After childbirth, a mother’s body continues to change over the next several weeks. During this time, she should rehabilitate her perineum, the muscle that surrounds the vagina, which has been weakened. This step is important for all women. “People often believe, wrongly, that delivery by cesarean does not affect the perineum. But it’s the pregnancy, the weight of the baby on the pelvic floor that relaxes this muscle,” explains Noémie Raphanel, a midwife specializing in perineal rehabilitation at Hôpital de La Tour.
Open Monday through Thursday in the Maternity building, perineal rehabilitation consultation are provided by specially-trained midwives. During these sessions, the perineum is strengthened using a variety of techniques. The course of treatment is selected according to each patient’s symptoms and abilities. Treatment should start at the earliest 6 to 8 weeks after the baby is born, but it is never too late.
Typically, it takes nine sessions, along with exercises mothers can do at home. “We give them the keys and encourage them to use these preventive techniques in their daily lives,” the midwife explains. If they do not take care of their perinea, women face the risk of urinary or gas incontinence, and prolapse, which is when one or more pelvic organs slide downwards.
However, perineal rehabilitation is not only for mothers who just gave birth. “We talk about rehabilitation, but we should be talking about education. Women who come to see us are often learning about their perineum for the first time,” says Noémie Raphanel.
Women of all age groups are affected
Hôpital de La Tour’s specialized consultations also help women suffering from dyspareunia, which is painful sexual intercourse. “This can be very distressing for them; they often find it hard to get health professionals to listen to them.” We also see patients who are pregnant, as well as many women in perimenopause. “We advise them to come in at the first symptoms of incontinence or pelvic pressure. Midwives are excellent specialists to consult because they are well informed about women’s bodies.”
Perineal rehabilitation improves symptoms of other medical conditions such as overactive bladder, which involves going to the bathroom 10 to 15 times a day. It helps women get back to a more comfortable lifestyle. “We see women discover their perineum and live fuller lives from one session to the next. The better women know their bodies and have control over their perineum, the better their sexual lives will be.”