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A levator ani avulsion is when there is partial interruption or complete rupture of the pelvic floor muscles. This can occur during vaginal birth. This does change the way that the pelvic floor muscles function, and can increase risk of concerns such as pelvic organ prolapse. Early postnatal recovery and rehab with an experienced pelvic floor physio is recommended to put proactive steps in place.
Risk factors for levator avulsion:
- maternal age at time of first vaginal delivery
-second stage longer than >2hr
-birth weight >4kg
-OASIS
-forceps-assisted delivery
Levator avulsion is associated with change in levator hiatus size, genital hiatus size and pelvic floor muscle strength long term. (Handa et al , 2020)
It is recommended to have a pelvic floor physiotherapy assessment postnatally.
An experienced Pelvic Floor Physio will often be able to determine whether a suspected levator ani avulsion has occurred during birth, and may or may not choose to recommend an ultrasound to confirm diagnosis.
Your Pelvic Floor Physio will be able to support your recovery and ensure that you are considering all aspects to reduce your risk over time and help return to the activities which bring you joy.