Whiston Perinatal Pelvic Health Service (PPHS)

The Perinatal Pelvic Health Service (PPHS) is part of a Cheshire and Merseyside 'Improving Me' programme which aims to enhance access to perinatal pelvic health services, providing education and treatment to help optimise your pelvic health.

During your pregnancy and postnatal period, you may experience symptoms of pelvic floor dysfunction such as pain, incontinence or prolapse. This page provides some additional information and links to useful resources to help you improve your pelvic health. 

You can be seen throughout pregnancy and up to 18 months postnatal.

Please note: This page and referral form is specifically for patients within the Whiston, St Helens, Knowsley, Widnes and Halton area and are delivering at Whiston Hospital or at home. MWL Southport and Ormskirk have a separate service and referral form.   

• Meet the Team

  We have a team approach with dedicated staff to provide advice and support through 1:1 clinics and various classes. 

  • Rachel Cox - Specialist Perinatal Pelvic Health Physiotherapist
  • Alesha Maguire - Specialist Perinatal Pelvic Health Midwife
  • Dr James Thomas - Lead Pelvic Health Obstetrician
  • Wider Pelvic Health Physiotherapy and Midwifery team
• Antenatal Pelvic Health Issues

  Signs & Symptoms 

  • Pregnancy-related Pelvic Girdle Pain (PGP) and/or pregnancy-related Low Back Pain 
  • Urinary Incontinence (leaking of urine) 
  • Bowel Incontinence (leaking of wind or poo)
  • Existing Pelvic Organ Prolapse 
  • Painful sex or pain with vaginal internal examination (Vaginismus) 
  • Painful perineum
  • Previous 3rd or 4th degree perineal tear/OASI 
  • Female Genital Mutilation (FGM)

  Ask your GP/Midwife to refer you to the Perinatal Pelvic Health Service (PPHS) or complete the self-referral form online. 
   

• Postnatal Pelvic Health Issues

  Signs & Symptoms 

  • Urinary Incontinence (involuntary leakage of urine) 
  • Bowel Incontinence (involuntary leakage of wind or poo)
  • 3rd or 4th degree tear/OASI
  • Perineal wound breakdown/haematoma (bruising)
  • Post natal Pelvic Organ Prolapse
  • Tummy muscle separation (rectus abdominis diastasis) (3 months beyond delivery)
  • Perineal wound infection 
  • Postnatal painful intercourse/internal examination (Vaginismus/ Dyspareunia)
  • Bladder retention 
  • Chronic pelvic pain
  • Pregnancy-related Pelvic Girdle Pain (3 months beyond delivery)
  • Sexual dysfunction/pain during sex (including pain associated with female genital mutilation) 

  Ask your GP/Midwife/Health Visitor to refer you to the Perinatal Pelvic Health Service (PPHS) or complete the self-referral form online. 
   

• Pelvic Floor Dysfunction

  Signs & Symptoms 

  • Urinary Incontinence (involuntary leakage or urine)
  • Bowel Incontinence (involuntary leakage of wind or poo)
  • Pelvic Organ Prolapse
  • Painful sex
  • Pelvic Pain

  Ask your GP/Midwife/Health Visitor to refer you to the Perinatal Pelvic Health Service (PPHS) or complete the self-referral form online. 
   

• Referrals

  Once the team receive your referral it will be triaged, and we will either arrange a 1:1 appointment or group education class for you to attend. 

  We aim to provide you with advice and support on managing your symptoms with personalised exercises and treatments. 
   

• Self Referral

  Have you experienced any of the symptoms below?

  • Loss of feeling/pins and needles in thighs/genitals when you wash or wipe
  • Loss of feeling/pins and needles below waits and down both legs
  • Pain/weakness in BOTH legs
  • Change of bladder control/unable to pass urine/loss of sensation when passing urine
  • Change in bowel control/ loss of sensation when passing stool/ leakage from bowels
  • Loss of sensation with sex?

  If you have answered YES to any of the above questions, please seek immediate medical attention by calling 111, visiting 111 online, or attending your local A&E. 

  Section A- General Questions

  First name*:

  Last name*:

  Email*:

  Date of birth DD/MM/YYYY*:

  Address and postcode*:

  Hospital or NHS Number:

  Ethnicity*: SelectAsian or Asian BritishBlack or Black BritishArabMixed EthnicityGypsy or TravellerWhiteOtherPrefer not to say

  Sex assigned at birth*: SelectFemaleMale

  Preferred pronouns*: SelectShe/herHe/himThey/themVe/vem/virOther

  If you have previously booked postnatal treatment, which hospital was this at?*: SelectWhiston HospitalOrmskirk HospitalCountess of Chester HospitalLiverpool Women’s HospitalLeighton HospitalWarrington and Halton HospitalsArrowe Park HospitalN/A

  What is your height (feet and inches):

  What is your current weight (kg):

  Do you have any long terms lung conditions or long term cough?*: YesNo

  Do you smoke?*: YesNo

  Do you have diabetes?*: SelectNoYes – Type 1Yes – Type 2Yes – Gestational Diabetes

  Are you over 35 years old?*: YesNo

  Have you ever been diagnosed with Fibromyalgia?*: YesNo

  Have you ever been previously diagnosed with any gynaecology cancer?*: SelectNoYes – Vulva cancerYes – Vagina cancerYes – Yes – Ovarian cancerYes – Cervical cancerYes – Uterine cancer

  Have you had any previous gynaecology surgery under general anaesthetic?*: YesNo

  Would you consider yourself as physically active?*: YesNo

  Please complete the section below if you are pregnant (antenatal):

  How many weeks pregnant are you?:

