Pre- & Postnatal Education Practices in a Midwestern State

Macie Harris, SPT, Emily Mensen, SPT, and Carly Uecker, SPT

 

DPT2020 PrePostnatal

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18 Comments on “Pre- & Postnatal Education Practices in a Midwestern State

  1. Great presentation, Macie, Carly, and Emily! The advocacy through research and education and and involvement of physical therapists in this area is greatly needed! I know you looked at a midwestern state for your project, but I was wondering if you saw any other research from other regions in the country or even in other countries and if so, was the lack of referral to PT similar? For example, I know that some other countries offer a longer maternity leave following a pregnancy or provide other resources for mom and baby. Just curious to know if any other places and/or countries are recognizing the importance of physical therapy for prenatal and postnatal care or if there is a global lack of recognition or education for how PT can help relating to this topic.

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    • Thanks, Justine! We did not find any other research similar to this. Therefore, it was difficult to find sources for a literature review, but further proved our need for th estudy. However, I would imagine it is similar throughout the nation as far as lack of referrals. I would like to think that people in more urban areas would be referred more as they tend to be more progressive, but I think the conversation of pelvic health is still “taboo” for many, and many providers do not ask the patient about their pelvic health and many patients are not willing to share which makes it very difficult to get more referrals to PT.

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  2. Nice work Macie, Carly, and Emily. As we all know, research revolving around pelvic health in general is severely lacking. I think this is a great way to advocate for what our profession can do. With that being said, how do you think PT can increase referrals for pre- and post- moms to address these issues? More so, how do we become a team member in postnatal care and help address issues both pre and postpartum? Lastly, why do you think PT is underutilized in care for postpartum? Thanks, ladies!

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    • To answer your first question, we believe we can increase PT referrals simply by educating the nurses, physicians, etc. about how prevalent pelvic floor conditions are before and after labor/delivery, and educate them about the PTs scope of practice in treating those conditions. We also want physicians and nurses to realize those conditions are NOT normal even though they are very common. My research group discussed how helpful it would be to have a pelvic health PT instruct the educational courses, instead of a nurse or physician. This way we could really educate the women about where to seek help if a pelvic condition arises. We think that PTs are underutilized in postpartum care simply because of how new and evolving our profession is. Most physicians and other healthcare providers do not realize we can become trained in treating pelvic health conditions so in turn PTs are not getting utilized in postpartum care.

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  3. Excellent job on your research and poster presentation. I was honestly shocked at the results of your research having learned in class all that physical therapists can offer this population of women. With that being said, I’m sure that there is a vast majority of the other medical professionals that are not aware of all that physical therapists can do to help these women. In your research you looked specifically at RNs and I wondered if there was a specific reason for that? Do you think that the results would be similar if you had included physicians, physician assistants, and specifically OBGYN staff? Also as a side question for my own curiosity, do you know if there will be any education based off of your research presented to medical professionals that are directly involved in pregnancy care?

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    • Hi Tiffany! Thanks for your comment. We tried including PAs, MDs, etc and 1) we were only able to obtain an email list-serve from the RN licensing board and 2) they were the only ones to respond to the survey! So we wish we would have had better participation, but we were happy to get as many RNs reply as we did! However, We did limit it to RNs who only practiced in pre/postnatal care as part of our inclusion criteria. I think the next step in our research would be formulating some kind of education that could be provided to other medical professionals in pregnancy care, but at this moment in time, we have not worked on this. We would love to spread the word as far and wide as possible!

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  4. First off, I just wanted to complement you on a wonderful poster! It was incredibly informative but not done in a simplified way so that anyone and everyone could understand the message you are trying to get across. The questions I have for you are relating mainly to how you completed the survey. I am asking these because I am now in Dr. Adamson’s pelvic health research group and would like to get a few tips for when we send out the surveys. First off, I’m just curious if you only sent it to RNs, or if you also sought out LPNs and CNPs? Second, I noticed you sent out a reminder email at 2 weeks, but what was your total time frame for allowing people to complete the survey? Finally, in reference to who you had validating the survey, were these RNs, PTs, and the physician specialists in pelvic health/gynecology? Again, great job!

