As most women are aware or come to realise, pregnancy and delivery cause some degree of changes to bladder, bowel and vaginal function. Many of these changes are quite transient and in the main part resolve with time. In addition, the associated euphoria, distraction, time constraints and tiredness of being a new parent often means that mother’s health becomes a secondary issue. Many women will neglect to discuss these issues with partners, other new mums or healthcare professionals as they are keen not to make a fuss, or see these problems as part and parcel of new motherhood. A significant number of women will continue to be troubled with problems affecting their bowels or bladder, or suffer with pain associated with vaginal tears sustained at delivery and episiotomy scars that limit their lifestyle. Even some women who have had caesarean sections will complain of pelvic pain or have problems with vaginal discharge, bleeding or develop menstrual problems.
The majority of women will improve with expert assessment, reassurance, minor medical interventions, and with focussed work on pelvic floor strengthening. Some women may benefit from ultrasound treatment to soften tender scar tissue. A small number of women may require surgery to remove painful poorly healed vaginal scars, or to help repair weakened perineal muscles (the muscles between the vagina and anus that play a role in maintaining vaginal tone).