One of my favorite rehabilitation approaches to practice and learn more about is DNS, or Dynamic Neuromuscular Stabilization. Pavel Kolar of the Prague School, organized the DNS clinical protocols and has also recently published a book, Clinical Rehabilitation. I swear, every time I open this book my mind is exposed to something new, or a correlation is drawn between two things I never placed together. There is a chapter specifically dedicated to treatment rehab in the fields of obstetrics and gynecology, from which this blog is sourced. Get ready for a crash course in all things childbirth!
The human gestation period lasts 38 weeks and 1 day from conception, and is separated into 3 terms. The 2nd trimester is the longest, lasting 16 weeks, with the 1st and 3rd set of 12 weeks framing it on either side. A fact many people may not appreciate is that the due date can include up to a 21 day period and should therefore be considered more of a due “range”. Every woman is different and as all parents know, children do not always follow a set schedule so counting on it being 1 specific day makes no sense!
I do not shy away from being referred to as a nerd and this might become evident due to the fact that I think it is so amazing and fascinating the changes a woman’s body goes through during pregnancy. Obviously the fetus must fill all of its needs through the mother, and her body must adapt to accommodate him/her. The cascade of events is triggered by 2 things: the fetus / placenta complex (duh), but also a portion of the brain called the hypothalamus. These cause hormone changes, leading to many physiologic changes, the most evident being the growth of the uterus. This organ grows by 18-24 times in weight and 900-1000 times in volume. Woah. This growth is not random either, the anatomy of the musculature and vessels are purposely formed in a way to better maintain and birth the baby.
On to the main event, birth. This, like pregnancy, is also broken down into 3 parts. These parts are called “stages” and the 1st begins with the onset of regular contractions of the uterus. Fun fact, mothers with a previous birth under their belts can progress through this stage up to three times quicker (4-8 hours vs. 8-12 hours for first timers). Full dilation of the cervix signals the 2nd stage, referred to as the “pushing stage.” Once again, previous birth experience may advance mothers through this stage at blazing speeds, 20-30 minutes, with novices taking 1-1.5 hours on average. The second stage of labor requires abdominal bracing (ask me how you can improve yours!). Finally, placenta delivery, or the 3rd stage, is one that much care is taken during, owing to complications that could occur, most commonly bleeding.
Even though this stage realistically lasts the next 18 years or more, by definition the postpartum/postnatal period is the 6 weeks following birth. If this were a more opinionated post, I would explain to you why this very crucial stage is given a frustratingly low amount of attention but never mind that. After the amazing transformation a woman’s body went through to develop a baby, it now begins to return to its pre-pregnancy state. The uterus shrinks, puffiness decreases, skin returns to its original pigment, and varicosities lessen or disappear.
Hopefully this crash course shed some light on the phenomenal process of carrying, delivering, and returning to normal after a baby. Stay tuned for my next blog covering the rehabilitation side of pregnancy and postpartum, addressing these changes we just covered!