Introduction and objective:
The aim of the study was to assess the role and availability of postpartum physiotherapy in women’s opinions

Material and methods:
The study included 112 women aged 37 ± 7 years who gave birth at least once. The research tool was an online questionnaire.

Eleven of the surveyed women (10%) who had a consultation with a physiotherapist in the hospital after childbirth rated it at 7 ± 3.74, on a scale of 0-10, where 0 meant that they considered the consultation to be definitely unnecessary, and 10 definitely needed. Women who had no contact with a physiotherapist in the hospital after childbirth assessed the validity of such consultation at 5 ± 4.70. After hospitalization, 25 women (22%) consulted a physiotherapist. Among the women who did not (78%), morethan a half (57%) did not know that there was such a possibility. Among the women who attended childbirth classes, 34% (n=15) were informed about the possibility of consulting a physiotherapist after childbirth.

Women’s awareness of the competence of.a urogynaecological physiotherapist should be increased, e.g. during childbirth classes and during hospitalization after childbirth. Solutions should be sought to enable women after childbirth an early access to urogynaecological physiotherapy, at least of an instructional nature. It is advisable to conduct further research aimed at determining the barriers in access to urogynaecological physiotherapy for postpartum women.

Simonds AH, Abraham K, Spitznagle T. Executive Summary of the Clinical Practice Guidelines for Pelvic Girdle Pain in the Postpartum Population. J Women’s Health Phys Ther. 2022;46.1:3–10.
Cooklin AR, Amir LH, Nguyen CD, et al. Physical health, breastfeeding problems and maternal mood in the early postpartum: a prospective cohort study. Arch Womens Ment Health. 2018;21(3):365–374.
Vleeming A, Albert HB, Ostgaard HC, et al. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J. 2008;17(6):794–819.
Wu WH, Meijer OG, Uegaki K, et al. Pregnancy-related pelvic girdle pain (PPP), I: Terminology, clinical presentation, and prevalence. Eur Spine J. 2004;13(7):575–589.
Rejano-Campo M, Desvergée A, Pizzoferrato AC. Caractéristiques et symptômes pelvi-périnéaux dans les douleurs de la ceinture pelvienne: une revue de la littérature [Relationship between perineal characteristics and symptoms and pelvic girdle pain: A literature review]. Prog Urol. 2018;28(4):193–208.
Starzec-Proserpio M, Lipa D, Szymański J, et al. Association Among Pelvic Girdle Pain, Diastasis Recti Abdominis, Pubic Symphysis Width, and Pain Catastrophizing: A Matched Case-Control Study. Phys Ther. 2022;102(4):pzab311.
Dunn G, Egger MJ, Shaw JM, et al. Trajectories of lower back, upper back, and pelvic girdle pain during pregnancy and early postpartum in primiparous women. Womens Health (Lond). 2019;15:1745506519842757.
Starzec-Proserpio M, Węgrzynowska M, Sys D, et al. Prevalence and factors associated with postpartum pelvic girdle pain among women in Poland: a prospective, observational study. BMC Musculoskelet Disord. 2022;23(1):928.
Wuytack F, Begley C, Daly D. Risk factors for pregnancy-related pelvic girdle pain: a scoping review. BMC Pregnancy Childbirth. 2020;20(1):739.
Wiezer M, Hage-Fransen MAH, Otto A, et al. Risk factors for pelvic girdle pain postpartum and pregnancy related low back pain postpartum; a systematic review and meta-analysis. Musculoskelet Sci Pract. 2020;48:102154.
Sakamoto A, Gamada K. Altered musculoskeletal mechanics as risk factors for postpartum pelvic girdle pain: a literature review. J Phys Ther Sci. 2019;31(10):831–838.
Kovacs FM, Garcia E, Royuela A, et al. Spanish Back Pain Research Network. Prevalence and factors associated with low back pain and pelvic girdle pain during pregnancy: a multicenter study conducted in the Spanish National Health Service. Spine (Phila Pa 1976). 2012;37(17):1516–1533.
