Perinatal Pelvic Health Service (PPHS)

HNY Perinatal Pelvic Health Service (PPHS)

Why do we need a PPHS?

Pelvic Floor 1 col Roughly 1 in 3 women experience urinary incontinence (unintentional passing of urine) 3 months after pregnancy, and around 1 in 7 experience faecal (bowel) incontinence 6 months after birth.

One in 12 women report symptoms of pelvic organ prolapse - which is when one or more of the organs in the pelvis slip down from their normal position and bulge into the vagina.

These distressing issues can affect women’s ability to work, their sexual and social relationships, and their mental health.

Whilst these symptoms are common, they are not normal and can be managed by the right services.

Pelvic physiotherapy is a specialist service which supports women suffering these symptoms and with midwifery input, will help women understand their pelvic health and recognise symptoms of pelvic floor dysfunction (difficulty in coordinating your pelvic floor muscles) so they can manage it with the right help at the right time.

Treatment for pelvic floor dysfunction varies for each person and is decided after a detailed assessment is undertaken and a personalised management plan put in place. This may include pelvic floor muscle rehabilitation, lifestyle advice, bladder and bowel advice, bladder retraining, manual therapy, biofeedback, neuromuscular electrical stimulation or scar management.

National call to action

The NHS Long Term Plan set out a commitment to “improve access to postnatal physiotherapy to support women who need it to recover from birth” and to ensure that “women have access to multidisciplinary pelvic health clinics and pathways across England”. The Single Delivery Plan for Maternity and Neonatal Services includes an ask that by March 2024, all Local Maternity and Neonatal Systems (LMNS) have a commissioned PPHS which aligns with the national Service Specification .

The PPHS will:

ensure all women are offered a self-assessment of their pelvic health as early as possible in pregnancy - and by 18 weeks at the latest
educate all women on the risk of pelvic floor dysfunction and birth injuries and preventative action they can take to reduce this risk
provide additional support to those at higher risk of pelvic health problems
reduce NHS waiting times and minimise administrative barriers to treatment
allow affected women to access appropriate physiotherapy assessment and personalised treatment.