by Heather van Raalte, M.D.
Did you ever notice that a great deal of medical attention is given to a woman through her childbearing years, immediately followed by a lack of medical attention through her childraising years? An important - but notably neglected - area of a woman's body is the pelvic floor, a network of muscles, ligaments and connective tissue that supports the bladder, uterus, intestines and rectum. Pelvic floor weakness or injuries can result in disorders such as urinary incontinence, overactive bladder, fecal incontinence and pelvic organ prolapse.
Unfortunately, women often wait many years after these problems start before seeking help. Most pelvic floor injuries occur during childbirth, with symptoms appearing soon thereafter. So why aren't physicians doing a better job of identifying and addressing these problems sooner?
Sometimes women believe their symptoms are just a normal part of aging, or they are too embarrassed to mention problems to their primary care provider. Sadly, some women do bring up their symptoms with their physician but are not given the answers they need.
The truth is that pelvic floor disorder symptoms are never a normal part of aging. They are, however, very common, and their likelihood increases with age. Nearly half of all women experience at least one major pelvic floor disorder in their lifetime. It is also estimated that more than one in 10 women undergoes surgery for these problems.
Rather than simply watching and waiting for pelvic floor conditions to develop after childbirth, The Institute for Female Pelvic Medicine & Reconstructive Surgery, in collaboration with the St. Luke's Center for Pelvic Health, will launch an obstetrical pelvic floor health and safety initiative in 2007. This unique initiative, involving obstetricians, midwives and nursing staff, is an early intervention program aimed at decreasing the incidence of pelvic floor disorders resulting from childbirth.
Physicians will carefully assess a woman's pelvic floor health after childbearing and assess her risk of developing pelvic floor problems in the future. With this information, physicians can customize a plan for intervention and prevention of maternal perinatal trauma. Patient education will also be a key focus, as women will be provided with information to help them make informed health care decisions and better lifestyle choices.
This program offers a much needed link between obstetrical care and the prevention of pelvic floor disorders, focusing on a lifetime of care for women. With the development of new medical therapies and minimally invasive surgical treatments, and a better understanding of alternative and preventive therapies, women should not have to wait until pelvic floor disorders become a burden on their life before taking control of their pelvic health.