Pelvic Health

Risk and evaluation

Perinatal Pelvic Risk Assessment

The Perinatal Pelvic Risk Assessment is a two-part screening tool for midwifery providers and clients.

Instructions:

  1. Start with Part 1: Risk Assessment by clicking the button Start Part 1: Risk Assessment. If you have already completed a Risk Assessment, start with Part 2: Pelvic Health by clicking the button Start Part 2: Pelvic Health. See below.

  2. Read each statement and click Yes if the statement is applies to your life experience. Click No if the statement does not apply to your life experience.

    *Learn more about why we ask about race on Part 1: Risk Assessment.

  3. At the end of Part 1: Risk Assessment click Calculate Score. You will receive a score between 0—12 that will be defined as either Low—Intermediate Risk or High Risk and a recommended care plan.

  4. For Low—Intermediate Risk the recommended next step is to complete Part 2: Pelvic Health. Access Part 2 by clicking Continue to Part 2.

  5. In Part 2: Pelvic Health read each statement and click Yes if the statement applies to your life experience. Click No if the statement does not apply to your life experience.

  6. At the end of Part 2: Pelvic Health you will receive a score between 0—9 that will be defined as either Possible Pelvic Floor Dysfunction or Most Likely Pelvic Floor Dysfunction and a recommended care plan.

OR

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Part 1: Risk Assessment

My pre-pregnancy BMI (Body Mass Index) was over 25. Calculate your BMI here

I had low-back pain and/or pelvic pain before pregnancy

I exercise vigorously at least 4 times per week. Examples of vigorous exercise include: running or soccer, yoga, dance, horseback riding, weightlifting.

I get frequent urinary tract infections (UTIs).

I have carried a previous pregnancy past 20 weeks' gestation

I smoke daily (tobacco or cannabis) and/or I have a regular cough.

I started menstruating (having a period) before the age of 11.

Research shows that certain qualities predispose someone to be more at risk for developing urinary incontinence and pelvic floor dysfunction during pregnancy and the postpartum period. Some of these qualities suggest links to regular distressing experiences that impact health. Research has yet to fully clarify why some of these qualities are risk factors. The following questions address these topics.

I have NOT completed a high school level of education

I have a history of depression.

I almost never have support from my family, friends, co-workers, community, or church members.

I expect to experience at least one moment of personal distress during this pregnancy. Examples of personal distress include: housing instability, intimate partner violence, financial instability, family instability.

I identify as Black or African American. People of color experience negative health outcomes more often, including before, during, and after pregnancy, because of complex and interdependent daily experiences that are influenced and impacted by the unequal racialized conditions of the United States (Muse et al., 2018). Race is not a biological inevitability leading to pelvic floor dysfunction, but rather an indication that an individual is likely experiencing forms of systemic oppression that affect health. Learn more about why we ask this about race

Your Score:

Score 0 – 3: Low to Intermediate Risk

This person has a low to moderate risk of currently experiencing or developing pelvic floor dysfunction during pregnancy or in the postpartum period and should have routine screenings.

Recommended Care Plan:

Complete the Perinatal Pelvic Risk Assessment, Part 2: Pelvic Health

Regardless of your score, if you have concerns about pelvic floor dysfunction, please contact a pelvic floor physical therapist

Please note: Perinatal Pelvic Risk Assessment is a screening tool that does not diagnose pelvic floor dysfunction.

Your Score:

Score 4 – 12: High Risk

TThis person has a high risk of currently experiencing or developing pelvic floor dysfunction during pregnancy or in the postpartum period and should be further evaluated.

Recommended Care Plan:

  • Basic Physical Assessment of the Pelvic Floor (advised)
  • UTI screening
  • Referral to a licensed pelvic floor physical therapist as indicated

Regardless of your score, if you have concerns about pelvic floor dysfunction, please contact a pelvic floor physical therapist

Please note: Perinatal Pelvic Risk Assessment is a screening tool that does not diagnose pelvic floor dysfunction.