Capobianco R, Cher D; SIFI Study Group. Safety and effectiveness of minimally invasive sacroiliac joint fusion in women with persistent post-partum posterior pelvic girdle pain: 12-month outcomes from a prospective, multi-center trial. Springerplus. 2015;4:570.
Le Huec JC, Tsoupras A, Leglise A, et al. The sacro-iliac joint: A potentially painful enigma. Update on the diagnosis and treatment of pain from micro-trauma. Orthop Traumatol Surg Res. 2019;105(1S):S31–S42.
Fiani B, Sekhon M, Doan T, et al. Sacroiliac Joint and Pelvic Dysfunction Due to Symphysiolysis in Postpartum Women. Cureus. 2021;13(10):e18619.
Hermans SMM, Paulussen EMB, Notermans RAJ, et al. Motion analysis in patients with postpartum sacroiliac joint dysfunction: A cross-sectional case-control study. Clin Biomech (Bristol, Avon). 2022;100:105773.
Anastasio MK, Anastasio AT, Kuller JA. Peripartum Pubic Symphysis Diastasis. Obstet Gynecol Surv. 2023;78(6):369–375.
Seidman AJ, Siccardi MA. Postpartum Pubic Symphysis Diastasis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; February 19, 2023.
Heim JA, Vang S, Lips E, et al. Pubic Symphysis Separation and Regression in Vaginal versus Cesarean Delivery. J Obstet Gynaecol Can. 2022;44(1):42–47.
Qiao J, Qin J, Feng J, et al. Relationship Between Pubic Symphysis Separation and Postpartum Pelvic Girdle Pain: A Retrospective Study of 32 Cases. PM R. 2020;12(12):1222–1226.
Wang Y, Li YQ, Tian MR, et al. Role of relaxin in diastasis of the pubic symphysis peripartum. World J Clin Cases. 2021;9(1):91–101.
Mota MJ, Cardoso M, Carvalho A, et al. Women's experiences of low back pain during pregnancy. J Back Musculoskelet Rehabil. 2015;28(2):351–357.
Long G, Yao ZY, Na Y, et al. Different types of low back pain in relation to pre- and post-natal maternal depressive symptoms. BMC Pregnancy Childbirth. 2020;20(1):551.
Mutaguchi M, Murayama R, Takeishi Y, et al. Relationship between low back pain and stress urinary incontinence at 3 months postpartum. Drug Discov Ther. 2022;16(1):23–29.
Horibe K, Isa T, Matsuda N, et al. Association between sleep disturbance and low back and pelvic pain in 4-month postpartum women: A cross-sectional study. Eur Spine J. 2021;30(10):2983–2988.
Gutke A, Josefsson A, Oberg B. Pelvic girdle pain and lumbar pain in relation to postpartum depressive symptoms. Spine (Phila Pa 1976). 2007;32(13):1430–1436.
Yan H, Ding Y, Guo W. Mental Health of Pregnant and Postpartum Women During the Coronavirus Disease 2019 Pandemic: A Systematic Review and Meta-Analysis. Front Psychol. 2020;11:617001.
Virgara R, Maher C, Van Kessel G. The comorbidity of low back pelvic pain and risk of depression and anxiety in pregnancy in primiparous women. BMC Pregnancy Childbirth. 2018;18(1):288.
Payne JL, Maguire J. Pathophysiological mechanisms implicated in postpartum depression. Front Neuroendocrinol. 2019;52:165–180.
Shi P, Ren H, Li H, et al. Maternal depression and suicide at immediate prenatal and early postpartum periods and psychosocial risk factors. Psychiatry Res. 2018;261:298–306.
Bodnar-Deren S, Klipstein K, Fersh M, et al. Suicidal Ideation During the Postpartum Period. J Womens Health (Larchmt). 2016;25(12):1219–1224.
Brummelte S, Galea LA. Postpartum depression: Etiology, treatment and consequences for maternal care. Horm Behav. 2016;77:153–166.
