Sydney Pelvic Floor Health

Whats Wrong With Me?

What's wrong with me: Health problems after childbirth

Health issues after childbirth are very common, as shown in the table below.  

whatswrongwithmegraph.png

Table 1. Postpartum symptoms and complaints over time. Modified from Borders, N. (2006); J Midwifery Women's Health, 51(4), 242-248

* There is not that much we can do about perineal pain or pain on intercourse due to scar formation after vaginal birth, except for suggesting lubrication and perineal massage. Sometimes, breastfeeding delays the re-establishment of a normal cycle, which means the vaginal skin can become thin and dry. The longer the periods remain absent, the more of an issue this can be. In these circumstances a small amount of local estrogen cream will help. In future we'll have to get much better at preventing perineal and vaginal trauma, so that such scars don't become a problem in the first place.

* Urinary incontinence (bladder leakage) is often worst during pregnancy. About 1/3 of all first-time mums start to notice urine leakage in pregnancy, but fortunately this often settles once the baby is born. If it's a major problem after childbirth one would suggest that you see a pelvic floor physiotherapist, and if that's not helping, a gynaecologist or urogynaecologist such as at our pelvic floor unit at Nepean Hospital.

* Anal or fecal incontinence (leakage from the back passage) can sometimes also be treated by a physiotherapist, but sometimes the help of a specialist doctor is needed for investigation and/ or treatment. The main cause of bowel leakage after childbirth is damage to the anal sphincter, which is explained in detail here.

* If hemorrhoids are a major problem one would suggest a consultation with a family doctor or a gastroenterologist/ colorectal surgeon. 

* For extreme tiredness and/ or symptoms of depression women should see their family doctor. Sometimes such symptoms can be severe, and their nature, and what to do about them, is explained in more detail here. In severe cases we call this PTSD. 

* For extreme tiredness and/ or symptoms of depression women should see their family doctor. Sometimes such symptoms can be severe, and their nature, and what to do about them, is explained in more detail here. In severe cases we call this PTSD.