Pelvic Floor in the Postpartum Patient: Evaluation and Treatment
Presented by Rachel Kilgore
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Nonfinancial: Rachel Kilgore has no competing nonfinancial interests or relationships with regard to the content presented in this course.
Additional Disclosure: A special thanks to Darla Cathcart, director of peripartum series curricula for Herman & Wallace, for her assistance in the development of this course.
There is a need for guidelines to help all rehabilitation practitioners screen for common pelvic floor muscle dysfunctions in the postpartum patient. Pelvic floor muscle anatomy and function will be presented along with an overview of pregnancy and birth effects on the pelvic floor, including perineal birth injuries. This course will help the participant be able to identify common postpartum pelvic floor muscle complaints for the bladder and bowel, pelvic support problems, and sexual complaints, and we will review general treatments for these conditions. General external pelvic floor muscle assessment for the non-pelvic-floor provider is described, which is helpful for identifying postpartum patients who may benefit from specific pelvic rehabilitation.
Meet your instructor
Rachel Kilgore
Rachel’s primary specialty is pelvic rehabilitation. This includes incontinence, prolapse, constipation, pelvic pain, and peripartum issues such as cesarean birth or diastasis rectus abdominis. She enjoys treating general orthopedics, with interest in the back, neck, knee, and shoulders. Additionally, playing collegiate…
Chapters & learning objectives
1. Anatomy and Physiology
This chapter will present anatomy and functions of the pelvic floor muscles (PFMs) and perineum. We will discuss perineal injuries sustained from labor and birth and how the journey of pregnancy and birth can influence the function of the PFMs.
2. Common Postpartum PFM Complaints
Pelvic floor muscle and fascial dysfunction in the postpartum period can affect bladder, bowel, and sexual functioning as well as pelvic organ positioning. This chapter explores common complaints in the postpartum patient, including incontinence, prolapse, and pain.
3. Pelvic Floor Muscle Screening and Assessment
The postpartum period can be a time in the life cycle where several pelvic floor impairments start, so identifying them early and treating them is important. This chapter reviews screening questions for pelvic dysfunction and demonstrates an external pelvic floor muscle assessment for the nonpelvic rehab provider to help identify patients who may have a PFM dysfunction or require further assessment.
4. Treatments
This chapter provides a general overview of specific strategies for treatment of common bladder, bowel, prolapse, and sexual symptoms once you have identified a PFM dysfunction. This chapter outlines treatment advice and behavioral instructions for patients with incontinence of bowel or bladder, urinary urgency, constipation, prolapse, and perineal scar pain.
