This is a one-hour session to check pelvic floor and abdominals, and give advice on back
care and safe movement. If required we are able to help with treatment. We then have a
follow-up session at around 36 weeks for advice on perineal massage and tips for postnatal
care. 

We have a detailed chat about what your goals are, and any problems you may be experiencing. We ask about bladder and bowel function, sexual function and symptoms of prolapse. We discuss any pain you may be experiencing – eg back, hip, pelvis, and we work with you to keep doing the exercise you want to be doing.

We usually carry out a pelvic floor examination to ensure that you’re doing pelvic floor muscle exercises correctly. (We know that 50% of people who do them based on written or verbal instructions do them wrong!) If you’re having a Casearian delivery it’s still important to do pelvic floor exercises.

Treatment involves/helps with:

• Bladder and Bowel Issues
• Prolapse
• Genital pain and sexual problems
• Suitable exercise – based on your goals
• Pelvic floor muscle training
• Back, hip and pelvic pain.
• Wrist or neck pain
• Advice on back care and safe movement
• prevention of diastasis
• Vulval varicosities
• Optimising birth and postnatal recovery
• Reducing the risk of birth trauma

 We also advise on treatment required to help minimise the risk of birth injury to the pelvic floor during a vaginal delivery.

Having strong, functional pelvic floor muscles is important for pregnancy, childbirth and
beyond. Hormone changes during pregnancy mean the pelvic floor muscles and surrounding
support structures soften and stretch, and become weaker.
It’s important to start pelvic floor exercises as early as you can, even if you’re not having
problems.

This can help:

• Reduce the chances of leaking as the pregnancy progresses (60% pregnant people leak urine!)
• Reduce the risk of more severe perineal tears during vaginal delivery
• Reduce the length of the pushing stage of labour
• Reduce chances of having problems after birth – regardless of the type of delivery

We see people around this time for advice on what to do (and what not to do!) in the first 6 weeks after birth. We also teach perineal massage, and we may check your pelvic floor muscles to make sure they are relaxing when you push. We know that some people’s pelvic floor muscles tighten instead of releasing when they bear down or push – this can slow down the second stage (pushing phase) of labour and increase the chances of birth trauma.

We normally see people around 6 weeks after the birth – whether you’ve had a Caesarian or vaginal delivery (but we’re happy to see you sooner of you have any concerns). This session involves a one hour appointment to check pelvic floor and abdominals, as well as assessing any pain or discomfort – eg back, neck, pelvis, perineum, vagina.

We can help with:

• Rehab following perineal, vaginal or labial tears, anal sphincter injuries
• Assessment for internal pelvic floor injuries that are not evident at the time of birth
• Assessment and treatment of prolapse – symptoms include heaviness or bulging 
• Pelvic floor strengthening
• Assessment of abdominal diastasis (tummy gap) and appropriate treatment
• Abdominal and core rehab
• Postural correction advice and exercises
• Advice on safe progression back to fitness and exercise
• Advice on lifestyle modification to prevent symptoms developing while you get your pelvic floor back to full function
• Pessary use – these are silicone devices that fit inside the vagina to help with prolapse

We are very aware that for many people, childbirth can be an emotional or traumatic experience. All of our staff are trained in this, and we are happy to listen, and direct you to appropriate resources and help if required.

Having a newborn baby can also be a stressful experience, with lack of sleep and getting used to new routines. We can help provide you with techniques to assist.

Birth injuries can be a source of stress and anxiety too – we deal with all these issues in a sensitive manner and will be able to offer self help strategies for you.

If you had a birth injury eg perineal tear, prolapse – ACC will contribute to the cost of your treatment. If you have not already had an ACC form filled out, we are to do this with you, and send a claim to ACC on your behalf.

If you have had a claim accepted already, please bring your ACC claim number for us.

Good care during pregnancy and after birth can help with prevention of problems later in life.
But it’s never too late – even if you had your baby many years ago, we can still help you!

We can help with:

• Pelvic floor training
• advice in lifestyle modifications to reduce stress on the pelvic floor
• Treatment of bladder and bowel problems
• Help with prolapse – including fitting of pessaries
• Help with sexual pain or dysfunction