L+M’s Pelvic Health rehabilitation after childbirth is a big hit with patients

It wasn’t until after the birth of her third child that Andrea Spelman, physical therapist, participated in rehabilitative care for her own postpartum pelvic health.

“I had the most amazing experience as a mom, getting individualized care for my personal needs,” she recalled. “And then I had this idea… Why can’t all moms have this?”

That eye-opening moment put Spelman on a mission that, today, represents a first across Yale New Haven Health – a program where every patient who has a baby at L+M is offered a physical therapy/occupational therapy consult after childbirth. The goal is to help patients deal with their own recovery process, particularly those who had cesarean sections.

“A mom who has had a c-section has gone through a major abdominal surgery, then right away virtually all the education she receives is about the care of her baby. That’s obviously very important, but, in terms of their abdominal surgery, there wasn’t an individualized service to offer the moms,” Spelman said.

Now, Spelman said, “We’re giving that tailored experience to moms to identify their pain points, assess their difficulty moving around and provide education, decreasing their pain, increasing their mobility and function, and making sure they’re responding well overall and not experiencing any other difficulties.”

One example of a technique therapists teach mothers after c-sections, is “log rolling” to get up from the bed. Patients are instructed to turn on one side, lower the legs off the bed and then push up to sit. It’s a simple but effective method that can give mothers greater independence after surgery, even if it’s just to get up and use the bathroom.

Lauren Lary, RN, nurse manager on L+M’s Maternity Unit, said the response to the new initiative has been overwhelmingly positive, both from patients and nurses on the unit, many of whom are young mothers themselves.

“I’ve actually never seen anything take off quite like this,” Lary said. “Traditionally, mom is not the focus after childbirth. When a person has any other kind of surgery, their recovery is the main focus. But after childbirth, it’s all about the baby. This new program lets moms know that we’re here to support their health as well as their baby’s.”

While it took some work to get the program up and running, Spelman said she had encouragement from Jennifer Lombardo, director of Rehab Services, Rebecca Burrell, manager of Rehab Services, her rehab colleagues, L+M Obstetrics, and the L+M Maternity nurses. The program launched in April with six referrals, followed by 20 referrals in May, and 24 in June.

Consultations are ordered collaboratively by each patient’s provider and nurses, then a physical or occupational therapist will visit the patient before discharge. 

“We see therapists walking the halls with patients and talking with patients, and the patients will mention it to us during rounding, telling us how helpful it was,” Lary said. “It’s a patient satisfier and great for our patient experience scores, too.”