When Postpartum Recovery Requires Specialized Care

While most women heal without significant complications after childbirth, research shows approximately five percent experience severe obstetrical injuries that may require intervention. Without timely treatment, these complications can increase the risk of chronic pain, pelvic floor dysfunction, infection, incontinence, and prolonged functional impairment. AHN Women’s Institute has established the AHN Postpartum Care Clinic to help meet the complex needs of these patients.

Supporting patients beyond routine postpartum recovery

Based at AHN West Penn Hospital and led by Lia M. Miceli, MD, board-certified OB/GYN and urogynecologist, the clinic works closely with AHN's five labor and delivery programs across the region to provide specialized evaluation and treatment for women recovering from complex obstetrical injuries.

While extended recovery is expected after advanced childbirth injury, poor wound healing and persistent or worsening pain should not be considered a normal part of recovery. Patients experiencing ongoing symptoms may benefit from specialized evaluation to identify complications early and support a more complete recovery.

Providers should consider referring patients who have:

• Third- or fourth-degree perineal lacerations requiring ongoing monitoring.
• Delayed healing or wound complications following childbirth.
• Persistent pelvic floor dysfunction, including prolapse and incontinence, beyond three months postpartum.

Integrated care for complex obstetrical injuries

Rather than requiring patients to navigate multiple referrals, the clinic brings specialists together through a coordinated care model that streamlines evaluation, treatment planning, and follow-up. Patients receive specialized evaluation from an OB/GYN and urogynecology care team with access to a broader network of:

• Pelvic floor therapists.
• Colorectal surgeons.
• Behavioral health specialists.
• Pain management specialists.
• Other women's health experts.

"The postpartum period is a joyful time for new mothers, but healing complications and pelvic floor disorders can make it difficult for women to enjoy this new chapter in their lives," said Dr. Miceli. "Having specialists from multiple areas working together allows us to support a more complete recovery in their fourth trimester and beyond."

Comprehensive treatment focused on restoring function

The clinic's multidisciplinary approach extends beyond treating pain to restore function and help women recover fully during the postpartum period. By addressing both the physical and functional effects of complex obstetrical injuries, the clinic helps patients return to their daily activities while reducing the risk of long-term complications.

Care plans are individualized and may include:

• Wound management and revision.
• Pelvic floor physical therapy and rehabilitation.
• Pain management therapies, including trigger point injections and prescription vaginal creams or ointments.
• Treatment for urinary or fecal incontinence, including surgical intervention when appropriate.
• Treatment of pelvic organ prolapse.
• Nutritional, behavioral health, and other supportive services.

"Clinical evidence shows that wound complications after childbirth can have lasting effects on physical recovery, emotional well-being, sexual health, and quality of life," said Dr. Miceli. "Early evaluation allows us to identify complications, begin treatment sooner, and help patients recover as completely as possible."

How to refer

If you have a patient experiencing persistent postpartum pain or complications following childbirth, refer her to the AHN Postpartum Care Clinic for evaluation. Early intervention can prevent temporary difficulties from becoming a chronic condition while helping restore mobility, function, continence, and overall well-being.

To make a referral, call 844-MD-REFER (844-637-3337) or visit Health Care Professionals at Allegheny Health Network.