Elizabeth,
Thank you for your thought-provoking discussion on incontinence that is
unrelated to parturition. Evidence of yet another exmaple of how myth
supports & perpetuates practices.
Could you possible suggest some references which support your points as it
would be useful to use this for teaching.
Cheers
Felicity
At 11:14 AM 09/13/1999 -0400, you wrote:
>Linda Brubaker, MD is a urogynecologist in Chicago who advocates C/Sec to
>prevent pelvic floor dysfunction and said so at her presentation at the
>First International Conference on the Pelvic Floor in Montreal last
>September. I have met a number of American and Australian female OB-GYN
>physicians who plan to have an elective Cesarean to avoid PFD!! In Rio
>de Janiero this is one of the main reasons for the higher than 65% rate (
>the figure I last heard). There is at least that show less USI following
>C/Sec but my mind tends to distrust and misplace such information!
>Few people trust Mother Nature any more...
>We have to keep in mind that recent studies (in US and Norway) have shown
>1/3 of competitive college athletes (nulliparous) to have USI. In May
>this year I heard a paper at the World Confederation of Physiotherapy in
>Yokohama about Scandinavian research that found 80% ( yes EIGHTY percent)
>of teenaged gymnasts suffered from USI (correlating with onset and
>duration of training). There are women who develop incontinence in
>pregnancy who miscarry, have C/Secs (as you noted) so it is not
>inevitably "the trauma of parturition" but clearly sometimes it certainly
>is! (22% of American women have 4th degree tears...extensions of that
>unkind cut, the episiotomy).
>USI is a complex problem with many causes. Emotions (being "pissed off"),
>lifestyle (no longer squatting for ADL...in Australia you can get a frame
>called "In Lieu" for your toilet), diet (lack of whole foods to build
>collagen, bladder irritants etc) and obesity (the average American gained
>10 lbs in the last decade; >30% are morbidly obese). After my recent trip
>to Australia, I would say that that it is heading in the same direction,
>sadly.
>Japan is too: chubby kids and adult diapers for sale in convenience
>stores...I never saw either in former visits.
>Living half the year in the Caribbean, where I also travel extensively
>and always visit maternity and WH clinics, it has become clear to me that
>incontinence is as uncommon among the blacks as it is common among the
>whites. The whites develop prolapse/incontinence, the blacks have more
>fibroids. I conclude that there is some biological superiority among
>blacks despite their diet: e.g. strong bones & teeth, great skin tone,
>lack of grey hair, infrequent pelvic floor dysfunction (despite obesity
>that is very common in the anglophone islands but conspicuous by its
>absence in the francophone islands). Whites have to work much harder to
>stay continent, especially as we are living ever-longer. The trend in
>Germany is to use functional activities rather than isolated exercises as
>a half-century of kegeling has not made a dent in the incontinence growth
>industry ( over $28 billion in the US, and almost $11 billion just for
>pads and laundry! That's more than the GNP for some small countries!). I
>address this issues in my video Pelvic Power, and the forthcoming book.
>Hormones can do it, too! Just like around menopause...
>
>
>
>Elizabeth Noble, PT
>OB-GYN Courses, New Life Images, Women's Health Resources
>448 Pleasant Lake Avenue, Harwich, MA 02645
>Ph: (508) 432-8040 Fx: (508) 432-9685
>www.capecod.net/newlife
>
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>
>
______________________________________________________________
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_--_|\,-- From Townsville ** Felicity Croker
/ \ in sunny ** Psychology & Sociology &
\_.--._/ North Queensland ** Centre for Women's Studies
v ** James Cook University
** TOWNSVILLE, QUEENSLAND 4811
AUSTRALIA
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