Early Intervention Is Key to Pelvic Floor and Birth Injury Recovery

Maternal birth injuries and traumatic deliveries are common, but often they are not discussed. These can leave women suffering from pelvic floor disorders during a time that can already be a complicated mix of joy and stress.

Despite bothersome symptoms, often these healing complications go unrecognized after a delivery, which can lead to long term pelvic floor disorders, says University Hospitals OB/GYN and female pelvic medicine and reconstructive surgery specialist Anne Sammarco, MD, MPH.

Common Maternal Birth Injuries and Complications

Some common maternal birth injuries include third and fourth-degree tears, which are also called obstetric anal sphincter injuries (OASIs) because they damage the anal sphincter. These tears are prone to infection and complications with healing, and can leave women with difficulty controlling stool and gas and can cause chronic pain.

There are a variety of other pelvic floor disorders that can arise after a delivery, including:

• Urinary leakage or difficulty emptying the bladder
• Pelvic organ prolapse
• Fistulas, which are abnormal connections between the vagina and the bladder (vesicovaginal fistula) or rectum (rectovaginal fistula)
• Bowel leakage, including gas and/or stool
• Infection and abnormal healing
• Painful intercourse
• Continued perineal pain after delivery

Identifying Problems Early Can Improve Recovery and Outcomes

These injuries and pelvic floor disorders can be embarrassing and difficult for patients to discuss. In the postpartum period, there is often so much going on with the infant and the expanding family that women sometimes put their own needs second, explains Dr. Sammarco. However, it is important to identify and address these issues early in order to optimize healing efforts.

“Delayed diagnosis and treatment leads to decreased quality of life and sometimes harder to treat problems down the road,” says Dr. Sammarco.

Dr. Sammarco recommends seeking treatment for a birth injury within 2 – 4 weeks of delivery. There are a variety of treatment options available for maternal birth injuries, especially when the problem is identified early. The treatment route will depend on the severity of the injury and/or symptoms. Treatments can include pelvic floor therapy and exercises to strengthen to muscles of the pelvic floor, medications to treat infections and pain, and minimally invasive or robotic-assisted gynecologic surgery.

It is also important to assess your mental health during the postpartum period, especially since a traumatic birth experience can lead to post-traumatic stress disorder, depression, anxiety and other postpartum mental health disorders.

Your provider can assess your physical and mental health and make referrals to other specialists as needed. In addition, a maternal birth injury can put you at risk for future deliveries, so you and your provider can be proactive in planning for any future pregnancies and deliveries if necessary.

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University Hospitals provides compassionate, trusted gynecological and prenatal/postpartum care delivered by our team of women’s health experts. Our Enhanced Recovery after Delivery (ERAD) Clinic provides multidisciplinary diagnosis and treatment for maternal birth injuries and other complications of childbirth. The clinic takes place the third Friday of every month at UH Rainbow Babies & Children’s Ahuja Center for Women & Children.