Volume 30, Issue 170, April 2026

Pelvic Floor Dysfunction During and After Pregnancy: Pathophysiology, Risk Factors and Current Management Strategies

Sara Hassan¹, Szymon Bienia^1♦, Aisha Hassan², Kamil Hassan³

¹Medical University of Silesia, 18 Medyków Street, 40-752 Katowice, Poland
²Cardinal Stefan Wyszyński University in Warsaw, Wóycickiego 1/3, 01-938 Warsaw, Poland
³Social Academy of Sciences in Łódź, Henryka Sienkiewicza 9, 90-113 Łódź, Poland

^♦Corresponding author
Szymon Bienia, Medical University of Silesia, 18 Medyków Street, 40-752 Katowice, Poland.

ABSTRACT

Pelvic floor dysfunction (PFD) is a frequent yet underrecognized complication of pregnancy and the postpartum period. It includes stress urinary incontinence, fecal incontinence, pelvic organ prolapse, chronic pelvic pain, and sexual dysfunction, all of which may persist long-term and significantly impair quality of life. The pathophysiology is multifactorial. The pelvic floor's foundation is often already under significant strain well before delivery, as the growing uterus and rising abdominal pressure slowly stretch and weaken its support. This baseline vulnerability is usually pushed to the limit during a vaginal birth—especially if labor is slow or instruments like forceps are needed—which can lead to serious injuries like levator ani avulsion or nerve damage. While we know that factors like maternal age, obesity, and the baby’s weight drive the risk higher, it’s a mistake to think a C-section is a perfect shield. It might reduce the likelihood of certain issues, but it certainly doesn't eliminate the risk entirely. While prevention is now the gold standard, largely thanks to the proven benefits of antenatal PFMT, the clinical focus must pivot to specialized rehab the moment a disorder is identified. We’re no longer guessing at the extent of the damage, either. The integration of high-resolution imaging—think pelvic floor ultrasound and MRI—now allows for a granular look at structural integrity, giving doctors the precision they need to guide effective treatment. Raising clinical awareness and implementing early management can lessen the long-term burden of PFD, improving quality of life and reproductive health outcomes for women.

Keywords: Pelvic floor dysfunction, pregnancy, postpartum, urinary incontinence, physiotherapy

Medical Science, 2026, 30, e65ms3656

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Published: 03 April 2026