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    • Thanks, Kelsey! What we did was reach out to the licensing board for nurses, PAs, MDs, etc. and ask if they had a database of emails they would be willing to share with us. However, nursing was the only one to work with us for their email list. We asked that respondents send the survey to others they thought would be willing to respond, but this did not happen from what we could tell. Therefore, we only had nurses respond at the time of making this poster and so we just went with that. We left it open for people to respond for months (really no specific end date), but I feel like if someone didn’t respond right away then they probably weren’t going to. To answer your final question, they were RNs, PTs and PAs who worked in OBGyn/prenatal/postnatal care.

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  5. Awesome presentation, Macie, Emily, and Carly! Your research shows some interesting findings. I guess my biggest question is why do you think there is drastically less education postnatal rather than prenatal? In my opinion, postnatal education is equally important if not more important since the body “undoes” all the changes that occurred and this is when many of the pelvic disorders occur.

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    • Josh, that is a great question. From our research on this topic we found that postnatal education is less due to the fact that many family practice doctors and Ob/gyn’s are overwhelmed by chronic pelvic pain, so when patients brought it up in check ups after birth the physician were just brushing them off. I also think that it is less because many mothers will have abnormal symptoms but then they ask family/friends and they tell them what they are experiencing is normal and then they never seek help for it.

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  6. Great job on this presentation! Everything was in an easy and readable format! In your future research section you guys list investigating why PT’s are not included in pre- and postnatal care but I was wondering if you guys had thoughts already as to why this may be and possible ways to “open the door” so PT’s are included?

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    • Great question! I think PTs aren’t typically included in the pre and post partum team because traditionally they have not been part of the labor and delivery team. I also think it is due to clinicians not realizing PTs are educated and trained in treating this population. We discussed that a great way to “open the door” would be offering a pelvic health PT as someone who can lead an education course for pre or post partum women instead of nursing leading these courses. If that isn’t possible, a pelvic health PT could put together an educational video that the nurses could add to their education course curriculum so that the women are still receiving the information.

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  7. Great poster presentation! The results in all of the tables are astounding. Regarding Tables 2-4, why do you think that so many of the pelvic dysfunctions for prenatal care, postnatal care, and even during the hospital stay are not discussed? Also, why do you think low back/SI pain was the only condition referred to PT in Table 5? The results of this study really prove that we need to advocate more for our profession and provide more education about our scope of practice, as well as the benefits of our services.

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    • Hi Erica! I think low back/SI pain was referred to PT most often because people associate that with physical therapy and they know for sure that we treat this. However, many have no idea that all of the other options could also be referable diagnoses. I also think low back/SI pain is something easily discussed by patients and they feel this isn’t normal, but they feel like pelvic pain or incontinence may be “normal” and if nobody asks them about it, they aren’t going to bring it up so they can be referred.

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  8. Thanks, ladies! Your poster looks great, and is very informative. Rather than a pre/post natal class what are your thoughts on a PT evaluation being the norm following delivery for those mothers, prior to discharge from the hospital. To me, this might look like a PT stopping into a new mothers room to discuss such conditions and how PT can help. Potentially, this is not a first time mother and she already knows issues she has previously dealt with following deliveries. I feel as if this would equip the patient with the information necessary to make an informed decision on her healthcare decisions, and get these patients seen sooner rather than later! What are your thoughts?

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  9. Hi Brooke! I completely agree that this would be an awesome solution to the problem and being able to meet mothers and tell them about our profession. Where I think the issue lies with that would be, that PT wouldn’t be getting much clinical work done and just educating for the majority of their day. Something to think about though would be having PTs create a handout and make it standard that every mother leaves with one! I will keep this idea in mind some day when I’m working in the field!

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  10. Great job ladies! I thought this was a really interesting study and your poster summarizes your results very well! If you would have been able to have other health care providers (such as physicians) participate in this study do you think that would have changed the results? Also, what finding, if any, were you most surprised about that did not quite match up with your hypothesis?

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  11. Very nice and concise poster. I like the idea you guys had about a plan to “open the door” to raise more awareness of how PT can help in the form of an educational session or becoming the go to clinician for treatment. What do you think we can do on a national level to raise more awareness that PT’s are skilled in pelvic health and a preferred provider? I had experience with my most recent clinical in pelvic health and learned a lot, especially with rural access. What are your guys’ thoughts on providing more access and awareness towards pelvic health PT in rural settings?

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