Hi all!
I haven’t posted before and am not a
midwife J, but an interested parent, active in an NGO “Parents in
Action” in Croatia.
You can read more about giving birth in Croatia at http://www.birthinternational.com/diary/archives/000516.html
and http://www.birthinternational.com/diary/archives/000517.html,
thank you again Andrea!
I have a question concerning this study - does
spontaneous vaginal delivery also mean that there was no episiotomy? Here’s
the abstract of the study (from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11192101&dopt=Abstract):
The
prevalence of pelvic floor disorders and their relationship to gender, age,
parity and mode of delivery.
MacLennan AH, Taylor AW, Wilson DH, Wilson D.
Department of Obstetrics and Gynaecology, The University of Adelaide, Australia.
OBJECTIVE: To define the prevalence of pelvic floor disorders in a
non-institutionalised community and to determine the relationship to gender,
age, parity and mode of delivery. DESIGN: A representative population survey
using the 1998 South Australian Health Omnibus Survey. SAMPLE: Random selection
of 4400 households; 3010 interviews were conducted in the respondents' homes by
trained female interviewers. This cross sectional survey included men and women
aged 15-97 years. RESULTS: The prevalence of all types of self-reported urinary
incontinence in men was 4.4% and in women was 35.3% (P<0.001). Urinary
incontinence was more commonly reported in nulliparous women than men and
increased after pregnancy according to parity and age. The highest prevalence
(51.9%) was reported in women aged 70-74 years. The prevalence of flatus and
faecal incontinence was 6.8% and 2.3% in men and 10.9% and 3.5% in women, respectively.
Pregnancy (> 20 weeks), regardless of the mode of delivery, greatly
increased the prevalence of major pelvic floor dysfunction, defined as any type
of incontinence, symptoms of prolapse or previous pelvic floor surgery.
Multivariate logistic regression showed that, compared with nulliparity, pelvic
floor dysfunction was significantly associated with caesarean section (OR 2.5,
95% CI 1.5-4.3), spontaneous vaginal delivery (OR 3.4, 95% CI 2.4-4.9) and at
least one instrumental delivery (OR 4.3, 95% CI 2.8-6.6). The difference
between caesarean and instrumental delivery was significant (P<0.03) but was
not for caesarean and spontaneous delivery. Other associations with pelvic
floor morbidity were age, body mass index, coughing, osteoporosis, arthritis and
reduced quality of life scores. Symptoms of haemorrhoids also increased with
age and parity and were reported in 19.9% of men and 30.2% of women.
CONCLUSION: Pelvic floor disorders are very common and are strongly associated
with female gender, ageing, pregnancy, parity and instrumental delivery.
Caesarean delivery is not associated with a significant reduction in long term
pelvic floor morbidity compared with spontaneous vaginal delivery.
From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On
Behalf Of Dean & Jo
Sent: Monday, July 11, 2005 1:47
PM
To: ozmidwifery@acegraphics.com.au
Subject: RE: [ozmidwifery] Message
for Jo Pelvic Floor Research -Archive Question
Here is the abstract for the study but you
might have to get further details regarding the things I mentioned.
Cheers Jo
Caesarean Section Does Not Reduce Risk of Pelvic Floor
Dysfunction
ADELAIDE,
Australia
(Reuters Health) Dec 01 - Caesarean section only marginally reduces the risk of
pelvic floor dysfunction after delivery compared with vaginal delivery,
according to the results of an Australian study.
The research team, from Adelaide
University, defined
pelvic floor dysfunction as any type of incontinence, symptoms of prolapse, or
previous pelvic floor surgery.
Lead researcher Dr. Alastair MacLennan and colleagues surveyed 3010
adults aged 15 to 97 years, who did not reside in an institution, and found
that while 46.2% of women had current or past pelvic floor dysfunction, only
11.1% of men did.
Of particular note, the authors say, was the prevalence of pelvic floor
dysfunction in women when differing modes of delivery were compared.
Nulliparity resulted in a 12.4% prevalence of pelvic floor dysfunction,
followed by caesarean section (43%), spontaneous vaginal delivery (58%), and
instrumental delivery (64%).
The team also found that when spontaneous vaginal delivery and/or instrumental
delivery were compared with caesarean section, only urge incontinence was
associated with a significantly higher prevalence following vaginal delivery.
The data are reported in the December issue of the British
Journal of Obstetrics and Gynaecology.
In an interview with Reuters Health, Dr. MacLennan pointed out that
"there is a new phenomenon in the last 10 years, of women wanting
caesarean section to prevent future troubles, but 80% of the problems a woman
having a vaginal delivery has, also happen to a women having a caesarean
section."
He concluded that "women who have had children are four to five
times more likely to be incontinent than a virgin female, and 10 times more
likely than a male. We hadn't realised the incidence was so high."
Br J Obstet Gynaecol
2000;107:1460-1470.
-----Original Message-----
From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On
Behalf Of Ceri & Katrina
Sent: Monday, July 11, 2005 5:34
PM
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] Message for
Jo Pelvic Floor Research - Archive Question
Hi Jo
just postimg an email here, not sure if you got my offlist one.
Katrina
Hi Jo
I was going through the archives this morning and came across an old post of
yours that you posted relating to the CS and Tracy Curro on 60 minutes...
You said " an Australian study has shown that lack of
pelvic floor exercises and pregnancy hormones affect the function of the pelvic
floor and CS birth can do nothing to prevent it. "
Do you have the reference for this article? I am looking for research on this
very topic for a speech for uni....
Thanks
Katrina
www.niagaraparkshow.com.au
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