Maternal Pelvic Floor Trauma

In short: Maternal pelvic floor trauma is injury to the muscles that support the bladder, bowel and uterus during pregnancy or delivery, which can lead to leakage, prolapse, pain or fistula. Dr. Alexandra Tabakin, a urologist and fellowship-trained urogynecologist in New Brunswick, NJ, evaluates pelvic floor problems after childbirth and treats them, beginning with options such as pelvic floor physical therapy.

What is maternal pelvic floor trauma?

The pelvic floor muscles support the pelvic organs, which include the bladder, bowel and uterus in women. Maternal pelvic floor trauma, sometimes referred to as childbirth injury, can occur during pregnancy or delivery and encompasses a variety of complications. Stress from pregnancy and vaginal delivery puts pressure on the pelvic floor muscles, weakening them and causing conditions such as prolapse, incontinence, pelvic pain, pain with intercourse or vaginal fistula.

What are symptoms of maternal pelvic floor trauma?

Issues stemming from maternal pelvic floor trauma can develop throughout a woman's lifetime.

Symptoms for this condition can vary, and may include one or more of the following:

• Urinary problems: these include urine leakage when coughing, sneezing or laughing (stress incontinence).
• Bowel problems: fecal incontinence from maternal pelvic floor trauma results in losing stool involuntarily.
• Prolapse: women who have a prolapse will have symptoms that include pelvic pressure and a pelvic organ that bulges out of the vagina.
• Pain: some women experience pain with intercourse as a result of tears or cuts to the vagina and perineum during childbirth.

What causes maternal pelvic floor trauma?

Common factors that can increase the risk of maternal pelvic floor trauma include:

• Pregnancy
• Vaginal birth
• Advanced maternal age
• Delivery with forceps or vacuum
• Prolonged pushing (second stage) during labor
• Obesity
• Delivering a large baby
• Deep, excessive vaginal tears

How is maternal pelvic floor trauma diagnosed?

Pelvic floor trauma can often be diagnosed via a physical examination by your gynecologist, urogynecologist, or urologist. Depending on your symptoms and medical history, your doctor may order additional tests, such as urodynamic testing or cystoscopy (bladder testing), to properly diagnose your condition.

How is maternal pelvic floor trauma treated?

Treatment for maternal pelvic floor trauma depends on the nature of the injury. Behavioral modification is often the first step, and physical therapy is frequently recommended to help retrain and strengthen the muscles as part of a treatment plan.

Learn more from the American Urogynecologic Society patient site, Voices for PFD: Pelvic Health for New Moms.

Page updated October 2026.