Childbirth, Pelvic Floor and Urinary Stress Incontinence

Childbirth is known to create a risk of urinary incontinence and of pelvic organ descent. This can happen at any time after the birth or in a woman’s later years.

Millions of women are giving birth every year. A woman’s experience in childbirth is individual. Each woman will have a tolerance level that is different from the next. Many women experience pelvic floor trauma from spontaneous obstetric laceration, episiotomy, or both. Delivery-related changes may lead to a decrease in pelvic floor strength and may predispose to symptoms of weakening.

Clinical studies have attempted to discover particular obstetric events that can lead to the development of incontinence and pelvic organ descent. Obvious causes include large babies and “difficult deliveries”, marked by lengthy pushing phases with and without instrumentation. No clear single event has been found to be responsible: postpartum pelvic floor dysfunction probably arises from a combination of physiological injuries.

Childbirth is a normal physiological event in a woman’s life, but it introduces extraordinary physical demands from the mother. For example, in childbirth the levator ani muscles have to stretch by anywhere from 25% to 250%, depending on the capacity of the muscles to stretch in a given woman. Amazingly, most women experience little damage. In some, the levator ani may overstretch during vaginal delivery, and this is associated with symptoms of pelvic floor weakening. Weak levator ani muscle functions are a hallmark of general pelvic floor dysfunction. Nerve damage has also been associated with urinary incontinence and can contribute to pelvic organ descent.

Recent studies suggest that, compared with spontaneous vaginal delivery, elective Caesarian section is not associated with a significant reduction in the risk of pelvic floor disorders. It does not seem to be an effective way to reduce the prevalence of pelvic floor disorders.

The cornerstone of obstetrical care is the safe birth of a child in a manner that is as non-traumatic as possible to both mother and child. Looking at each woman holistically—considering her whole body, its structures, abilities, and needs—is essential for promoting the best possible maternal and child healthcare. Obstetrical care also includes individual creative approaches, so that as much functional integrity as possible is preserved in the pelvic floor.

For more information on pelvic floor reeducation:

• Kegel Exercises
• Pelvic Floor Reeducation with LadySystem® Vaginal Cones
• How to Use LadySystem® - Video Presentation