Perinatal pelvic health service

Women and birthing people booked to birth their baby at The Princess Alexandra Hospital NHS Trust (PAHT) or have chosen to have a home birth with PAHT midwives, are eligible to access the PPHS.

We offer an online antenatal webinar relating to perinatal pelvic health. For further information, including how to book, please use this link >

 

Women and birthing people can self-refer to the service at any point throughout their pregnancy journey, or up to 12 months after their baby is born. 

Please be aware that the PPHS is not an emergency service and if the following signs and symptoms are experienced, please contact your GP immediately, or the NHS 111 service out of hours.

• Urinary retention (including a sudden inability to pass urine, usually with some pain or discomfort in your bladder)   
• Urinary tract infection (including pain or a burning sensation when urinating, urine that looks cloudy, darker or stronger smelling than usual) 
• Wound infection or breakdown (including an increase in pain, new bleeding or pus-like discharge, or feeling unwell)

Please contact triage via our maternity helpline on 01279 827286 if you think the fluid you are leaking is not urine and that your waters may have released (waters broken).

If any of the following symptoms are experienced within last five days, it may be a sign of cauda equina syndrome (a rare and severe type of spinal stenosis). Please contact your GP or the NHS 111 service immediately.

• Loss of feeling/pins and needles between your thighs or genitals (private parts)
• Loss of sensation/pins and needs below the waist or down either of your legs 
• Pain or weakness in both of your legs 
• Change in bladder control - unable to wee or loss of sensation when you pass urine 
• Changes in bowel control - loss of sensation when you have a poo or leaking from the bowel
• Loss of sensation with sex

To access the service, please complete the self-referral form via this link >

If you need support to fill out the form, please call 07484 079833 and a member of the team will be able to assist you. 

The team are available from Monday-Friday, 9am-5pm. Once you have submitted your completed form, a member of the team will contact you within five to seven working days.

Clinic location 
The clinic is located at Herts and Essex Community Hospital (Haymeads Lane, Bishop’s Stortford, Hertfordshire, CM23 5JH).

Parking 
Parking is available at the hospital – full details are available via this link >

Types of referrals 

Antenatal 

• Poor control or leaking of urine, wind or poo
• Symptoms of vaginal prolapse (bulging/heaviness from the vagina) 
• Previous third or fourth degree tear 
• Previous complex perineal trauma (if symptomatic) 
• Persistent perineal pain (pain in the area between your vagina and anus which began after the birth of your baby) 

Postnatal 

• Poor control or leaking of urine, wind or poo
• Symptoms of vaginal prolapse (bulging/heaviness from the vagina) 
• Postnatal dyspareunia (painful sex after birth) 

Pelvic floor dysfunction is when you have difficulty coordinating your pelvic floor muscles.

This may present as urinary incontinence (unintentional passing of urine), anal (poo and/or wind) incontinence, vaginal prolapse and/or perineal pain (pain felt between the vagina and anus). 

Sometimes symptoms are not obvious or they can occur at a later date if not prevented. 

Treatment can vary for each person. This will be agreed after an assessment and a personalised management will be 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. 

Evidence shows that it can take three to four months to improve pelvic floor dysfunction, so it is essential to be active and committed to your personalised management plan.

Your first appointment will last up to 60 minutes. We will have received information from your referral form, however, we will still need to ask some additional questions to ensure that we provide the most appropriate treatment.

You may be offered a physical assessment including, where appropriate, an internal vaginal and/or rectal examination to enable a full assessment of the pelvic floor muscles. 

If you are pregnant, we will ask you further questions before deciding whether or not to perform an internal examination, which will only be carried out with your full consent.

At your appointment, you will have the opportunity to ask questions that you may have and receive more information about what the examination entails.

Your appointment will be with a female specialist physiotherapist or a specialist midwife. Our specialist teams are highly aware of the sensitive nature of the condition and are sympathetic to any concerns you may have about your treatment. 

Yes, please still attend your appointment and if we need to carry out a vaginal examination, this can be done at a later date. If you are only lightly bleeding, and are comfortable to do so, a successful vaginal examination can still be carried out with your full consent.

Please be aware that there is no childcare available at the hospital, however if you have a baby/young child and are unable to find childcare, you are welcome to bring them with you into your appointment. 

Yes, you are welcome to bring a family member or friend with you if this would make you feel more comfortable.

If you prefer, you can request a formal and trained chaperone to be in your appointment with you. If you would like to have a formal chaperone, please telephone the PPHS in advance to arrange this, at least 48 hours before your appointment date.  

This service is specifically for women and birthing people at any point throughout their pregnancy journey, or up to 12 months after their baby is born. 

If you require help after 12 months since you have had your baby, help is still available - please contact your GP and ask them to refer you to your local pelvic health service. 

If you are not booked to birth your baby at PAHT, you are not able to refer yourself to our service.

There may be a similar service available at the hospital that you are booked to birth your baby at, alternatively you can contact your GP and ask them to refer you to your local pelvic health service.

In addition to the PPHS, the resources below will provide you with further useful information and guidance about pelvic health concerns.

• My Health London  – discover a range of NHS approved exercises to improve your posture and to support your body during and after pregnancy. 
• Pelvic obstetric and gynaecological physiotherapy  - search for local pelvic physiotherapists, seek pelvic health advice and access useful information through a range of accessibility and language options. 
• Royal College of Obstetricians and Gynaecologists  - learn more about perineal tears and episiotomies in childbirth. 
• The MASIC Foundation  - learn more about supporting services for women and birthing people who have suffered injuries during childbirth.
• Our maternity team have developed an online resource, known as a padlet, to provide you with a range of information during your pregnancy, labour and birth, and caring for your baby after birth. Access the padlet via this link >