Postpartum pelvic floor repair
Childbirth stretches the pelvic floor. Most of it recovers; some of it does not. This page is about the problems that persist, when to be assessed, and what repair involves.
Medically reviewed by Dr. Mo Hyung-jin, MD, PhD, board-certified OB-GYN specialist · Last reviewed
Consultations in English · Private single-occupancy recovery suites · Insurance claim documents prepared
What childbirth changes
Vaginal delivery stretches the pelvic floor muscles and the ligaments that support the bladder, vagina and uterus. Tears and episiotomy add scarring. Common results are stress incontinence, vaginal laxity, a bulge from early prolapse, and perineal discomfort.
What NICE advises after birth
NICE guidance on pelvic floor dysfunction (NG210) says to consider a supervised 3-month pelvic floor training program for women who had an assisted vaginal birth with forceps or vacuum. It gives the same advice after a vaginal birth with the baby face up and after an injury to the anal sphincter.
NICE also advises that women who have recently given birth should be encouraged to do pelvic floor training, because it helps prevent symptoms of pelvic floor dysfunction. If you had stitches or a tear, ask your midwife or doctor when to begin.
When to be assessed
If symptoms persist a year after delivery, or earlier if they limit your life. Pelvic floor training is the first step; measurement shows whether the supports are intact enough for it to work.
What an assessment involves
The clinic uses vaginal endoscopy imaging to examine the vaginal wall before treatment. Vaginal laxity is measured numerically rather than judged by hand. Consultations are available in English. A consultation is needed to decide whether a procedure suits you.
Options
Supervised training and energy-based treatment for tone; perineal repair for scarring; pelvic ligament suspension when the supports have failed and cause leaking or prolapse. Two of our three OB-GYN specialists are women.
Training and other non-surgical care
The International Urogynecological Association (IUGA) notes that bladder control may not change for 3 to 6 weeks of regular training, and that full benefit can take up to 6 months. Technique matters, because a common mistake is pushing down when you should be pulling up.
Non-surgical options for incontinence include radiofrequency and fractional laser vaginal treatments, chosen after measurement. Dryness can add to discomfort after childbirth. Vaginal estrogen is prescribed when appropriate.
When the supports have failed
If measurement shows that the supports have failed, pelvic ligament suspension is the operation used. The technique restores pelvic support by re-anchoring the patient's own lax pelvic ligaments. Pelvic ligament suspension uses the patient's own ligaments and sutures, without synthetic mesh.
Timing
Repair is usually advised once childbearing is complete, because another pregnancy can undo it. If you plan more children, we discuss conservative options now and definitive repair later.
Cost
Written estimate after consultation. Whether an insurer reimburses a repair depends on your plan; we provide the documents, not coverage decisions (see Insurance and paperwork below).
Insurance and paperwork
We prepare the documents international insurers typically require: an itemized English receipt, a medical certificate, procedure codes and a completed claim form. Whether a procedure is reimbursed depends on your policy; we provide documentation, not coverage decisions.
Ask your insurer before you travel whether it covers pelvic floor repair, whether it needs pre-authorization and which documents it requires.
Who performs it
Dr. Mo Hyung-jin, Medical Director
- Board-certified OB-GYN specialist
- MD, Yonsei University College of Medicine; OB-GYN residency, Severance Hospital, Seoul
- Fellow, International College of Surgeons (Korea Section), 2016
Questions
Is it too late years after my last child?
No. Many women are treated in their forties, fifties and beyond; the tissue is assessed as it is now.
Can I be repaired between pregnancies?
Conservative treatment is preferred until childbearing is complete; we discuss your plans openly.
How soon after birth can I start pelvic floor exercises?
NICE advises encouraging women who have recently given birth to do pelvic floor training. If you had a tear or stitches, ask your midwife or doctor when to begin and how to check that you are lifting, not pushing down.
Will my insurer pay for postpartum repair?
Whether a procedure is reimbursed depends on your policy; we provide documentation, not coverage decisions. Ask your insurer before you travel.
Can I see a female doctor?
Two of the clinic's three OB-GYN specialists are women. Tell us about any preference when you book.
Sources
About the reviewer
Dr. Mo Hyung-jin, MD, PhD, board-certified OB-GYN specialist, is the medical director of Podo Women's Clinic. He developed the pelvic ligament suspension technique used at the clinic for stress urinary incontinence and pelvic organ prolapse. Profile
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Gangnam Podo Women's Clinic
2F, 428 Gangnam-daero, Gangnam-gu, Seoul, South Korea
Mon–Fri 10:00–19:00 · Sat 10:00–17:00
Closed Sundays and public holidays