To mark the start of Women’s Health Week the Australian Physiotherapy Association (APA) is reiterating its call for Medicare subsidies for physiotherapy assessment and management for all Australian women during pregnancy and up to one year post-partum.

One third of Australian women live with some form of incontinence. Almost three quarters of all vaginal births result in perineal tearing, which can cause significant pain and reduced quality of life. Rates of difficult deliveries are increasing in Australia as the average age and health conditions of expectant mothers increases.

While most privately insured women have access to physiotherapy to manage and treat the debilitating effects of vaginal birth trauma, women birthing in the public health system often have minimal to no access, creating a significant health and economic burden.

APA National Chair of the Women’s and Pelvic Health group, Cath Willis, says this results in women living with the indignity of incontinence, prolapse and pain, often for many years.

“If left untreated, conditions like perineal tears, pelvic floor muscle damage, incontinence and prolapse will cause lifelong harm, affecting a woman’s relationships, quality of life, likelihood to have more children and ability to re-enter the workforce.”

“It’s imperative that the federal government removes the cost barrier for physiotherapy treatment for all women so they can be appropriately diagnosed and treated during and after pregnancy.”

“Up to twenty per cent of vaginal births can result in muscle detachment from the pelvic wall, which is often undiagnosed, and this figure increases to almost 65% if forceps are used in delivery. We need to do better for Australian women.”

The economic cost of incontinence as a result of traumatic birth injuries is significant. Data1 shows a health system expenditure of $271 million for incontinence conditions, which was predicted to grow to $450 million this year. Economic productivity losses are estimated at more than $34 billion due to lower than average return to employment for women suffering incontinence.

Additional data2 commissioned by the APA from Nous Group also highlights that physiotherapy treatment of stress urinary incontinence can save the health system $16,000 per person in ongoing medical costs.

Ms Willis says the evidence is irrefutable. “We know that a preventive health approach is so important for women during pregnancy, and engaging them in the process so they understand the importance of pelvic floor muscle training and other health impacts will bring about a better outcome for them. Women should have access to the treatment that is best for them, so they can make informed birth decisions that will support their post-partum mental and physical health, social engagement and return to the workforce.” 


1. The Economic Impact of Incontinence on Australia Report, Deloitte Access Economics and Incontinence Foundation Australia, 2011

2. The Value of Physiotherapy in Australia, Nous Group and Australian Physiotherapy Association, 2020, forthcoming report


Cath Willis is available for further comment.


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