Peripartum Evaluation and Assessment of the Pelvic Floor around Delivery (PEAPOD) Clinic
At Prentice Women’s Hospital, over 11,000 women each year give birth. The birth of a child can be a hectic and overwhelming time for new moms, and pelvic floor complications are not always addressed.
With this incredibly high delivery volume, Northwestern Medicine’s Division of Female Pelvic Medicine and Reconstructive Surgery faculty are in a unique position to offer comprehensive specialty care for women’s pelvic floor needs before, during, and after pregnancy.
Northwestern Medicine’s PEAPOD clinic is a unique program in Chicago, designed to help pregnant women and new moms receive specialized care sooner than a standard six-week postpartum appointment. The North and West suburb locations also focus on the peripartum care of women who experience pelvic floor symptoms.
Dr. Christina Lewicky-Gaupp, a board-certified specialist in Female Pelvic Medicine and Reconstructive Surgery (FPMRS) at the Northwestern Medicine Women's Integrated Pelvic Health Program, directs this innovative, transdisciplinary care program for new mothers. Under Dr. Lewicky-Gaupp’s leadership, the urogynecologist team works cooperatively with obstetrician-gynecologists throughout the region to provide comprehensive care plans for these women.
The Northwestern Medicine Peripartum Evaluation and Assessment of the Pelvic Floor around Delivery (PEAPOD) Clinic consists of experts from various backgrounds to adequately address, evaluate and manage the needs of all of our pregnant and postpartum patients. We have developed a multi-faceted program to accomplish the best care possible for new mothers, and our team includes Female Pelvic Medicine and Reconstructive Surgery physicians, physical therapists, psychologists, and sex counselors.
When to Seek Care
Many women begin experiencing pelvic floor symptoms during their pregnancy. While some of these symptoms will resolve after delivery, many women have bothersome symptoms that can be addressed during pregnancy and should be discussed with a primary obstetrician-gynecologist.
Obstetrician-gynecologists may recommend that women consult with one of the urogynecologists in the Peripartum Evaluation and Assessment of the Pelvic Floor around Delivery (PEAPOD) Clinic during pregnancy or after delivery.
We recommend that women with severe obstetric lacerations or tears be seen within one week of delivery. Our multidisciplinary team comes together weekly to care for all pregnant or recently delivered women to accommodate that need. Often, we find that patients only require one visit to reassure them that they are healing correctly. However, if a patient has a more complicated recovery, she may be seen multiple times. Once a patient has recovered properly, she will resume care with her primary obstetrician-gynecologist.
One of the urogynecologists in the PEAPOD clinic may conduct additional tests of your pelvic floor and anal sphincter muscles, including:
Many women experience new, bothersome pelvic floor symptoms during their pregnancy or after their delivery. In fact, one in three women develop urinary incontinence during or after pregnancy. A more detailed list of the problems women can experience includes:
Risk factors for developing a severe obstetric anal sphincter laceration include the following:
Women who have suffered perineal trauma (or severe tears) after delivery typically can have their symptoms managed with a variety of surgical and non-surgical options.
Severe (third- and fourth-degree) tears are 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.
We always recommend good perineal care for new mothers, including daily sitz baths and proper drying techniques afterward. Wound healing is accelerated and infection can be prevented with good perineal care, with the addition of antibiotics if necessary.
Medical management of urinary and anal incontinence
In the immediate postpartum period, symptoms of urinary and anal incontinence are not uncommon in women who have suffered severe tears.
In PEAPOD, we offer immediate treatment of urinary incontinence with pessaries that are fit in the clinic. Similarly, patients can be fitted with vaginally placed bowel-control devices that they can easily remove and replace themselves to help with anal incontinence immediately after delivery. These interventions, while simple, can be life-changing during the early days after pelvic floor injury before complete recovery has occurred.
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 function after delivery.
Physical therapy is also helpful for a myriad of other issues that are common after childbirth such as 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 FPMRS specialists are trained extensively in the surgical management and revision of perineal wounds.
Surgery to correct the anal sphincter is known as an anal sphincteroplasty and this is often accompanied by a revision of the vaginal and perineal injury.
Sexual dysfunction after a vaginal delivery is not rare. While some patients have pain with intercourse, many have anxiety and fear of intimacy, especially if they have sustained a severe tear. Our nurse practitioner, Maureen Sheetz, is a certified sex counselor who works weekly with our patients to optimize their sexual function.
In collaboration with the Department of Psychology, we have expanded our offering of counseling and group session work for women to share their stories and experiences of birth trauma, being new moms, and supporting one another in the postpartum period.
To Request an Appointment
If you're suffering from a pelvic floor disorder, you don't have to live with the symptoms. To learn about treatment options, call 312.694.7337 to schedule an appointment with one of our urogynecologists.
MEET OUR TEAM
Our transdisciplinary team works together to ensure that each patient receives a tailored and highly individualized plan of care.