Treatment Options

Treatments Offered at the Northwestern Medicine PEAPOD Clinic

Women who have suffered perineal trauma after delivery can typically have their symptoms managed with a variety of surgical and nonsurgical options. We have developed a multidisciplinary program to accomplish the best care possible for new mothers including Urogynecology and Reconstructive Pelvic Surgery (URPS) physicians, physical therapists, psychologists and sex counselors.

More severe tears can be prone to complications including wound separation/breakdown and infection. In our PEAPOD Clinic, we counsel patients and offer various treatments to decrease their risk of developing wound complications.

• Perineal care: We always recommend good perineal care for new mothers including daily baths and good drying techniques afterwards. Wound healing is accelerated and infection can be prevented with good perineal care and/or antibiotics if necessary.

• Medical management of urinary and anal incontinence: In the immediate postpartum period, urinary and anal incontinence are not uncommon in women who have suffered a severe tear. In PEAPOD we offer immediate treatment of urinary incontinence with pessaries that are fitted in the clinic. Similarly, patients can be fitted with Eclipse systems to help with anal incontinence immediately after delivery.

• Pelvic floor physical therapy: We recommend pelvic floor physical therapy for all women who have had a vaginal delivery, especially those that were complicated by a more severe tear. Pelvic floor physical therapy is instrumental in helping the anal sphincter and pelvic floor muscles regain their strength after delivery. Physical therapy is also helpful for a myriad of other issues that are common after childbirth such as urinary incontinence, pelvic pain, pain with intercourse, and pain due to vaginal scarring.

• Surgical correction of wound breakdown: If a vaginal tear does not heal properly, wound care (such as packing and dressing) and even surgery are sometimes necessary to ensure good healing and recovery. Our URPS specialists are trained extensively in the management and revision of perineal wounds. Surgery to correct the anal sphincter is known as an external anal sphincteroplasty and this is often accompanied by a revision of the vaginal and perineal injury.

• Sexual counseling: Oftentimes, after a vaginal delivery, sexual dysfunction can occur. While some patients have pain with intercourse, many have anxiety and fear of intimacy, especially if they have sustained a severe tear.

• Support groups: In collaboration with many of our patients, we have formed the Moms Offering Postpartum Support group. “MOPS” meets monthly over coffee and snacks to share stories and experiences of birth trauma, being new moms, and supporting one another in the postpartum period.