Many women experience new, bothersome pelvic floor symptoms during their pregnancy or after their delivery. In fact, one in three women develops symptoms of urinary incontinence during pregnancy or after delivery.
Some of the problems women experience can include:
- A severe tear or laceration that affects the anal sphincter (otherwise known as a third or fourth degree tear)
- Infection or breakdown of a tear
- Anal incontinence or accidental bowel leakage (involuntary loss of gas and/or stool)
- Urinary incontinence
- Urinary urgency and frequency
- Urinary retention
- Pelvic pain
- Pain with intercourse
- Sexual dysfunction
Risk factors for developing a severe obstetric anal sphincter laceration include the following:
- Use of forceps to help deliver the baby vaginally
- Long “pushing” phase of labor
- Large baby
- Delivery position of baby (“sunny side up”)
- Older maternal age
Treatments for Pelvic Floor Disorders
- Perineal care: We always recommend good perineal care for new mothers including daily baths and good drying techniques afterwards. Wound healing is accelerated and infection can be prevented with good perineal care and/or antibiotics if necessary.
- Medical management of urinary and anal incontinence:Early diagnosis and treatment of urinary incontinence is crucial in management of patients with these conditions.
- Pelvic floor physical therapy: We recommend pelvic floor physical therapy for all women who have had a vaginal delivery, especially those that were complicated by a more severe tear. Pelvic floor physical therapy is instrumental in strengthening the pelvic floor muscles. Physical therapy is also helpful for a myriad of other issues that are common after childbirth such as urinary incontinence, pelvic pain, pain with intercourse, and pain due to vaginal scarring.
- Sexual counseling: Oftentimes, after a vaginal delivery, sexual dysfunction can occur. While some patients have pain with intercourse, many have anxiety and fear of intimacy, especially if they have sustained a severe tear.