The Importance of Proactive Perinatal Care
A Unique Perspective from the Field
As the primary care sports medicine doctor for the New York Liberty, I have the privilege of treating elite athletes, connecting my background as a Division I athlete to the world of professional sports medicine. This role allows me to care for a historically marginalized population just as the healthcare landscape begins to value female athletes and their unique needs. My daily routine involves managing a range of issues—everything from acute injuries to basic ailments like sore throats and earaches. Yet, my perspective took a dramatic turn after the birth of my second child, positioning me on the other side of the care spectrum.
Personal Struggles and Professional Insights
Postpartum, I faced diastasis recti—a condition affecting many women, where the abdominal muscles separate, causing discomfort and weakness. Despite having access to top-tier healthcare and clinical expertise, I found myself still recovering eight months later. This experience highlighted a stark reality: many women lack the resources and guidance necessary for healing. They navigate recovery without proper support, leading to frustrating and often painful journeys.
The Gaps in the Healthcare System
Pregnancy impacts nearly every organ system, yet most women receive minimal guidance on protecting or rebuilding their health. Our healthcare system is reactive, waiting for problems to emerge rather than preventing them. There’s an urgent need for a shift to proactive perinatal care—a model that supports women before, during, and after pregnancy while integrating musculoskeletal medicine, physical therapy, and nutritional guidance.
The Power of Exercise
Research clearly shows that pelvic floor and core-strengthening exercises can reduce risks of complications, such as urinary incontinence and low back pain. These strategies also enhance delivery outcomes by improving the likelihood of a vaginal birth and shortening labor times. Even modest levels of exercise during pregnancy—just 140 minutes weekly—can significantly lower the risk of gestational diabetes and hypertension, which can lead to more serious conditions like preeclampsia.
Overall Benefits of Physical Activity
Exercise helps mitigate excessive weight gain during pregnancy, a factor associated with several postpartum issues, including recovery challenges. Additionally, it supports mental health, which is essential given that perinatal depression affects about 1 in 7 individuals during pregnancy or within the year following childbirth. Encouraging regular activity during and after pregnancy is vital for overall well-being.
The Role of Resistance Training
Resistance training, in particular, plays an essential role in maintaining strength through pregnancy and postpartum. Women who adapt to resistance routines typically find it easier to return to these activities after childbirth. Conversely, halting such practices often results in a difficult transition back to fitness.
Importance of Postpartum Care
Postpartum care is equally essential. Physical activity contributes to a smoother recovery journey, improving cardiovascular health, reducing depressive symptoms, and enhancing sleep quality. Experts suggest women engage in 150-300 minutes of moderate exercise weekly postpartum, alongside strength training and stretching.
Standard Care Lags Behind Research
Unfortunately, this evidence hasn’t translated into standard medical practice. Many healthcare providers intervene only when issues arise, leaving women searching for pelvic floor therapy and reliable specialist referrals. Too often, the burden rests on the patient to navigate care, with many feeling isolated or resigned to enduring chronic discomfort.
Revolutionizing Perinatal Care
Determined to effect change, I helped launch a perinatal program at the Hospital for Special Surgery, aiming to integrate proactive, comprehensive care into the maternity experience. “Sports medicine” may sound exclusive to athletes, but it’s about supporting strength and recovery during significant life transitions. We should reframe our approach to focus on “movement medicine.”
Building Comprehensive Support Systems
Our model at HSS connects women with physical therapists, nutritionists, and medical professionals who understand the complexities of the perinatal journey. Similar initiatives, like that at Brigham and Women’s Hospital in Boston, exemplify how integrating musculoskeletal and wellness care into routine perinatal practice can create a scalable, evidence-based approach essential for all women.
A Call for Change in Healthcare Systems
Healthcare systems must abandon outdated practices that hinder effective care. The standard six-week postpartum visit is inadequate for addressing emerging health issues. Likewise, prenatal care often centers disproportionately on fetal development, neglecting maternal health until complications present.
Misconceptions Around Coverage
Many myths persist regarding what insurance covers—specifically relating to pelvic floor therapy and nutritional support. In truth, these services are often insured when diagnosed correctly. It’s not a question of feasibility but rather a need for heightened awareness and a cultural shift within healthcare to prioritize proactive care.
The Responsibility of Healthcare Providers
For physicians, especially those specializing in movement or women’s health, the responsibility lies in advancing the standard of care. Many OB/GYNs may not be trained to identify musculoskeletal issues or connect patients to appropriate specialists, making it imperative to ensure that providers are informed and that patients feel supported from the outset.
The Need for Comprehensive Care
As both a physician and a mother, I understand the urgency behind advocating for comprehensive perinatal care. Women deserve a healthcare system that fully supports them during every stage of their journey into motherhood—a system that prioritizes their health alongside that of their newborns.
