Urinary incontinence after childbirth: Vaginal delivery and cesarean section examined

This study evaluated the long-term effects of child delivery on urinary incontinence. Researchers concluded that vaginal childbirth was associated with an increased risk of long-term urinary incontinence, and preventive measures should be recommended for such women.

Childbirth can weaken pelvic-floor muscles and damage nerves that control urinary function, often resulting in urinary incontinence (UI). Stress UI (involuntary urine leakage during exertion, sneezing, coughing, lifting or any other physical activity) and urge UI (involuntary urine leakage accompanied by a sudden and compelling desire to pass urine) can both significantly impact quality of life and challenge everyday activities. Vaginal childbirth is associated with an increased risk of pelvic-floor trauma, when compared to a cesarean section. However, the long-term effects of mode of delivery on UI are still under exam.

This study included 16 separate studies, involving a combined total of 102,699 women undergoing childbirth. Results were pooled into a single analysis examining the outcome of mode of childbirth (vaginal delivery or cesarean section) on stress or urge UI one year after delivery.

Analysis showed that women after vaginal delivery were 85% more likely to experience stress UI one year after delivery, when compared to delivery with cesarean section. This effect was more pronounced for younger women (aged 30 years or less), and diminished with age. The likelihood of experiencing urge UI one year after delivery was also increased (by about 30%) among women undergoing vaginal childbirth, compared to women undergoing cesarean section. Overall, there was no difference between different types of vaginal deliveries, including assisted delivery (use of forceps or vacuum device), spontaneous birth, or induced vaginal delivery.

This large study concluded that vaginal childbirth is associated with an increased risk of developing both stress and urge urinary incontinence. Women who underwent, or are intending to undergo vaginal delivery should be counseled regarding preventive measures to improve urinary function.