This petition is part of a wider campaign developed in collaboration with re|Born, The Mummy MOT, and The Active Pregnancy Foundation to improve postnatal care and services offered for women in the United Kingdom (UK).

We welcome the recently updated National Institute for Health and Care Excellence (NICE) guideline for postnatal care [NG194] but argue that this has not gone far enough in ensuring consistent pelvic health advice, signposting, and rehabilitative care. In France, for example, postnatal women are referred for at least 10 free rehabilitation sessions to “re-educate” their pelvic floor. However, in the UK women lack awareness, rehabilitative instruction, and pelvic health checks; leaving many to suffer with long-term mental and physical health issues.

Pelvic floor disorders (PFDs), including pelvic organ prolapse (POP), stress and urgency urinary incontinence (UI), and faecal incontinence, are common and arise from loss of pelvic support. Although severe disease often does not occur until women become older, pregnancy and childbirth are major risk factors for PFDs (Wilson et al., 2014; Nygaard et al., 2017).

• Approximately 1 in 4 women experience pelvic floor dysfunction after having a baby, irrespective of mode of delivery (Wu et al., 2014).
• 1 in 2 postnatal women have some degree of symptomatic or asymptomatic POP (Hagen & Stark, 2011).
• 1 in every 10 women will require surgical intervention for prolapse by age 80. This may be prevented if diagnosed and treated at an early stage (Memon & Handa, 2013).
• Prevalence of Diastasis Rectus Abdominis (DRA) following childbirth is 60% at 6 weeks, 45% at 6 months, and 33% at 12 months (Sperstad et al., 2016).
• Major risk factors for PFDs include UI before pregnancy; ethnicity; age at birth of the first child; body mass index (BMI); family history; baby’s weight; and maternal height (Wilson et al., 2014).
• The cost to the National Health Service (NHS) for treatment of UI was estimated at £233million in 2000 with the personal costs to women estimated at £178 million. UI symptoms affect quality of life, sexual function, prevent engagement with physical activities and are associated with depression, social isolation, and psychological distress in older women (Grant et al., 2020).

Our campaign calls for greater awareness and discussion of PFDs throughout pregnancy and the postnatal period and at least one pelvic health check for every woman after childbirth. Early intervention has significant benefits and can help with many issues arising postpartum.

We, however, recognise the current constraints within the NHS, both from a human resources and financial perspective, and that it will take significant time before pelvic health assessments can be implemented as routine care.  We therefore propose that EVERY WOMAN who gives birth should be offered appropriate pelvic health advice; signposting to evidence-based information; and that those who need it most, have access to a pelvic health examination and rehabilitation delivered by an appropriately qualified healthcare or allied professional.

There must be a wider societal change where issues such as 'leaky bladders' are not normalised, and more value is placed on women’s quality of life. Women deserve better - as life-givers, as care providers, and as a major part of the UK workforce. We ask that the UK government act on our call for greater awareness and discussion of PFD throughout pregnancy and the postnatal period and for every woman have at least one pelvic health check 8-12 weeks after giving birth.

Finally, we encourage women to join in the discussion to help inform the development of the government’s Women’s Health Strategy. This consultation is open till the 13th of June 2021. Your voice matters.

https://consultations.dhsc.gov.uk/talkwomenshealth