Turan V, Colluoglu C, Turkyilmaz E, et al. Prevalence of diastasis recti abdominis in the population of young multiparous adults in Turkey. Ginekol Pol. 2011;82(11):817–821.
Vicente-Campos V, Fuentes-Aparicio L, Rejano-Campo M. Evaluación de las consecuencias físicas y psicosociales de la diástasis de rectos abdominales y su interferencia en la salud: un estudio mixto [Evaluation of the physical and psychosocial consequences of the diastasis of the rectus abdominis and its interference in health: A mixed study]. Rehabilitacion (Madr). 2023;57(2):100744.
Joueidi Y, Vieillefosse S, Cardaillac C, et al. Impact du diastasis des muscles droits de l’abdomen sur les symptômes pelvi-périnéaux: revue de la littérature [Impact of the diastasis of the rectus abdominis muscles on the pelvic-perineal symptoms: Review of the literature]. Prog Urol. 2019;29(11):544–559.
Dasikan Z, Ozturk R, Ozturk A. Pelvic floor dysfunction symptoms and risk factors at the first year of postpartum women: a cross-sectional study. Contemp Nurse. 2020;56(2):132–145.
Nygaard IE, Wolpern A, Bardsley T, et al. Early postpartum physical activity and pelvic floor support and symptoms 1 year postpartum. Am J Obstet Gynecol. 2021;224(2):193.e1–193.e19.
Hartinah A, Usman AN, Sartini, et al. Care for perineal tears in vaginal delivery: An update for midwife. Gac Sanit. 2021;35 Suppl 2:S216–S220.
Stupak A, Kondracka A, Fronczek A, et al. Scar Tissue after a Cesarean Section-The Management of Different Complications in Pregnant Women. Int J Environ Res Public Health. 2021;18(22):11998.
Roofthooft E, Joshi GP, Rawal N, et al. PROSPECT Working Group* of the European Society of Regional Anaesthesia and Pain Therapy and supported by the Obstetric Anaesthetists’ Association. PROSPECT guideline for elective caesarean section: updated systematic review and procedure-specific postoperative pain management recommendations. Anaesthesia. 2021;76(5):665–680.
Feenstra MM, Jørgine Kirkeby M, Thygesen M, et al. Early breastfeeding problems: A mixed method study of mothers› experiences. Sex Reprod Healthc. 2018;16:167–174.
Cheng HY, Carol S, Wu B, et al. Effect of acupressure on postpartum low back pain, salivary cortisol, physical limitations, and depression: a randomized controlled pilot study. J Tradit Chin Med. 2020;40(1):128–136.
Franke H, Franke JD, Belz S, et al. Osteopathic manipulative treatment for low back and pelvic girdle pain during and after pregnancy: A systematic review and meta-analysis. J Bodyw Mov Ther. 2017;21(4):752–762.
Ghavipanje V, Rahimi NM, Akhlaghi F. Six Weeks Effects of Dynamic Neuromuscular Stabilization (DNS) Training in Obese Postpartum Women With Low Back Pain: A Randomized Controlled Trial. Biol Res Nurs. 2022;24(1):106–114.
Kazeminia M, Rajati F, Rajati M. The effect of pelvic floor muscle-strengthening exercises on low back pain: a systematic review and meta-analysis on randomized clinical trials. Neurol Sci. 2023;44(3):859–872.
Adnan H, Ghous M, Shakil Ur Rehman S, et al. The effects of a static exercise programme versus Swiss ball training for core muscles of the lower back and pelvic region in patients with low back pain after child delivery. A single blind randomized control trial. J Pak Med Assoc. 2021;71(4):1058–1062.
Nayyab I, Ghous M, Shakil Ur Rehman S, et al. The effects of an exercise programme for core muscle strengthening in patients with low back pain after Caesarian-section: A single blind randomized controlled trial. J Pak Med Assoc. 2021;71(5):1319–1325.
