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Hannah Gray's Expertise in Women's Health
Hannah Gray's Expertise in Women's Health: Improving Patient Outcomes
Women's health physiotherapy is a specialised area that addresses a range of conditions unique to women, including pelvic floor dysfunction, prolapse, and issues related to pregnancy and menopause.
One of the key challenges in women's health physiotherapy is the lack of awareness amongst patients about the available treatments. Many women suffer in silence due to the personal nature of their conditions and the stigma surrounding them.
We recently interviewed Hannah Gray, who has extensive experience working within the NHS and private sector and has worked in some of the UK’s leading hospitals, specialising in women's health since 2006.
In your expert opinion, what are some of the key challenges currently facing clinicians within your field of specialism?
Women's health physiotherapy is still a relatively unknown area of physiotherapy, meaning that patients often don't realise that physiotherapy treatments exist. The problems are often quite personal in nature, and this can be a challenge, as patients can be embarrassed to seek help, and talking openly about these topics can be considered 'taboo'.
Could you discuss a new or innovative approach to treatment in your field of specialism that you consider has significant potential to improve patient outcomes?
I have recently attended (2025) a Prolapse course run by the Pelvic, Obstetrics and Gynaecology Physiotherapists Society - POGP). This included a review of all evidence-based research for the assessment and treatment of this condition. Practitioners need to have a comprehensive understanding and experience of prolapse assessment (vaginal and ano-rectal examinations), so they can provide evidence-based conservative treatment, including exercise, and they need to consider the World Health Organisation’s exercise recommendations. Prolapse can occur during the perinatal period and peri/menopause, and surgical management of prolapse can be required. Surgical management of prolapse can include vaginal mesh surgery, which involves inserting a mesh implant to support weakened pelvic tissues, primarily used to treat stress urinary incontinence (SUI) and pelvic organ prolapse (POP). This type of treatment can lead to mesh complications, such as;
· Vaginal mesh exposure, where the mesh comes through into the vagina, bladder, urethra or bowel causing pain, discharge/bleeding, and pain having sexual intercourse.
· The mesh can be 'too tight', causing problems emptying the bladder and/or bowel.
· Pain or changes in sensation (numbness/pins and needles) in the vagina, groin, leg, back, abdomen and pelvis or fibromyalgia (chronic pain in many different parts of the body).
· Urinary and/or faecal incontinence (not getting to the toilet in time).
Clinicians require a sound understanding of the predisposing risk factors for prolapse, this awareness will significantly improve patient outcomes. These risk factors include;
· Inciting factors - childbirth and pelvic floor surgery,
· Decompensation factors - aging, menopause, and co-morbidities, such as osteoporosis,
· Promoting factors - constipation, obesity, chronic cough/smoking.
As an expert witness in this field, what do you consider to be the most important skills or qualities for clinicians to possess?
A women’s health physiotherapist expert requires a combination of specialised skills and qualities within their clinical role to effectively treat and support their patients. Here are some key attributes:
Strong Knowledge of Women's Health: In-depth understanding of conditions related to women's health, including pregnancy-related issues, postnatal recovery, and pelvic health concerns.
Assessment and Treatment Skills: Proficiency in conducting thorough assessments and developing personalised treatment plans.
Communication and Interpersonal Skills: Excellent ability to communicate and interact with patients, providing compassionate care and support.
Problem-Solving and Critical Thinking: Strong analytical skills to address complex patient needs and develop effective treatment strategies.
Collaboration: Ability to work collaboratively with other healthcare professionals to provide comprehensive care.
Continuous Professional Development: Commitment to ongoing learning and staying updated with the latest research and advancements in women's health physiotherapy.
Having these skills and attributes enables me as a women’s health physiotherapist expert to accept both Claimant and Defendant cases, review the evidence, and give treatment recommendations.
Could you discuss a recent research study or clinical trial that has produced meaningful findings within your field of specialism, and what implications these findings may have for clinicians moving forward?
The 2014 POPPY trial was published in the Lancet - Protocol for Women's Health Physiotherapists Intervention/practice for Pelvic Organ Prolapse. This study has had a significant impact on the practice of women's health physiotherapy. The trial provided a protocol for managing pelvic organ prolapse, offering a structured approach that has improved patient outcomes.
Hannah's knowledge and excellence in women's health physiotherapy ensure that her patients receive the highest standard of care. Hannah's expertise in this field is invaluable. She can provide assessments and recommendations for Claimants navigating these often sensitive and personal health challenges with compassion and professionalism.
Do you require a Women's Health Physiotherapist for a clinical negligence case involving a perineal injury during childbirth or following surgeries, such as mesh surgery? These cases often involve complex medical histories and severe gynaecological and urological injuries, necessitating an expert opinion regarding their future treatment needs.
Hannah's expert profile is available to view on our website, Hannah Gray.
You can reserve Hannah for your case by completing our enquiry form here.
Phone: 01494 792711
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