Pelvic Floor Physical Therapy in Pregnant and Postpartum Women

This project had three main goals: 1) Explore how pregnancy and childbirth affect the female pelvic floor anatomy and physiology, 2) Examine current practices through a literature review and interviews conducted with pelvic floor physical therapists currently practicing in various clinical settings across the United States, and 3) Develop suggestions to mitigate the challenges currently faced in the field by patients and therapists. The female pelvic floor undergoes extensive changes throughout pregnancy as its structures are targeted by laxity-inducing hormones and mechanical stress from the growing fetus. During childbirth, the system is stretched beyond its physiological limit, causing damage to the muscles, connective tissues, and nerves in the region. As a new mother’s body begins returning to its pre-pregnancy state, she is often left with symptoms of pelvic floor dysfunction that impact her everyday functioning and quality of life. An effective means of combatting pelvic floor dysfunction is attending pelvic floor physical therapy (PFPT) under the supervision of a specialized therapist. It can be concluded that while pelvic floor therapists seem to follow a similar set of guidelines, there is still much variety in the treatment methods and programming each uses. There is also a common set of barriers associated with each clinical setting, with the greatest barriers being lack of patient knowledge, lack of local providers, and lack of time. Recommendations for improved access to care include fostering interest in the pelvic floor discipline amongst student physical therapists, implementing a standardized training and certification program, and increasing patient education about pelvic floor dysfunction and treatment options.