Postpartum management of the pelvic floor

Abstract

One of the most socially devastating sequelae of vaginal delivery is PFM damage and the subsequent loss of bladder or bowel control. The expulsive forces of the fetal head as it descends through the birth canal lead to overstretching of both nerve and muscle tissues, which do not always undergo full recovery. Such trauma can result in symptoms of urinary incontinence or anal sphincter incompetence, including incontinence of feces or flatus and fecal urgency.1 Symptoms such as these are both embarrassing and debilitating, and although they may be transient following a first vaginal delivery, subsequent deliveries are likely to cause further deterioration.2 Continence promotion in the postpartum period involves a multicomponent, multidisciplinary approach, which is described in this chapter. © 2008 Springer-Verlag London.