquote><p>Are you thinking this sounds expensive? Think again. Since implementing their collaborative approach to inpatient PT\/OT for newly postpartum moms, Duke University saved an estimated $500,000 over 18 months due to prevention of readmissions\u2014proving that good, timely care is better for everyone (moms, babies, <em>and<\/em> hospital systems).&nbsp;<\/p><\/blockquote><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-moms-who-give-birth-vaginally-may-benefit-from-inpatient-pt-ot-too\"><span id=\"moms-who-give-birth-vaginally-may-benefit-from-inpatient-pt-ot-too\">Moms who give birth vaginally may benefit from inpatient PT\/OT too<\/span><\/h2>\n\n\n\n<p>C-section moms aren\u2019t the only ones who can benefit from in-hospital PT\/OT. According to the Duke University press release about their program, PT\/OT referrals are also appropriate for \u201cperineal tears, pelvic girdle pain in pregnancy, coccygodynia (a painful syndrome affecting the tailbone\/coccygeal region) and pelvic organ prolapse, among others.\u201d&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"h-help-for-moms-who-experience-vaginal-tearing\"><span id=\"help-for-moms-who-experience-vaginal-tearing\">Help for moms who experience vaginal tearing<\/span><\/h3>\n\n\n\n<p>Perineal tears range from first-degree (least severe) tears involving the outer layer of the vagina, which don\u2019t require stitches but may be quite painful, to fourth-degree tears involving all the tissue from the vagina back to the rectum, leading to inability to control bowel movements and requiring surgical correction.&nbsp;<\/p>\n\n\n\n<p>While the impact of PT\/OT for a more severe tear is self-evident, even a tear that\u2019s \u201conly\u201d first-degree could benefit from PT\/OT, particularly for a first-time mom. This isn\u2019t coddling, it\u2019s caring. While a less-severe tear might not incapacitate a woman, PT\/OT can help her identify less-painful ways to move, pick up, and care for her baby, leading to improved functionality, mobility, confidence, and mental health.&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-pullquote\"><blockquote><p>While the impact of PT\/OT for a more severe tear is self-evident, even a tear that\u2019s \u201conly\u201d first-degree could benefit from PT\/OT, particularly for a first-time mom. This isn\u2019t coddling, it\u2019s caring. While a less-severe tear might not incapacitate a woman, PT\/OT can help her identify less-painful ways to move, pick up, and care for her baby, leading to improved functionality, mobility, confidence, and mental health.&nbsp;<\/p><\/blockquote><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"h-early-identifications-of-childbirth-related-musculoskeletal-injuries\"><span id=\"early-identifications-of-childbirth-related-musculoskeletal-injuries\">Early identifications of childbirth-related musculoskeletal injuries<\/span><\/h3>\n\n\n\n<p>Additionally, <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0002937823021166\" target=\"_blank\" rel=\"noreferrer noopener\">2024 research<\/a> found that levator ani muscle injury, which can occur during vaginal birth due to overstretching of the levator muscle and birth canal tissues, occurred in 55% of women who years later experienced pelvic organ prolapse [5]. What if we could get to these women much, much sooner?&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"h-kickstarting-recovery-for-moms-who-were-on-bedrest-before-giving-birth\"><span id=\"kickstarting-recovery-for-moms-who-were-on-bedrest-before-giving-birth\">Kickstarting recovery for moms who were on bedrest before giving birth<\/span><\/h3>\n\n\n\n<p>Finally, <em>any<\/em> mom who was on bedrest before birth due to a high-risk pregnancy condition naturally experiences deconditioning from lack of activity. No matter how she ultimately gave birth, her strength, range of motion, and functional mobility should be assessed. <strong>Helping a woman get back on her literal feet should be standard of care, and the glaring absence of in-hospital protocols around this is a blight on the field of women\u2019s healthcare.