Perinatal Pelvic Health Service

Pelvic health during and after pregnancy

Your body goes through many changes when you are pregnant. These changes help you grow, carry, and birth your baby.

It can sometimes be hard to know which changes are normal and when you should get help.

The Perinatal Pelvic Health Service can help if you have problems with your pelvic health during your pregnancy or for up to 1 year after giving birth. This time is called the perinatal period.

We can give you advice, treatment and support for pelvic health problems.

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Information for women and families

Pelvic health is about taking care of the muscles that support your bowel, bladder and womb. These muscles are called your pelvic floor muscles.

Pelvic health issues include:

Pelvic health problems can be embarrassing. Many people struggle to talk about them.

These problems are more common than you may think. Lots of people have them. But they are problems that you can and should get help with. We can often treat them.

A survey of 2,000 women showed that:

  • more than 60 out of 100 had at least 1 symptom of poor pelvic floor health
  • over half of those women did not ask for help from a healthcare professional

The Perinatal Pelvic Health Service helps you get treatment from physiotherapists who specialise in pelvic health. It can also connect you with other services, like gynaecologists, if you need them.

It will help you get the right care for you.

We have some videos that can tell you more.

This video is a general overview of the Perinatal Pelvic Health Service. It is about 6 minutes long.

This video tells you what you can expect from a pelvic health physiotherapy appointment. It is about 3 minutes long.

We are here to help you with your pelvic health problems. You don’t have to deal with them on your own. But we know that it can be hard to find the time or the courage to speak to a healthcare professional.

There are things you can do on your own that may help. They include:

Keeping your bladder and bowel healthy

Make sure you empty your bladder and bowel as well as you can. Try not to strain.

When you wee, try to take your time and relax. Gently rock backwards and forwards, or put a bit of pressure on your lower tummy with your hand. These things can help you to fully empty your bladder.

When pooing, you can adjust your posture to try to empty your bowels properly without straining.

  • Try having your feet apart and putting them up on a small stool.
  • Rest your arms comfortably on your legs.
  • Try to keep your tummy relaxed.
  • Try not to hold your breath.

Doing pelvic floor exercises

Pelvic floor muscle exercises are important. They help with:

  • supporting your pelvic organs
  • issues with weeing and pooing
  • having and enjoying sex

It is important to learn how to do pelvic floor exercises properly. Relaxing the muscles is just as important as squeezing them.

These resources can help you with pelvic floor muscle exercises.

There are lots of resources online that can tell you more about pelvic health problems and what you can do about them. Here are some that we recommend.

My Health London

This YouTube channel has videos about how your pelvic health can be affected by pregnancy and birth.

Watch My Health London videos: https://www.youtube.com/user/MyHealthLondon

 

Pelvic Obstetric Gynaecological Physiotherapy (POGP)

The POGP website has information available in over 100 languages via Reciteme. Click on the red button at the top right of their webpage.

Visit the POGP website: https://thepogp.co.uk/

You may find these pages useful:

 

Obstetric anal sphincter injury (OASI)

This video is about 3rd and 4th degree tears or OASIs. It is about 9 minutes long.

 

This video is about Amy’s experience. It is about 8 minutes long.

 

You may be able to improve your symptoms by using the resources on this page. But if you need more support, you can:

  • ask your midwife or GP to refer you to the service

It can help to talk to other people who are pregnant or have just given birth. They may be having the same problems as you. These organisations can all help you connect with others.

National Childbirth Trust

www.nct.org.uk/

Mama Social Co

www.mammasocialco.com/book-online

Bright Futures NE

www.brightfuturesne.co.uk/

Baby Buddy

www.bestbeginnings.org.uk/

MASIC

www.masic.org.uk

SANDS baby loss support

www.sands.org.uk/

Information for healthcare staff

The NHS Long Term Plan (2019) includes a commitment for NHS England to:

improve access to postnatal physiotherapy to support women who need it to recover from birth

and make sure that:

all women have access to multidisciplinary pelvic health clinics and pathways across England.

The Perinatal Pelvic Health Service is nationally driven by NHS England, to improve the prevention, identification and time to access treatment for pelvic floor dysfunction (PFD) symptoms during pregnancy and the childbearing year.

PFD includes symptoms like:

  • bladder and bowel incontinence
  • pelvic organ prolapses
  • vaginal and sexual health concerns such as painful sex (dyspareunia)

This service has launched in the North East and North Cumbria, to provide pelvic health support to women in pregnancy and up to one year postnatally.

This service has been co-developed with service users with lived experience, primary care and specialised clinical staff.

The PPHS service provides  pelvic health support to women in pregnancy and up to one year postnatally.

  • Routine antenatal education for all women about pelvic floor dysfunction
  • Ensuring adoption and adherence by women to pelvic floor muscle training throughout pregnancy
  • To offer a baseline self-assessment of pelvic health in early pregnancy
  • Additional support provided for those at higher risk
  • Provision of quality information and training to all staff about pelvic health common issues, symptoms and how to access support
  • Provision of a single point of access or standardised multiple points of access across the system for women to self-refer or health professionals to refer for common pelvic floor problems
  • Reducing referral to treatment times by streamlining referral processes
  • Increasing establishment of specialist women’s health physiotherapists to better meet demand
  • Leadership in the local planning and provision of services aimed to improve perinatal pelvic health care
  • Pathway development
  • Referral criteria
  • Service User Survey circulation and collation of feedback for service implementation and improvement
  • Service policy, guidelines and process development (e.g. complex tears and birth reflections, Bladder care etc.)
  • Identification and delivery of standardised, specialist Pelvic Health staff training.  This includes new staff induction and future staff core training support
  • Preparing a standardised electronic template for perinatal pelvic health data to ensure KPIs are captured for national and local dashboards (including one-stop-clinic audits)
  • Development of a standardised approach to patient information provision
  • Modelling of a standardised staffing structure for each trusts service
  • Development a co-produced service model for all the population