Preconception

(3+ Months Prior to Conception)

Physiotherapy

• Establish a baseline of pelvic floor muscle strength, tension, and function.

• Treatment for painful intercourse if applicable.

• Physical activity guidance.

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Dietetics

• Optimal nutrition for conception and early embryonic development. 

• Prenatal vitamin consultation.

• Targeted nutrition strategies for fertility treatments.

 

Perinatal Counselling Therapy

• Establish a baseline for mental health.

• Identify perinatal support systems. 

• Support for fertility / assisted reproductive technology patients (ART).

 

Early Pregnancy 

Physiotherapy (Weeks 10-21)

• Safe movement for pregnancy (pregnancy mobility) and pelvic pain management.

• Abdominal wall health - diastasis recti abdominis (DRA) precautions. 

• Pelvic floor muscle education for pregnancy / prevention of urinary incontinence. 

 

Dietetics

• Adapting to pregnancy demands.

• Nausea management in early pregnancy.

• Food hygiene/foods to avoid.

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Perinatal Counselling Therapy (12-20 weeks)

• Psychoeducation in Circle of Security Parenting Program ©.

• Establishing a network of emotional support.

 

Middle Pregnancy

Physiotherapy (Weeks 22-32)

• Vaginal assessment of pelvic floor muscle function following the results of 20-week anatomy scan, if indicated, in the absence of contraindications. 

• Prenatal exercise guidance. 

• Treatment and management of musculoskeletal symptoms of pregnancy.

 

Dietetics

• Management of pregnancy side effects (constipation, heartburn).

• Gestational diabetes management.

• Healthy weight gain.

 

Perinatal Counselling Therapy (24-32 weeks)

• Attachment and parenting.

• Cultivating and establishing healthy relationships.

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Late Pregnancy

Physiotherapy: Birth Preparation (35 weeks)

• Birth partners are welcome at this appointment.

• Positions for labour and delivery, pushing techniques. 

• Pelvic floor muscle relaxations and perineal massage.

• Birth preparation for vaginal and cesarean delivery. 

 

Dietetics

• Dietary needs for physical recovery from birth (iron, protein).

• Meal preparation guidance for early postpartum.

• Nutrition for breastfeeding.

 

Perinatal Counselling Therapy (34-36 weeks)

• Establishing birth supports during labour, delivery and postpartum.

• Addressing/managing fear of childbirth.

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Lactation Consultant

• Identification of risk factors related to lactation.

• Hand expression prior to delivery. 

• Develop feeding plan and goals.

 

Early Postpartum

Physiotherapy

• Birth story, pain management, early rehabilitation (2-3 weeks postpartum, telehealth). 

• Pelvic floor and abdominal wall muscle (re)assessment (6-8 weeks postpartum).

• Gentle postpartum exercise. 

 

Dietetics * If education not received during third trimester or if support needed*

• Dietary needs for physical recovery from birth (iron, protein).

• Nutrition for breastfeeding.

 

Perinatal Counselling Therapy 

• Establishing mental health needs (3-4 weeks, telehealth or in-person visit).

• Addressing birth trauma (8-12 weeks postpartum).

 

Lactation Consultant

• Initial consult within 1-7 days following discharge home from the hospital.

• Identify any potential concerns or feeding challenges.

• Follow up at 2-3 weeks of age to ensure ongoing feeding management.

 

Postpartum Ongoing

Physiotherapy (12+ weeks)

• Pelvic floor and abdominal wall rehabilitation.

• Movements for motherhood and postural strengthening. 

• Return to physical activity/impact exercise/running/sport guidance.

• Pain management.

 

Dietetics

• Nutrition support for returning to regular routine/habits.

• Family eating support (as infant starts eating solids with family).

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Perinatal Counselling Therapy  (16 - 24 weeks)

• Continuation of addressing birth trauma processing as needed.

 

Lactation Consultant

• Navigating older baby feeding concerns (distraction, early teething, weight gain). 

• Anticipatory guidance for starting solids/parents returning to work early. 

• Follow up for introduction of solids (6-9 months) and for return to work (10 months).