Risk of Pelvic Organ Prolapse and Incontinence Increases after Vaginal Delivery

February 19, 2013 2 min read

Women are more likely to experience urinary incontinence (UI), prolapse, and fecal incontinence 20 years after one vaginal delivery compared to one caesarean section, according to new research published in a thesis from Sahlgrenska Academy at Gothenburg University in Sweden.

Conducted in 2008, the SWEPOP (Swedish Pregnancy, Obesity, and Pelvic floor) study examined the damages of pelvic floor function, specifically symptomatic pelvic organ prolapse (sPOP) and urinary incontinence (UI), in women 20 years after giving one birth through vaginal delivery or cesarean section. The thesis, which appeared in last month’s An Incontinence Journal of Obstetrics and Gynaecology (BJOG), used data obtained from the Swedish Medical Birth Register of women who had delivered only one child in 1985-1988 and had no other children.

The study included 6,148 women who filled out a survey about urinary and fecal incontinence symptoms, prolapse, menopause, and hormone treatment. Results showed that the prevalence of sPOP more than doubled after vaginal delivery (14.7%) compared with caesarean section (6.2%). Vaginally delivered women with sPOP were three times as likely to experience UI compared with women who delivered by caesarean section and had sPOP.

The most important risk factors for sPOP were: vaginal delivery, infant birthweight above 9.92 lbs., current body mass index (BMI) and UI. Those who took the vaginal delivery route, especially if there was a 2nd degree perineal tear, were more likely to experience fecal incontinence.

While some women may be concerned about long-term pelvic floor damage due to vaginal delivery, keep in mind that incontinence can be caused by various factors, including weak pelvic floor muscles not related to pregnancy and childbirth, menopause, behavioral habits, and urinary tract infections (UTIs).


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