My profession involves providing medical care to professional athletes.
I serve as the primary care sports medicine physician for the New York Liberty. Having been a Division I athlete myself, I feel privileged to stay involved with the sport I cherish and to treat some of the world’s top players. I recognize my role in providing healthcare for a group that has historically been overlooked, particularly as the healthcare system begins to acknowledge the importance of female athletes. I approach this duty with great seriousness, coordinating the team’s year-round medical needs, which range from acute and chronic musculoskeletal conditions to common ailments like sore throats and ear infections.
However, following the birth of my second child, I experienced being a patient myself, grappling with diastasis recti, a postpartum issue characterized by the separation of abdominal muscles, leading to discomfort and reduced strength.
Despite having access to exceptional medical care and my own clinical expertise, I am still recovering eight months later. This places me among the fortunate few. The majority of women lack the resources I have, compelling them to manage intricate, frequently painful recoveries independently.
In truth, pregnancy impacts almost every bodily system, yet most women get minimal to no advice on how to safeguard or restore their well-being. Our healthcare approach tends to react to issues only after they emerge, seldom focusing on prevention.
It is high time we transitioned to a proactive model of perinatal care—a system that supports women prior to, throughout, and following pregnancy—and incorporates musculoskeletal medicine, physical therapy, and nutritional guidance.
Scientific evidence confirms that strengthening the pelvic floor and core muscles can substantially lower the risk of various complications, such as urinary incontinence, severe perineal tears, diastasis recti, and lower back discomfort. Additionally, these practices enhance birth outcomes by making vaginal deliveries more probable and decreasing the duration of the second stage of labor.
Regular physical activity, even performed at lower intensities, serves as an effective preventative measure. Engaging in just 140 minutes of prenatal exercise each week can decrease the likelihood of gestational diabetes by 25%. Furthermore, women who exercise over three times weekly for 25 minutes experience a 39% reduced risk of developing gestational hypertension, a condition that can advance to preeclampsia.
Physical activity additionally assists in controlling excessive weight gain throughout pregnancy, which is associated with numerous problems, ranging from birth canal injuries to more challenging postpartum recuperation. Moreover, it contributes to enhancing overall mental well-being—a crucial factor, considering that perinatal depression impacts “around 1 in 7 individuals during pregnancy or within the initial year following childbirth.”
Strength training, specifically, can offer substantial benefits when adjusted appropriately. Women who maintain these exercise regimens during pregnancy are more inclined to possess the fundamental strength required to safely and confidently resume them postpartum. Conversely, those who discontinue often encounter more significant obstacles in returning to their routines.
Furthermore, offering comprehensive healthcare during the postpartum period is equally vital. Consistent physical activity post-childbirth aids in a more seamless recovery by boosting cardiovascular health, alleviating depressive symptoms, improving sleep quality, and fostering general physical and mental welfare. Guidelines recommend 150-300 minutes of moderate activity weekly postpartum, in addition to strength training and stretching.
However, this body of evidence is not yet integrated into standard medical practice. All too frequently, healthcare providers only intervene when complications arise. Consequently, the onus is on women to independently seek out pelvic floor physical therapy, determine safe movements, or locate appropriate specialists. A large number are unsure where to start—and many OB/GYNs lack the training to provide proper guidance. This results in countless women feeling alone, misinformed, or accepting chronic discomfort as an inherent aspect of motherhood.
This is precisely what I aimed to alter after my first child was born. I contributed to establishing a perinatal program at the Hospital for Special Surgery (recognized as one of the nation’s foremost women’s sports medicine centers) to introduce proactive, integrated medical care into the pregnancy and postpartum journey.
The phrase “sports medicine” is, in fact, somewhat inaccurate; its purpose extends beyond merely treating athletes to assisting individuals in recovering and maintaining strength during significant life changes. It should perhaps be viewed as “movement medicine.”
At HSS, we have developed a framework that links women with physical therapists, nutritionists, and medical doctors equipped to provide support through all phases, from preconception through postpartum.
We are not the only ones implementing such initiatives. Brigham and Women’s Hospital in Boston has established a comparably extensive model, incorporating musculoskeletal and wellness care into their standard perinatal services. This adaptable, evidence-backed methodology ought to be accessible to all women.
It is imperative that other healthcare systems adopt similar practices and discard antiquated protocols. The conventional six-week postpartum appointment is often too delayed to detect new problems, let alone address them. Throughout pregnancy, support frequently focuses primarily on monitoring the baby’s growth, with comparatively little consideration given to the mother’s well-being unless clear complications appear. This represents a deficiency in care.
Numerous obstacles can be overcome. A common misconception is that insurance does not cover pelvic floor therapy or nutritional support. However, these services are frequently covered when physicians provide diagnoses like “weak pelvic floor” for therapy or “dietary counseling” for nutrition. Our team consistently operates within these established guidelines.
The core problem isn’t about feasibility. Instead, what is lacking is awareness and a healthcare culture that emphasizes proactive prevention rather than merely reacting to issues.
Medical professionals, particularly those within systems specializing in movement medicine or women’s health, are crucial in spearheading the transformation of standard care. Obstetricians/gynecologists often lack the specific training to identify musculoskeletal problems or to refer patients to suitable specialists. It is our responsibility to change this—to guarantee that providers are knowledgeable, and patients receive comprehensive support from the outset.
As a medical doctor, I am certain this model is effective. As a mother, I understand its profound necessity. The moment has come to provide women with the all-encompassing perinatal care they have long merited.