Pregnancy, Childbirth And Recovery: Dr Sanjana Venkataraman On The Role Of Physiotherapy

Pregnancy and childbirth bring major physical and emotional changes for a woman, but the focus often remains firmly on the baby’s health, leaving the mother’s recovery overlooked. Dr Sanjana Venkataraman, a women’s health physiotherapist who has been practising in the field for the past one year, believes this needs to change.

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In an exclusive interview with The Free Press Journal, Venkataraman said the lack of awareness around postnatal physiotherapy is closely linked to the conservative way pregnancy and childbirth are viewed in India. “People focus more on the child rather than the mother’s health,” she said, adding that many women and families worry that physical activity during pregnancy could harm the mother or the baby.

The mother’s health often takes a back seat

Venkataraman said pregnancy is still sometimes treated as a condition that requires women to restrict their activities, rather than as a normal part of life. She attributed this partly to misconceptions and a lack of education about physical activity during pregnancy and after childbirth.

She also pointed to increasingly sedentary lifestyles. Women today may not engage in the same amount of physical work as women did in earlier generations, making it harder for those who have not been active to suddenly take up exercise during pregnancy or after delivery.

In her view, physiotherapy should be considered as part of the pregnancy journey rather than something women seek only after developing symptoms.

Preparation can start before conception

Venkataraman recommends that women planning to conceive consider consulting a physiotherapist before pregnancy. This can help assess their fitness levels and identify medical conditions that may require precautions or changes to their exercise routine.

Women with a complicated medical history can also benefit from early guidance. Even when a caesarean section is expected, a physiotherapist can help prepare the woman for the physical changes associated with pregnancy and childbirth.

“Right from day one to childbirth and post childbirth, physiotherapy can play a major role,” she said.

The approach, she explained, is not limited to exercise. It involves helping women adapt to the physical changes that occur during pregnancy and after delivery.

Childbirth can leave lasting physical changes

Pregnancy involves substantial hormonal and physical changes, which continue after delivery as the body adjusts.

Venkataraman said women can face problems following both normal delivery and caesarean section. Incontinence is one common issue, while another concern is the abdomen not returning to its pre-pregnancy state.

The abdominal muscles undergo significant changes as the body accommodates the growing baby. Muscle laxity can continue to affect women after delivery, she said.

Starting appropriate rehabilitation during pregnancy can help women manage some of these physical changes and make the recovery process easier, according to Venkataraman.

Exercise needs to be tailored to pregnancy

Venkataraman said physical activity should depend on the stage of pregnancy and the individual woman’s condition.

During the first three months, she said women are advised to avoid vigorous exercise. Calming activities, meditation and relaxation exercises can be considered during this period.

From the fourth or fifth month, women without complications may be able to begin exercises under appropriate guidance. Venkataraman said maintaining fitness can help women prepare for childbirth and cope with some of the physical challenges that follow.

She added that women who wish to have a normal delivery may also benefit from appropriate preparation, depending on their individual circumstances.

Recovery extends beyond the physical

The changes associated with pregnancy and childbirth can affect a woman’s emotional as well as physical well-being. Venkataraman said physiotherapy can form part of the process of helping women regain their strength and return to their routines.

She believes beginning fitness work early can also make the postnatal period more manageable. After childbirth, caring for a baby can leave mothers with little time to begin an exercise routine.

“If she tries to start with all the required fitness training right from the beginning, it will be easier for her to manage everything post delivery,” she said.

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Awareness remains a challenge within physiotherapy too

The lack of awareness is not limited to women and their families. Venkataraman said that while specialising in women’s health, she encountered physiotherapists who were unaware that the field existed.

“Is there a stream like this in physiotherapy?” was a question she said she heard from physiotherapists themselves.

She believes women’s health physiotherapy has received less attention than areas such as orthopaedic and neurological physiotherapy. The result, she said, is limited awareness among both professionals and the public.

There is also a perception that childbirth is something every woman goes through and therefore does not require specialised support. Venkataraman believes this mindset needs to change.

Awareness is growing, but there is a long way to go

According to Venkataraman, efforts to educate mothers and families about women’s health physiotherapy have increased over the past three to four years.

She has observed greater awareness in cities such as Mumbai, Bengaluru and Delhi, although several other cities still have limited awareness of the field.

For Venkataraman, the bigger change lies in recognising the mother’s health as an important part of the pregnancy journey, rather than treating recovery as an issue that begins only after childbirth.

Her message to new mothers is that postnatal physiotherapy can help them deal with the physical changes associated with pregnancy and delivery and return to their daily routines. Ideally, she believes, women should begin preparing for these changes before they give birth.

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