What's Money Got To Do With It: Pelvic Floor
We spoke with Caitlin Day and Sophie Lax about pelvic floor injuries and the recent ACC changes that have improved coverage for women. Caitlin and Sophie are both mothers, pelvic floor physios, and co-founders of Unity Studios.
Ok, so you know we’re all for full transparency at Crayon…. So let’s pull the pants down on this hidden cost of childbearing and a recent legislative change that makes it a little more affordable for Kiwi mums.
Pelvic floor TL:DR
The pelvic floor comprises the muscles, ligaments and connective tissues that support the pelvic organs: the bladder, rectum and womb (for women). The pelvic floor helps control essential bodily functions, such as pooping, peeing and having sex.
Most women experience pelvic floor injuries during birth
Pelvic floor muscles work extra hard during pregnancy. Not only are they under pressure from the growing weight of the baby, but the effects of pregnancy hormones also soften them.
The statistics on pelvic floor injuries resulting from pregnancy and birth are startling:
85% of women experience perineal tearing during birth
1 in 3 women leak urine after birth
50% of women who have been pregnant experience prolapse, when one to all three of the pelvic organs bulge into the vagina
1 in 8 still experiences pain after the baby’s first birthday
ACC now covers more pelvic floor injuries
From1 October 2022, ACC provided more funding to support women’s care and recovery from an expanded list of birth injuries for births occurring after 1 October 2022. If you meet the criteria, you can see health practitioners who treat pelvic floor injuries at a discounted rate if they process ACC (check with them before booking in).
You can also be considered for further cover if you suffer a mental injury or any other physical injury caused by a covered maternal birth injury. Talk to your GP, midwife or obstetrician in the first instance.
Previously, the list was so narrowly defined that most women had to either pay out of their own pocket for treatment. Without subsidies, pelvic floor treatments can range from a couple of hundred dollars to a couple of thousand dollars. The alternative was to apply to the District Health Board (DHB) for free treatment and potentially wait more than a year to be seen.
This change could help between 17,000 to 18,000 women each year who suffer from birth injuries, including:
Levator ani avulsion
Anterior wall, posterior wall or uterine prolapse
Obstetric fistula (includes vesicovaginal, colovaginal and ureterovaginal)
Labial, vaginal, vulval, clitoral, cervical, rectal and perineal tears
Ruptured uterus during labour
Obstetric haematoma of pelvis
Pudendal neuropathy
Pubic ramus fracture
Coccyx fracture or dislocation
Symphysis pubis capsule or ligament tear
Every woman can benefit from a pelvic floor WOF
Both Crayon and Unity are big believers in including a financial reserve in your family budget for your well-being. As parents, we know this doesn’t necessarily come naturally, but a physical recovery plan can be as worthy an investment as a great pram - IOHO (in our humble opinion). You can't pour from an empty cup.
Post-natal WOF
“Every woman is unique, and physiotherapists are able to give tailored exercise programmes and guidance to help women safely return to the exercise they love”
Caitlin and Sophie recommend that every mother has a pelvic floor check regardless of how they give birth because the body undergoes extraordinary changes during both pregnancy and birth. Postpartum, it is normal to have pelvic floor and abdominal weakness, changes to joint flexibility and postural imbalances in the body. Jumping back into high-impact exercises such as running or HIIT without addressing these issues could worsen pelvic floor symptoms, such as leaking or heaviness, or cause an injury like pelvic organ prolapse.
A postnatal WOF (warrant of fitness) is advised from six weeks postnatal but can be done weeks, months or even years after birth. This involves questions about your symptoms, a pelvic floor ultrasound and a physical assessment of your abdominals, diastasis, posture and general strength.
Prenatal WOF
Caitlin and Sophie also recommend a prenatal WOF 20 weeks into your pregnancy. This involves a pelvic floor assessment via real-time ultrasound and education on exercise in pregnancy, birth preparation and postnatal recovery.
The pelvic floor needs to be strong and flexible for birth, so an assessment at 20 weeks can screen women with tense or tight pelvic floors, which could lead to an obstructive delivery. A pelvic floor physio can support these women throughout their pregnancy to help them learn how to relax their pelvic floor and improve their chances of an uncomplicated birth.
Last word
“The general rule of thumb is the earlier, the better - but it’s never too late. And in fact, strengthening your pelvic floor can benefit women well into menopause and beyond.”
If you’ve given birth on or after 1 October 2022, chat with your GP, midwife, obstetrician or the team at Unity Studios about whether the policy change covers your birth injuries. Even if it’s been years since you gave birth, a WOF could be just the thing to help you build your pelvic floor strength and boost your physical and mental well-being. If you can manage it financially, it’s an investment in your future health that gets a big thumbs up from us.
Now for the important legal part: The information we provide is general and not regulated financial advice for the purposes of the Financial Markets Conduct Act 2013. Please seek independent legal, financial, tax or other advice in considering whether the content in this article is appropriate for your goals, situation or needs. The information in this article is current as at 9 November 2022.
