The days and weeks following delivery can be a time of great joy for a new mom, but also great stress as she tries to adjust to her new baby and new body. For many women, this time may be further complicated by the pain and worry of a vaginal tear that won’t heal.
“The post-partum period is already difficult for a mom,” explains Pamela J. Levin, MD, assistant professor of Clinical Obstetrics and Gynecology at Penn Medicine. “When a complicated tear occurs during delivery, it becomes very hard to manage that and the baby. Not many women realize these can happen and are caught off guard. Often, they don’t know where to turn for help.”
An Undertreated Condition
This reality was the underlying impetus for Penn Medicine’s Postpartum Pelvic Floor Recovery Program, which is overseen by Dr. Levin and her colleagues from the Penn Urogynecology Program.
The program is a new option for women in the region and part of a growing national trend.
“Our program is modeled after similar programs at other large academic medical centers in the U.S. and strives to provide these women with the support, surveillance and treatment they need if they develop a tear during childbirth,” Dr. Levin explains. “In these cases, our team can deliver the advanced care that these women need, including surgery if needed.”
According to Dr. Levin, the program’s typical patient has a third- or fourth-degree tear — meaning that it extends to some degree into the rectum. Most patients come to her after first consulting with their own obstetrician, who assessed the injury at the time of delivery. Patients are also directly referred to the program by the delivering doctors on the Labor and Delivery Unit, or the doctors providing the patient with postpartum care.
Providing Comfort and Hope
“We try to see new referrals on the same day or within a few days, so they can be assessed quickly and treated or supported with close surveillance,” Levin says. “It’s important that women are seen as early as possible, so we can help them avoid some of the problems that these tears can cause in the future, including ongoing discomfort, pain during intercourse and urinary and fecal incontinence.”
Levin and her team also counsel women on their future delivery options, emphasizing that these tears are not exclusive to first-time moms.
“Meeting with these women is one of the most rewarding parts of my job,” she says. “Women seem to really appreciate the help and guidance that they receive, and I feel like I’m providing them with a valuable service.”