&nbsp;<\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-how-inpatient-postpartum-pt-ots-can-help-with-maternal-mental-health\"><span id=\"how-inpatient-postpartum-pt-ots-can-help-with-maternal-mental-health\">How inpatient postpartum PT\/OTs can help with maternal <em>mental <\/em>health<\/span><\/h2>\n\n\n\n<p>As Dr. Rebeca Segraves, OT, founder of the <a href=\"https:\/\/www.instagram.com\/p\/DUiyy2AkVR-\/\" target=\"_blank\" rel=\"noreferrer noopener\">Pelvic Health Network<\/a> advocating for inpatient PT and OT for new moms, observed in a candid interview on the <a href=\"https:\/\/www.youtube.com\/watch?v=af73fkyB6g8\" target=\"_blank\" rel=\"noreferrer noopener\">OT Potential Podcast<\/a> (starting around 28:00), in-hospital PTs and OTs can play an indispensable role in a new mother\u2019s care, but<em> not just through physical support.<\/em>&nbsp;<\/p>\n\n\n\n<p>Maternal mental health issues, collectively referred to as postpartum mood and anxiety disorders or PMADs, are the <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC11058917\/\" target=\"_blank\" rel=\"noreferrer noopener\">single greatest contributor<\/a> to maternal death in the first year postpartum [6]. But a PT or OT, who s<em>pends more sustained one-on-one time (between 30 minutes and an hour for one session) with a patient than perhaps any other professional in the inpatient healthcare setting<\/em>, has a privileged front row seat to a woman\u2019s labor and birth story.&nbsp;<\/p>\n\n\n\n<p>If a woman needs to unpack her experience, a PT\/OT communicates by their very presence that they are there for <em>her<\/em>, not just for her baby. She is not alone but supported, not forgotten but surrounded. And if there are red flags for significant mental health issues early on, a PT or OT can be part of the solution, sounding the alarm to get help.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-how-can-you-check-whether-your-hospital-offers-pt-ot-for-postpartum-moms-nbsp\"><span id=\"how-can-you-check-whether-your-hospital-offers-pt-ot-for-postpartum-moms\">How can you check whether your hospital offers PT\/OT for postpartum moms?&nbsp;<\/span><\/h2>\n\n\n\n<p><a href=\"https:\/\/pelvichealthnetwork.org\/hospitals\/\" target=\"_blank\" rel=\"noreferrer noopener\">This directory<\/a>, which was created by Dr Segraves\u2019 <a href=\"https:\/\/www.instagram.com\/p\/DUiyy2AkVR-\/\" target=\"_blank\" rel=\"noreferrer noopener\">Pelvic Health Network<\/a> organization and is updated as more institutions come on board, lists the 118 hospitals nationwide that <a href=\"https:\/\/longisland.news12.com\/first-in-the-state-st-vincents-launches-postpartum-rehab-program-for-women\" target=\"_blank\" rel=\"noreferrer noopener\">currently offer inpatient physical therapy and\/or occupational therapy<\/a>. Each listing further specifies whether inpatient postpartum OT\/PT is for C-section moms only.&nbsp;<\/p>\n\n\n\n<p>Want to find out more about how you can incorporate this innovative approach to postpartum care in your practice or hospital system? Healthcare professionals can learn more about facilitating inpatient PT\/OT <a href=\"https:\/\/enhancedrecoveryafterdelivery.com\/\" target=\"_blank\" rel=\"noreferrer noopener\">here<\/a>.