Pelvic floor injury after birth · Part 5 of 5
Living With a Pelvic Floor Injury After Birth, and What a Claim Can Cover
In this article
This final part of the series is about the long road. I'll talk about the ways a pelvic floor injury reaches into everyday life, the treatment options available, and what to know about medical devices. Then I'll explain, as plainly as I can, what a compensation claim in NSW can and can't cover, and what the process actually looks like.
This series: pelvic floor injury after birth
- Prolapse after a forceps birth: when it isn't just "normal"
- Levator avulsion: the injury no one told you about
- "Why didn't anyone tell me forceps could do this?"
- "It's normal after a baby": when pelvic floor symptoms are dismissed
- Living with a pelvic floor injury, and what a claim can cover (you are here)
The life you've been quietly rearranging.
No one sees most of it.
The way you scan for toilets the moment you walk into somewhere new. The jumping castle you watch from the side. The heavy shopping bags you leave for someone else. The running shoes at the back of the cupboard.
The conversation you keep not having with your partner. The fear, every time you think about another baby.
Pelvic floor injuries are often described as "quality of life" injuries, as if that makes them small. But your quality of life is your life.
This isn't a small thing. It's every day.
Treatment, and a word about mesh
The good news is that there are things that can help, and many women find real improvement.
The Australian Commission on Safety and Quality in Health Care's consumer guide to treatment options for prolapse sets out the range. It includes lifestyle changes, specialist-guided pelvic floor exercises, vaginal pessaries (removable devices that give support), and surgery. Jean Hailes describes a similar step-by-step approach, with surgery generally the last option.
A word about mesh
The same Commission guide notes that transvaginal mesh was removed from the Australian Register of Therapeutic Goods for prolapse treatment in January 2018, because its risks were judged to outweigh its benefits.
In plain terms: if surgery is ever discussed, ask exactly what will be used and why, and what the risks are. My own research has focused on what happens when medical devices fail, and who is held accountable. It's a conversation worth having carefully.
A pelvic health physiotherapist is often the best first step. The Australian Physiotherapy Association's position statement on physical birth trauma notes that recovery support may be needed for a year or more. The APA has also called for Medicare funding for pelvic health physiotherapy and a dedicated Medicare item for birth-related injury, because the cost puts it out of reach for many women.
Pelvic Floor First has practical guidance, and the free National Continence Helpline is on 1800 33 00 66.
Sex, exercise, work and the next baby
Sex and intimacy.
Pain, changed sensation, or simply fear of leaking can make intimacy feel impossible. This is one of the most common, and least discussed, effects of these injuries. It's a real loss, and it's okay to name it as one, including in a claim.
Exercise and your body.
Many women have to give up the exercise that kept them well, both physically and mentally. Others are told to avoid lifting, which is a hard instruction when you have a baby or toddler.
Work.
Some women have to change jobs, reduce hours, or turn down roles that involve standing or lifting. That has a financial cost that can stretch out over a whole working life.
The next baby.
If you're thinking about another pregnancy, talk with a specialist about how you might give birth next time. Professor Hans Peter Dietz has noted that a caesarean avoids levator avulsion, though it has its own risks. And if the decision has been made for you, and you won't have the family you planned, that is a profound loss too.
If this is landing for you, and you're realising how much of your life has quietly shifted, I'd be glad to hear your story. There's no pressure to decide anything.
What a claim can cover
I'll be honest about both sides, because you deserve to make decisions with the full picture.
First, a claim needs more than an injury. It needs negligence: something in your care that fell below the standard it should have met. That might be the decision to use forceps, how they were used, a failure to tell you the risks, or a failure to diagnose your injury in time. It also needs causation: that this failure caused your injury, or made it worse.
If those are established, compensation in NSW can include:
- Medical and treatment costs, past and future: physiotherapy, specialist care, pessaries, surgery, and psychological treatment
- Lost income, now and in the future, if your injury affects your work
- Help at home with tasks you can no longer do, such as lifting, cleaning or caring for children
- Pain, suffering and loss of enjoyment of life, known as "non-economic loss"
The non-economic loss threshold
In NSW, compensation for pain and suffering is only available if the injury is severe enough to reach a legal threshold, measured against the most extreme case imaginable.
In plain terms: not every injury qualifies for this part of compensation, even when negligence is clear. Other parts, such as treatment costs and lost income, don't have this threshold. A proper assessment of your injury is part of working out what applies to you.
There's also a bigger picture. Women's Agenda has reported estimates that birth injuries cost Australia billions of dollars a year. Birth Trauma Australia has called for a national strategy for the care and treatment of birth injuries, including mandatory postnatal screening. Individual claims are one of the ways the system learns what it has been getting wrong.
What the process looks like
I know the idea of "making a claim" can feel overwhelming. Here's roughly how it goes.
It starts with a conversation. You tell me your story, in your own words and at your own pace. Then we get your records: hospital, GP, physio and specialist notes, with your permission. Next, independent experts review your care. Usually that's an obstetrician and sometimes a urogynaecologist, who give honest opinions about whether your care met the standard it should have. Only then do we talk about whether a claim is worth bringing. Many claims resolve through negotiation, without a court hearing.
Time limits matter. In NSW, they're set by the Limitation Act 1969 and are often linked to when your injury and its cause became known to you. Please don't let that clock run down while you're deciding.
A claim isn't the only route to answers, either. NSW public hospitals have an open disclosure process. You can also raise concerns with the Health Care Complaints Commission.
Frequently asked questions
How much is a pelvic floor injury claim worth?
There's no standard figure. It depends on your injury, your treatment needs, your work, and how your life has been affected. Anyone who gives you a number before reviewing your records and getting expert evidence is guessing.
Will I have to go to court?
Many claims resolve through negotiation without a hearing. If yours did need to go further, we'd talk through every step before it happened.
Can I afford to bring a claim?
That's one of the first things we'd talk about together, including the options for funding a claim.
I also had a severe tear. Can that be part of the same claim?
Often, yes, if it happened in the same birth. My article on third and fourth degree tears explains more.
A closing thought
If you've read this whole series, thank you for staying with something so hard.
Whatever you decide, I hope you take one thing from it. What happened to your body was real, it deserved attention, and you're allowed to want answers.
So here's my last question for you: what would it look like to stop rearranging your life around this, and start asking for what you need?
If you'd like to start from the beginning, Part 1 explains prolapse after forceps, and Part 2 covers levator avulsion. For support, Birth Trauma Australia, PANDA (1300 726 306) and the Gidget Foundation are all there for you.
This article is general information only. It is not legal or medical advice, and reading it does not create a lawyer–client relationship. Every situation is different. If you are in crisis, please call Lifeline on 13 11 14 or 000 in an emergency.