Sigurdardottir T, Steingrimsdottir T, Geirsson RT, et al. Can postpartum pelvic floor muscle training reduce urinary and anal incontinence?: An assessor-blinded randomized controlled trial. Am J Obstet Gynecol. 2020;222(3):247.e1–247.e8.
Artymuk NV, Khapacheva SY. Device-assisted pelvic floor muscle postpartum exercise programme for the management of pelvic floor dysfunction after delivery. J Matern Fetal Neonatal Med. 2022; 35(3): 481–485. /14767058.2020.1723541.
Brook G. Postpartum physiotherapy: a commentary on evidence-based guidance and current practice, including a survey of International Organization of Physical Therapists in Women’s Health delegates. J Pelvic Obstet Gynaecol Physiother. 2020;126:11–15.
Rouhi M, Stirling C, Ayton J, et al. Women's help-seeking behaviours within the first twelve months after childbirth: A systematic qualitative meta-aggregation review. Midwifery. 2019;72:39–49. https://doi. org/10.1016/j.midw.2019.02.005.
Bidzińska G, Zwierzchowski K, Pasternok M, et al. Elektromiograficzna analiza zmian aktywności bioelektrycznej mięśni prostowników grzbietu w wyniku aplikacji Kinesiology Taping u kobiet po porodzie – doniesienie wstępne. „Interdyscyplinarość współczesnej rehabilitacji, tom 1”. Paprocka-Borowicz M, Jarząb S, Kuciel-Lewandowska J, editors. Wrocław; 2016.
Critchley CJC. Physical Therapy Is an Important Component of Postpartum Care in the Fourth Trimester. Phys Ther. 2022;102(5):pzac021.
Postnatal care. London: National Institute for Health and Care Excellence (NICE); April 20, 2021.
https://szpitalmadalinskiego.p... program-bezplatnych-konsultacji-fizjoterapeutycznych-dla-kobiet-po-porodzie-oraz-noworodkow (access: 2023.07.28).
58. -rodzacych-i-pacjentek-ginekologicznych-uck.html (access: 2023.07.28).
Fizjoterapeutka pomaga kobietom po porodach i cesarskich cięciach w szpitalu w Kielcach ( (access: 2023.07.28).
Kraśnianin E, Semczuk M, Skret A, et al. Satysfakcja z opieki okołoporodowej pacjentek rodzacych w Polsce/Rzeszow i w Republice Federalnej Niemiec/Gross-Gerau [Level of satisfaction in patients giving birth in Poland/Rzeszów and in the Federal Republic of Germany/Gross-Gerau]. Ginekol Pol. 2013;84(1):17–23.
Keil MJ, Delgado AM, Xavier MA de O, et al. Physiotherapy in obstetrics through the eyes of pregnant women: a qualitative study. Fisioter mov [Internet]. 2022;35(spe):e356017.
Potera A, Mazur-Biały A. Wiedza położnic na temat profilaktycznych zachowań zalecanych w połogu. „Medycyna, zdrowie a styl życia. Człowiek wobec wyzwań współczesnego świata II”. Naumowicz M, editor. ArchaeGraph Wydawnictwo Naukowe; 2021.
Qazi WA, Razzaq M, Bokhari NA, et al. Availability of physical therapists for women after their cesarean section. Rawal Med J. 2022;47(1):241.
Moossdorff-Steinhauser HFA, Albers-Heitner P, Weemhoff M, et al. Factors influencing postpartum women's willingness to participate in a preventive pelvic floor muscle training program: a web-based survey. Eur J Obstet Gynecol Reprod Biol. 2015;195:182–187. https://
Nazar G. Awareness about the role of physical therapy in post-partum females among gynecologists. Healer J Physiother Rehab Sci. 2021;1(1):21–26.
Hermansen IL, O'Connell B, Gaskin CJ. Are postpartum women in Denmark being given helpful information about urinary incontinence and pelvic floor exercises? J Midwifery Womens Health. 2010;55(2):171–174.