Marjolijn Lutke Holzik-Mensink’s scientific contributions

This chapter will pay attention to the disturbances related to the pelvic floor, focusing on their sexuality-related consequences. It will start with the troubles during pregnancy, followed by the problems after childbirth. At the end of each topic, it will offer treatment recommendations. The urinary disorders will cover stress urinary incontinence (SUI), urgency urinary incontinence (UUI), climacturia (losing urine during orgasm), and urinary tract infections. The defecation disorders will cover anal incontinence, flatal incontinence, and constipation. Pelvic organ prolapse (POP) does usually not happen in the first pregnancy, though the primigravid woman can have similar complaints. Pelvic girdle pain (PGP) tends to start during pregnancy. Pregnancy and vaginal birth are the most common risk factors for postpartum PF disorders: stress urinary incontinence, overactive bladder syndrome, pelvic organ prolapse, and anal incontinence. On the one hand, that may sound like pathologizing childbirth. On the other hand, healthcare providers should be aware that they tend to underestimate the rates of (anal) obstetric injuries, and most textbooks do not mention levator ani avulsion. Aspects of pelvic floor muscle training (PFMT) receive ample attention in the treatment recommendations. In the postpartum part, the chapter pays extra attention to perineal pain, vaginal laxity, and overactive pelvic floor. Those are disruptive elements for intimacy and sexuality, just like all the other mentioned disturbances. This chapter is part of ‘Midwifery and Sexuality’, a Springer Nature open-access textbook for midwives and related healthcare professionals.

This chapter is devoted to the pelvic floor (PF). Maternity care has always considered the PF muscles an essential part of the birth and its disturbances. Gradually, the pelvic floor became a vital element for both sexual pleasure and sexual problems. This chapter will start by explaining its role in posture and movement, and sexuality and delineate the differences between the normotonic, the hypotonic, and the hypertonic pelvic floor and their influences on sexuality. The chapter also gives some elementary education on assessing pelvic floor function. After explaining the PF concerning pregnancy and birth, the chapter will address aspects of prevention and prehabilitation. In other words, this chapter will also deal with how to optimally prepare the pregnant woman for a relaxed birth with as low as possible negative consequences regarding vaginal laxity or pelvic floor prolapse. For the severe pelvic floor disturbances and their implications on sexuality and quality of life, the reader is recommended to look at Chap. 16 . This chapter is part of ‘Midwifery and Sexuality’, a Springer Nature open-access textbook for midwives and related healthcare professionals.