In this blog, we will delve into the topic of the pelvic floor and its importance during pregnancy and postpartum. We interviewed Fallon Norfolk, a specialist pelvic floor physiotherapist from the West Midlands, who will provide valuable insights and tips on pelvic floor recovery.

What is the Pelvic Floor?

The pelvic floor refers to a group of muscles that act like a sling, providing support for the bladder and bowel. It is located at the floor of the pelvis and plays a crucial role in maintaining continence of both the bladder and the bowel. Despite its significance, the pelvic floor is often overlooked, especially as women age. It is important to understand the basics of the pelvic floor and its functions.

Pelvic Floor Trauma and Recovery:

During childbirth, the pelvic floor muscles can experience trauma or injury. However, the good news is that the pelvic floor is highly resilient and can recover well with proper rehabilitation. Similar to any muscle in the body, the pelvic floor benefits from exercise and guidance during the early stages of healing.

For women who have had perineal trauma, it is recommended to consult a specialist pelvic health physiotherapist for assistance. These experts can provide guidance and support to help women regain strength and function in their pelvic floor muscles.

The Impact of Third and Fourth Degree Tears:

Third and fourth-degree tears involve the more delicate muscles of the external and internal anal sphincter, which are crucial for bowel control. As such, women who experience these severe tears may be more likely to have persistent symptoms. It is important to provide additional support and rehabilitation to women who have gone through these injuries.

While some hospitals in the UK offer specialized services for pelvic floor recovery, it is not universally available. However, there are clinics such as OASI clinics that provide comprehensive support and rehabilitation for women with these injuries. In cases where specialized services are not accessible, community midwives or health visitors can assist in finding appropriate clinics or making referrals.

Symptoms and Management of Pelvic Floor Trauma:

Women who have experienced pelvic floor trauma may encounter various symptoms, including bladder and bowel incontinence, prolapse, and pain during intercourse. Fortunately, many of these symptoms can be improved with the help of guided support, pelvic floor exercises, and lifestyle modifications.

A specialist pelvic health physiotherapist can provide advice on the most comfortable ways to manage bladder and bowel function. They may also recommend dietary changes, fluid intake adjustments, and suggest helpful equipment or resources. It is essential for women to seek help and not suffer in silence, as there are products, support, and treatments available to alleviate symptoms.

The Importance of Assessments:

To assess the condition of the pelvic floor and provide appropriate guidance, a thorough assessment is conducted by pelvic health physiotherapists. The initial assessment may start with a phone consultation to establish a rapport with the patient and discuss the treatment plan. The follow-up physical examination generally includes a vaginal and rectal examination, which may seem intimidating but should not cause discomfort or pain.

The assessments aim to provide patients with reassurance and feedback regarding their muscle function. Since the pelvic floor is an invisible muscle, feedback during assessments is crucial to ensure correct exercise performance. With guidance and prompting, patients can achieve better muscle movement and improve their exercise outcomes.

Patients should not feel hesitant or intimidated about assessments, as pelvic health physiotherapists prioritize patient dignity and comfort. The initial conversation before the assessment helps establish trust and allows patients to express their concerns and symptoms.

The Positive Outlook for Recovery:

During the initial weeks after experiencing an obstetric anal sphincter injury (OASI), it is natural for women to feel frightened and believe their symptoms will be permanent. However, most symptoms greatly improve or even resolve completely over time. The pelvic floor is an incredible part of the body that can heal and accommodate future vaginal births.

One important message emphasized in clinics is that perineal trauma does not mean the end of vaginal deliveries. Many women who have experienced such injuries can successfully have subsequent vaginal deliveries after investigation and discussion. It is essential for women to know that there is help, support, and treatment available to aid in their recovery.

Managing Bowel Issues Post-Delivery:

Women may face bowel issues after delivery, including constipation or dehydration related to breastfeeding. Basic advice for managing bowel symptoms includes ensuring adequate fluid intake and improving diet by incorporating fiber-rich foods. Additionally, adjusting sitting positions on the toilet, such as using a stool to elevate the feet, can facilitate smoother bowel movements.

New mothers should be mindful of their well-being in addition to caring for their newborns. Breastfeeding can deplete hydration levels, so it is crucial to drink plenty of water and maintain hydration. It is essential to address any bowel issues promptly, as neglecting them or rushing to the toilet without allowing proper time can exacerbate the problem.

In conclusion, understanding the pelvic floor and its role in pregnancy and postpartum is crucial for women’s overall well-being. Through proper rehabilitation, support, and guidance from specialized pelvic health physiotherapists, women can navigate their pelvic floor recovery journey with confidence. Remember, reaching out for help and seeking professional advice can lead to improved symptoms and a better quality of life.

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