Mending Minds and Bodies: How occupational therapy is returning to its community roots with maternal health
Occupational therapy in maternal and perinatal health is considered an emerging practice. Yet, there is nothing emerging about it. In fact, it is a practice returning to the profession’s roots in community mental health.
Occupational therapy was founded in the early 20th century. The profession gained momentum during World War I from 1914 to 1918. Occupational therapists, then known as reconstruction aides, engaged injured soldiers in meaningful activities like woodworking, weaving, and leather crafting. The outcomes for soldiers who received occupational therapy during World War I were transformative. Occupational therapy significantly aided in their physical recuperation and improved fine motor skills, while also providing profound psychological benefits. Soldiers experienced reduced symptoms of trauma and depression, gained a renewed sense of self-worth and purpose, and were better equipped for a smoother transition back into civilian life.
The role of occupational therapy expanded further during World War II. There was a greater recognition of the need for rehabilitation services for soldiers suffering from both physical injuries and psychological trauma, such as post-traumatic stress disorder (PTSD). The demand for occupational therapy led to the development of more structured educational and training programs and the creation of the occupational therapy assistant role to meet the growing needs. Occupational therapy practitioners used a holistic approach, addressing the physical, emotional, social, and vocational needs of soldiers. This often involved preparing them for the return to civilian life with adaptive skills and coping mechanisms. OTs worked closely with doctors, nurses, psychologists, and other healthcare professionals to provide comprehensive care tailored to each soldier's needs.
Like soldiers recovering from war, mothers experience many disruptions during pregnancy and postpartum. Matrescence, the physiological, hormonal, social, and mental transition to motherhood, is a period of occupational disruption and transformation. Mothers must integrate into a role with new daily activities, physically and psychologically heal from pregnancy and birth, and take care of themselves, an infant and a family unit.
Occupational therapy plays a crucial role in supporting the maternal and perinatal population, though this role has most recently been filled through a medicalized system by doctors and nurses. Within this same model, if a person has a surgery, injury or illness they might receive occupational therapy for rehabilitation, 3 hours per day for up to 2 weeks or more, or if in the home setting, 2-3 times per week. In contrast, after 9 months of pregnancy, labor and birth of a human, mothers receive 15 minutes of standard care at a single appointment 6 weeks postpartum and no rehabilitative therapy.
This glaring gap in modern maternal care needs to be filled. Occupational therapy should be a part of every maternity and early parenthood. A holistic and activity-based approach to a period of occupational disruption provided in the home and community promotes mental and physical health of the mother/parent, the baby and the family unit. The occupations of early motherhood are demanding, often repetitive and physically taxing, requiring endurance, adaptation and support.
Postpartum, a mother is healing from pregnancy, labor and the birth of a child. Her daily activities are crucial for both herself and her child. They include managing personal care and healing from childbirth, which may involve dealing with physical discomforts, adjusting to bodily changes, and ensuring proper wound care after surgery. Mothering requires demanding cooperative tasks between herself and her baby: breastfeeding or bottle-feeding, changing diapers, bathing, carrying, holding and soothing. She also faces the challenge of balancing her own rest and recovery with the continuous demands of caring for a newborn. The emotional and physical effort of adjusting to a new routine, sleep disruption, and shifts in the nuclear family and personal identity can be overwhelming.
Occupational therapy practitioners support mothers in this period by providing guidance on efficient management of caregiving tasks while also prioritizing self-care, physical recovery and well-being. They offer strategies to modify daily routines, use ergonomic techniques to prevent strain and injury during infant care, and suggest ways to simplify tasks, conserve energy and mental load. This support is vital as it helps mothers adapt to their new roles and responsibilities, ensuring the health and well-being of both mother and baby during this critical time.
The parallels between the origins of occupational therapy and its application in maternal and perinatal health are striking and deeply rooted in our profession's core principles. Occupational therapy was instrumental in the holistic rehabilitation of soldiers during and after war, engaging them in meaningful activities. This approach not only enhanced their physical skills but also provided significant mental health benefits, aiding in their reintegration into civilian life. Soldiers experienced profound improvements in their physical and psychological well-being, demonstrating the multifaceted impact of the work.
Similarly, in the realm of maternal and perinatal health, occupational therapy practitioners play a vital role. Like soldiers adjusting to post-war life, mothers during the perinatal period undergo a significant transformation, facing physical, emotional, and social challenges. OTs support mothers through purposeful and therapeutic engagement in parenting tasks, while also addressing physical recovery from childbirth and the mental and emotional adjustments to motherhood.
In both contexts, occupational therapists meet individuals where they are, in their own environment. The profession's commitment to promoting mental and physical health through meaningful occupations remains consistent, embodying an individualized and holistic approach. This parallel highlights the enduring value and versatility of occupational therapy, from its historical roots in community mental health to its crucial role in supporting maternal and perinatal health today.
If you are an occupational therapy practitioner or student who is interested in working in maternal health or with the perinatal population, check out maternalhealthot.org for resources, mentorship and community.
