According to a research study from Yale School of Medicine, during the first year after vaginal delivery women are more prone to pelvic organ prolapse than women who deliver via C-section. The study, completed in conjunction with Wenzhou Third People’s Hospital, was published in BJOG.
C-section delivery rates have decreased dramatically over the last decade thanks to focus on decreasing medical risk associated with elective C-section deliveries. However, according to this research study, vaginal deliveries increase a woman’s risk of pelvic organ prolapse – giving doctors new information to utilize when choosing between vaginal and C-section delivery.
The increased risk of pelvic organ prolapse during the first year postpartum is due to a relaxation of the pelvic floor muscles during labor and vaginal delivery. For at least 12 months after vaginal delivery, the pelvic muscles do not fully recovery from the relaxation, causing a window of increased risk. In addition to relaxation of pelvic floor muscles, the passage of baby through the birth canal may cause damage to connective tissue. Loss of support causes organs to fall – the primary cause of urinary incontinence and loss of bowel control after delivery.
Study authors evaluated 110 women in late pregnancy. Prolapse was present in most women during late pregnancy, but women who delivered vaginally were less likely to recover from the prolapse. All women were evaluated at six weeks, six months and one year postpartum. Women who delivered via C-section with no labor were less likely to suffer prolonged prolapse.
Researchers note this study is, by no means, a reason for doctors to choose C-section delivery over vaginal delivery in uncomplicated pregnancies. According to one study author, “Our study is among the few that provide information about short- and long-term effects of labor and route of delivery on pelvic floor support to determine if and when recovery of pelvic floor support structures occurs over long durations of time. More research should be done to better identify women at greatest risk for, or predisposed to developing, long-term pelvic floor consequences.”
Source: Y Chen, F-Y Li, X Lin, J Chen, C Chen, MK Guess. The recovery of pelvic organ support during the first year postpartum. BJOG: An International Journal of Obstetrics and Gynaecology. DOI: 10.1111/1471-0528.12369.