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What Europe is Doing for Women that America Isn’t…


Did you know that in Europe, it is customary for women to be referred to a Physiotherapist if they report any bowel or bladder issues at their 6 week postpartum check-up?

Yes.  It’s true!

According to the 2006 Guidelines from “NICE,” The National Institute for Health & Care Excellence, if a woman reports any involuntary leakage of urine or feces at their 6 week postpartum check-up, they are immediately referred to a Physiotherapist that specializes in Women’s Health (

According to Sophie Libbesart, a french Physiotherapist who now practices in Miami, Florida,

If you were in France, the Government would offer you the appropriate treatment at no cost, but in the United States these treatments are only modestly available and must be privately funded. Although many of us have established new roots in this country, many seek the services that used to be available to them.” 

Childbirth is an amazing experience, but it definitely has a large impact on the pelvic floor muscles.

The pelvic floor muscles are suspended from our pubic bones to our coccyx (tailbone), and they play a major part in our bowel, bladder, sexual and spinal function.  When they have normal muscle tone, they allow us to stay continent or Dry.  Strong pelvic floor muscles also contribute to orgasm and a healthy sex life.  Additionally, when our pelvic floor muscles are functioning well, they keep our pelvis in alignment.  All of these areas can be affected if the pelvic floor muscles are weak or damaged from pregnancy or childbirth.

Nearly 70% of women experience some degree of perineal tearing with childbirth.  Can you think of any other muscle tear in the body that wouldn’t warrant a direct referral to Physical Therapy???  …..the answer is NO.  I have been a Physical Therapist for 20 years, and have never known a physician that does not recommend PT for a patient who has torn a rotator cuff muscle, an abdominal muscle, a hamstring, etc.

So, why is the United States a bit “behind the times” when it comes to referral to PT after childbirth?  Is it just a lack of education?  Do women in the U.S. feel that they just need to grin and bear it?  Are we too proud?

I hope in my daughter’s lifetime, it will be standard for healthcare providers in the U.S. to refer any woman experiencing bowel, bladder, sexual or spinal dysfunction after childbirth to a Physical Therapist that specializes in the area of pelvic health.  We have so much to offer these women, and it’s a shame for them to suffer from conditions that could easily be treated with conservative measures.

If you or anyone you know has pelvic dysfunction from childbirth, please contact our clinic, Foundational Concepts, for a consultation.  You will be happy you did.

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