What is the Referral Process for Symptoms of Pelvic Floor Dysfunction in the UK?
England
Speak to Your Midwife
- Midwives can refer you directly to a pelvic health physiotherapist.
- If you mention symptoms such as leaking, heaviness, or pelvic pain during an antenatal appointment, your midwife can submit a referral for you.
- Some maternity units also have helplines or online referral forms.
Ask Your GP
- GPs can refer you to women’s health physiotherapy through the NHS e-Referral system.
- You’ll need to provide your details and explain your symptoms so your GP can include this in the referral.
Self-Referral
- Many NHS trusts now allow pregnant women to self-refer to pelvic health physiotherapy.
- Check your local NHS trust’s website and search for “pelvic health physiotherapy self-referral” or “women’s health physiotherapy”.
- You’ll usually complete an online form with your name, date of birth, NHS number, and reason for referral.
Perinatal Pelvic Health Services (PPHS)
- NHS England is rolling out specialist perinatal pelvic health services across the country.
- These services provide early access to pelvic floor support, usually through a single point of access.
- Ask your midwife or GP if this is available in your area.
Scotland
Speak to Your Midwife
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Midwives in Scotland can refer you directly to pelvic health physiotherapy.
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Mention symptoms such as leaking, heaviness, or pelvic pain during an antenatal appointment. Your midwife can submit a referral.
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Some maternity units also have helplines or online referral forms.
Ask Your GP
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GPs can refer you to women’s health physiotherapy through local NHS Scotland referral pathways.
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Be ready to explain your symptoms clearly so your GP can include all relevant information in the referral.
Self-Referral
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Some NHS boards in Scotland allow pregnant and postpartum women to self-refer to pelvic health physiotherapy.
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Check your local NHS board website and search for “pelvic health physiotherapy self-referral” or “women’s health physiotherapy.”
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You’ll usually complete an online form with your details, NHS number, and reason for referral.
Specialist Perinatal Pelvic Health Services
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Many NHS boards in Scotland offer perinatal pelvic health services.
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These services provide early access to pelvic floor support, often through a single point of contact.
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Ask your midwife or GP if this service is available in your area.
Wales
Speak to Your Midwife
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If you’re pregnant or postnatal and you mention symptoms like leaking, heaviness, or pelvic pain during an antenatal appointment, your midwife can refer you directly to a pelvic health physiotherapist (subject to your local health board).
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Some maternity units may have helplines or online referral forms — ask your midwife or midwifery team.
Ask Your GP
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Your GP can refer you to women’s health or pelvic health physiotherapy via your local health board’s referral pathway.
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Be ready to describe your symptoms clearly, so the referral includes all relevant details.
Self‑Referral
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In many parts of Wales, adults (including pregnant or postpartum women) can self‑refer to pelvic health physiotherapy services. For example:
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The service for Cwm Taf Morgannwg University Health Board accepts self‑referral by calling the service number and completing a self‑assessment form. ctmuhb.nhs.wales
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The service for Powys Teaching Health Board allows individuals aged 16+ to self‑refer for pelvic health physiotherapy using an online form. Powys Teaching Health Board
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To check whether you can self‑refer in your area, visit your local health board’s website and search for “pelvic health physiotherapy self‑referral” or “women’s health physiotherapy”.
Northern Ireland
Speak to Your Midwife
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If you are pregnant or in the postpartum period, mention symptoms like leaking, heaviness, or pelvic pain to your midwife. They can refer you directly to the relevant physiotherapy or pelvic‑health service within your local Health & Social Care Trust.
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Some maternity units may offer helplines or online referral options—ask your midwife or maternity team for details.
Ask Your GP
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Your GP can refer you to women’s health or pelvic health physiotherapy via your local Health & Social Care Trust’s physiotherapy services.
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Be ready to describe your symptoms clearly so the referral can include all relevant details (for example: “I leak when I cough or sneeze”, “I feel a heavy bulge in my pelvis”, or “I have pelvic pain when I exercise”).
Self‑Referral
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In some Trusts, there may be options for self‑referral to physiotherapy services (including pelvic health physiotherapy) especially for pregnant/postnatal women or those with bladder/bowel/pelvic floor symptoms.
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Visit your local Trust’s website (for example, a service like Western Health & Social Care Trust lists a Pelvic Health Physiotherapy service in Omagh, Altnagelvin and South West Acute Hospital settings). westerntrust.hscni.net
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If you find a self‑referral form, you’ll typically complete an online or paper form with your name, date of birth, health number (if known), and a brief summary of your symptoms.
Pelvic floor dysfunction is common in pregnancy and after birth. It can cause symptoms such as leakage, heaviness, or pain. The good news is—help is available, and you can be referred for specialist care on the NHS.
What Is Pelvic Health Physiotherapy?
Pelvic health physiotherapy is a specialist type of physiotherapy that focuses on the muscles, ligaments, and nerves of the pelvic floor. These muscles support your bladder, bowel, and uterus, and play a vital role in continence, stability, and sexual health.
- Urinary incontinence: Difficulty controlling urination, including urge incontinence, stress incontinence, and mixed incontinence.
- Fecal incontinence: Difficulty controlling bowel movements.
- Pelvic pain: Pain in the lower abdomen, pelvis, or perineal area.
- Sexual dysfunction: Pain during intercourse, erectile dysfunction, or difficulty achieving orgasm.
- Pelvic organ prolapse: When pelvic organs (like the bladder or uterus) descend into the vagina.
- Pregnancy and postpartum care: Addressing pelvic floor muscle changes and related issues during and after pregnancy.
What to expect at your appointment
Your first appointment will usually be face-to-face in a clinic setting, but sometimes it may take place over the telephone or via video call. This first session is very important and usually lasts about one hour.
Here’s what typically happens:
- Getting to know you – Your physiotherapist will ask about your lifestyle, pregnancy/birth history, any medical conditions or surgery, medications, and your symptoms. This helps them understand your condition before starting treatment.
- Gentle assessment – If you attend in person, you may be offered an internal examination (vaginal and/or rectal) to assess how your pelvic floor muscles work and check for prolapse. Sometimes, an ultrasound scan is used to see how your bladder empties and how your muscles are functioning. You don’t need to come with a full bladder unless you’re specifically asked to.
- Clear communication – Everything will be explained carefully, and your consent will always be asked before any examination. You can also request a chaperone if you would like one.
- Your plan – Based on the assessment, your physiotherapist will create a personalised treatment plan. This may include exercises, advice for daily activities (like lifting, feeding, or exercise), and ongoing support to track your progress.
Most women find the first session reassuring and leave with a clearer understanding of their pelvic floor and practical steps to improve symptoms.
If you need an interpreter, ask when first seeking a referral.
Perinatal Pelvic Health Services (PPHS)
- NHS England is rolling out specialist perinatal pelvic health services across the country.
- These services provide early access to pelvic floor support, usually through a single point of access.
- Ask your midwife or GP if this is available in your area.
Private Women’s Health Physiotherapy
- If NHS services are limited or waiting times are long, you may choose to see a private women’s health physiotherapist.
- Always check they are HCPC-registered and have pelvic health training.