Prenatal & Postpartum Care
One-on-One Pregnancy PT with Dr. Maks Birikov
Every session is with me directly — not a rotating aide, not a technician watching you do exercises. I assess, I treat, and I adjust as your body changes across each trimester and into postpartum recovery. Cash-pay, by design, because insurance-driven volume models do not allow the time or continuity that pregnancy care requires.
What Gets Treated
What Pregnancy Physical Therapy Actually Treats
Pregnancy shifts your center of gravity, increases joint laxity through hormonal changes, and loads your pelvis, lumbar spine, and hips in ways that accumulate over months. The result is a specific set of mechanical problems — not generic 'discomfort.'
Pelvic girdle pain and SI joint dysfunction are among the most common and most undertreated conditions in pregnancy. The sacroiliac joint becomes hypermobile as relaxin increases, and when the surrounding musculature cannot compensate, pain at the posterior pelvis, groin, or inner thigh follows. Manual therapy and targeted stabilization work directly on that mechanism.
Round ligament pain — the sharp, pulling sensation in the lower abdomen or groin — responds to soft tissue work and load management strategies. Diastasis recti risk is addressed through early education on intra-abdominal pressure and movement patterns that reduce strain on the linea alba before separation becomes a problem. Low back pain driven by postural load, sciatica from piriformis compression or lumbar nerve root irritation, and rib and thoracic pain from the expanding ribcage are all within scope. So is postural correction for the forward head and rounded shoulder pattern that worsens as the abdomen grows.
Prenatal Through Postpartum
How Sessions Work — Before and After Birth
Treatment is not a single-phase episode. The work that starts in the first or second trimester carries forward. Early sessions focus on load management, postural correction, and preventing the compensation patterns that become entrenched by the third trimester. As pregnancy progresses, manual therapy addresses the changing demands on the pelvis and spine. Birth preparation includes pelvic floor education, breathing mechanics, and positioning strategies.
Postpartum recovery is a continuation of that arc, not a separate referral. Diastasis recti assessment, pelvic floor rehabilitation, scar tissue mobilization after cesarean delivery, and the gradual return to load-bearing activity all follow from the baseline I have already established. The body you bring to your six-week postpartum appointment is one I already know.
Session frequency depends on trimester, symptom severity, and how your body responds. Most patients begin with weekly or biweekly sessions and adjust from there. I give you a realistic estimate at the first appointment — not a package, not a protocol, a plan based on your actual presentation.
The Clinical Reason
Why One-on-One Care Matters During Pregnancy
Pregnancy is not a static condition. Your posture, joint mobility, pain patterns, and functional capacity change week to week. A treatment plan that was accurate at sixteen weeks may need significant revision at twenty-eight. That kind of responsiveness requires a provider who is present for every session and tracking every change.
What Insurance-Based Clinics Cannot Offer
The standard insurance-driven PT model is built around volume: short evaluations, exercise instruction delegated to aides, and limited hands-on time per visit. That structure is not well-suited to a pregnant patient whose presentation shifts continuously and whose treatment requires skilled manual therapy, not supervised exercise alone.
ViewWhat This Model Provides Instead
Sixty minutes, one provider, every session. I perform the hands-on work myself — joint mobilization, soft tissue release, myofascial techniques — and I adjust based on what I find that day. If something has changed since your last visit, I know, because I was there for your last visit.
ViewSports Injuries
Recurring injuries — IT band, hamstring, ankle — treated at the movement pattern, not the symptom.
ViewChronic Pain After Failed Treatment
Pain that has not responded to prior therapy — reassessed from the mechanism up.
ViewYour First Visit
What to Expect at Your First Appointment
History and Assessment
I start with a detailed intake: what hurts, when it started, what makes it better or worse, what you have already tried. For prenatal patients, that includes obstetric history, current trimester, and any prior pelvic or lumbar conditions. Nothing is assumed from a chart — I ask directly.
Movement and Postural Screening
I observe how you move: gait, weight-bearing patterns, how you transition from sitting to standing. Pregnancy-specific compensation patterns — hip hiking, altered lumbar curve, anterior pelvic tilt — are visible in movement before they are visible on imaging.
Hands-On Evaluation
Palpation of the SI joints, lumbar spine, hip musculature, and surrounding fascia to identify the mechanical source of pain. For postpartum patients, this includes diastasis recti assessment and scar tissue evaluation where applicable.
Plan and First Treatment
I explain what I found and what I intend to do about it. Treatment begins the same session. You leave with a clear picture of what is driving your symptoms and a realistic estimate of how many sessions to expect.
Plan for sixty minutes. Wear comfortable clothing that allows access to the lower back, hips, and pelvis. No referral is required to book.
Before You Book
How This Differs from Insurance-Based PT Clinics
Is pregnancy physical therapy safe in all trimesters?
Yes, with appropriate modifications. Manual therapy techniques are adjusted based on trimester, position tolerance, and individual presentation. Prone positioning, for example, is modified or avoided as pregnancy progresses. I work within established clinical guidelines for prenatal care and coordinate with your OB or midwife when indicated. If there is a contraindication specific to your pregnancy, I will tell you directly at the first appointment.