  How many pregnancies (including miscarriages, stillbirths and termination of pregnancies) have you had prior to this pregnancy?:

  Is this a multiple pregnancy?: SelectNoTwinsTripletsQuadruplets

  Have any of your previous babies weighed over 4kg?: SelectYesNoNot applicable

  Were forceps using during your baby’s birth previously?: SelectYesNoNot applicable

  Was a ventouse (suction cup) used previously?: SelectYesNoNot applicable

  Did you have to actively push for more than 1 hour during any of your births?: SelectYesNoNot applicable

  Have you previously had a 3rd or 4th degree tear (known as OASI)?: SelectYesNoNot applicable

  During a previous birth did you baby’s shoulders get stuck and need help from midwife/doctor?: SelectYesNoNot applicable

  During a previous birth, was your baby born in the back to back position?: SelectYesNoNot applicable

  Please complete the section below if you have given birth within the last 18 months (postnatal):

  When did you give birth?:

  What type of delivery did you have?: SelectVaginalForcepsVentouseCaesarean section

  Did you baby’s shoulders get stuck and need help from midwife/doctor?: YesNo

  Was your baby over 4kg at birth?: YesNo

  Did you actively push for more than 1 hour?: YesNo

  Did you have episiotomy?: YesNo

  Have you previously had a 3rd or 4th degree tear (known as OASI)?: YesNo

  Did you perineal wound heal well previously?: YesNo

  If you your perineal would did not heal well, were you followed up in the specialist perineal clinic for wound care?: YesNo

  Section B - Bladder Symptoms

  Approximately, how many times a day (24 hours) do you have to pass urine?: SelectUp to 6 times7-12 times13 times or more

  Do you feel you fully empty your ladder when you wee?: YesNo

  Are you experiencing any problems relating to your bladder (urinary leaking or urgency)?: YesNo

  If yes, do you have any leakage of urine when you sneeze, cough, jump, laugh, sing, lift and exercises?: YesNo

  Section C - Bowel Symptoms

  Are you experiencing any problems relating to your bowels such as constipation, leakage or urgency?: YesNo

  If you have answered Yes, please answer the questions below:

  When you need to open you bowels do you have to rush to the toilet?: YesNo

  Do you feel able to control your wind?: YesNo

  Do you experience leakage of faeces (poo) if you are unable to reach the toilet in time?: YesNo

  Do you find faecal soiling (poo) in your underwear?: YesNo

  Do you find you have to use your hand or device to support you to have a poo?: YesNo

  Section D - Prolapse Symptoms

  Are you experiencing any problems relating to your bowels such as constipation, leakage or urgency?: YesNo

  Have you noticed a bulge/lump at the entrance or inside of the vagina?: YesNo

  Does the bulge/lump sit at the entrance/come out of the vagina?: YesNo

  Do you experience pelvic pain with sexual intercourse/ insertion of tampon/ during vaginal examination?: YesNo

  Section E - Stomach Muscles

  Do you have a wide gap in the muscles of your stomach muscles/ bulging in the middle of your stomach during certain movements such as coughing/lifting/caring/ sitting up in bed/during exercise?: YesNo

  Do you experience pain in the front and/or back of pelvis/hips/lower spine?: YesNo

  Have you experienced any of the symptoms below?: YesNo

  • loss of feeling/pins and needles in thighs/genitals when you wash or wipe
  • loss of feeling/pins and needles below waits and down both legs
  • pain/weakness in BOTH legs
  • change of bladder control/unable to pass urine/loss of sensation when passing urine
  • change in bowel control/ loss of sensation when passing stool/ leakage from bowels
  • loss of sensation with sex?

  Section G - Mental Health

  Are any pelvic health symptoms negatively influencing your mental health?*: YesNo

  How are you feeling about your birth and relationship with your baby?*:

  During the past month, have you often felt down/depressed/hopeless?*: YesNo

  During the past month, have you had little interest or pleasure in doing things?*: YesNo

  Section H - Service Specific Questions

  Are you happy to attend a group session if required?*: YesNo

  What is your preferred spoken language?*:

  Would you like an interpreter present? Family members are unable to act as chaperone/interpreter due to the Trust Policy*: YesNo

  Thank you for completing this patient self-referral form.

  Send

• Classes

  Pelvic Girdle Pain Class
  Location: Parentcraft Room, Level 2, Whiston Hospital 
  When: Mondays, 1.15pm to 2.15pm
  To book, refer yourself online or ask a midwife to refer you.

  Pelvic Health Antenatal Education Class
  Location: Online via Attend Anywhere
  When: Tuesdays 5.00pm to 6.00pm
  To book, please call 0151 430 1878. 
   

• Further resources

  Videos

  • All Perinatal Pelvic Health videos
  • Pelvic floor exercises during and after pregnancy
  • Bladder and vaginal problems during and after pregnancy
  • Back and pelvic pain during pregnancy
  • Exercise during pregnancy
  • Constipation during and after pregnancy
  • When to start and how to do perineal massage (from 35 weeks) 
  • Posture and positioning during pregnancy and following the birth
  • Perineal Massage (Recommend perineal massage from 35 weeks gestation. Can be beneficial in reducing risk of perineal tearing in labour.)
  • When to start and how to do perineal massage
  • After birth week 1 – bladder care
  • After birth week 1 – pain management and wound care
  • After birth – your stomach muscles
  • After birth – return to exercise

  Documents

  • Booklets | POGP
  • Third- and Fourth-degree Perineal Tears, Management (Green-top Guideline No. 29) | RCOG
  • Perineal tears and episiotomies in childbirth | RCOG

  Websites

  • Pelvic Health Information - Squeezy
  • How to help a weak bladder - NHS