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4 Comments
Regarding your question to patients about feeling vaginal heaviness getting worse at the end of the day in order to differentiate open birthing pattern from prolapse – is the expectation with an open birthing patter that the vaginal heaviness would not change over the course of the day? Also, regarding avulsions, are there any symptoms or signs you would be looking out for that would cause you to suspect an avulsion of the pelvic floor before you are able to assess internally?
Exactly an OBP doesn’t change at end of day, it remains the same, prolapse gets worse. Avulsions don’t always have sx or signs externally, I think weakness is the biggest sign, especially if there is a big difference side to side but that can only be found internally. That’s the challenging part of this.
Can you please clarify when you would not have your clients do PF contractions postpartum and when you would have them do submaximal PF contractions? I got a little confused when you were explaining this part:)
If you suspect they might have an avulsion, if you feel a divot in their pelvic floor, they don’t have good strength on one side, we don’t want them doing max contractions. They may benefit from a pessary to help support the tissues and allow healing of the muscles and then see what is happening in several months, length of time is undetermined. Hope this helps.
Regarding your question to patients about feeling vaginal heaviness getting worse at the end of the day in order to differentiate open birthing pattern from prolapse – is the expectation with an open birthing patter that the vaginal heaviness would not change over the course of the day? Also, regarding avulsions, are there any symptoms or signs you would be looking out for that would cause you to suspect an avulsion of the pelvic floor before you are able to assess internally?
Exactly an OBP doesn’t change at end of day, it remains the same, prolapse gets worse. Avulsions don’t always have sx or signs externally, I think weakness is the biggest sign, especially if there is a big difference side to side but that can only be found internally. That’s the challenging part of this.
Can you please clarify when you would not have your clients do PF contractions postpartum and when you would have them do submaximal PF contractions? I got a little confused when you were explaining this part:)
If you suspect they might have an avulsion, if you feel a divot in their pelvic floor, they don’t have good strength on one side, we don’t want them doing max contractions. They may benefit from a pessary to help support the tissues and allow healing of the muscles and then see what is happening in several months, length of time is undetermined. Hope this helps.