For many women, pregnancy and the first few months postpartum is a joyful and exciting time; however, this joyful time can also be accompanied by physical and mental challenges.
Some of the most common challenges include low back pain, depression, anxiety, pelvic floor dysfunction, and upper limb neuropathies such as carpal tunnel syndrome and DeQuervain’s tenosynovitis. Each of these concerns can be addressed with your primary care provider but may also benefit from a referral to an occupational therapist. Here are three ways an occupational therapist can support a postpartum mom:
Modifications to Childcare Routines: Both low back pain and upper limb neuropathies are most commonly associated with less than ideal body positioning during prolonged, repetitive childcare tasks. Occupational therapists are trained to utilize their in-depth knowledge of anatomy and physiology to analyze activities such as placing a child’s car seat in a vehicle, breastfeeding, or lifting a child out of a crib and modifying the activity to improve a mother’s ergonomics and decrease the negative impact on her body. Additionally, occupational therapists can recommend modifications to the environment (i.e. different seating or pillow for breastfeeding, alternate crib option, etc) to decrease the amount of effort required by the mother. If upper limb neuropathies persist even after modifications to childcare routines are made, occupational therapists can provide splints to allow the strained hand or wrist to rest.
Mental Health Support: Currently, very few resources are available to postpartum mothers suffering from depression or anxiety. Organizations such as the American College of Obstetricians and Gynecologists have publicly recognized that the current state of postpartum care is not adequate. Fortunately, emerging studies are beginning to show the benefits of postpartum mothers receiving occupational therapy to support their mental health. Some of the interventions provided by occupational therapists in these studies include skilled training in relaxation techniques to mothers on bedrest, providing education on psychosocial changes in the perinatal period, facilitating success in breastfeeding, and leading activity-based support groups for new mothers.
Pelvic Floor Health: A wide variety of experts work to treat pelvic floor dysfunction but often the most successful treatment plans include a multidisciplinary team. Occupational therapists can be an important member of this team and offer a unique perspective. Not only do occupational therapists have training in the biomechanical aspects of pelvic floor dysfunction, but they also have training in addressing the psychosocial concerns that may arise associated with pelvic floor dysfunction. The Occupational Therapy Practice Framework highlights the fact that occupational therapists can approach and treat pelvic floor dysfunction from the perspective of how does this concern impact activities of daily living like toileting, rest/sleep, and sexual activity.
American College of Obstetricians and Gynecologists, ACOG Committee Opinion. (May 2018). Optimizing postpartum care (No. 736). Retrieved from https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Optimizing-Postpartum-Care?IsMobileSet=false
American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy, 68(Suppl. 1), S1-S48. doi:10.5014/ajot.2014.682006
Borg-Stein, J. & Dugan, S. A. (2007). Musculoskeletal disorders of pregnancy, delivery and postpartum. Physical Medicine and Rehabilitation Clinics of North America, 18, 459–476. doi: 10.1016/j.pmr.2007.05.005
Carroll, T. C., & Loesche, S. J. (2017). Caring for the caregiver: How occupational therapy can support those who care for young children. OT Practice, 22(7), 8–11.
Cassar V. (2005). Developing occupational therapy intervention in perinatal maternal mental health in Malta. World Federation of Occupational Therapists Bulletin, 52(1), 35–38. doi: 10.1179/otb.2005.52.1.007
Cheng, C., Fowles, E., & Walker, L. O. (2006). Postpartum maternal health care in the United
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Hallock, J. L., & Handa, V. L. (2016). The Epidemiology of Pelvic Floor Disorders and Childbirth: An Update. Obstetrics and gynecology clinics of North America, 43(1), 1–13. https://doi.org/10.1016/j.ogc.2015.10.008
Harris, R., Gibbs, D., Mangin-Heimos, K., & Pineda, R. (2018). Maternal mental health during the neonatal period: Relationships to the occupation of parenting. Early Human Development, 120, 31-39. doi: 10.1016/j.earlhumdev.2018.03.009
John, H.B., Philip, R.M., Santhanam, S., Padankatti, S.M., Sebastian, T., Balan, I., & Rajapandian, E. (2018). Activity based group therapy reduces maternal anxiety in the neonatal intensive care unit—a prospective cohort study. Early Human Development, 123, 17-21. doi:10.1016/j.earlhumdev.2018.07.001
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Yeager, J. (2019). Relaxation interventions for antepartum mothers on hospitalized bedrest. American Journal of Occupational Therapy, 73. doi:10.5014/ajot.2019.025692
Happy OT Month!
Individual therapy is currently being offered as a hybrid model including a mix of both telehealth and in-person services based on the individual needs of the child and their family. Our occupational therapists evaluate and treat children to improve their independence and develop the skills they need to participate in their daily “occupations” such as self-care activities, playing, learning, and participating in social settings. We utilize family coaching and play-based therapy to engage children in purposeful activities to improve sensory integration, fine motor, visual motor, cognitive, self-regulation, oral, and feeding skills. The goal of pediatric occupational therapy is not only to help children adequately progress but to challenge them appropriately, helping to build self-esteem and confidence in their capabilities. Occupational therapists can address the following:
Play and Motor Skills
Fine Motor Skills
Fine Motor/Social/Self-Care Developmental Milestones
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Your Guide to Getting Started in Telepractice (For Clinicians)
Do you feel prepared for your teletherapy sessions? Are your clients prepared and feeling confident in their ability to effectively participate? This packet is designed to make sure you and your clients are ready for each session. These easy-to-use checklists will ensure you don't forget any of the steps and keep your session set-up efficient.
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About the Author
Serena Dewey is an occupational therapist, was born and raised in western Washington but has lived throughout the northwest. She completed her bachelor's degree at Walla Walla University in Speech Communication and then completed her master's degree in Occupational Therapy at Eastern Washington University. While at Eastern Washington University, Serena participated in community-based volunteer opportunities including the organization of a Halloween costume design and trick-or-treating event for children with mobility limitations. Serena also enjoyed partnering with children and their families during a constraint-induced movement therapy camp offered at Eastern Washington University. She has experience working in a variety of settings including inpatient rehabilitation, mental health, pediatrics, early intervention pediatrics, and telehealth.