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Part 2: Pelvic Health

I sometimes have pain in 1 OR MORE of the following areas. • Genitals • Perineum (the area between your vagina and anus) • Pubic bone • Bladder (including pain with urination)

I can remember falling hard and injuring my tailbone, lower back, or buttocks (including any injuries in childhood).

I have a history of pain in 1 OR MORE of the following areas: • Low back • Hips • Groin • Tailbone • Buttocks

I sometimes experience urinary symptoms. Check 'YES' if you experience 1 OR MORE of the following symptoms: • Accidental loss of urine (leaking urine) • Feeling unable to completely empty my bladder • Having to urinate within a few minutes of a previous urination • Pain or burning with urination • Difficulty starting or frequent stopping/starting of urine stream

I sometimes experience bowel symptoms. Check 'YES' if you experience 1 OR MORE of the following symptoms: • Loss of bowel control (inability to delay, incontinence) • Difficulty controlling gas, involuntary flatulence • Feeling unable to completely empty my bowels • Straining or pain with starting or having a bowel movement

Normal daily activities increase my urinary and bowel symptoms and discomfort. Check 'YES' if you experience 1 OR MORE of the following symptoms: • Bending, squatting, getting out of bed • Sitting, standing, walking • Dressing myself • Going up and down the stairs • Carrying my children • Household chores (cooking, cleaning, laundry)

I sometimes experience pain or discomfort with sexual activity or intercourse. Check 'YES' if you experience 1 OR MORE of the following symptoms: • Little or no interest in sexual activity • Little or no vaginal lubrication or wetness • Pain or discomfort touching the vulva or perineum • Pain or discomfort with initial vaginal or anal penetration • Pain or discomfort during vaginal or anal intercourse • Pain or discomfort after finishing sexual activity • Sexual activity increases one or more of my other symptoms (such as low back pain or pelvic heaviness)

I sometimes have a feeling of increased pelvic pressure, bulging in my vagina, or the sensation of my uterus, cervix, or bladder slipping down or falling out.

When I have a physical injury I have repetitive negative thoughts. Examples of negative thoughts include: • “I don’t have time or energy to help myself” • “Most people don’t understand how severe my condition is” • “This is the way my life will always be” • “No one should have to live like this”

Your Score:

Score 0 – 4: Possible Pelvic Floor Dysfunction

It is possible that this person is currently experiencing pelvic floor dysfunction and should be further evaluated by their provider.

Recommended Care Plan:

  • Basic Physical Assessment of the Pelvic Floor (optional)
  • Discuss and review pelvic floor dysfunction
  • Offer prophylactic pelvic floor muscle training
  • Re-screen again in pregnancy and in the postpartum period

Regardless of your score, if you have concerns about pelvic floor dysfunction, please contact a pelvic floor physical therapist

Please note: Perinatal Pelvic Risk Assessment is a screening tool that does not diagnose pelvic floor dysfunction.

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Your Score:

Score 5 - 9: Most Likely Pelvic Floor Dysfunction

It is highly likely that this person is currently experiencing pelvic floor dysfunction and should be further evaluated.

Recommended Care Plan:

  • Basic Physical Assessment of the Pelvic Floor (advised)
  • UTI screening
  • Referral to a licensed pelvic floor physical therapist as indicated

Regardless of your score, if you have concerns about pelvic floor dysfunction, please contact a pelvic floor physical therapist

Please note: Perinatal Pelvic Risk Assessment is a screening tool that does not diagnose pelvic floor dysfunction.

Reset

A web-based assessment is helpful, but an app is more helpful!

Click the button below to get instructions on how to easily transform the web-based Perinatal Pelvic Risk Assessment into a ready-to-use bookmark that functions like an app on any smartphone. One click and you’ll have easy access to all of the information on this site, including the PPRA to use in clinic or on the go!