STATEMENT: A Global Call to Action
Addressing Chronic Maternal Pelvic Morbidity
Support the Call, Sign for Change
Millions of women around the world live with life-altering pelvic floor disorders (PFDs) resulting from childbirth trauma – conditions that are preventable, treatable, and yet routinely ignored. These conditions, including pelvic organ prolapse, urinary incontinence, fecal incontinence, perineal trauma and sexual dysfunction, constitute chronic maternal pelvic morbidity and affect an estimated one in four women globally.
Pelvic floor disorders often emerge months or years after childbirth and severely compromise physical function, mental health, economic productivity, and personal dignity. Yet, despite the global progress in reducing maternal mortality in the last few decades, most maternal public health services end at six weeks postpartum globally. They fail to account for the chronic and progressive nature of pelvic floor trauma.
This policy-based structural neglect has led to a critical global care deficit:
- Inadequate training: Health workers who conduct vaginal deliveries are rarely trained to prevent, recognize and manage PFDs.
- Inequitable Care Models: Current care frameworks emphasize curative, high-cost, surgical treatments over prevention, screening, primary care and referral pathways.
- Stigma and Silence: Lack of IEC (information, education and communication) approaches – together with cultural taboos – discourages care-seeking.
- Under-Reporting and Underfunding: Systemic under-reporting leads to misperception that PFDs are infrequent and insignificant. Therefore, there is chronic underinvestment in basic research, innovation and development of low-cost therapies.
It is time to Redefine Maternal Health. We call on the WHO, multilateral agencies, national health ministries, and various civil society organizations to take the following urgent actions:
- Acknowledge that childbirth can have a lifelong impact on women’s pelvic health.
- Formally recognize chronic pelvic morbidity as a critical component of maternal health regardless of time of onset post childbirth. The definition of maternal health needs to be extended beyond the six weeks postpartum limit to include long-term pelvic floor sequalae of childbirth.
- Collaborate with IUGA to develop evidence-based global guidelines for prevention, screening, referral and treatment of PFDs and locally relevant guidelines in various countries.
- Strengthen health systems capacity by training frontline health workers in prevention, screening, and referral of PFDs, especially in low-and-middle-income countries.
- Include PFD indicators in global monitoring frameworks of maternal health and SDG metrics.
- Establish integrated care pathways within existing maternal, reproductive and fistula programs, especially in low- and middle-income countries, to ensure scalable and affordable access.
- Invest in research, innovation and development of low-cost diagnostics and affordable treatments.
We urge global leaders to act now! Help us amplify this neglected truth loud and clear: maternal health does not end at birth. This is not merely a public health issue – it is a matter of gender equality, human rights and reproductive justice. Chronic maternal pelvic morbidity is a true measure of a woman’s long-term health and quality of life.
Every woman deserves to not only live through childbirth – but thrive afterward. Let us close this critical gap! Let us break the silence! Let us ensure that no woman is left behind to suffer in silence!
Pelvic Health is Maternal Health!