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-the-bottom-line\"><span id=\"the-bottom-line\">The bottom line<\/span><\/h2>\n\n\n\n<p>Whether it\u2019s an<a href=\"https:\/\/naturalwomanhood.org\/early-labor-lounge\/\" target=\"_blank\" rel=\"noreferrer noopener\"> early labor lounge<\/a> to help reduce the likelihood of an unnecessary C-section or encouraging every single new mother (whether it\u2019s her first or twelfth baby) to see a <a href=\"https:\/\/naturalwomanhood.org\/pelvic-floor-physical-therapy\/\" target=\"_blank\" rel=\"noreferrer noopener\">pelvic floor physical therapist<\/a>, we at Natural Womanhood strive to promote best practices throughout <a href=\"https:\/\/naturalwomanhood.org\/preventing-preeclampsia-with-exercise-is-it-possible\/\" target=\"_blank\" rel=\"noreferrer noopener\">pregnancy<\/a>, <a href=\"https:\/\/naturalwomanhood.org\/eating-and-drinking-during-labor\/\" target=\"_blank\" rel=\"noreferrer noopener\">labor<\/a>, <a href=\"https:\/\/naturalwomanhood.org\/hospital-birth-story\/\" target=\"_blank\" rel=\"noreferrer noopener\">birth<\/a>, and the <a href=\"https:\/\/naturalwomanhood.org\/navigating-the-fourth-trimester-good-postpartum-nutrition\/\" target=\"_blank\" rel=\"noreferrer noopener\">postpartum<\/a> period.&nbsp;<\/p>\n\n\n\n<p>PT and OT care for new moms, starting before they\u2019ve even left the hospital, is in keeping with that commitment to the health and wellbeing of both mothers and babies. When a mother is supported, both mentally and physically, she can better care for both herself and her new child. <strong>Both are worth fighting for.&nbsp;<\/strong><\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"h-references\"><span id=\"references\">References:<\/span><\/h4>\n\n\n\n[1]Brown HK. Pre-existing conditions and pregnancy: A call to action for multidisciplinary, patient-centred care. Paediatr Perinat Epidemiol. 2024 Jul;38(5):394-396. doi: 10.1111\/ppe.13100. Epub 2024 Jun 17. PMID: 38886332.<\/p>\n\n\n\n[2]Thomaidi S, Sarantaki A, Tzitiridou Chatzopoulou M, Orovou E, Jotautis V, Papoutsis D. The Rising Global Cesarean Section Rates and Their Impact on Maternal and Child Health: A Scoping Review. J Clin Med. 2025 Nov 15;14(22):8102. doi: 10.3390\/jcm14228102. PMID: 41303138; PMCID: PMC12653877.<\/p>\n\n\n\n[3] Atwani R, Robbins L, Saade G, Kawakita T. Association of Maternity Care Deserts With Maternal and Pregnancy-Related Mortality. Obstet Gynecol. 2025 Jun 26;146(2):181-188. doi: 10.1097\/AOG.0000000000005976. PMID: 40570350; PMCID: PMC12258799.<\/p>\n\n\n\n[4] Segraves, Rebeca L. et al. Initiating Occupational and Physical Therapy in the Hospital After Birth: Access, Reimbursement, and Outcomes. Journal of Women&#8217;s &amp; Pelvic Health Physical Therapy 47(1):p 26-35, January\/March 2023. | DOI: 10.1097\/JWH.0000000000000262<\/p>\n\n\n\n[5] DeLancey JOL, et al. Pelvic floor injury during vaginal birth is life-altering and preventable: what can we do about it? Am J Obstet Gynecol. 2024 Mar;230(3):279-294.e2. doi: 10.1016\/j.ajog.2023.11.1253. Epub 2024 Jan 2. PMID: 38168908; PMCID: PMC11177602.<\/p>\n\n\n\n[6] Weingarten SJ, Osborne LM. Review of the Assessment and Management of Perinatal Mood and Anxiety Disorders. Focus (Am Psychiatr Publ). 2024 Jan;22(1):16-24. doi: 10.1176\/appi.focus.20230023. Epub 2024 Jan 12. PMID: 38694149; PMCID: PMC11058917.<\/p>\n","protected":false},"excerpt":{"rendered":"De bonnes choses se produisent lorsque nous prenons soin des nouvelles mamans","protected":false},"author":85,"featured_media":24094,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_kad_blocks_custom_css":"","_kad_blocks_head_custom_js":"","_kad_blocks_body_custom_js":"","_kad_blocks_footer_custom_js":"","csco_singular_sidebar":"","csco_page_header_type":"","csco_page_load_nextpost":"","csco_post_video_location":[],"csco_post_video_url":"","csco_post_video_bg_start_time":0,"csco_post_video_bg_end_time":0,"footnotes":""},"categories":[5394],"tags":[6335],"class_list":{"0":"post-24093","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-postpartum","8":"tag-c-section","9":"cs-entry","10":"cs-video-wrap"},"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.2 (Yoast SEO v27.2) - 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