Acute Obstetric Rehabilitation

Published January 1, 2026

What You Need to Know 

Hospital-based obstetric rehabilitation helps improve maternal health and prevent costly postpartum issues. Nearly 84% of U.S. women give birth by age 40, and most births occur in hospitals—making inpatient rehab a critical part of maternal care.

• Recovery from a Cesarean delivery lacks standard rehabilitation: Despite being the most common surgery in the U.S., patients with a Cesarean delivery rarely receive a rehabilitation plan before discharge, which may help reduce complications and support long-term maternal function.

• Early intervention matters: The first six weeks postpartum carry the highest risk for complications, and timely physical therapy can reduce readmissions and improve outcomes.

• Postpartum rehabilitation in acute care settings is key: Embedding physical therapy into postpartum units supports health equity, however, hospitals must navigate a variety of barriers. A national survey of acute care physical therapists and obstetricians identified inadequate staffing and lack of organizational support as the most common obstacles to providing inpatient obstetric rehabilitation (Swartz et al., 2025) 

Acute obstetric rehabilitation programs in hospital settings offer a high-value intervention to improve maternal outcomes and reduce costly postpartum complications (Lestari, 2025; Segraves, 2024). Physical therapists provide early screening, mobility training, task modification, coping strategies, support system planning, pain management, bowel/bladder health training, guidance on finding outpatient pelvic providers, and early rehabilitation education tailored to the realities of the postpartum experience. Given that nearly 84% of U.S. women will give birth at least once by their 40s and that the vast majority of births occur in hospitals, (MacDorman, 2019; Osterman et al.,2024) postpartum rehabilitation should not be viewed as a niche specialty but rather an essential service within maternal care. 

Cesarean deliveries alone account for approximately 1.3 million procedures annually, making them the most common surgery performed in the U.S., nearly double the rate of hip and knee replacements. (Osterman, 2024; Jones et al.,2025) Yet, unlike patients undergoing other major abdominal surgeries, individuals recovering from cesarean delivery are rarely provided a rehabilitation plan of care prior to discharge. This is particularly concerning given that the highest rates of complications following birth occur within the first six weeks postpartum, a critical window for intervention (Segraves, 2024). Standardized therapy protocols that begin during hospital admission and extend through the first year can help reduce complications and support long-term maternal function (Jones, et al., 2025; Davenport, 2025; Jaramillo et al., 2025). Embedding therapy services into labor, delivery and postpartum units can reduce emergency department visits, enhance patient safety, improve patient satisfaction scores, and facilitate earlier recognition of impairments that could lead to readmissions, which are costly and penalized under many value-based care models. (Segraves et al., 2024; Segraves et al., 2023). 

To realize the full potential of these early rehabilitation efforts, however, hospitals must navigate reimbursement models and operational barriers that can impact access, delivery, and sustainability. Most hospitals operate under bundled or global maternity payments that include therapy services without added cost to the patient. (Segraves et al., 2023; Wang et al., 2023). However, in critical access hospitals or fee-for-service models, physical therapy may be billed separately, raising concerns about cost transparency and consent. (Segraves et al., 2023; Wang et al., 2023). Proactive communication with case management and billing departments is essential to ensure equitable and sustainable implementation.(Wang et al., 2023).Including physical therapy in enhanced recovery protocols for standardized hospital order sets and enhanced recovery protocols can support hospital financial or reimbursement needs and align with Centers for Medicare & Medicaid Services (CMS) goals for postpartum quality care, and to bring obstetric surgery in line with standards for other major abdominal surgeries. (Segraves et al., 2023; Wang et al., 2023). Expanding postpartum rehabilitation in acute care settings advances health equity by reaching underserved populations who may not access outpatient follow-up. This supports broader policy efforts to reduce disparities and improve maternal health outcomes nationwide. (Segraves et al., 2024; Segraves et al., 2023).  

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